BACKGROUND:Human memory is significantly correlated with recognition. When recognition begins to decrease, a decrease in memory appears first. How about the memory of rural population?OBJECTIVE:To investigate the picture memory related factors of the rural households who are over 50 years old.SETTING:Department of Geriatrics,Huaian First Hospital,Nanjing Medical University;Department of Neurology, Huashan Hospital,Fudan University.PARTICIPANTS:Totally 50 rural inpatients at the Department of Geriatrics,Huaian First Hospital Nanjing Medical University,who would be recovered and out of charge,were selected from March 2003 to February2004. Meanwhile, 11 relatives of the patients and 55 healthy elderly people from Dingji Town,Huaiyin District, were also included.All the participants were over 50 years old.METHODS:Employing questionnaire,mini-mental state examination,auditory-verbal learning test (AVLT), pictorial learning test and many nonmemory tests were performed. According to the levels of education,participants were divided into illiterate group,primary school group,junior middle school group and higher than junior middle school group.The correlation of picture memory ability with sex,age,educational level and simple intelligence test was compared. And the interactions among variables of picture memory were also investigated.MAIN OUTCOME MEASURES:The relationships between the variablesof picture memory and age, sex, educational level and simple intelligence of rural households in Huaian city were calculated. And the interactions among these variables were all investigated.RESULTS:Practically, 103 participants entered the statistical analysis proage,sex,educational level and simple intelligence:Except for recurring figures, all the other variables of picture memory had positive correlations with simple intelligence and educational level (r=0.197-0.533, P ＜ 0.05-0.01).Among them, immediate memory showed the closest correlation with simple intelligence (r=0.533).Delayed recall memory of pictures, recurring figures,and serial memory 4 (the number of recalled pictures in the last 4 pictures in delayed recall test) had negative correlation with age (r=-0.194 to -0.324,P ＜ 0.05-0.01),among them, serial memory of 4 pictures had the closest correlation with age (r=-0.324),while, all the other variables were not related to age. All the variables of picture memory were not linked to sex. Recurring pictures was not linked to educational level 1 (period of education:0-11 years),2 (education level: illiterate, primary school, junior middle interactions among these variables:Recurring figures was not linked to serial memory 2 (the number of recalled pictures in the last 4 pictures in immediate memory test),serial memory 1 (the number of recalled pictures in the first4 pictures in immediate memory test) was not related to serial memory 2 and serial memory 4.Except for these cases, variables of picture memory had significant correlations with each other (r =0.206-0.855 ,P ＜ 0.05-0.01),and delayed recall memory of pictures had the closest relationship with conceptual memory 2 (r=0.855).CONCLUSION:Picture memory capacity of middle aged and elderly rural households is not linked to sex, while it is correlated with age,educational level and intelligence.

Objective: To compare the role in recognizing mild cognitive impairment of visual logical memory to auditory logical memory. Methods: 41 normal aged controls and 41 patients with mild cognitive impairment(MCI) were required to finish immediate recall and delay recall by visual and auditory logical memory test. Results: There was significant difference in immediate recall and delay recall between the two groups who received visual and auditory logical memory test, and the LM of visual logical memory test was superior to that of auditory one. Auditory logical memory-II could recognize more MCI individuals than visual logical memory-II. The accuracy of recognizing MCI by visual logical memory test was 88% when we set the standard score at 5 points, and 93% for auditory logical memory test with the standard score at 3 points. Conclusion: Delay recall of auditory logical memory test is the most sensitive one among all the logical memory tests for recognizing MCI.

Objective: To probe the significance of spontaneous and mimicking clock drawing tests (CDT) to evaluate the severity of Alzheimer’s disease (AD). Methods: 30 normal middle aged to senile people as the control, and 20 amnestic mild cognitive impairment patients, 20 mild AD patients, 19 moderate AD patients and 14 severe AD patients were asked to finish the series of neuropsychologic test including the spontaneous and mimicking clock drawing tests. Results: For spontaneous CDT, there was significant difference in the "anchoring part"(draw the four key points-12-3-69 first) between the MCI patients and normal controls (P

Objective To draw up the Chinese Words Reading Test and try to use it as way of premorbid intelligence. Methods 373 health middle-elderly people as study subjects, from five communities in Shanghai city, are between age 55 and 85, and their edueational background is junior high school or above, and their MMSE scores are more than 24 points. 34 of the cases have finished CWRT and Weehsler Adult Intelligence Scale (WAIS) Chinese Revised edition. The main analysis indicators of CWRT: CWRT-Ⅰ for number of right reading 50 characters and CWRT-Ⅱ for 50 words. Results Both CWRT-Ⅰ and CWRT-Ⅱ are relative to education level( r = 0.462,0.489, and P < 0.01), while the correlation with age is not signifieant. Performance of the male participants are better than that of the female. The coefficient of correlation between scores of CWRT-Ⅰ and full IQ of WAIS is 0.79. The mean and standard deviation of scores of CWRT-Ⅰ and CWRT-Ⅱ for the normal elder people with different education levels and gender are provided. Conclusion CWRT is not very diffieuh or easy, and is highly relative to score of WAIS. So it can be used as an evaluating tool for premorbid intelligence.

