㧠㧚ᄢᐭᏒߦ߅ߌࠆ⹺⍮ᯏ⢻ૐਅᛥ೙ലᨐߦ㑐ߔࠆታ⸽⎇ⓥႎ๔ᦠ࿖┙㐳ኼක≮⎇ⓥ࠮ࡦ࠲࡯
ᄢᐭᏒ‫ޤ⊛⋡ޣ‬ ട㦂ߣߣ߽ߦჇടߔࠆ⹺⍮∝ߪ‫ޔ‬ᖚ⠪ᧄੱ߿ኅᣖߩ↢ᵴࠍ፣უߐߖࠆߣߣ߽ߦᄙ㗵ߩක≮߿੺⼔⾌↪ࠍⷐߔࠆߎߣ߆ࠄ‫੍ޔ‬㒐߿ᴦ≮ᣇᴺߩ⏕┙ߪᕆോߩ⺖㗴ߢ޽ࠆ‫߇ࠊߦߊߣޕ‬࿖ߩᕆㅦߥੱญ᭴ㅧߩᄌൻࠍ⠨ᘦߔࠆߣ‫⹺ޔ‬⍮∝ߦኻߔࠆ໧㗴ߪ੹ᓟ߹ߔ߹ߔ㊀ⷐߥ⺖㗴ߣߥࠆ‫ޕ‬⃻࿷ߩߣߎࠈ‫⹺ޔ‬⍮∝ߩਥߥේ࿃∔ᖚߢ޽ࠆࠕ࡞࠷ࡂࠗࡑ࡯∛߿⣖ⴊ▤∔ᖚߩᩮᴦ⊛ᴦ≮ᴺߪ⏕┙ߐࠇߡ޿ߥ޿ߚ߼‫⹺ޔ‬⍮∝ࠍ੍㒐‫ࠍ∝⊒ߪߚ߹ޔ‬ㆃᑧߔࠆߚ߼ߩขࠅ⚵ߺ߇‫⹺ޔ‬⍮∝ኻ╷ߣߒߡ㊀ⷐߥᓎഀࠍᜂ߁‫ޕ‬ ⹺⍮∝ߢߪߥ޿߇シᐲߥ⹺⍮ᯏ⢻ߩૐਅࠍ᦭ߔࠆ⁁ᘒߪ‫ޔ‬シᐲ⹺⍮㓚ኂ㧔mild cognitive
impairment: MCI㧕ߣ๭߫ࠇ‫⹺ޔ‬⍮∝ࠍ੍㒐ߔࠆ೨㚟⁁ᘒߣߒߡᵈ⋡ߐࠇߡ޿ࠆ‫ޕ‬ᣣᧄߩ࿾ၞ࿷૑㜞㦂⠪ࠍኻ⽎ߣߒߚᄢⷙᮨ∉ቇ⎇ⓥߢߪ‫ޔ‬MCI ߩ᦭∝₸ߪ᭎ߨ 㨪ߣߐࠇߡ޿ࠆ‫ޕ‬ߎࠇࠄ࿾ၞ࿷૑ߩ MCI 㜞㦂⠪ߪ‫ ޔ‬ᐕ㑆ߢ ߇⹺⍮∝ߦ⒖ⴕߒߚߩߦኻߒߡ‫ޔ‬MCI ࠍᜬߚߥ޿㜞㦂⠪߇⹺⍮∝ࠍ⊒∝ߒߚߩߪ ߢ޽ߞߚߣႎ๔ߐࠇߚ‫ ߩޔߚ߹ޕ‬MCI ߪ ᐕᓟߦᱜᏱߦ࿁ᓳߔࠆߚ߼ ‫⹺ޔ‬⍮∝ࠍ੍㒐ߔࠆߚ߼ߦߪ‫ޔ‬MCI ᡷༀߩߚ߼ߩขࠅ⚵ߺ߇㊀ⷐߣߥࠆ‫ޕ‬ MCI ߩᡷༀ߿⹺⍮∝⊒∝੍㒐ߩߚ߼ߦ‫ޔ‬ෂ㒾࿃ሶߩឃ㒰߿⊒∝ㆃᑧࠍ⋡⊛ߣߒߚ⮎‛≮ᴺ
ߣ‫↢ޔ‬ᵴ⠌ᘠߩᡷༀߥߤࠍ฽߼ߚ㕖⮎‛≮ᴺߦࠃࠆኻಣ߇ߥߐࠇߡ޿ࠆ‫≮‛⮎ޕ‬ᴺߣߒߡߪ‫ޔ‬ࠕ࡞࠷ࡂࠗࡑ࡯∛߿⣖ⴊ▤∔ᖚߩෂ㒾࿃ሶߢ޽ࠆ㜞ⴊ࿶∝‫ޔ‬㜞⢽ⴊ∝‫♧ޔ‬ዩ∛ߦኻߔࠆᛩ⮎߿‫⹺ဳ࡯ࡑࠗࡂ࠷࡞ࠕޔ‬⍮∝ߩ⊒∝ㆃᑧࠍ⋡⊛ߣߒߚႮ㉄࠼ࡀࡍࠫ࡞ߩಣᣇ߇ߥߐࠇߡ޿ࠆ‫ޕ‬ߒ߆ߒ‫ޔ‬ෂ㒾࿃ሶࠍឃ㒰ߔࠆߚ߼ߩ⮎‛≮ᴺߩ⋥ធ⊛ߥലᨐߪᛠីߔࠆߎߣ߇㔍ߒߊ‫ޔ‬Ⴎ㉄࠼ࡀࡍࠫ࡞ߪ㒢ቯ⊛ߥലᨐߒ߆ᦼᓙߢ߈ߥ޿ ‫ޕ‬ 㕖⮎‛≮ᴺߦࠃࠆ⹺⍮∝੍㒐ࠍ⋡⊛ߣߒߚ੺౉ᣇᴺߣߒߡߪ‫ޔ‬⠌ᘠ⊛ߥㆇേߩଦㅴ ‫ޔ‬᛫㉄ൻ‛⾰߿᛫Ἳ∝ᚑಽࠍᄙߊ฽߻㘩‛ߩ៨ข ‫␠ޔ‬ળෳട߿⍮⊛ᵴേ߳ߩෳട  ߇‫⹺ޔ‬⍮∝⊒∝ߦኻߔࠆ଻⼔⊛࿃ሶߣߒߡ⹺߼ࠄࠇߡ޿ࠆ‫⚛㉄᦭ߦߊߣޕ‬ㆇേߩታᣉߣࠕ࡞࠷ࡂࠗࡑ࡯∛⊒∝੍㒐ߣߩ㑐ㅪߪᄙߊߩ⍮⷗߇ᓧࠄࠇߡ߅ࠅ‫ޔ‬ㄭᐕ MCI 㜞㦂⠪ߦኻߔࠆㆇേߩലᨐࠍᬌ⸽
ߒߚ࡜ࡦ࠳ࡓൻᲧセ⹜㛎ߩ⚿ᨐ߇ႎ๔ߐࠇߚ ‫⎇ߩߘޕ‬ⓥߢߪ  ฬߩኻ⽎⠪ࠍ࡜ࡦ࠳ࡓߦ᦭
㉄⚛ㆇേ‫⚛㉄᦭ޔ‬એᄖߩㆇേ⟲‫ ࡦࡒ࠲ࡆޔ‬B ᦯↪⟲‫ޔ‬ன⮎᦯↪⟲ߦഀࠅઃߌ‫ ޔ‬ᐕ㑆ߩ੺౉ࠍታᣉߒߚ‫ޕ‬ㆇേߪㅳ  ࿁‫ ޔ‬࿁ߦߟ߈  ಽ㑆ታᣉߒ‫⚛㉄᦭ޔ‬ㆇേߪࠣ࡞࡯ࡊߢߩᱠⴕ✵⠌߇ⴕࠊࠇߚ‫⚿ߩߘޕ‬ᨐ‫⚛㉄᦭ޔ‬ㆇേߦࠃࠆ⹺⍮ᯏ⢻ᡷༀߦኻߔࠆ᦭ᗧߥലᨐߪ⹺߼ࠄࠇߥ߆
ߞߚ‫⚿ߩߎޔߒߛߚޕ‬ᨐߪ  ࿁߽ㆇേߦ಴Ꮸߒߥ߆ߞߚ  ฬߩኻ⽎⠪ࠍ฽߼ߚ intention totreat analysis ߦၮߠߊ߽ߩߢ޽ࠆ‫⚛㉄᦭ޕ‬ㆇേ⟲ߦ߅޿ߡ಴Ꮸ₸ߩ㜞߆ߞߚ㜞㦂⠪ߩߺࠍಽᨆኻ⽎ߣߔࠆߣ‫⸥ޔ‬ᙘ߿ᵈᗧജߩะ਄߇⹺߼ࠄࠇ‫ޔ‬MCI 㜞㦂⠪ߦኻߔࠆ᦭㉄⚛ㆇേߩ᦭ലᕈ
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13:41:42߇㒢ቯ⊛ߢߪ޽ࠆ߇⏕⹺ߐࠇߚ‫ޔߚ߹ޕ‬ㄭᐕߩႎ๔ߦ߅޿ߡߪᐔဋ  ᱦߩ MCI 㜞㦂⠪ߦኻߒߡ 㨪㧑ᔃᜉᢙ੍஻ߩᒝᐲߢㅳ  ࿁  ߆᦬㑆ߩ᦭㉄⚛ㆇേࠍⴕߞߚ⚿ᨐ‫ޔ‬ታⴕᯏ⢻ߩ᦭ᗧߥะ਄߇⹺߼ࠄࠇߚߣߐࠇߡ޿ࠆ ‫ޕ‬ ߎߩࠃ߁ߦㆇേ߇⹺⍮ᯏ⢻ߦኻߒߡ⦟ᅢߥᓇ㗀ࠍ෸߷ߔẜ࿷⊛ߥࡔࠞ࠾࠭ࡓߣߒߡ‫ޔ‬േ‛ታ㛎߆ࠄߩ⍮⷗ࠍਛᔃߦ‫⚻␹ޔ‬Ἳ∝ߩᷫዋ‫▤ⴊޔ‬ᣂ↢‫⚻␹ޔ‬ౝಽᴲ෻ᔕ‫⫾࠼ࠗࡠࡒࠕޔ‬Ⓧᷫ
ዋߥߤ߇␜ໂߐࠇߡ޿ࠆ‫ޔߚ߹ޕ‬ㄭᐕߩੱࠍኻ⽎ߣߒߚ⎇ⓥߢ‫᦬߆ ޔ‬㑆ߩ᦭㉄⚛ㆇേߦࠃߞߡ‫ޔ‬ട㦂ߦࠃࠆ⹺⍮ᯏ⢻ૐਅߣ㑐ㅪߒߚ㗔ၞߦ߅ߌࠆ⣖ߩኈ㊂߇Ⴧടߒߚߣ޿߁ႎ๔߇޽ࠆ ‫⚛㉄᦭ߪࠇߎޕ‬ㆇേߦࠃߞߡ߽ߚࠄߐࠇߚⴊ▤ߩᣂ↢߿⣖ⴊᵹ㊂ߩჇᄢߦࠃࠆ߽ߩߣ⠨߃ࠄࠇߡ޿ࠆ ‫ޕ‬ ߎࠇࠄߩ⎇ⓥ⢛᥊ࠍ〯߹߃‫⎇ᧄޔ‬ⓥߦ߅޿ߡߪ᦭㉄⚛ㆇേࠍਛᔃߣߒߚㆇേ੺౉ߦࠃߞߡ
MCI 㜞㦂⠪ߩ⹺⍮ᯏ⢻ะ਄߇น⢻߆ߤ߁߆ᬌ⸛ߔࠆߎߣࠍ⋡⊛ߣߒߚ‫ޔߚ߹ޕ‬ᯏ⢻ᄌൻߣߣ߽ߦ⣖ኈ㊂‫ޔ‬⣖ᯏ⢻ߩะ਄߇⹺߼ࠄࠇࠆ߆ߤ߁߆ࠍ࡜ࡦ࠳ࡓൻᲧセ⹜㛎ߦߡᬌ⸽ߒߚ‫ޕ‬‫ޣ‬ᣇᴺ‫ޤ‬㧝㧚ኻ⽎⠪ ᧄ⎇ⓥߩኻ⽎⠪ߪ‫ޔ‬ᣣᧄ⺆ࠍᲣ࿖⺆ߣߔࠆ  ᱦએ਄ߩ㜞㦂⠪ߢ޽ߞߚ‫ޕ‬ኻ⽎⠪ߩ㒰ᄖၮḰࠍ⴫㧝ߦ␜ߒߚ‫ޕ‬ኻ⽎⠪ߩㆬቯߪ‫ޔ‬㧝ᰴ⺞ᩏ㧔⾰໧⚕⺞ᩏ n㧕‫ޔ‬㧞ᰴ⺞ᩏ㧔⹺⍮ᯏ⢻ᬌᩏ n㧕‫ޔ‬㧟ᰴ⺞ᩏ㧔MRI ᠟ᓇ n㧕ߦࠃࠅታᣉߒߚ㧔࿑㧝㧕‫ޕ‬ኻ⽎⠪ߪᄢᐭᏒߦ࿷૑ߔ
