Lôo Henri, Gallarda Thierry, Amado Isabelle, Olie Jean-Pierre
L'Académie Nationale de Médecine.
Bull Acad Natl Med. 2005 Oct;189(7):1383-90; discussion 1390-1.
Clinical signs and symptoms preceding the onset of dementia are sometimes acute, such as mood disorders often associated with hypochondriacal traits and cognitive slowing, sudden and serious suicide attempts, character and conduct disorders contrasting with the previous state, and psychotic disorders presenting as pathological mistrust, or ill-structured prejudice or persecution. Most forerunning symptoms reflect a progressive deterioration of cognitive functions over a long period, that have been masked by various coping strategies used by the patient with the spouse's help. Progressive cognitive deficits may develop over years before dementia can be diagnosed with confidence. Quantitative tools can help to detect dementia incipiens, such as the Folstein Mini Mental Test, the Mattis Dementia Scale, the five-word learning test, the clock drawing test, and the brief cognitive battery. The profile of early cognitive deterioration varies according to the type of dementia (Alzheimer's disease, fronto-temporal dementia, Lewy body dementia, and vascular dementia). The symptoms of dementia may be interlinked with symptoms of other disorders. Neuropsychological tests and brain imaging are needed to validate the diagnosis.
痴呆症发作前的临床体征和症状有时较为急性，例如常伴有疑病特质和认知迟缓的情绪障碍、突然且严重的自杀企图、与先前状态不同的性格和行为障碍，以及表现为病理性不信任、结构不良的偏见或迫害妄想的精神障碍。大多数前驱症状反映了认知功能在很长一段时间内的渐进性衰退，这些衰退被患者在配偶帮助下采用的各种应对策略所掩盖。在能够确诊痴呆症之前，渐进性认知缺陷可能会持续数年。定量工具有助于检测早期痴呆症，如福斯汀简易精神状态检查表、马蒂斯痴呆评定量表、五字学习测试、画钟测试和简短认知成套测验。早期认知衰退的特征因痴呆症类型（阿尔茨海默病、额颞叶痴呆、路易体痴呆和血管性痴呆）而异。痴呆症的症状可能与其他疾病的症状相互关联。需要进行神经心理学测试和脑部成像来验证诊断。
