Yaari Roy, Corey-Bloom Jody
Department of Neurosciences and the Alzheimer's Disease Research Center, University of California, San Diego, La Jolla, California 92161, USA.
Semin Neurol. 2007 Feb;27(1):32-41. doi: 10.1055/s-2006-956753.
Alzheimer's disease (AD) is the most common cause of dementia in the elderly. Currently, 4.5 million individuals in the United States are estimated to have AD, and that number is projected to increase to at least 14 million by the year 2050. AD is a major cause of disability and mortality, and its impact on health care costs, including direct and indirect medical and social service costs, is estimated to be greater than $100 billion per year. AD typically presents with an insidious decline in memory that progresses to affect language, visuospatial perception, calculations, and executive functioning. Behavioral and psychiatric symptoms are also frequent in AD. Diagnosis is determined clinically, as there is currently no laboratory test to confirm AD in life. The neuropathologic hallmarks of AD are neuritic plaques and neurofibrillary tangles. Currently available medical therapies have demonstrated modest benefits but likely do not alter disease progression. Caregivers play a large role in managing the patient and should be encouraged to seek out adult day care centers, home health services, respite care, and additional social support.
阿尔茨海默病(AD)是老年人痴呆最常见的病因。目前,据估计美国有450万人患有AD,预计到2050年这一数字将增至至少1400万。AD是导致残疾和死亡的主要原因,其对医疗保健费用的影响,包括直接和间接的医疗及社会服务费用,估计每年超过1000亿美元。AD通常隐匿起病,以记忆力减退为首发症状,随后逐渐进展至影响语言、视空间感知、计算及执行功能。行为和精神症状在AD患者中也很常见。由于目前尚无实验室检查可在生前确诊AD,其诊断主要依靠临床判断。AD的神经病理学特征为神经炎性斑块和神经原纤维缠结。目前可用的药物治疗已显示出一定益处,但可能无法改变疾病进展。护理人员在患者管理中发挥着重要作用,应鼓励他们寻求成人日托中心、居家健康服务、临时护理及其他社会支持。