ࠆ㜞㦂⠪ߣߒ‫ߩߟ ޔ‬㓸࿅߆ࠄ൐㓸ߒߚ‫ߪߟ ޕ‬ή૞ὑ᛽಴ߦࠃࠆ㓸࿅ߢ‫ߩߎޔ‬ਛ߆ࠄ CDRߩ㜞㦂⠪ࠍ᛽಴ߒߚ‫ઁޕ‬ᣇߪᄢᐭᏒߩ․ቯஜ⸻ฃ⸻⠪߆ࠄ‫ޔ‬ਥⷰ⊛ߦ⸥ᙘߦኻߔࠆ໧㗴ߩ⸷߃߇޽ࠆ⠪ࠍ᛽಴ߒߚ‫ޕ‬ၮḰߦ⹥ᒰߒ⎇ⓥ߳ߩෳടߦหᗧߒߚ  ฬߦኻߒߡ⹺⍮ᯏ⢻ᬌᩏࠍታᣉߒ‫ ޔ‬ฬ߇ /4+ ᠟ᓇࠍฃߌߚ‫ޕ‬㧞ᰴ߅ࠃ߮㧟ᰴ⺞ᩏߢ  ฬ߇㒰ᄖၮḰ޽ࠆ޿ߪෳട
ࠍᜎุߒ‫ ޔ‬ฬߩ /%+ 㜞㦂⠪߇੺౉ኻ⽎⠪ߣߒߡㆬᛯߐࠇߚ‫ߩࠄࠇߎޕ‬ኻ⽎⠪ࠍஜᔓဳ MCI
ߢጀൻߒߡή૞ὑߦஜᐽ⻠ᐳ⟲㧔ኻᾖ⟲㧕ߣㆇേᢎቶ⟲㧔੺౉⟲㧕ߣߦഀࠅઃߌߚ㧔࿑㧝‫ޔ‬⴫㧞㧕‫ޕ‬㧞㧚⹏ଔ㗄⋡ ⺞ᩏߪ੺౉೨ᓟߦ⹺⍮ᯏ⢻ᬌᩏ‫ޔ‬ㆇേᯏ⢻ᬌᩏ‫ޔ‬MRI ᬌᩏࠍోኻ⽎⠪ߦታᣉߒߚ㧔⴫㧞㧕‫ޕ‬
MRI ᬌᩏߢߪ⣖ኈ㊂⸘᷹ࠍⴕ޿‫ߡߦࠣࡦࡇ࠶ࡑࠢ࠶࡝࠻ࡔ࡜ࡄ⊛⸘⛔ޔ‬ᮡḰ⣖ߦኻߔࠆ⣖ో૕ߩਛߢᆔ❗ߒߡ޿ࠆ㗔ၞߩഀวࠍ᳞߼ߚ‫ޕ‬ஜᔓဳ /%+ ߩၮḰࠍḩߚߒߚ  ฬ㧔ኻᾖ⟲ ฬ‫  ⟲౉੺ޔ‬ฬ㧕ߦߟ޿ߡߪ=F?fluorodeoxyglucose㧔FDG㧕ࠍ↪޿ߚࡐࠫ࠻ࡠࡦᬌᩏ㧔PET㧕ࠍታᣉߒߚ‫ޕ‬FDG PET ߪ three-dimensional stereotactic surface projection㧔DSSP㧕ࠍ↪޿ߡᮡḰ࠺࡯࠲ࡌ࡯ࠬߦኻߔࠆ⋧ኻ⊛ߥ FDG ขࠅㄟߺ↹௝ࠍ૞ᚑߒߚ‫ ޔߚ߹ޕ‬ฬ㧔ኻᾖ⟲  ฬ‫  ⟲౉੺ޔ‬ฬ㧕ߩኻ⽎⠪ߦߪ near infrared spectroscopy㧔NIRS㧕ᬌᩏࠍ੺౉೨
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13:41:43 ੺౉ਛߦߪ‫ޔ‬ㆇേᢎቶ⟲ߦ߅޿ߡᲤᣣߩㆇേᤨ㑆ߣᱠᢙࠍ⸥㍳ߒߚ‫ޔߚ߹ޕ‬ㆇേᢎቶෳട
ᤨߦߪㆇേ೨ᓟߩ⣂ᜉᢙߩ᷹ቯࠍⴕߞߚ‫ޕ‬㧟㧚੺౉ࡊࡠࠣ࡜ࡓ ㆇേᢎቶ⟲ߩ੺౉ߪ‫᦬߆ ޔ‬㑆‫ޔ‬ㅳ  ࿁‫ ޔ‬࿁ߦߟ߈  ಽ㑆‫  ⸘ޔ‬࿁ታᣉߒߚ‫ߩߟ ޕ‬ᢎቶߪ⚂  ฬߩኻ⽎⠪ߣߒߡ‫ޔ‬ℂቇ≮ᴺ჻  ฬ‫ޔ‬ㆇേ⵬ഥຬ  ฬߢ੺౉ࠍታᣉߒߚ‫ߩ౉੺ޕ‬ౝኈߪ‫╭ޔ࠴࠶࡟࠻ࠬޔ‬ജ࠻࡟࡯࠾ࡦࠣ‫⚛㉄᦭ޔ‬ㆇേ‫ޔ‬⣖ᵴᕈൻㆇേ‫ⴕޔ‬േᄌኈᛛᴺߦࠃࠆㆇേߩ⠌ᘠൻߣߒߚ‫ޔߚ߹ޕ‬ㆇേᢎቶ⟲ߩኻ⽎⠪ߦߪ‫ޔ‬ᱠᢙ⸘ߩⵝ⌕ࠍ߁ߥ߇ߒ‫⋡ޔ‬ᮡᱠᢙ߳ߩ೔㆐ߣࠬ࠻࡟࠶࠴‫╭ޔ‬ജ࠻࡟࡯࠾ࡦࠣߩታᣉࠍᲤᣣⴕ߁ࠃ߁ផᅑߒߚ‫ޕ‬ ஜᐽ⻠ᐳ⟲ߦߪ‫੍∛∔߿⼔੺ޔ‬㒐ߦ㑐ߔࠆஜᐽ⻠ᐳࠍ  ߆᦬㑆ߦ  ࿁ታᣉߒߚ‫޽ޔߚ߹ޕ‬ࠊߖߡᬌᩏ⚿ᨐߩ⺑᣿ࠍታᣉߒߚ‫ޕ‬‫⚿ޣ‬ᨐ‫ޤ‬㧝㧚ㆇേᢎቶߩታᣉ⁁ᴫ ㆇേᢎቶ⟲ߩ  ฬ㧔㧑㧕߇‫ ޔ‬࿁ߩ੺౉ߩ 㧑એ਄ߩ಴Ꮸࠍߒߚ‫ ޕ‬ฬ㧔㧑㧕ߩኻ⽎⠪ߪ 㧑એਅߩ಴Ꮸߢ޽ߞߚ㧔࿑㧞㧕‫ޕ‬ㆇേᢎቶታᣉਛߩ᦭ኂ੐⽎ߪߥ߆ߞߚ‫ޕ‬㧞㧚੺౉೨ߩஜᐽ⻠ᐳ⟲ߣ੺౉⟲ߩ⹺⍮ᯏ⢻ ࡌ࡯ࠬ࡜ࠗࡦᤨߦ߅ߌࠆஜᐽ⻠ᐳ⟲ߣㆇേᢎቶ⟲㑆Ყセߦ߅޿ߡ‫ޔ‬ᐕ㦂‫ޔ‬ㆇേᯏ⢻‫ޔ‬ᵴേ⁁ᘒ‫ޔ‬ᢎ⢒ᱧ‫⹺ޔ‬⍮ᯏ⢻‫ޔ‬⣖ኈ㊂ߔߴߡߩ㗄⋡ߢ‫߮ࠃ߅଀ోޔ‬ஜᔓဳ /%+ ⟲ߣ߽ߦ᦭ᗧᏅߪ
⹺߼ࠄࠇߥ߆ߞߚ㧔⴫㧟㧕‫ޕ‬㧟㧚੺౉೨ᓟߩ⹺⍮ᯏ⢻ߩᄌൻߣ⟲㑆Ყセ㧔ోኻ⽎⠪㧕 ஜᐽ⻠ᐳ⟲ߦ߅ߌࠆ੺౉೨ᓟߩᲧセߦ߅޿ߡ‫ޔ‬Wechsler memory scale WMS I A㧔හᤨౣ↢㧕‫ޔ‬ΤA㧔 ಽᓟౣ↢㧕‫ޔ‬Rey-Osterrieth Complex Figure Test㧔ROCF㧕 ಽᓟౣ↢‫ޔ‬
Digit Symbol㧔DS㧕ߦ߅޿ߡ᦭ᗧߥᯏ⢻ߩะ਄ࠍ⹺߼ߚ‫ޕ‬ㆇേᢎቶ⟲ߦ߅޿ߡߪ‫ޔ‬Alzheimer's
Disease Assessment Scale-cognitive subscale㧔ADAS-cog㧕‫ޔ‬WMS-I A‫ޔ‬WMS-I B‫ޔ‬WMS-I
total‫ޔ‬WMS-II A ‫ޔ‬WMS-II B‫ޔ‬WMS-II total‫ޔ‬Stroop test I ߦ߅޿ߡ᦭ᗧߥ⹺⍮ᯏ⢻ߩะ਄ࠍ⹺߼ߚ㧔⴫㧠㧕‫ޕ‬ ⟲㑆ᏅࠍᲧセߒߚ⚿ᨐ‫ޔ‬WMSΣB‫ޔ‬DS‫ޔ‬Word Fluency Test㧔WFT㧕category ߦ߅޿ߡ᦭ᗧߥ੤੕૞↪߇⹺߼ࠄࠇߚ㧔⴫㧠‫ޔ‬࿑㧠㧕‫ޕ‬㧠㧚ஜᔓဳ MCI 㜞㦂⠪ߩ੺౉೨ᓟߩ⹺⍮ᯏ⢻ߩᄌൻߣ⟲㑆Ყセ ஜᐽ⻠ᐳ⟲ߦ߅ߌࠆ੺౉೨ᓟߩᲧセߦ߅޿ߡ‫ޔ‬Mini Mental State Examination㧔//5'㧕߇᦭ᗧߦૐਅߒߚ‫ޔߒ߆ߒޕ‬WMS-II B‫ޔ‬ROCF3 ಽᓟౣ↢ߣ  ಽᓟౣ↢‫ޔ‬DS ߦ߅޿ߡ᦭ᗧ
－95－

