Rabinovici Gil D, Carrillo Maria C, Forman Mark, DeSanti Susan, Miller David S, Kozauer Nicholas, Petersen Ronald C, Randolph Christopher, Knopman David S, Smith Eric E, Isaac Maria, Mattsson Niklas, Bain Lisa J, Hendrix James A, Sims John R
Memory & Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
Division of Medical & Scientific Relations, Alzheimer's Association, Chicago IL, USA.
Alzheimers Dement (N Y). 2016 Sep 20;3(1):83-91. doi: 10.1016/j.trci.2016.09.002. eCollection 2017 Jan.
Dementia is often characterized as being caused by one of several major diseases, such as Alzheimer's disease (AD), cerebrovascular disease, Lewy body disease, or a frontotemporal degeneration. Failure to acknowledge that more than one entity may be present precludes attempts to understand interactive relationships. The clinicopathological studies of dementia demonstrate that multiple pathologic processes often coexist. How overlapping pathologic findings affect the diagnosis and treatment of clinical AD and other dementia phenotypes was the topic taken up by the Alzheimer's Association's Research Roundtable in October 2014. This review will cover the neuropathologic basis of dementia, provide clinical perspectives on multiple pathologies, and discuss therapeutics and biomarkers targeting overlapping pathologies and how these issues impact clinical trials.High prevalence of multiple pathologic findings among individuals with clinical diagnosis of AD suggests that new treatment strategies may be needed to effectively treat AD and other dementing illnesses.
痴呆症通常被认为是由几种主要疾病之一引起的，如阿尔茨海默病（AD）、脑血管疾病、路易体病或额颞叶变性。如果不承认可能存在多种病因，就无法理解它们之间的相互作用关系。痴呆症的临床病理研究表明，多种病理过程常常同时存在。2014年10月，阿尔茨海默病协会研究圆桌会议探讨了重叠的病理发现如何影响临床AD及其他痴呆症表型的诊断和治疗。本综述将涵盖痴呆症的神经病理学基础，提供关于多种病理情况的临床观点，并讨论针对重叠病理情况的治疗方法和生物标志物，以及这些问题如何影响临床试验。临床诊断为AD的个体中多种病理发现的高发生率表明，可能需要新的治疗策略来有效治疗AD和其他痴呆性疾病。
