Kramer J H, Miller B L
University of California, San Francisco Medical Center, USA.
Semin Neurol. 2000;20(4):447-54. doi: 10.1055/s-2000-13177.
Alzheimer's disease (AD) is the most common form of dementia in elderly individuals. Although the diagnosis of AD requires pathological confirmation, several common clinical features of AD have been identified. These include insidious onset, gradual progression, medial temporal atrophy, temporoparietal hypoperfusion, early and prominent deficits in episodic memory and mental tracking, and later deficits in semantic memory. These characteristic features of AD have enabled excellent in vivo diagnostic sensitivity. It has become increasingly clear, however, that AD is a heterogeneous disorder. The left and right cerebral hemispheres can be affected to varying degrees, and variability on the anterior-posterior axis has also been reported. AD can also present as a focal degenerative disease, and clinicians must be aware that there may be diagnostic overlap between AD, primary progressive aphasia, posterior cortical atrophy, corticobasal degeneration, and frontotemporal dementia.
阿尔茨海默病（AD）是老年人中最常见的痴呆形式。尽管AD的诊断需要病理证实，但已确定了AD的几种常见临床特征。这些特征包括隐匿起病、逐渐进展、内侧颞叶萎缩、颞顶叶灌注不足、情景记忆和心理追踪早期及显著缺陷，以及后期语义记忆缺陷。AD的这些特征使得其在活体诊断中具有出色的敏感性。然而，越来越清楚的是，AD是一种异质性疾病。左右大脑半球可能受到不同程度的影响，并且前后轴上的变异性也有报道。AD也可表现为局灶性退行性疾病，临床医生必须意识到AD、原发性进行性失语、后皮质萎缩、皮质基底节变性和额颞叶痴呆之间可能存在诊断重叠。