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13:41:44ߥ⹺⍮ᯏ⢻ߩะ਄ࠍ⹺߼ߚ‫ޕ‬ㆇേᢎቶ⟲ߢߪ‫ޔ‬ADAS-cog‫ޔ‬WMS-I A‫ޔ‬WMS-I total‫ޔ‬WMS-IIA ‫ޔ‬WMS-II B‫ޔ‬WMS-II total‫ޔ‬Stroop test III‫ޔ‬WFT-letter‫ޔ‬Digit span forward㧔DSF㧕
ߦ߅޿ߡ᦭ᗧߥᯏ⢻ะ਄ࠍ⹺߼ߚ㧔⴫㧡㧕‫ޕ‬ ⟲㑆ᏅࠍᲧセߒߚ⚿ᨐ‫ޔ‬MMSE‫ޔ‬WMS-I total‫ޔ‬WFT-category‫ޔ‬WFT-letter ߦ߅޿ߡ᦭
ᗧߥ੤੕૞↪߇⹺߼ࠄࠇߚ㧔⴫㧡‫ޔ‬࿑㧡㧕‫ޕ‬㧡㧚⣖ኈ㊂᷹ቯ ੺౉೨ᓟߩᲧセߦ߅޿ߡ‫ޔ‬⣖ᆔ❗㗔ၞߩഀว߇ஜᐽ⻠ᐳ⟲ߢ‫ోޔ‬ኻ⽎⠪߅ࠃ߮ஜᔓဳ MCI
㜞㦂⠪ߩਔᣇߩಽᨆߦߡ᦭ᗧߦ਄᣹ߒ‫⟲ޔ‬㑆Ყセߢߪஜᔓဳ MCI 㜞㦂⠪ߩಽᨆߦ߅޿ߡ੤੕
૞↪߇⹺߼ࠄࠇߚ㧔⴫㧢‫ޔ‬࿑㧢㧕‫ޕ‬㧢㧚⣖ᯏ⢻᷹ቯ㧔੐଀ᬌ⸛㧕 MCI 㜞㦂⠪⟲ߦ߅޿ߡ੤੕૞↪ߩ⹺߼ࠄࠇߚ WMS ߩ୯߇੺౉೨ߦหߓᓧὐߢ޽ߞߚ  ฬߩኻ⽎⠪ߩ 3DSSP ↹௝ࠍ࿑㧣㧔ஜᐽ⻠ᐳ⟲ኻ⽎⠪㧕‫ޔ‬࿑㧤㧔ㆇേᢎቶ⟲ኻ⽎⠪㧕ߦ␜ߒߚ‫ޕ‬ஜᐽ⻠ᐳ⟲ኻ⽎⠪㧔 ᱦ‫ޔ‬ᅚᕈ㧕ߩ WMS-I total ᓧὐߪ੺౉೨ߦ  ὐ‫౉੺ޔ‬ᓟߦ  ὐߣࠊߕ߆ߦૐਅߒߚ‫৻ޕ‬ᣇ‫ޔ‬ㆇേᢎቶ⟲ኻ⽎⠪㧔 ᱦ‫↵ޔ‬ᕈ㧕ߩ WMS-I total ᓧὐߪ‫౉੺ޔ‬೨ߦ ὐ‫౉੺ޔ‬ᓟߦߪ  ὐߦ਄᣹ߒߚ‫ޕ‬3DSSP ↹௝߆ࠄߪ‫ޔ‬ஜᐽ⻠ᐳ⟲ኻ⽎⠪ߢߪᶏ㚍ற࿁ߩ⋧ኻ⊛ߥ FDG ขࠅㄟߺߩ਄᣹߇ૐਅߒߚ‫৻ޕ‬ᣇ‫⸥ޔ‬ᙘᯏ⢻߇ะ਄ߒߚㆇേᢎቶ⟲ߩኻ⽎⠪ߦ߅޿ߡߪ‫ޔ‬หㇱ૏ߩขࠅㄟߺ਄᣹߇⹺߼ࠄࠇߚ‫ޕ‬‫⎇ޣ‬ⓥ⾌‫ޤ‬ᧄ⎇ⓥߪ‫ޔ‬ෘ↢ഭ௛⋭ߩ੺⼔੍㒐ታᘒ⺞ᩏಽᨆᡰេ੐ᬺߣߒߡታᣉߒߚ‫ޕ‬‫⎇ޣ‬ⓥᬺ❣㧔ᛩⓂਛ߅ࠃ߮⊒⴫੍ቯࠍ฽߻㧕‫ޤ‬
࿖㓙⺰ᢥ
1.

