Steffens D C, Morgenlander J C
Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina 27710, USA.
Postgrad Med. 1999 Oct 15;106(5):72-6, 79-80, 82-3. doi: 10.3810/pgm.1999.10.15.745.
The initial clinical approach to suspected dementia involves asking the right questions of the patient and a knowledgeable family member or caregiver. These questions should focus on the nature of the cognitive problem (e.g., the onset, duration, and severity of memory difficulties). The clinical interview is supplemented with thorough examination of the patient's physical, neurologic, mental, and functional status. Once a diagnosis of dementia is established, the underlying cause should be identified by a standardized workup, including laboratory testing and, in most cases, neuroimaging. Genetic testing for the APOE epsilon 4 allele can help confirm the diagnosis in patients with late-onset familial or sporadic Alzheimer's disease.
对于疑似痴呆症的初步临床诊断方法包括向患者以及知识渊博的家庭成员或护理人员提出恰当的问题。这些问题应聚焦于认知问题的本质（例如记忆困难的起病、持续时间和严重程度）。临床问诊还需辅以对患者身体、神经、精神和功能状况的全面检查。一旦确诊为痴呆症，应通过标准化检查来确定潜在病因，包括实验室检测，且在大多数情况下还需进行神经影像学检查。对APOE ε4等位基因进行基因检测有助于确诊晚发性家族性或散发性阿尔茨海默病患者。
