Moretti Rita, Torre Paola, Antonello Rodolfo M, Pizzolato Gilberto
Università di Trieste, Dipartimento di Medicina Clinica e Neurologia, UCO di Neurologia dell'Università degli Studi di Trieste, Ospedale di Cattinara, 34149 Trieste, Italy.
Expert Rev Neurother. 2006 May;6(5):705-10. doi: 10.1586/14737175.6.5.705.
Behavioral problems produce excess disability that can be potentially devastating in cognitively impaired patients. These behavioral symptoms can be a major cause of stress, anxiety and concern for caregivers. While psychotropic drugs are frequently used to control these symptoms, they have the potential for significant side effects, which include sedation, disinhibition, depression, falls, incontinence, parkinsonism and akathisias. On examination of the consequences of adverse events, somnolence, as well as postural instability and postural hypotension, have been noted. All patients with Alzheimer's disease (AD) and other progressive dementias will advance through stages of moderate-to-severe AD unless effective treatments suspend transition from mild deterioration to dementia, or competitive mortality truncates survival. Treatment trials suggest that these patients respond to both disease-modifying (such as inhibitors of cholinesterase and butirrylcholinesterase) and symptomatic (such as neuroleptics) agents. Relatively few studies have been conducted in this patient population, and more information regarding the type of behavioral disturbances exhibited, how best to measure them in this disabled population and their optimum treatment are urgently needed.
行为问题会导致额外的残疾，这对认知受损患者可能具有潜在的毁灭性。这些行为症状可能是护理人员压力、焦虑和担忧的主要原因。虽然精神药物经常用于控制这些症状，但它们有产生显著副作用的可能性，这些副作用包括镇静、去抑制、抑郁、跌倒、尿失禁、帕金森综合征和静坐不能。在检查不良事件的后果时，已注意到嗜睡以及姿势不稳和体位性低血压。所有阿尔茨海默病（AD）和其他进行性痴呆患者都会经历中度至重度AD阶段，除非有效的治疗能中止从轻度恶化到痴呆的转变，或者竞争性死亡率缩短生存期。治疗试验表明，这些患者对疾病修饰药物（如胆碱酯酶和丁酰胆碱酯酶抑制剂）和对症药物（如抗精神病药）均有反应。针对这一患者群体开展的研究相对较少，因此迫切需要更多关于所表现出的行为障碍类型、在这一残疾人群体中如何最好地对其进行测量以及其最佳治疗方法的信息。