Shimada H, et al.. Relationship between atrophy of the medial temporal areas andmemory function in elderly adults. (in submitting)2.

Makizako H, et al.. Exercise capacity is related to the atrophy of medial temporal
areas in community-dwelling older adults with mild cognitive impairment. (insubmitting)3.

Yoshida D, et al.. The relationship between atrophy of the medial temporal area anddaily activities in community-dwelling older adults. (in submitting)4.

Doi T, et al.. Characteristics of Cognitive Function in Early and Late Stages ofAmnestic Mild Cognitive Impairment. (in submitting)－96－

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13:41:44ቇળ⊒⴫
1.

Makizako H, et al.. Dual㧙task performance and multi㧙domain of neurocognitive
functions in older adults with and without amnestic mild cognitive impairment.
International Conference on Alzheimer's Disease, Paris, 2011. (in submitting)2.

Yoshida D, et al.. The relationship between atrophy of the medial temporal area anddaily activities in community-dwelling older adults. International Conference on
Alzheimer's Disease, Paris, 2011. (in submitting)3.

Doi T, et al.. Whole brain atrophy and spatiotemporal gait parameters during
dual-task gait. International Conference on Alzheimer's Disease, Paris, 2011. (insubmitting)4.

Makizako, et al.. Exercise capacity is related to entorhinal cortex atrophy incommunity 㧙 basedolder

adultswith

mild

cognitive

impairment.

World

Confederation for Physical Therapy, Amsterdam, 2011.
5.

Doi T, et al.. the characteristics of mobility and cognitive function in early and latestage with mild cognitive impairment. World Confederation for Physical Therapy,
Amsterdam, 2011.

6.

ፉ↰ ⵨ਯ ઁ.

㜞㦂⠪ߦ߅ߌࠆ༦ౝ㊁⊹⾰๟࿐ߩ⪜❗ߣ⹺⍮ᯏ⢻ߣߩ㑐ଥ. ╙ 53 ࿁ᣣᧄ⠧ᐕකቇળቇⴚ㓸ળ, ᧲੩, 2011 ᐕ. (ᩏ⺒ਛ)
7.

’ㄼ 㘧㓶㚍 ઁ. シᐲ⹺⍮㓚ኂࠍ᦭ߔࠆ㜞㦂⠪ߩ QOL ߣ㑐ㅪߔࠆⷐ࿃. ╙ 53 ࿁ᣣᧄ⠧ᐕකቇળቇⴚ㓸ળ, ᧲੩, 2011 ᐕ. (ᩏ⺒ਛ)

8.

࿯੗ ೰ᒾ ઁ.

ᢥሼᵹᥰᕈ⺖㗴ߣࠞ࠹ࠧ࡝࡯ᵹᥰᕈ⺖㗴ߩ⺖㗴․ᕈ. ╙ 53 ࿁ᣣᧄ⠧ᐕකቇળቇⴚ㓸ળ, ᧲੩, 2011 ᐕ. (ᩏ⺒ਛ)
9.

ศ↰ ᄢテ ઁ.

⹺⍮㓚ኂߣ㑐ㅪߔࠆᣣᏱ↢ᵴᵴേߩᬌ⸛. ╙ 53 ࿁ᣣᧄ⠧ᐕකቇળቇ

ⴚ㓸ળ, ᧲੩, 2011 ᐕ. (ᩏ⺒ਛ)
10. ’ㄼ 㘧㓶㚍 ઁ.

ੑ㊀⺖㗴᧦ઙਅߢߩ෻ᔕᤨ㑆ߣ⹺⍮ᯏ⢻߅ࠃ߮⣖⪜❗ߣߩ㑐ㅪ.

╙ 46 ࿁ᣣᧄℂቇ≮ᴺቇⴚᄢળ, ችፒ, 2011 ᐕ
11. ࿯੗ ೰ᒾ ઁ.

