年長者輕度認知功能損傷評量工具之回顧

Current Assessments in Mild Cognitive Impairment

10.6143/JSLHAT.2010.06.04

羅意琪(Yi-Chi Lo)

聽覺誘發電位 ； 老年聽力學 ； 輕度認知功能損傷 ； 阿茲海默症 ； Auditory evoked potential ； Geriatric audiology ； Mild cognitive impairment ； Alzheimer's disease

台灣聽力語言學會雜誌

25期（2010 / 06 / 01）

65 - 78

繁體中文

輕度認知功能損傷(Mild Cognitive Impairment, MCI)被認為是介於正常老化(normal aging)的認知功能衰退及阿茲海默症(Alzheimer's Disease, AD)的一個階段。研究顯示，符合MCI條件的個案比一般年長者，具有較高的風險在未來將轉變為阿茲海默症。阿茲海默症的患者，除了記憶及認知功能的衰退之外，其日常生活能力也會受到疾病的影響，漸漸需要仰賴他人照顧。因此，若能早期發現MCI的個案，對阿茲海默症的預防及處遇將有所貢獻。 現今臨床上用來診斷MCI 的工具有心理認知功能評量測驗(neuropsychological assessment)、大腦造影技術(brain imaging technology)以及聽覺誘發電位(auditory evoked potentials)。本文將分別介紹這三種測驗，說明其臨床應用上的優缺點，文中並提出聽力師面對年長者除了考量其聽覺損傷之外，應考量認知功能衰退所造成的影響，本文更進一步說明未來以MCI為主題的研究方向。

Mild cognitive impairment (MCI) is the transitional stage between normal aged cognitive decline and Alzheimer's disease (AD). Research results indicated that people with MCI have a high risk of developing AD and convert at the rate of 10% to 15% per year (Petersen, 2000; Petersen et al., 1999). This annual conversion rate to AD was more than 6 times the rate in the normal control group. Hence, early detection of people with MCI is an important issue for the prevention of AD. Numerous tests are used to identify people with MCI. In the past, the major measurements for MCI relied on the neuropsychological tests. Although neuropsychological tests provide the behavioral performance in each cognitive domain for individuals, there is still no consensus on a specific test battery and best cut-off scores in each test for diagnosing MCI accurately. While improvements in brain-image technologies provide anatomic and physiological evidence of the differences between MCI and normal aging, many unclear points remain about the process of neural generation. Therefore, the interpretation of the cognitive activations findings should be considered carefully. Recently, researchers are paying attention to neurophysiological methods, especially in auditory evoked potentials (AEP). The AEP is a noninvasive method in the assessment of MCI. Nevertheless, this is a novel area and guidelines must be developed for MCI diagnosis. In this paper, those current assessments for MCI will be discussed.

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