DeKosky S T, Orgogozo J M
Alzheimer's Disease Center, University of Pittsburgh, Pennsylvania 15213, USA.
Alzheimer Dis Assoc Disord. 2001 Aug;15 Suppl 1:S3-7.
Alzheimer disease (AD) is the most frequent cause of dementia in developed Western countries. Over time, affected patients invariably develop cognitive and functional decline, and most develop early or later behavioral disturbances. Declining cognitive and functional abilities contribute to loss of independent living and feelings of denial, confusion, fear and guilt until, finally, the patient loses most abilities to think, move, speak, or perceive. As patients' dependency on assistance increases, the level of caregiver strain rises. The caregiver may develop feelings of anger, grief, loneliness and resentment, and the health and well-being of most caregivers are often affected. Approximately 3-4 million people currently have AD in the USA, at an annual cost of up to US$100 billion, and the disease is expected to reach epidemic proportions by 2020. To achieve a clinically relevant, long-term outcome, pharmacotherapy must have sustained favorable effects on cognitive, functional and behavioral symptoms of AD. Slowing the development of these features of the disease will mean a long-term improvement in quality of life for patients and caregivers. Postponing the emergence of behavioral symptoms would bring about direct beneficial effects on patients with AD and their families, help delay long-term care placement and lower costs.
阿尔茨海默病（AD）是西方发达国家痴呆症最常见的病因。随着时间的推移，受影响的患者不可避免地会出现认知和功能衰退，大多数患者迟早会出现行为障碍。认知和功能能力的下降导致独立生活能力丧失，并产生否认、困惑、恐惧和内疚感，最终患者会丧失大部分思考、行动、说话或感知能力。随着患者对他人帮助的依赖增加，照顾者的压力水平也会上升。照顾者可能会产生愤怒、悲伤、孤独和怨恨等情绪，大多数照顾者的健康和幸福也常常受到影响。目前美国约有300万至400万人患有AD，每年花费高达1000亿美元，预计到2020年该疾病将达到流行程度。为了实现具有临床意义的长期疗效，药物治疗必须对AD的认知、功能和行为症状产生持续的有利影响。减缓疾病这些特征的发展将意味着患者和照顾者生活质量的长期改善。推迟行为症状的出现将对AD患者及其家庭产生直接的有益影响，有助于推迟长期护理安置并降低成本。
