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神经心理学评估在阿尔茨海默病与血管性痴呆鉴别诊断中的作用。

Role of neuropsychological assessment in the differential diagnosis of Alzheimer's disease and vascular dementia.

作者信息

Pimentel Érica Maria Lima

机构信息

Universidade Federal do Ceará (UFC) e Pós-graduada em Neuropsicologia pela Faculdade Christus, Fortaleza, CE, Brazil.

出版信息

Dement Neuropsychol. 2009 Jul-Sep;3(3):214-221. doi: 10.1590/S1980-57642009DN30300007.

Abstract

The prevalence of dementia increases significantly from the age of 65 years, doubling every five years thereafter. Alzheimer's disease (AD) and vascular dementia (VaD) constitute the two main dementia types. Differentiating them encompasses anamnesis, neurological examination, laboratory and neuroimaging exams and neuropsychological assessment. Neuropsychological assessment produces different findings for each dementia type, and reveals those areas most impaired as well as those most preserved. The aim of the present article was to describe the role of neuropsychology in diagnosing dementia and achieving a differential diagnosis between AD and VaD. A general overview follows of the most widely known instruments used to assess cognitive function in dementia, and the cognitive changes seen in AD and VaD. The conclusion drawn was that there is significant overlap in cognitive changes between both these dementia types, while each type has its own specific characteristics which are identifiable and quantifiable on neuropsychological assessments and provide the basis for reaching a differential diagnosis.

摘要

痴呆症的患病率从65岁起显著增加,此后每五年翻一番。阿尔茨海默病(AD)和血管性痴呆(VaD)是两种主要的痴呆类型。对它们进行鉴别包括问诊、神经学检查、实验室和神经影像学检查以及神经心理学评估。神经心理学评估对每种痴呆类型会产生不同的结果,并揭示受损最严重的区域以及保存最完好的区域。本文的目的是描述神经心理学在痴呆症诊断以及AD和VaD鉴别诊断中的作用。接下来是对痴呆症认知功能评估中最广为人知的工具以及AD和VaD中所见认知变化的概述。得出的结论是,这两种痴呆类型的认知变化存在显著重叠,而每种类型都有其自身的特定特征,这些特征在神经心理学评估中是可识别和量化的,并为做出鉴别诊断提供依据。

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