Objective To investigate the decreasing pattern of activities of daily living (ADL) in patients with dementia. Methods A total of 204 patients with dementia were collected,among which 106 cases were with Alzheimer's diseases(AD),54 cases with vascular dementia(VD),44 cases with other types of dementia.According to the scores of mini-mental state examination(MMSE),mild,moderate and severe dementia were 42 cases,37 cases and 125 cases,respectively.All of them were assessed by Barthel index(BI) and compared among degrees of dementia,between AD and VD,and levels of education. Results The most reserved items were bowel movement (48.5 ％),urination (44.1 ％) and grooming (40.2％),while the most vulnerable items were climbing stairs (25.5％) and bathing(18.1％).With increasing impairment of cognition,the scores of BI were getting decreasing. There were significant differences among severe [(23.20 ± 29.27)scores],moderate[(65.54 ± 26.35) scores] and mild [(87.38 ± 22.69) scores] groups (x2 =99.686,P =0.000). Basic ADL were more reserved in AD (16.98％-53.77％) compared with VD (1.85％-33.33％) patients.No significant differences were found(x2 =3.653,P=0.161)among patients with education of primary school and below [(40.1 ± 39.0) scores],middle school[(45.3 ± 39.6 ) scores],and high school and above[(53.1 ± 37.7) scores]. Conclusions Among patients with dementia,bowel control,bladder control and grooming are well reserved,climbing stairs and bathing are vulnerable functions.Basic activities of daily living may be affected by cognitive status and the types of dementia but not levels of culture.

Objective To explore the relationship between the common vascular risk factors and cerebrovascular reserve in the aged patients.Methods 700 patients with sex unlimited were selected from Zhejiang Hospital from July 2007 to July 2010.The clinical data about gender,age,smoking history,drinking history,hypertension,diabetes,dyslipidemia,bilateral carotid artery B ultrasonic examination were collected.The patients were divided into vascular risk factors group(n=400)aged(73.4± 6.8)years and control group(n=300)aged(72.4± 6.9)years.Intracranial vascular reaction was dertermined using transcranial doppler ultrasonography combined with breathholding test to calculate the breath-holding index(BHI)and evaluate cerebrovascular reserve.Results BHI in vascular risk factors group and control group were(0.57±0.18)and(0.97±0.31),respectively,and cerebrovascular reserve in the patients with vascular risk factors was decreased than without risk factors(t =10.87,P ＜ 0.01).Multifactor retrospective analysis showed hypertension,hyperlipidemia,diabetes and smoking were related with cerebrovascular reserve(F=6.51,P =0.000),and the degree to influnce from small to large was followed by diabetes,hypertention,smoking and hyperlipidemia.Conclusions Cerebrovascular reserve is damaged in the aged patients with vascular risk factors.Hypertension,hyperlipidemia,diabetes,smoking may affect cerebrovascular reserves among which the greatest influence is in diabetes.