Ellison James M
Harvard Medical School, USA.
JAMA. 2008 Oct 1;300(13):1566-74. doi: 10.1001/jama.300.9.jrr80008. Epub 2008 Sep 2.
Many older individuals experience or demonstrate cognitive impairment that is significantly abnormal for their age and education yet beneath the threshold for a diagnosis of dementia. This mild cognitive impairment causes minimal functional impairment and is often overlooked in clinical settings, yet affected individuals are at heightened risk for a range of adverse outcomes including conversion to dementia. The case of Ms E, a 60-year-old woman with mild memory impairment and white matter lesions on magnetic resonance imaging, provides an opportunity to consider the questions that face patient, family, and clinicians when mild cognitive symptoms prompt a search for diagnosis and management options. Discussion of her case reviews mild cognitive impairment with emphasis on an evidence-based approach to evaluation and treatment, including management of comorbid medical conditions, lifestyle changes, and pharmacotherapy.
许多老年人存在或表现出认知障碍,这种认知障碍相对于他们的年龄和教育水平而言明显异常,但尚未达到痴呆症的诊断阈值。这种轻度认知障碍导致的功能损害极小,在临床环境中常常被忽视,然而受影响的个体面临一系列不良后果的风险增加,包括转化为痴呆症。E女士是一名60岁女性,有轻度记忆障碍且磁共振成像显示有白质病变,她的案例为我们提供了一个机会,来思考当轻度认知症状促使人们寻求诊断和管理方案时,患者、家庭和临床医生所面临的问题。对她的病例讨论回顾了轻度认知障碍,重点是基于证据的评估和治疗方法,包括合并症的管理、生活方式改变和药物治疗。