颈动脉内膜中层厚度对阿尔茨海默病的预测价值

以往研究表明临床心脑血管病是认知功能减退和痴呆的危险因素,近年来研究认为亚临床血管病包括颈动脉粥样硬化、颈动脉内膜中层厚度、狭窄及斑块等可能通过各种机制包括遗传易感性、脑灌注减低、血管危险因素等介导了动脉粥样硬化和痴呆的相关性,提示颈动脉内膜中层厚度对阿尔茨海默病的预测及痴呆的加重有重要的临床意义.     

阿尔茨海默病早期诊断的研究方向

<正>阿尔茨海默病(AD)是发生于老年和老年前期,以进行性 痴呆为特征的大脑退行性病变。其发病率随年龄的增长而 增高,65岁以上人群中,西方约有5％的人患此病,85岁以上老 人患病率高达47％～50％,为欧美国家老年期痴呆的主要原 因。日本患病率低于西方,为4％。我国60岁以上人群AD患 病率为3％～5％。AD自Alzheimer(1907)首次描述以来, 至今已近百年历史,目前AD的病因和发病机制迄今仍不清 楚,也没有客观、特异的生物学指标及影像学标准,因此早期诊 断AD仍为世界性难题。近年来随着神经心理学,神经生化     

尿液AD7c-NTP检测在阿尔茨海默病早期诊断中的价值

目的 探讨尿液阿尔茨海默病(AD)相关神经丝蛋白(AD7c-NTP)表达水平在AD及遗忘型轻度认知障碍(aMCI)中的诊断价值.方法 采用酶联免疫吸附试验检测尿液AD7c-NTP表达水平,比较54例AD组、68例aMCI组及46例对照组患者的尿液AD7c-NTP表达水平的差异,并分析尿液AD7c-NTP检测在AD及aM...     

精神障碍诊断量表对阿尔茨海默病的现场测试

目的 通过现场测试阿尔茨海默病（AD）,对中国精神疾病分类方案与诊断标准第3版（CCMD－3）中AD诊断标准的制订提出建议。方法 应用与CCMD－2配套的精神障碍诊断量表（DSMD）对71例AD患者进行现场测试,并进行1年随访。用Hachinski缺血指数量表（HISA）排除血管性痴呆。结果 71例AD均完成现场测试,其中完成1年随访者34例,均符合中国精神疾病分类方案与诊断标准第2版修订本（CCMD－2－R）的AD诊断标准。部分AD患者伴有思维症状和情感症状等精神病性症状。CCMD－2－R有较好的预测效度。结论 建议CCMD－3中AD诊断标准按症状标准、严重程度标准、病程标准和排除标准四项进行制定。     

阿尔茨海默病早期诊断的研究进展

阿尔茨海默病(AD)是一种多发于老年人的疾病,其发病率日渐增高,严重影响老年人的生活质量。AD在早期是可以进行治疗与干预的,因此,AD的早发现、早诊断至关重要。AD的早期诊断已成为近年来医学领域研究的热点。本文就AD早期诊断相关的研究进展做一综述,为AD早期诊断和治疗提供参考和依据。     

五边形复制测试在路易体痴呆和阿尔茨海默病鉴别诊断中的应用

目的 探讨简易精神评价量表(MMSE)五边形复制定性评分测试(QSPT)对路易体痴呆(DLB)与阿尔茨海默病(AD)的鉴别诊断价值.方法 选取符合纳入标准的2018年1月至2021年8月在首都医科大学宣武医院神经内科就诊的患者为研究对象,回顾性分析61例DLB患者与71例AD患者.比较两组患者性别、年龄、受教育年限、M...     

阿尔茨海默病睡眠脑电图的研究进展

本文综述了阿尔茨海默病脑电图的特点及在鉴别诊断中的作用。     

阿尔茨海默病睡眠脑电图的研究进展

本文综述了阿尔茨海默病脑电图的特点及在鉴别诊断中的作用。     

脑电图在路易体痴呆和阿尔茨海默病鉴别中作用的研究

目的此研究的目的是探讨总计脑电图(GTE)得分用于区别诊断路易体痴呆(DLB)和阿尔茨海默病(AD)的作用。方法根据GTE得分对30例DLB患者和52例AD患者的脑电图(EEG)进行了直观的评估。结果 DLB患者平均得分显著高于AD患者,得分比为9:4.DLB患者以6.5的GTE截止得分区别于AD患者,其灵敏度为80%,特异性为78%。GTE和DLB之间的关联独立于年龄、性别、简易精神状态检查和药物使用。额叶间歇节奏增量活性(FIRDA)在DLB患者和AD患者中分别为16.7%、1.9%。结论 EEG作为日常临床实践中区分DLB和AD的诊断工具应该发挥更加突出的作用。GTE得分法已被证明是适用于日常临床实践的可靠简单的评分法。定性EEG分析对于区别诊断DLB和AD帮助较大,并且有较高的灵敏度和特异性。     

血管性认知障碍的神经心理学研究进展

血管性认知障碍(vascular cognitive impairment,VCI)是常见的认知损害类型,相比阿尔茨海默病(Alzheimer's disease,AD),VCI具有相对可预防性和治疗性,早期识别意义重大。精确的神经心理学评估能提高早期检出率,但VCI临床表现为以执行功能障碍为主的单个或多个领域认知损害综合征,具有异质性,目前尚无统一的VCI神经测查量表,现有量表需要进一步验证和完善。     

