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Objective To investigate the diagnostic significance of the difference values between Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)in elderly patients with dementia.Methods 331 elderly patients with dementia were collected from outpatients in our hospital.There were 148 people with Alzheimer's disease (AD),87 cases with vascular dementia (VaD),44 cases with mixed dementia (MD),41 cases with frontotemporal dementia (FTD) and 11 cases with dementia with Lewy bodies (DLB).MMSE and MoCA were applied to test the cognitive impairment separately.Results The difference values between MMSE and MoCA was (3.3±1.7) points,(6.6±2.1) points,(6.6±2.1) points,(5.4±2.3) points,(6.1 ± 1.9) points in AD,VaD,MD,FTD and DLB group respectively,and there were statistical differences among the five groups (F=46.420,P=0.000).Statistical differences were found in the difference values between MMSE and MoCA between dementia patients with AD and non-AD (t=-13.429,P=0.000).According to receiver operating characteristic curve (ROC curve),the optimal cut off point of the difference values between MMSE and MoCA for differential diagnosis between AD and non-AD dementia was 5 points,with 79.8％ sensitivity and 78.4％ specificity,and area under the curve was 0.848 (95％CI:0.807-0.890).Conclusions The difference values between MMSE and MoCA may be one of parameters for differential diagnosis between AD and non-AD dementia.
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Objective To explore the effectiveness and safety of deep brain magnetic stimulation technique (dTMS) for treatment of Alzheimer's disease (AD).Methods Totally 116 patients with AD were randomly divided into 4 groups:(1) dTMS:given dTMS really stimulation therapy,(2)medication group:treatment with donepezil 5 mg/d,(3) combination treatment group:given dTMS and donepezil therapy,(4) blank control group:given pseudorandom stimulation treatment.33 healthy control cases were given dTMS's stimulation treatment.The treatment course was 6 months.Application of mini mental state examination scale (MMSE),the Montreal cognitive assessment scale (MoCA),Hamilton Depression Scale (HAMD),ischemic scale (HIS),Boston naming test,activity of daily living(ADL) and neuropsychological questionnaire (NPI) were used to evaluate the cognitive function.All the participants received blood tests and ECG in order to evaluate the safety of dTMS.Results After 6 months treatment,compair with the blank control group,all scale scoresof dTMS group,medication group and combined treatment group were improved significantly in MMSE (t=2.49,2.46,2.20),MoCA(t=2.59,2.39,2.87),ADL(t=2.35,2.17,2.83),NPI(t=3.05,2.40,2.65) and sub-cognitive scale score (all P＜0.05).All scale scores of combination treatment group were better than dTMS group and medication group (P＜0.05).There's no significant difference between drug treatment groups and dTMS group (P＞0.05).After 6 months treatment,compared with healthy control group,the scale scores were aggravated in 4 groups of AD (P＜0.05)Conclusions dTMS can be effective and safe in the treatment of AD patients with cognitive and noncognitive symptoms.
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Objective To investigate the value of Alzheimer-associated neuronal thread protein (AD7c-NTP) level in urine for diagnosing Alzheimer's disease (AD). Methods The urine samples of 450 subjects were collected from out-department of our hospital.There were 257 people with AD diseases (131 mild cases,126 moderate and severe cases) and 193 healthy control.ELISA was applied to test the level of AD7c-NTP in urine samples. Results The levels of AD7c-NTP were (1.94±0.74)μg/L,(3.92 ± 0.86 ) μg/L and (0.65 ± 0.80) μg/L in mild AD,moderate and severe AD,healthy control groups,respectively.There were differences among three groups(F=-13.520,P＜0.001),and between mild and moderate and severe AD(t =1.727,P＜ 0.001).The level of AD7c-NTP was negatively related with MMSE score in mild AD (r =- 0.23,P =0.006),while no correlation was found between AD7c-NTP and MMSE in moderate and severe AD(r=0.59,P =0.113).Using receiver operating characteristic curve(ROC curve),the optimal cutoff point of AD7cNTP in urine for diagnosis of AD was 1.50 μg/L,with 90.6％ sensitivity and 91.8％ specificity,area under the curve was 0.94(95％ CI:0.91-0.97). Conclusions The level of AD7c-NTP in urine may be one of parameters for diagnosing AD.