Ritchie K, Touchon J
Institut National de la Santé et de la Recherche Médicale, CHRU Lapeyronie, Montpellier, France.
J Clin Epidemiol. 1992 Dec;45(12):1391-8. doi: 10.1016/0895-4356(92)90201-w.
Although senile dementia of the Alzheimer type (SDAT) is commonly referred to as a disease involving global intellectual deterioration, clinical reports suggest the existence of variable patient profiles. A review of the clinical and biological research reporting heterogeneity in SDAT is summarized in terms of three descriptive models representing stage, compensation and sub-type hypotheses. Together the results suggest the existence of both quantitative and qualitative differences within a SDAT population. While the former may be partly attributable to the use in cross-sectional studies of persons at different stages of the disorder, qualitative differences in clinical evolution, variable patterns in regional cerebral blood flow, genetic markers and type of cognitive deficit strongly suggest the existence of different groups. This hypothesis requires verification by longitudinal neurological and psychometric studies of elderly persons with early dementia.
尽管阿尔茨海默型老年痴呆症（SDAT）通常被认为是一种涉及整体智力衰退的疾病，但临床报告显示存在不同的患者特征。对有关SDAT异质性的临床和生物学研究报告的综述，依据代表阶段、代偿和亚型假说的三种描述模型进行了总结。总体结果表明，SDAT人群中存在数量和质量上的差异。前者可能部分归因于在横断面研究中使用了处于该疾病不同阶段的人群，而临床演变中的质量差异、局部脑血流的可变模式、基因标记以及认知缺陷类型，都有力地表明存在不同的群体。这一假说需要通过对早期痴呆老年人进行纵向神经学和心理测量学研究来验证。