㜞㦂⠪ߦ߅ߌࠆᱠⴕᜰᮡߪ⣖⪜❗ߣ㑐ଥߔࠆߩ߆㧫╙ 46 ࿁ᣣᧄℂቇ≮ᴺቇⴚᄢળ, ችፒ, 2011 ᐕ
12. ศ↰ ᄢテ ઁ. ࿾ၞ㜞㦂⠪ߦ߅ߌࠆౝ஥஥㗡⪲ߩ⣖⪜❗ߣᣣᏱ↢ᵴᵴേߣߩ㑐ଥ. ╙46 ࿁ᣣᧄℂቇ≮ᴺቇⴚᄢળ, ችፒ, 2011 ᐕ
13. ࿯੗ ೰ᒾ ઁ. ⹺⍮㓚ኂࠍ᦭ߔࠆ㜞㦂⠪ߦ߅ߌࠆ dual-task ᱠⴕ. ╙ 1 ࿁ᣣᧄၮ␆ℂቇ
≮ᴺቇળቇⴚ㓸ળ‫(ޕ‬ᩏ⺒ਛ)‫ޣ‬ᜂᒰ⠪‫ޤ‬࿖┙㐳ኼක≮⎇ⓥ࠮ࡦ࠲࡯ ㋈ᧁ㓉㓶‫ޔ‬ፉ↰⵨ਯ‫’ޔ‬ㄼ㘧㓶㚍‫ޔ‬࿯੗೰ᒾ‫ޔ‬ศ↰ᄢテ
－97－

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13:41:45ᄢᐭᏒ ‫ޣ‬ᒁ↪ᢥ₂‫ޤ‬
1. ⍹Ꮉᥓਭ, ⼱ะ ⍮. シᐲ⹺⍮㓚ኂ㧔MCI㧕ࠍ⠨߃ࠆ㧦シᐲ⹺⍮㓚ኂߩ੍ᓟߦ㑐ߔࠆ∉ቇ⺞ᩏ⚿ᨐࠍߤ߁⠨߃ࠆ߆. ⠧ᐕ♖␹කቇ㔀⹹ 2009;20(3):258-64.
2. ૒‫ᧁޘ‬ᕺ⟤, ᦺ↰ 㓉. ⨙ၔ⋵೑ᩮ↸⎇ⓥߩ⚿ᨐ߆ࠄ㧦AD ߳ߩࠦࡦࡃ࡯࡚ࠫࡦࠍ⠨ኤߔࠆ.

⠧ᐕ♖␹කቇ㔀⹹ 2006;17㧔Ⴧೀ-Τ㧕:55-60.
3. Ishikawa T, Ikeda M, Matsumoto N, Shigenobu K, Brayne C, Tanabe H. A longitudinal
study regarding conversion from mild memory impairment to dementia in a
Japanese community. Int J Geriatr Psychiatry 2006;21(2):134-9.
4. Petersen RC, Thomas RG, Grundman M, Bennett D, Doody R, Ferris S, et al. Vitamin
E and donepezil for the treatment of mild cognitive impairment. N Engl J Med
2005;352(23):2379-88.
5. Larson EB, Wang L, Bowen JD, McCormick WC, Teri L, Crane P, et al. Exercise isassociated with reduced risk for incident dementia among persons 65 years of age
and older. Ann Intern Med 2006;144(2):73-81.
6. Yaffe K, Barnes D, Nevitt M, Lui LY, Covinsky K. A prospective study of physicalactivity and cognitive decline in elderly women: women who walk. Arch Intern Med
2001;161(14):1703-8.
7. Lindsay J, Laurin D, Verreault R, Hebert R, Helliwell B, Hill GB, et al. Risk factors for
Alzheimer's disease: a prospective analysis from the Canadian Study of Health andAging. Am J Epidemiol 2002;156(5):445-53.
8. Wang HX, Karp A, Winblad B, Fratiglioni L. Late-life engagement in social and leisureactivities is associated with a decreased risk of dementia: a longitudinal study fromthe Kungsholmen project. Am J Epidemiol 2002;155(12):1081-7.
9. van Uffelen JG, Chinapaw MJ, van Mechelen W, Hopman-Rock M. Walking or vitamin
B for cognition in older adults with mild cognitive impairment? A randomised
controlled trial. Br J Sports Med 2008;42(5):344-51.
10. Baker LD, Frank LL, Foster-Schubert K, Green PS, Wilkinson CW, McTiernan A, et al.
Effects of aerobic exercise on mild cognitive impairment: a controlled trial. Arch

Neurol 2010;67(1):71-9.
11. Colcombe SJ, Erickson KI, Scalf PE, Kim JS, Prakash R, McAuley E, et al. Aerobic
exercise training increases brain volume in aging humans. J Gerontol A Biol Sci Med

Sci 2006;61(11):1166-70.
12. Fratiglioni L, Paillard-Borg S, Winblad B. An active and socially integrated lifestyle－98－

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in late life might protect against dementia. Lancet Neurol 2004;3(6):343-53.
13. Morris MC, Evans DA, Bienias JL, Tangney CC, Hebert LE, Scherr PA, et al. Dietary
folate and vitamin B12 intake and cognitive decline among community-dwellingolder persons. Arch Neurol 2005;62(4):641-5.
14. Mischoulon D, Raab MF. The role of folate in depression and dementia. J Clin

Psychiatry 2007;68 Suppl 10:28-33.
15. Barberger-Gateau P, Letenneur L, Deschamps V, Peres K, Dartigues JF, Renaud S.
Fish, meat, and risk of dementia: cohort study. BMJ 2002;325(7370):932-3.
16. Morris MC, Evans DA, Bienias JL, Tangney CC, Bennett DA, Wilson RS, et al.
Consumption of fish and n-3 fatty acids and risk of incident Alzheimer disease. Arch

Neurol 2003;60(7):940-6.
17. McMahon JA, Green TJ, Skeaff CM, Knight RG, Mann JI, Williams SM. A controlled
trial of homocysteine lowering and cognitive performance. N Engl J Med
2006;354(26):2764-72.
18. Freund-Levi Y, Eriksdotter-Jonhagen M, Cederholm T, Basun H, Faxen-Irving G,
Garlind A, et al. Omega-3 fatty acid treatment in 174 patients with mild to moderate
Alzheimer disease: OmegAD study: a randomized double-blind trial. Arch Neurol
2006;63(10):1402-8.
19. Kotani S, Sakaguchi E, Warashina S, Matsukawa N, Ishikura Y, Kiso Y, et al. Dietary
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－99－

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13:41:45⴫ 1 ኻ⽎⠪ߩ㒰ᄖၮḰ␹⚻∔ᖚࡄ࡯ࠠࡦ࠰ࡦ∛‫ޔ‬ᄙ⊒ᕈ⣖᪪Ⴇ‫ޔ∛ࡦ࠻ࡦ࠴ࡦࡂޔ‬ᱜᏱ࿶᳓㗡∝‫ޔ‬⣖⣲≌‫ޔ‬ㅴⴕᕈᩭ਄ᕈ㤗∽‫⤑⎬ޔࠎ߆ࠎߡޔ‬ਅⴊ⣲‫ޔ‬ᄙ⊒ᕈ⎬ൻ∝‫ޔ‬ᓟㆮ∝ࠍᱷߒߚ㗡ㇱᄖ்‫♧ޔ‬ዩ∛‫ߘޔ‬ߩઁ‫ޕ‬

