Department of Gynecology, Federal University of São Paulo, UNIFESP/EPM, Sao Paulo, Brazil.
Best Pract Res Clin Obstet Gynaecol. 2013 Oct;27(5):661-72. doi: 10.1016/j.bpobgyn.2013.06.005. Epub 2013 Sep 3.
Improved medical, economic and socio-cultural conditions have increased life expectancy, especially for women. The incidence of hypertension, diabetes mellitus, psychiatric and degenerative brain diseases, especially stroke and dementia, are more frequently seen in older people. Each of these conditions can separately, or in combination, result in similar signs and symptoms of cognition, memory, mood and motor function disorders. Therefore, it is important to understand the effects of normal ovarian ageing and the menopause on the nervous system, as well as the hallmarks of disease entities; many of these are described here. Also, the complexity of these issues is increased by the similarity of their effects to those of the polypharmacy and metabolic imbalances that are common in this population. These are complex issues, and it may be difficult and time-consuming to discern between normal brain functional changes and specific pathology in practice. Early evaluation of correctable possibilities, including imaging studies, may be key to management. Referral to specialists for diagnosis before starting clinical treatment is useful to address these issues.
医疗、经济和社会文化条件的改善提高了预期寿命,尤其是女性的预期寿命。高血压、糖尿病、精神和退行性脑部疾病(尤其是中风和痴呆)的发病率在老年人中更为常见。这些疾病中的每一种都可能单独或联合导致认知、记忆、情绪和运动功能障碍的类似体征和症状。因此,了解正常卵巢衰老和更年期对神经系统的影响以及疾病实体的特征非常重要;这里描述了其中许多特征。此外,这些问题的复杂性因这些疾病实体的影响与该人群中常见的多药治疗和代谢失衡相似而增加。这些都是复杂的问题,在实践中,可能难以区分正常的大脑功能变化和特定的病理。早期评估包括影像学研究在内的可纠正的可能性可能是管理的关键。在开始临床治疗之前,向专家转诊以明确诊断对于解决这些问题非常有用。