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 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.

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 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。

Objective:To analyze identify method of mild cognitive impairment. Methods:The Wechsler Adult Intelligence Scale-Chinese Revised (WAIS-RC) and Wechsler Memory Scale-Chinese Revised (WMS-RC) were examined in 150 patients with memory complaints. 63 individuals whose intelligence quotient (IQ) and memory quotient (MQ) over 85 were designated as normal elderly group;and 33 individuals whose IQ scores over 85 and MQ score between 70 and 84 as mild cognitive impairment(MCI-1) group; and 25 individuals whose IQ scores over 85 and MQ scores between 55 and 69 as MCI-2 group; 29 individuals whose IQ scores and MQ scores less than 85 and conformed with DSM-Ⅳ as Alzheimer disease group.Results: Picture short memory and mental control (B)showed the highest identification between the 2 MCI groups and normal elderly group. Besides, visual reproduction played an important role in mild memory decline (MCI-1) group. Tactile memory, logical memory and associated learning played an important role in moderate memory decline (MCI-2) group.Conclusion: Picture short memory and mental control (B) contribute to identify MCI speedily and effectively.

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 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 the manifestation and essence of the knowledge of Chinese animal zodiacs in normal and cognitive impaired Chinese elders by Animal Fluency Test (AFT).Methods:512 normal elders, 153 patients with amnesic mild cognitive impairment (aMCI) and 124 patients with Alzheimer disease (AD) were evaluated with AFT and other tests (the mini-mental state examination, auditory verbal memory test, etc).Results:AFT total correct numbers and non-zodiac-animal numbers rather than zodiac-animal numbers showed significant relationships with gender, education level, premorbid ability, general cognitive and memory functions (r=-0.107~0.311,P

Objective: To evaluate the applicability, reliability and validity of the Rey-Osterrieth Complex Figure Test (CFT)in Chinese normal elderly. Methods: A total of 111 normal elderly were assessed by the CFT (Form A) and the mini-mental state examination (MMSE). Among these subjects, 40 were also administered the CFT (Form B), the Block Design and the Visual Reproduction tests. Results: No significant difference was found between CFT (Form A) and CFT (Form B) with respect to copy, delayed recall and recognition. Recall performance was related to copying strategy and level of organization. Details of accuracy and their respective placement were evaluated in both copy and delayed recall trials for CFT (Form A). Conclusion: As a measure for visual-spatial constructional ability and visual memory, the CFT (Form A & B) was assessed to be psychometrically reliable and valid to be used in normal Chinese elderly.