MRI ᚲ⷗

Screening ᤨὐ߿ Baseline ߩ MRI ߢᗵᨴ∝‫⹺ޔ‬⍮ᯏ⢻ߦᓇ㗀ࠍਈ߃ࠆࠃ߁ߥ⣖᪪Ⴇ╬ߩዪᚲ∛ᄌ߇⷗ߟ߆ߞߚ႐ว
ߪ㒰ᄖ‫ޕ‬
ࡍ࡯ࠬࡔ࡯ࠞ࡯‫ޔ‬േ⣂≜ࠢ࡝࠶ࡊ‫ੱޔ‬Ꮏᑯ‫ੱޔ‬Ꮏౝ⡊ߘߩઁ‫ޔ‬૕ౝߦ㊄ዻ߇౉ߞߡ޿ࠆ႐วߪ㒰ᄖ‫ޕ‬♖␹⑼∔ᖚㆊ෰㧝ᐕએౝߦᄢ߁ߟ∛߿෺ᭂᕈ㓚ኂߩ⸻ᢿࠍฃߌߚ
㧔DSM-IV㧕⛔วᄬ⺞∝ߩᣢᓔ㧔DSM-IV㧕ᦨㄭߩ㧟ࡩ᦬એౝߦ agitation ߥߤߩ♖␹∝⁁߇ᒝߊ‫ࡊޔ‬ࡠ࠻ࠦ࡯࡞ߩቢੌ߇࿎㔍ߣᕁࠊࠇࠆ႐ว‫ޕ‬ࠕ࡞ࠦ࡯࡞ଐሽ

ㆊ෰㧞ᐕ㑆ߦࠕ࡞ࠦ࡯࡞߿ઁߩ⮎‛ଐሽߩᣢᓔ߇޽ࠆ
㧔DSM-IV㧕ోり⁁ᘒ࡮⥃ᐥᬌᩏ㊀◊ߥ∔ᖚ߿⁁ᘒߩ቟ቯߒߥ޿∔ᖚࠍᛴ߃ߡ޿ࠆ‫ޕ‬ࡆ࠲ࡒࡦ B12 ᰳਲ‫ޔ‬᪢Ქ‫⁁↲ޔ‬⣼ᯏ⢻⇣Ᏹ߇޽ࠆ‫ޕ‬ᣉ⸳౉ᚲߔߢߦᣉ⸳౉ᚲߒߡ޿ࠆ

ઁߩᴦ㛎߳ߩෳട

ߔߢߦઁߩᴦ㛎߳ߩෳടߒߡ޿ࠆ႐วߪ㒰ᄖ

࠼ࡀࡍࠫ࡞

㒰ᄖ

ᴦ㛎⮎ߩ᦯↪

㒰ᄖઁ੐ᬺ߳ߩෳട

㐳ኼක≮⎇ⓥ࠮ࡦ࠲࡯㐳ᦼ❑ᢿ⎇ⓥߦෳടߒߡ޿ࠆ႐ว

ߘߩઁ⎇ⓥ⠪߇ኻ⽎⠪ߣߒߡਇㆡᒰߣ್ᢿߒߚ႐ว

－100－

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13:41:46⴫㧞 ⹏ଔ㗄⋡
ᬌᩏ㗄⋡

੺౉೨

੺౉ᓟ

⹺⍮ᯏ

Mini mental state examination

٤

٤

⢻ᬌᩏ

ADAS-cog٤٤Wechsler memory scale-logical memory I٤٤Wechsler memory scale-logical memory II
Rey ⶄ㔀࿑ᒻ-ᮨ౮

٤

٤

٤

٤

Rey ⶄ㔀࿑ᒻ-㧟ಽᓟౣ↢٤٤Rey ⶄ㔀࿑ᒻ-30 ಽᓟౣ↢٤٤

Digit span-㗅໒٤٤Digit span-ㅒ໒٤٤Word fluency٤٤Category fluency

٤٤Trail making test-part A٤٤

Trail making test-part B٤٤

Volumetric MRI٤٤ᘒ࡮ᯏ⢻ FDG PET (n=26)
ᬌᩏ
NIRS (n=24)

٤

٤

٤

٤

ㆇേᯏ

ីജ

٤

٤

⢻ᬌᩏ

⤒િዷ╭ജ

٤

٤

⣉┙૏

٤

٤

5m ᱠⴕᤨ㑆㧔ㅢᏱ㧕٤٤

6 ಽ㑆ᱠⴕ〒㔌

٤

٤

ᣣᏱᵴ

⠧⎇ᑼᵴേ⢻ജᜰᮡ

٤

٤

േ⁁ᴫ

International physical activity questionnaire٤٤Life space assessment

٤

٤

ᔃℂ⁁

Medical outcome scale short form-8

٤

٤

ᘒ

Geriatric depression scale

٤

٤

৻⥸ஜ

ォୟ⁁ᴫ

٤

٤

ᐽ⁁ᘒ

∔∛⁁ᴫ

٤

٤

᦯⮎⁁ᴫ

٤

٤

⣖ᒻ

੺౉ਛ

ࡊࡠ࠮

ᢎቶ಴Ꮸ࿁ᢙ

٤

ࠬ⹏ଔ

ㆇേᤨ㑆

٤

㧔ㆇേ

ᱠᢙ

٤

ᢎቶ⟲

ㆇേ೨ᓟߩ⣂ᜉᢙ

٤

ߩߺ㧕

－101－

11-05-297.indd101

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13:41:48⴫㧟 ࡌ࡯ࠬ࡜ࠗࡦᤨߦ߅ߌࠆኻ⽎⠪ߩၮᧄᖱႎ
ஜᔓဳ MCI

