摘要
衰老相关认知功能障碍发病率随着全球人口平均寿命的增加而逐年升高,严重影响老年群体的日常生存质量和心理健康状况,已经成为广受社会关注的临床热点.本研究就衰老相关认知功能障碍定义、危险因素、发病机制、诊断、康复评定和康复治疗手段进行归纳总结,以期为衰老相关认知功能障碍的早期诊断和精准防治提供理论基础.其中,衰老相关认知功能障碍发病机制主要涉及氧化应激水平、突触可塑性、表观遗传修饰和慢性炎症.康复评定方法主要包括神经心理学评估[简易精神状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)、记忆韦氏评定量表(WMS)和洛文斯顿认知成套测验(LOTCA)]、电生理和神经影像学检查[脑电图(EEG)、磁共振成像(fMRI)和磁共振波谱(MRS)].康复治疗方法主要包括药物治疗(乙酰胆碱酯酶抑制剂和N-甲基-D-天冬氨酸受体拮抗剂)和非药物疗法[认知训练、运动训练、多模态认知训练、中医药及其传统医学技术、其他疗法(生活方式干预和音乐治疗)].
Abstract
The incidence of aging-related cognitive impairment has been increasing year by year with the increase of the aver-age life expectancy of the global population,which seriously affects the daily quality of life and mental health of the elderly,and has become a clinical hotspot of wide social concern.This study summarized the definition,risk factors,pathogenesis,diagnosis,rehabil-itation assessment and rehabilitation treatment methods of aging-related cognitive impairment,in order to provide a theoretical basis for early diagnosis and precise prevention and treatment of aging-related cognitive impairment.Among them,the pathogenesis of aging-related cognitive impairment mainly includes oxidative stress,synaptic plasticity,epigenetic modification and chronic inflam-mation.Rehabilitation assessment mainly includes neuropsychological assessment[Mini-Mental State Examination(MMSE),Mon-treal Cognitive Assessment(MoCA),Wechsler Memory Scale(WMS)and Loewenstein occupational therapy cognitive assessment(LOTCA)],electrophysiological and neuroimaging examination[electroencephalogram(EEG),functional magnetic resonance imag-ing(fMRI)and magnetic resonance spectroscopy(MRS)].Rehabilitation treatment methods mainly include drug therapy(acetylcho-linesterase inhibitors and N-methyl-D-aspartate receptor antagonists)and non-drug therapy[cognitive training,exercise training,multimodal cognitive training,traditional Chinese medicine and traditional medical techniques,other therapies(lifestyle interven-tions and music therapy)].
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