Thind K, Sabbagh M N
The Cleo Roberts Center for Clinical Research, Sun Health Research Institute, Sun City, AZ 85351, USA.
Panminerva Med. 2007 Dec;49(4):191-5.
Although Alzheimer's disease (AD) has been investigated for more than 100 years, it was not until the 60s that quantitative measures of the disease progression and severity in relation to function and neuropathology were made by Blessed and his colleagues. With the increasing understanding of the pathological changes of AD that take place, there is growing interest in identifying which pathological marker most reliably predicts the dementia and the cognitive profile. Markers of pathology that have been investigated include senile plaques, neurofibrillary tangles, synaptic loss, and neurochemical changes. Many clinical measures have been evaluated as well including Clinical Dementia Rating, Mini Mental State Examination, and Functional Assessment Staging as ways of both predicting the presence of pathological changes of AD as well as correlating with the specific measures of pathology. Accumulation of neuropathology appears to correlate with functional, global, and cognitive decline as people progress through AD. This review will summarize evidence of which neuropathological change correlates robustly with cognitive decline and which cognitive index predicts pathological changes in AD. In general, tangles and synaptic loss are better correlates of cognitive decline and correlate better.
尽管阿尔茨海默病（AD）已被研究了100多年，但直到60年代，Blessed及其同事才对该疾病与功能和神经病理学相关的进展和严重程度进行了定量测量。随着对AD发生的病理变化的认识不断加深，人们越来越有兴趣确定哪种病理标志物最可靠地预测痴呆症和认知特征。已被研究的病理标志物包括老年斑、神经原纤维缠结、突触丧失和神经化学变化。许多临床测量方法也得到了评估，包括临床痴呆评定量表、简易精神状态检查表和功能评估分期，这些方法既可以预测AD病理变化的存在，也可以与具体的病理测量方法相关联。随着人们病情发展至AD阶段，神经病理学的积累似乎与功能、整体和认知衰退相关。本综述将总结哪些神经病理学变化与认知衰退密切相关，以及哪种认知指标可预测AD中的病理变化的证据。一般来说，缠结和突触丧失与认知衰退的相关性更好。