ో଀
ஜᐽ⻠ᐳ⟲

ㆇേᢎቶ⟲

ஜᐽ⻠ᐳ⟲

ㆇേᢎቶ⟲

ᐕ㦂

75.8 ± 6.1

74.8 ± 7.4

76.8 ± 6.8

75.3 ± 7.5

ីജ23.5 ± 7.3

24.7 ± 8.1

23.1 ± 8.4

25.2 ± 7.3⤒િዷ╭ജ㧔Nm/kg㧕1.1 ± 0.4

1.1 ± 0.4

1.1 ± 0.4

1.2 ± 0.5

31.2 ± 23.9

34.6 ± 24.6

29.3 ± 23.6

34 ± 25.1

5m ㅢᏱᱠⴕ

4.7 ± 0.9

4.9 ± 1.9

4.6 ± 0.8

5.2 ± 2.3

TMIG index

12.3 ± 0.9

12.1 ± 1.7

12.3 ± 0.9

12.3 ± 1.1

ᢎ⢒ᱧ

10.4 ± 2.4

10.9 ± 2.8

10.8 ± 2.7

11.1 ± 2.4

MMSE26.3 ± 2.7

26.8 ± 2.3

26.6 ± 1.6

26.8 ± 1.8

ADAS6.5 ± 2.8

6 ± 2.8

6.8 ± 2.2

6.3 ± 2.2CDT

1.3 ± 0.6

1.3 ± 0.7

1.2 ± 0.5

1.3 ± 0.7

WMS-I A

7.4 ± 4.7

7.8 ± 4.3

6.2 ± 3.1

6 ± 3.6

WMS-I B

6.4 ± 3.2

6.8 ± 3.4

5.8 ± 2.4

6.5 ± 3.3

WMS-I total

13.8 ± 7.4

14.6 ± 6.9

12 ± 4.9

12.5 ± 5.9

WMS-II A

5.1 ± 4.5

5.5 ± 4.1

3.3 ± 2.7

4 ± 2.6

WMS-II B

4.3 ± 3.3

5 ± 3.8

3.6 ± 2.8

4.2 ± 3.2

WMS-II total

9.4 ± 7.4

10.5 ± 7.4

6.9 ± 58.2 ± 5.4

Rey ᮨ౮

34 ± 1.7

33.8 ± 2

33.7 ± 1.6

33.2 ± 2.4

Rey3 ಽᓟౣ↢14.7 ± 7

16.3 ± 5.3

13.4 ± 6.5

14.4 ± 4.9

Rey30 ಽᓟౣ↢14 ± 7.1

15.8 ± 5.9

12.9 ± 6.8

14 ± 6.2

DSC

42.8 ± 14.9

48.9 ± 1644.3 ± 16.3

47.5 ± 15.4

TMT-A

137.3 ± 52.6

123.3 ± 42.3

130.8 ± 49.7

124.5 ± 49

TMT-B

218 ± 145.2

181.7 ± 82.7

221.8 ± 146.7

185.7 ± 93.5

TMTB-A

81.7 ± 115.6

61 ± 66.4

91.7 ± 120.6

66.6 ± 81.3

ࠬ࠻࡞࡯ࡊ I

22.9 ± 9.8

22.2 ± 9.2

23.4 ± 11.1

22.6 ± 9.7

ࠬ࠻࡞࡯ࡊ III48.4 ± 34.4

44.9 ± 25.5

41.5 ± 17.742 ± 13.7

ࠬ࠻࡞࡯ࡊ III-I

25.5 ± 31.1

22.7 ± 22.2

18.2 ± 18.8

19.4 ± 12.6

WFT-category

31.5 ± 8.7

34.2 ± 7.3

31.2 ± 7.7

33.1 ± 6.9

WFT-letter

16.2 ± 5.9

16.8 ± 6.1

16.9 ± 6

16 ± 5.3

Digit span forward

7.7 ± 2.1

7.6 ± 2.3

7.7 ± 2.2

7.2 ± 2.3

Digit span back

5.2 ± 1.6

5.1 ± 1.7

5 ± 1.4

5 ± 1.8⣖ᆔ❗㗔ၞߩഀว

8.3 ± 4.6

7.3 ± 4.7

7.4 ± 3.3

7.9 ± 3.9

㐿⌒

⿷┙ߜᤨ㑆

－102－

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13:41:48⴫㧠 ోኻ⽎⠪ߦ߅ߌࠆ⹺⍮ᯏ⢻ߩᲧセஜᐽ⻠ᐳ⟲㧔n =45㧕ㆇേᢎቶ⟲㧔n =47㧕

੺౉೨

੺౉ᓟ

੺౉೨

੺౉ᓟ

p‡

MMSE

26.5 ± 2.6

26.2 ± 3.0

26.9 ± 2.2

27.1 ± 2.6.32ADAS ᵈ6.3 ± 2.8

6.1 ± 3.0

5.8 ± 2.7

5.0 ± 3.0††

.16

CDT

1.3 ± 0.6

1.3 ± 0.5

1.3 ± 0.7

1.5 ± 0.7

.28

WMS-I A

7.8 ± 4.7

8.9 ± 4.5*

8.1 ± 4.2

9.9 ± 3.9††.32

WMS-I B

6.7 ± 3.2

6.5 ± 3.6

6.9 ± 3.5

7.9 ± 3.6†

.05

WMS-I total

13.8 ± 7.4

13.9 ± 8.4

14.6 ± 6.9

16.7 ± 7.9†

.08

WMS-II A

5.5 ± 4.5

6.9 ± 4.9**

5.8 ± 4.0

8.0 ± 4.1††.23

WMS-II B

4.6 ± 3.2

5.1 ± 3.4

5.1 ± 3.9

6.3 ± 3.6†

.25

WMS-II total

9.4 ± 7.4

10.8 ± 8.1

10.5 ± 7.4

13.4 ± 7.6††.15

Rey ᮨ౮

33.9 ± 1.7

33.3 ± 2.1

33.8 ± 2.0

33.2 ± 2.4.93

Rey3 ಽᓟౣ↢ᵈ15.0 ± 7.0

16.1 ± 5.7

16.5 ± 5.3

17.7 ± 6.9.97Rey30 ಽᓟౣ↢14.2 ± 7.0

15.7 ± 5.5*

16.2 ± 5.5

16.9 ± 6.8.4843.2 ± 15.0

47.2 ± 14.3**

49.6 ± 16.2

50.4 ± 17.8

.03

128.2 ±42.7

123.0 ± 32.9

116.6 ± 32.9

122.4 ± 41.4

.12171.3 ± 56.2

161.7 ± 40.9

153.5 ± 54.7

154.4 ± 48.7

.33

47.7 ± 52.6

45.0 ± 35.7

43.6 ± 52.5

43.5 ± 43.5

.84ࠬ࠻࡞࡯ࡊ I

22.9 ± 10.0

22.2 ± 6.8

22.0 ± 9.3

19.2 ± 6.3†

.26

ࠬ࠻࡞࡯ࡊ III48.8 ± 35.7

44.9 ± 17.4

44.9 ± 26.0

41.0 ± 22.3

1.00ࠬ࠻࡞࡯ࡊ III-I

25.9 ± 32.5

22.7 ± 15.3

23.0 ± 22.7

21.7 ± 18.0

.70

WFT-category

32.2 ± 8.4

30.9 ± 8.5

34.3 ± 7.4

35.5 ± 9.1.03

WFT-letter

16.6 ± 5.9

16.8 ± 6.3

17.2 ± 6.0

18.5 ± 6.3.22Digit span forward

7.7 ± 2.1

7.4 ± 2.0

7.8 ± 2.2

7.9 ± 1.9

.33

Digit span back

5.3 ± 1.6

5.1 ± 1.6

5.2 ± 1.5

5.6 ± 2.2

.16

ᵈ

DSC
TMT-A ᵈTMT-B

ᵈTMTB-Aᵈ* p < .05, ஜᐽ⻠ᐳ⟲‫ **ޔ‬p < .01, ஜᐽ⻠ᐳ⟲‫ † ޔ‬p < .05, ㆇേᢎቶ⟲‫ ††ޔ‬p < .01, ஜᐽ⻠ᐳ⟲‫ ‡ޔ‬੤੕૞↪ߩᬌቯ
 ADAS㧦ㆇേᢎቶ⟲ߦߡ 1 ฬߩᰳ៊޽ࠅᵈ

TMT-A㧦ஜᐽ⻠ᐳ⟲ߦߡ 2 ฬ‫ޔ‬ㆇേᢎቶ⟲ߦߡ 1 ฬߩᰳ៊޽ࠅ



TMT-B㧦ஜᐽ⻠ᐳ⟲ߦߡ 9 ฬ‫ޔ‬ㆇേᢎቶ⟲ߦߡ 8 ฬߩᰳ៊޽ࠅ

 㧔TMT ߩਛᱛၮḰߪ 300 ⑽એ਄㧕
Rey3 ಽᓟౣ↢㧦ㆇേᢎቶ⟲ߦߡ 1 ฬߩᰳ៊޽ࠅ
Rey30 ಽᓟౣ↢㧦ஜᐽ⻠ᐳ⟲ߦߡ 1 ฬ‫ޔ‬ㆇേᢎቶ⟲ߦߡ 1 ฬߩᰳ៊޽ࠅ

－103－

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13:41:49⴫㧡 ஜᔓဳ MCI 㜞㦂⠪ߦ߅ߌࠆ⹺⍮ᯏ⢻ߩᲧセஜᐽ⻠ᐳ⟲㧔n = 23㧕ㆇേᢎቶ⟲㧔n = 24㧕