非类固醇性抗炎药与Alzheimer病

在阿尔茨海默病(AD)的发病机制中,神经炎症可能是神经元损伤的一个原因。流行病学证据提示,长期服用非类固醇性抗炎药(NSAID)可能对AD有保护作用,减低AD发病率和发生AD的危险。实验研究发现,NSAID的作用除了COX机制外,还可能涉及非COX机制。但是,大规模的临床随机双盲对照试验尚未证实NSAID对AD的治疗作用。本文就NSAID对AD保护机制的实验研究、流行病学研究和临床试验作一综述。     

Risk Factors for Progression of Alzheimer Disease in a Canadian Population: The Canadian Outcomes Study in Dementia (COSID)

Objective:

To determine risk factors for clinically significant progression during 12 months in patients with mild-to-moderate Alzheimer disease.

Method:

Community-dwelling patients with mild-to-moderate Alzheimer disease were enrolled in a 3-year prospective study, the Canadian Outcomes Study in Dementia (commonly referred to as COSID), at 32 Canadian sites. Assessments included the Global Deterioration Scale (GDS) for disease severity, the Mini-Mental State Examination (MMSE) for cognition, the Functional Autonomy Measurement System (SMAF) for daily functioning, and the NeuroPsychiatric Inventory (NPI) for behaviour, measured at baseline and at 12 months. Logistic regression identified factors associated with GDS decline, and subsequent stepwise regression identified key independent predictors. Area under the curve (AUC) was then calculated for the model.

Results:

Among 488 patients (mean age 76.5 years [SD 6.4], MMSE 22.1 [SD4.6], 44.1% male), 225 (46%) showed GDS decline. After adjusting for age, baseline risk factors for deterioration included the following: poorer cognition (lower MMSE score, OR 0.55; 95% CI 0.4 to 0.72 per 5 points, P ≤ 0.001), greater dependence (lower SMAF, OR 0.72; 95% CI 0.63 to 0.83 per 5 points, P ≤ 0.001), and more neuropsychiatric symptoms (higher NPI, OR 1.11; 95% CI 1.02 to 1.2 per 5 points, P = 0.02), with a protective effect of male sex (OR 0.59; 95% CI 0.39 to 0.9, P = 0.02), and higher (worse) GDS score (very mild, compared with mild OR 0.25; 95% CI 0.09 to 0.70, P ≤ 0.01; compared with moderate, OR 0.08; 95% CI 0.03 to 0.23, P < 0.001; compared with moderately severe, OR 0.03; 95% CI 0.01 to 0.11, P < 0.001). The AUC was 73% (P < 0.001) (sensitivity 90% and specificity 33%).

Conclusion:

The progression of Alzheimer disease in Canada can be predicted using readily available clinical information.     

Does visuospatial memory in senile dementia of the Alzheimer type depend on the severity of the disorder?

Visuospatial memory was studied in patients suffering from senile dementia of the Alzheimer type (SDAT). They had been allocated into one of two groups depending on the severity of their disorder (mild or moderate), and a control group of healthy elderly subjects was included. Three different microcomputer-controlled tasks were used. The spatial span task was able to distinguish between the two SDAT groups. Both groups were impaired, relative to control, on spatial recognition. The deficit in spatial working memory was also equivalent in the mild and moderate groups and was accompanied by evidence of an intact strategic approach to the task. The normal positive relationship between spatial memory performance and strategy was in fact reversed in the SDAT groups, suggesting a pure spatial memory deficit. These results show that spatial memory processes are impaired in the early stages of SDAT and get worse as the disease progresses. They also suggest that the neuroanatomical foci of the deficits may be predominantly in posterior cortical regions (including hippocampus), rather than the frontal cortex.     

吸烟与阿尔茨海默病

目的 探讨吸烟与阿尔茨海默病(AD)的关系。方法 以社区为基础进行1：1配对病例对照研究。结果 共282对患者和对照者纳入研究，与≥50岁以后不吸卷烟者相比，50岁以后吸烟量为0．1～9．9包年者的OR值为0．748(95％CI：0．536～1．045)，吸烟量≥10包年者的OR值为0．560(95％CI：0．287～1．091，P=0．0884)。被动吸烟与AD无显著性联系(P=0．9568)。结论 ≥50岁时吸卷烟可能对AD有保护作用，且两者间的联系有边缘统计学意义，因此值得扩大样本量或选取暴露率更高的目标人群进一步研究。     

Alzheimer disease

In an attempt to determine the risks for and kinds of dementia most prevalent among the African American population, the Alzheimer's Disease Research Center at the University of Pittsburgh developed a community satellite program specifically targeting the African American and historically medically underserved communities in Allegheny County, PA. The primary mission of the Alzheimer Outreach Center (AOC) was to increase the awareness of AD among the targeted population. The number of nonwhite patients participating in the studies at ADRC increased from 2 to 16% in the first year of the program. In May 1995, the AOC became a permanent ADRC program.     

Creutzfeldt－Jakob病与Alzheimer病并存

本文报告１例病程长达１２年，经组织病理与免疫组化染色方法证实的Ｃｒｅｕｔｚｆｅｌｄｔ－Ｊａｋｏｂ病与Ａｌｚｈｅｉｍｅｒ病并存病例。