Poncet Michel
CHU de Marseille, hôpital de La Timone Adultes, service de neurologie, 13005 Marseille.
Rev Prat. 2011 Sep;61(7):914-9, 921.
Alzheimer's disease, which was considered to be a rare disease in subjects aged under 65 until the seventies/eighties, has become a very common disease affecting mostly older subjects. Many consider that it is important to review the meaning of the eponym "Alzheimer's disease", and a revolution, quite literally, is likely to occur. The role of vascular lesions in the onset of dementias among older subjects is widely acknowledged; considering those dementias as Alzheimer's disease may have negative consequences for patient management. Indeed, vascular lesions can be prevented and treated, while Alzheimer's lesions cannot. It may be justified to use "Alzheimer syndrome" instead of "Alzheimer's disease" when vascular risk factors and, all the more so, vascular lesions are present. Significant progress has been made in the understanding of the pathological proteins involved in Alzheimer's disease, as well as their effects on neurons and synapses. However, the etiology of the disease is still unknown, except in the rare hereditary cases, and there is no cure for Alzheimer's disease at present. Clinical research is progressing, and diagnostic criteria for the pre-dementia stage of Alzheimer's disease were suggested. In France, the outstanding Alzheimer plan 2008-2012 should play an important role in enhancing the understanding of Alzheimer's disease, Alzheimer's syndromes and related disorders.
直到七八十年代，阿尔茨海默病在65岁以下人群中还被视为罕见疾病，如今它已成为一种主要影响老年人群的常见疾病。许多人认为，重新审视“阿尔茨海默病”这一名称的意义很重要，而且很可能会发生一场名副其实的变革。血管病变在老年人群痴呆症发病中的作用已得到广泛认可；将这些痴呆症视为阿尔茨海默病可能会对患者管理产生负面影响。事实上，血管病变是可以预防和治疗的，而阿尔茨海默病的病变则无法治疗。当存在血管危险因素尤其是血管病变时，使用“阿尔茨海默综合征”而非“阿尔茨海默病”可能是合理的。在对阿尔茨海默病所涉及的病理蛋白及其对神经元和突触的影响的理解方面已经取得了重大进展。然而，除了罕见的遗传病例外，该病的病因仍然不明，目前也没有治愈阿尔茨海默病的方法。临床研究正在取得进展，并且有人提出了阿尔茨海默病痴呆前期的诊断标准。在法国，出色的《2008 - 2012年阿尔茨海默病计划》应该在增进对阿尔茨海默病、阿尔茨海默综合征及相关疾病的理解方面发挥重要作用。