੺౉೨

੺౉ᓟ

੺౉೨

੺౉ᓟ

p‡

MMSE

26.6 ± 1.6

25.2 ± 2.9*

27.0 ± 1.8

27.2 ± 2.3

.04

ADAS

6.7 ± 2.2

6.7 ± 3.0

6.2 ± 2.2

5.0 ± 2.3††

.10

CDT

1.3 ± 0.5

1.4 ± 0.7

1.3 ± 0.8

1.3 ± 0.6.30

WMS-I A6.3 ± 3.0

7.3 ± 3.7

6.2 ± 3.6

9.3 ± 3.9††.07

WMS-I B

5.9 ± 2.4

5.4 ± 2.6

6.6 ± 3.3

7.3 ± 3.3

.12

WMS-I total

12.2 ± 4.7

12.7 ± 5.1

12.8 ± 5.9

16.5 ± 6.5††.04

WMS-II A

3.3 ± 2.7

5.0 ± 3.9

4.2 ± 2.6

6.9 ± 3.4††.27

WMS-II B

3.5 ± 2.6

4.0 ± 2.4*

4.2 ± 3.3

5.2 ± 2.9†

.46

WMS-II total

6.9 ± 4.8

9.0 ± 5.5

8.4 ± 5.5

12.1 ± 5.9††.26

Rey ᮨ౮

33.6 ± 1.6

33.3 ± 1.6

33.3 ± 2.4

33.0 ± 2.4.96Rey3 ಽᓟౣ↢12.9 ± 6.4

14.8 ± 5.2*

14.5 ± 4.9

17.1 ± 6.3.70

Rey30 ಽᓟౣ↢12.1 ± 6.5

14.8 ± 4.1*

14.5 ± 5.5

16.1 ± 5.7

.51

DSC

43.8 ± 16.4

47.3 ± 14.8*

48.0 ± 15.5

47.7 ± 15.2

.10ᵈ124.7 ± 46.0

129.5 ± 39.8

114.5 ± 33.4

127.7 ± 43.2

.41

TMT-B ᵈ176.2 ± 57.6

166.7 ± 37.5

157.2 ± 64.3

155.5 ± 51.5

.68

TMTB-A

61.5 ± 55.1

49.5 ± 28.9

49.6 ± 68.3

39.6 ± 46.1

.92ࠬ࠻࡞࡯ࡊ I

23.6 ± 11.5

22.5 ± 6.8

22.1 ± 9.6

19.0 ± 6.6.49ࠬ࠻࡞࡯ࡊ III41.9 ± 18.4

42.0 ± 15.5

41.8 ± 13.9

37.2 ± 17.4†.26ࠬ࠻࡞࡯ࡊ III-I

18.3 ± 19.6

19.6 ± 14.0

19.7 ± 12.8

18.1 ± 12.1

.55

WFT-category

31.0 ± 7.9

29.3 ± 8.5

33.3 ± 7.0

34.8 ± 9.0.05

WFT-letter

17.0 ± 6.2

16.0 ± 6.0

16.1 ± 5.4

19.0 ± 6.0†.01

Digit span forward

7.6 ± 2.2

7.5 ± 2.2

7.4 ± 2.2

8.0 ± 1.7†

.20

Digit span back

5.2 ± 1.4

5.1 ± 1.8

5.1 ± 1.6

5.5 ± 1.3

.37

TMT-A

* p < .05, ஜᐽ⻠ᐳ⟲‫ **ޔ‬p < .01, ஜᐽ⻠ᐳ⟲‫ † ޔ‬p < .05, ㆇേᢎቶ⟲‫ ††ޔ‬p < .01, ஜᐽ⻠ᐳ⟲‫ ‡ޔ‬੤੕૞↪ߩᬌቯ
 TMT-A㧦ஜᐽ⻠ᐳ⟲ߦߡ 1 ฬ‫ޔ‬ㆇേᢎቶ⟲ߦߡ 1 ฬߩᰳ៊޽ࠅ

ᵈ

TMT-B㧦ஜᐽ⻠ᐳ⟲ߦߡ 6 ฬ‫ޔ‬ㆇേᢎቶ⟲ߦߡ 5 ฬߩᰳ៊޽ࠅ

 㧔TMT ߩਛᱛၮḰߪ 300 ⑽એ਄㧕

－104－

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13:41:49⴫㧢 ኻ⽎⠪ߦ߅ߌࠆ㧹㧾㧵ᜰᮡߩᲧセ
ஜᐽ⻠ᐳ⟲

ㆇേᢎቶ⟲

੺౉೨

੺౉ᓟ

੺౉೨

੺౉ᓟ

p‡

8.3 ± 4.5

8.9 ± 4.7*

6.9 ± 4.2

7.0 ± 4.3

.16

7.3 ± 3.4

8.2 ± 3.7*

8.0 ± 4.0

7.9 ± 4.3

.05

ోኻ⽎⠪
⣖ᆔ❗㗔ၞߩഀว
ஜᔓဳ MCI 㜞㦂⠪⣖ᆔ❗㗔ၞߩഀว

* p < .05, ஜᐽ⻠ᐳ⟲‫ ‡ޔ‬੤੕૞↪ߩᬌቯ

－105－

11-05-297.indd105

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13:41:50

㒰ᄖ (n=1,408)ਥⷰ⊛⸥ᙘߦ໧㗴ߥߒ (n=765)⣖ⴊ▤∔ᖚߩᣢᓔ (n=32)ᔃ∔ᖚߩᣢᓔ (n=35)ઁߩකቇ⊛໧㗴 (n=14)ઁߩ⎇ⓥࡊࡠࠫࠚࠢ࠻߳ෳട (n=10)ㅪ⛊ߥߒ (n=299)
CDR, 0 (n=150)
CDR, 1 to 3 (n=100)ෳടᜎุ (n=3)৻ᰴ⺞ᩏ
CDR ߅ࠃ߮ࠕࡦࠤ࡯࠻
n=1,543ੑᰴ⺞ᩏ⹺⍮ᯏ⢻ᬌᩏ
n=135

㒰ᄖ (n=9)⛮⛯ᜎุ (n=4)කቇ⊛໧㗴 (n=5)

ਃᰴ⺞ᩏ
MRI
n=126

㒰ᄖ (n=26)㒰ᄖၮḰߦ⹥ᒰ (n=18)⛮⛯ᜎุ (n=8)
ஜᐽ⻠ᐳ⟲
n=50

ㆇേᢎቶ⟲
n=50

ㅊ〔⺞ᩏਇ⢻ (n=5)

ㅊ〔⺞ᩏਇ⢻ (n=3)࿑㧝 ⎇ⓥߩᵹࠇ

－106－

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106

2011/06/02

13:41:50࿑㧟 ᣣᏱߦ߅ߌࠆᱠⴕᵴേ㊂ߩᄌൻ࿑ਛߩ୯ߪ 1 ᣣߩᐔဋᱠᢙrᐔဋ⺋Ꮕࠍ␜ߔ‫ޕ‬－107－

11-05-297.indd107

2011/06/02

13:41:50

a                 bc࿑㧠 ోኻ⽎⠪ߩ⹺⍮ᯏ⢻ᄌൻ
a: Wechsler memory scale-logical memory IB score, b: digit symbol coding, c: word fluency
test-category޿ߕࠇߩ㗄⋡߽᦭ᗧߥ੤੕૞↪ࠍ⹺߼ߚ‫ޕ‬－108－

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108

2011/06/02

13:41:50         a                 b         c                 d࿑㧡 ஜᔓဳ MCI 㜞㦂⠪ߩ⹺⍮ᯏ⢻ᄌൻ
a: Mini mental state examination, b: Wechsler memory scale-logical memory I total score,
c: word fluency test-category, d: word fluency test-letter.
޿ߕࠇߩ㗄⋡߽᦭ᗧߥ੤੕૞↪ࠍ⹺߼ߚ‫ޕ‬－109－

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109

2011/06/02

13:41:51          ab࿑㧢 MRI ᜰᮡߦࠃࠆ⣖⪜❗ߩഀวa: ోኻ⽎⠪ߦ߅ߌࠆ⣖⪜❗ߩഀว, b: ஜᔓဳ MCI 㜞㦂⠪ߦ߅ߌࠆ⣖⪜❗ߩഀว᦭ᗧߥ੤੕૞↪ߪஜᔓဳ MCI 㜞㦂⠪ߩߺߦߺࠄࠇߚ‫ޕ‬－110－

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110

2011/06/02

13:41:51࿑㧣 ஜᐽ⻠ᐳ⟲ኻ⽎⠪ߦ߅ߌࠆ㧟DSSP ߦࠃࠆ⣖ᯏ⢻↹௝਄Ბ㧦੺౉೨‫ޔ‬ਅᲑ㧦੺౉ᓟ‫ޔ‬Ꮐ஥㧦⋧ኻ⊛ߦ FDG ขࠅㄟߺ਄᣹‫ޔ‬ฝ஥㧦⋧ኻ⊛ߦ FDG ข
ࠅㄟߺૐਅ

－111－

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111

2011/06/02

13:41:51࿑㧤 ㆇേᢎቶ⟲ኻ⽎⠪ߦ߅ߌࠆ㧟DSSP ߦࠃࠆ⣖ᯏ⢻↹௝਄Ბ㧦੺౉೨‫ޔ‬ਅᲑ㧦੺౉ᓟ‫ޔ‬Ꮐ஥㧦⋧ኻ⊛ߦ FDG ขࠅㄟߺ਄᣹‫ޔ‬ฝ஥㧦⋧ኻ⊛ߦ FDG ข
ࠅㄟߺૐਅ

－112－

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112

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13:41:51