Srinivas P
Department of Medicine, University of Malaya, Kuala Lumpur.
Med J Malaysia. 1999 Dec;54(4):541-9; quiz 550.
Alzheimer's disease (AD) has become recognised as a major cause of morbidity and mortality in the ageing population worldwide. Over 20 million people worldwide are affected by AD, which ensures that the disease imposes a major economic burden. Alzheimer's disease is a progressive neurodegenerative disorder with characteristic clinical and neuropathological features. Neurofibrillary tangles, neuritic plaques and amyloid angiopathy occur in varying severity in brains of patient's with Alzheimer's disease. Biological markers of AD allowing an early definitive premorbid diagnoses are currently not available. Memory loss for recent events is invariable and often the earliest prominent symptom. Language disorders, difficulties with complex tasks, depression, psychotic symptoms and behavioral changes are other common manifestations of AD. Diagnosis involves the early detection of cognitive decline and ruling out other causes of dementia like vascular dementia, Lewy body dementia, fronto-temporal degeneration or reversible causes like hypothyroidism. Acetylcholinesterase inhibitors have shown to be effective in mild to moderate AD in improving the cognitive function of patients in clinical trials. Caregiver intervention programs have considerable potential to improve both the caregiver and patient quality of life.
阿尔茨海默病（AD）已被公认为全球老年人口发病和死亡的主要原因。全球超过2000万人受AD影响，这使得该疾病带来了重大经济负担。阿尔茨海默病是一种具有特征性临床和神经病理学特征的进行性神经退行性疾病。神经原纤维缠结、神经炎性斑块和淀粉样血管病变在阿尔茨海默病患者大脑中的严重程度各不相同。目前尚无能够进行早期明确的病前诊断的AD生物学标志物。近期事件的记忆丧失是必然的，且往往是最早出现的突出症状。语言障碍、复杂任务困难、抑郁、精神症状和行为改变是AD的其他常见表现。诊断包括早期发现认知衰退并排除其他痴呆原因，如血管性痴呆、路易体痴呆、额颞叶变性或甲状腺功能减退等可逆原因。在临床试验中，乙酰胆碱酯酶抑制剂已显示出对轻至中度AD有效，可改善患者的认知功能。护理者干预计划在改善护理者和患者生活质量方面具有相当大的潜力。
