阿尔茨海默病的流行病学。

Epidemiology of Alzheimer disease.

机构信息

Gertrude H. Sergievsky Center, Columbia University Medical Center, 630 West 168th Street, New York, NY 10032, USA.

出版信息

Nat Rev Neurol. 2011 Mar;7(3):137-52. doi: 10.1038/nrneurol.2011.2. Epub 2011 Feb 8.

Abstract

The global prevalence of dementia is estimated to be as high as 24 million, and is predicted to double every 20 years through to 2040, leading to a costly burden of disease. Alzheimer disease (AD) is the leading cause of dementia and is characterized by a progressive decline in cognitive function, which typically begins with deterioration in memory. Before death, individuals with this disorder have usually become dependent on caregivers. The neuropathological hallmarks of the AD brain are diffuse and neuritic extracellular amyloid plaques-which are frequently surrounded by dystrophic neurites-and intracellular neurofibrillary tangles. These hallmark pathologies are often accompanied by the presence of reactive microgliosis and the loss of neurons, white matter and synapses. The etiological mechanisms underlying the neuropathological changes in AD remain unclear, but are probably affected by both environmental and genetic factors. Here, we provide an overview of the criteria used in the diagnosis of AD, highlighting how this disease is related to, but distinct from, normal aging. We also summarize current information relating to AD prevalence, incidence and risk factors, and review the biomarkers that may be used for risk assessment and in diagnosis.

摘要

全球痴呆症的患病率估计高达 2400 万,预计到 2040 年每 20 年翻一番,导致疾病负担沉重。阿尔茨海默病(AD)是痴呆症的主要原因,其特征是认知功能逐渐下降,通常从记忆恶化开始。患有这种疾病的人在死前通常已经依赖护理人员。AD 大脑的神经病理学标志是弥漫性和神经突细胞外淀粉样斑块,这些斑块通常被营养不良的神经突包围,以及细胞内神经原纤维缠结。这些标志性病变通常伴随着反应性小胶质细胞的存在和神经元、白质和突触的丧失。AD 中神经病理学变化的病因机制仍不清楚,但可能受到环境和遗传因素的影响。在这里,我们提供了 AD 诊断中使用的标准概述,强调了这种疾病与正常衰老的关系,但又有所不同。我们还总结了目前关于 AD 患病率、发病率和危险因素的信息,并回顾了可能用于风险评估和诊断的生物标志物。

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