Objective: To develop Auditory Verbal Memory Test (AVMT) suitable for Chinese elderly. Method:100 normal elderly and 22 patients with mild to moderate Alz heimer' s disease were evaluated by AVMT, mini mental state examination. 40 person randomly selected from the 100 sample were assessed in follow up by AVMT, Wechsler Memory Scale ( Chinese Revised Version), information and similaritias subtests of Wechsler Adult Intelligence Scale - Chinese Revised Version (WAIS- RC) . Results: The correlation between inter- raters was 0.99, test- retest reliability at 3 months interval were 0.87～0.94. Education was a prominent influence factor of memory and recognition of AVMT. There were significant correlation between third recall, short delayed recall and total scores of VMS- RC, between long delayed recall and verbal sceres of WAIS - RC. Semantic clustering strategy showed gradual strongly correlation with measures of recall ability in higher education group. Performance of Alzheimer group was poorer than that of matched normal control. Scores of long delayed re call differed most obviously in group comparison. Conclusion: AVMT had good reliability and validity

Objective:To assess clinical validity of the Chinese version of Mattis Dementia Rating Scale (DRS) in differentiating dementia of Alzheimer type (AD). Methods:Administered the DRS, mini-mental state examination (MMSE) and clinical dementia rating(CDR) to 61 outpatients with AD and 104 healthy elderly subjects in Shanghai.Results:There was significant correlation between DRS and the total score,and DRS and MMSE.DRS of the AD group had significant correlation with CDR.Its significant correlation with CDR suggested satisfactory concurrent validity of the scale. The optimal DRS cutoff score for AD according to education level revealed a sensitivity of 85%～94% and a specificity of 90%～94%.Conclusion:The DRS is a clinically valid test for the detection of AD and its severity of cognitive impairment.

Objective: To analyze neuropsychological test identification of neurodegenerative (NMCI) and vascular (VMCI) subtypes of mild cognitive impairment. Methods: 94 normal elderly, 107 NMCI and 32 VMCI were evaluated by neuropsychological tests, such as mini mental state examination(MMSE), auditory verbal memory test (AVMT), Rey-Osterrich complex figure test (CFT), trailmaking test (TMT), Stroop Color Words Test (CWT), Verbal fluency test (VFT) and Clock Drawing Test (CDT). MMSE total score of 3 groups were 28.1?1.6, 26.9?1.8 and 26.2?1.7 , respectively. Results: There are similar global severity between NMCI and VMCI groups. VMCI group performed better than NMCI group in verbal delay memory rather than verbal short memory, or figure memory. Stroop interference effect and TMT interference effect of VMCI group were more powerful significantly than that of NMCI. VMCI group also generated fewer figure copy score on CFT. But there wasn't difference on VFT and CDT. Conclusion: These results suggest that decline in executive function is associated with cerebral vascular factors, and decline in episodic memory (such as verbal delay memory) is associated with neurodegenerative factors.

Objective: To study the cognitive function of patients with myasthenia gravis.Methods: Cognitive function of 35 patients with general myasthenia gravis and 31 patients with Eye-Muscles myasthenia gravis,and 35 control subjects was examined with cognitive measures of Recall of Auditory Verbal Learning Test,Symbol Digit Modalities Test,Trail Making Test,Logic Memory Test,Stroop Color Words Test(A、B 、C),Verbal fluency Test and Boston Naming Test.Results: MG patients performed worse than the control subjects on several cognitive measures.Conclusion: There is disorder of cognitive function in the patients with myasthenia gravis,revealing that there may exist deficiency in the central neuroal system of the patients with myasthenia gravis.

Objective:To compare the cognitive functions between elderly of Shanghai, Hong Kong and San Diego.Method:104 elderly in Shanghai was evaluated by the Chinese version of Mattis Dementia Rating Scale (DRS)and mini-mental state examination (MMSE), the results were compared with that of 104 persons in Hong Kong and 150 elderly participants in San Diago.Result:Compared with Hong Kong participants, Shanghai participants performed significantly higher on one item, but there were significantly differences in five items between Shanghai participants and the San Diego participants which age and education were matched.Conclusion:Some DRS subscales or individual items may be susceptible to cultural differences.

Objective:To analyze neuropsychological characteristics of a Chinese patient with semantic dementia (SD)。Methods:A patient with SD was selected to finish 11 neuropsychological tests and MRI and XeCT。Results:(1)Selective impairment of semantic memory caused severe anomia, impaired spoken and written single-word comprehension, reduced generation of exemplars on category fluency tests and an impoverished fund of general knowledge; (2)relative sparing of other components of language output and comprehension; normal perceptual skill and non-verbal problem-solving abilities; relatively preserved episodic memory; (3)a reading disorder with pattern of surface dyslexia;(4) radiological investigations (MRI and XeCT) have shown severe left temporal neocortex atrophy.Conclusion:There are similar clinical and neuropsychological characteristics for SD between the Chinese patient and the sample of Western. Selective impairment of semantic memory may bring about by left temporal neocortex atrophy。