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The first part of the MCI screening neuropsychological Background: mild cognitive impairment (Mild Cognitive Impairment, MCI) is considered a transitional state between normal aging and dementia, has important implications for the early diagnosis of dementia or intervention , early screening of MCI has been a research focus. MCI can be further divided into different subtypes, I showed isolated memory impairment (Amnestic MCI-single domain, aMCI-s); Ⅱ type, that is, damage to MCI, multiple cognitive domains in addition to memory impairment, as well as language perform one or more other cognitive domains damage (Amnestic MCI-multiple domain, aMCI-m); Ⅲ type: single non-memory impairment MCI, simple language or other cognitive dysfunction (Nonamnestic MCI-single domain , naMCI-s); Ⅳ type, that is, more non-memory cognitive domains damage MCI, multiple cognitive domains mild damage, but the memories remain intact (Nonamnestic MCI-multiple domain naMCI-m). Ⅰ and Ⅱ collectively known as amnestic MCI (Lu said. While aMCI) type III and type Ⅳ collectively referred to as non-amnestic the MCI (naMCI). Many current screening methods for MCI's domestic revision of the Montreal Cognitive Assessment (Montreal Cognitive Assessment, MoCA) has three different cities (Beijing, Guangzhou, Chongqing) use of the report, but in the Shanghai area sieve the effectiveness of the investigation is unclear, and the MoCA whether used for early identification of non-amnestic MCI doubtful. Objective: To validate the MoCA (Shanghai Edition) (MoCA-S) as the validity of the the Shanghai region MCI screening tool, the preparation of Quick Cognitive Screening Test the (Quick Cognitive Screening Test, QCST) and verify that also quickly identify amnestic MCI and non effectiveness of amnestic MCI. Methods: (1) the healthy control group (Normal Control, NC) 178 cases, including level of education (Edu) for 5 years ≤ Edu ≤ 8 years 46 cases, 9 ≤ Edu ≤ 12 years, 52 cases of Edu ≥ 13 years, 80 cases ; MCI group 104 cases (aMCI-s30 cases, aMCI-m43 patients 31 cases of naMCI), of which 5 years ≤ Edu ≤ 8 years in 31 cases, nine years ≤ Edu ≤ 12 years there were 34 cases, Edu ≥ 13 years of 39 group of 32 patients with mild AD cases; All subjects completed the MoCA-S, MMSE, and a detailed neuropsychological tests, including the overall level of awareness, memory, language, executive function, space, the use of various cognitive domains. Analysis of different groups of subjects performance MoCA-S, and the development of the different levels of education demarcation points. (2) healthy control group 171 cases, of which 5 years ≤ Edu ≤ 8 years, 41 cases to 9 years ≤ Edu ≤ 12 years 54 cases Edu ≥ 13 years, 76 cases; MCI group of 83 patients (aMCI-s26 cases, aMCI-m36 cases, naMCI 21 cases), of which 5 years ≤ Edu ≤ 8 years 11 cases, 9 ≤ Edu ≤ 12 years, 42 cases of Edu ≥ 13 years, 30 cases; All subjects completed QCST (contains language, memory, attention, the use of space, perform, directed a total of 10 factors points, 10 points each, out of 100), with the project complete neuropsychological examination to confirm its validity. Compare different groups of subjects QCST performance and development of the demarcation of the different levels of education. Results: (1) the project and the total score of MoCA-S in NC, MCI, AD groups were statistically significant differences. NC and MCI groups the MoCA-S project points difference is delayed recall, the difference is minimal similarity and sentences to repeat. Education level in five years ≤ Edu ≤ 8 years 9 years ≤ Edu ≤ 12 years, the elderly Edu ≥ 13 years the MoCA-S total score of demarcation points respectively ≤ 21 points, 22 points, 23 points, get identify MCI's overall sensitivity of 76.0% (wherein the sensitivity of the identification aMCI-s 70%, the sensitivity of the identification aMCI-m 93% identify naMCI sensitivity of 55%), specificity of 80%. (2) the NC group the MCI group QCST total score of each project points were statistically significant differences. Education level in five years ≤ Edu ≤ 8 years 9 years ≤ Edu ≤ 12 years, Edu ≥ 13-year-old in QCST total score of demarcation points were ≤ 70 points, 73 points, 76 points, QCST score with identify MCI's overall sensitivity of 88.3% (which identify aMCI-s sensitivity of 80.8%, 91.7% sensitivity to identify aMCI-m identify naMCI sensitivity 90.5%), specificity was 81.9%. Conclusion: the the MoCA-S and QCST generally have better sensitivity, specificity, and provide more choices for clinical work MCI and its subtypes, dementia screening. The MoCA-S is more suitable for screening for amnestic MCI QCST screening sensitivity than non-amnestic MCI MoCA-S, apply early screening of the two types of MCI. The use of function of the second part of AD research background: apraxia as Alzheimer's disease (Alzheimer's disease, AD) one of the core symptoms of the diagnostic criteria for its prevalence in the AD, and most often in the course of which stage various opinions vary. Based on semantic memory and action generated \ignore the detection of another link, it is difficult to judge the test different aspects or the loss of use of different types of the distribution ratio, it is difficult to sort out the different components are mutually affected or are separated from each other. Negri and others will use the action to be broken down into five steps and concatenated detection, analysis of damaged areas, which can be judged dyspraxia appear in the stage or movement of the concept of perceptual processing stage. At present, such detection paradigm is not applied to the reports of the AD patients. Objective: Negri et al study based on the different components of apraxia assessment summarized the characteristics of the different severity of AD patients dyspraxia, dyspraxia of AD patients early evidence. Select the more sensitive tests as a routine examination tool AD ??apraxia. Method: NINCDS-ADRDA diagnostic criteria for dementia in patients with mild AD 25 cases, severe in 14 cases of patients with AD, mild cognitive impairment (Mild Cognitive Impairment, MCI) 23 patients and healthy controls (Normal Control, NC) 60 cases. All completed items use quiz Intransitive a single gesture quiz (meaningful and meaningless gestures) and intransitive complex gestures imitate, inspection items include items of the conceptual system naming, naming the function and operation of the item, as well as action generation system performative gesture, the actual use and imitation. Were needed to complete the MMSE, CDR and comprehensive assessment of cognitive function tests, and daily living scale. Comparing four groups of subjects in the different uses of test performance, analysis of the use of damage characteristic of MCI and AD. Results: MCI hands gesture imitation and articles is named poor compared to NC. Correct rate of single items of the AD patients: impersonation gestures items / tools; moderate to severe AD - action imitation goods / tool concept> action order> action generated. Conclusion: The use of function in AD early even MCI can occur damage. AD patients in the use of the various aspects of both damage and higher incidence of moderate to severe AD damage than the mild AD. Intransitive complex gestures mimic the function can be used directly for the use of AD screening.
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