- 學位論文
初探認知功能障礙者感染新冠肺炎後的神經認知與精神症狀改變
Exploring Neurocognitive and Neuropsychiatric Changes in Individuals with Cognitive Impairment after COVID-19
摘要
先前研究發現感染新冠肺炎者（coronavirus disease-2019, COVID-19）會出現疲勞、焦慮和認知障礙等後遺症，尤其是年長者。然而這些量化研究在調查既存認知功能障礙症感染者，在長期認知影響方面尚有待釐清的部分。本研究旨在使用臨床評估工具調查感染者神經認知和精神症狀的影響。本研究從失智科與神經內科門診招募29 名年齡超過50 歲曾感染新冠肺炎的認知功能障礙者（15名診斷為失憶型輕度認知缺損〔amnestic mild cognitive impairment, aMCI〕；12名診斷為阿茲海默型失智症〔dementia of Alzheimer’s type, DAT〕）。該群感染者在2022年6月至2024年3月期間接受神經心理評估與感染COVID-19相關症狀訪談。14名感染者在首次評估後至少5個月接受追蹤神經心理評估檢查。從回溯性神經心理學資料庫中篩選29名受試者組成匹配非感染組。研究結果顯示：曾感染新冠肺炎的認知功能障礙者報告急性期間疲勞是最常被報告的症狀（62.1%）。感染者在聽覺記憶學習方面的表現低於非感染組，注意力/處理速度表現亦低於非感染組。DAT感染新冠肺炎後多領域認知功能表現顯著比非感染DAT族群差。在第二次評估的感染者中認知症狀仍未緩解，且整體一般認知功能顯著減退。
並列摘要
Previous research has found that individuals with cognitive impairment after coronavirus disease-2019 (COVID-19) may experience sequelae such as fatigue, anxiety, and cognitive impairment, especially elderly. However, there are limited studies quantitatively investigate the long-term cognitive effects and changes among the individuals. This study aims to utilize clinical assessment tools to investigate the impact of COVID-19 on the neurocognitive and psychiatric symptoms of elderly individuals. 29 elderly individuals with cognitive impairment after COVID-19 aged over 50 years were recruited from memory clinics (15 patients of amnestic mild cognitive impairment [aMCI]; 12 patients with dementia of Alzheimer’s type [DAT]) and underwent neuropsychological assessments and interviews regarding symptoms associated with COVID-19 from June, 2022 to March, 2024. 14 participants received a follow-up neuropsychological assessment at least 5 months after the first assessment. A matched control group consisting of 29 subjects was selected from a retrospective neuropsychological database. The results show that: Fatigue is the most frequently reported symptom (62.1%) in COVID-19 group. COVID-19 group scored lower than the control group on the tasks assessing learning aspect of auditory memory and Attention/Processing speed. The infected DAT group demonstrated significantly poorer performance across multiple cognitive domains compared to the non-infected DAT group. Cognitive symptoms remained unresolved at the second assessment, and general cognitive function had declined significantly.