A 50-Year-Old Man with Deteriorating Cognitive Function and Impaired Movement 英文参考文献.docVIP

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A 50-Year-Old Man with Deteriorating Cognitive Function and Impaired Movement 英文参考文献.doc

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A 50-Year-Old Man with Deteriorating Cognitive Function and Impaired Movement 英文参考文献

Learning Forum A 50-Year-Old Man with Deteriorating Cognitive Function and Impaired Movement Andrew J. Larner D E S C R I P T I O N o f C A S E Box 1: Description of Cognitive Tests A Mini-Mental State Examination (MMSE) A brief (5–10 minutes) mental status questionnaire assessing attention, orientation, memory, language, and visuospatial copying. 50-year-old man was referred to the Cognitive Function Clinic with a 12- to 18-month history of deterioration in his memory. The symptoms reported by the patient and his wife included forgetting what he was supposed to be doing, occasional disorientation in place, misplacing objects, and word-finding difficulties, all of which had affected his occupational function as a high school teacher. His past medical history was unremarkable. In the family history, his mother was said to have had Alzheimer disease (AD) in her fifties and died in her sixties, but no further details were available to confirm or refute this. The patient’s neurological examination was normal. Wechsler Adult Intelligence Scale–Revised (WAIS-R) Widely used test battery of general cognitive abilities, deriving a full scale IQ from six subtests that comprise Verbal IQ and five subtests that comprise Performance IQ. Administration time 1–2 hours; may require more than one consultation if patients become fatigued. National Adult Reading Test (NART) A reading test of 50 irregularly spelled words. Since this function is relatively preserved in some forms of dementia, the NART may be used to estimate premorbid cognitive function, since longitudinal assessments of IQ are almost never available in initial clinical evaluation. Initial Investigations On the Mini-Mental State Examination (MMSE; see Box 1 for brief descriptions of cognitive tests), the patient scored 26/30 with evidence of impaired delayed recall. Initial neuropsychological assessment showed no evidence of generalised intellectual loss, since the full scale IQ measured with the Wechsler Adult Inte