Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
Curr Psychiatry Rep. 2018 Oct 27;20(12):117. doi: 10.1007/s11920-018-0978-8.
To explore the most recent developments in the effective diagnosis and treatment of neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD).
The clinical diagnosis of NPS in AD is facilitated by the use of the Neuropsychiatric Inventory (NPI). CT and MRI scans can be useful for detecting structural changes indicating AD. Other promising diagnostic methodologies that are less frequently used in the clinical setting include positron emission tomography (PET) scans for detecting amyloid and blood tests for detecting serum biomarkers. Numerous pharmaceutical agents have been studied for their use in managing NPS, with antipsychotics being popular for managing agitation but also having significant side effects. Non-pharmacological interventions, such as reminiscence therapy and the Describe, Investigate, Create, Evaluate (DICE) approach may be able to provide treatment without such adverse effects. Diagnosing AD and the comorbid NPS remains primarily a clinical endeavor with CT and MRI scans sometimes used, but evidence is amassing for the use of other imaging modalities and different lab tests for convenient and empiric diagnosis of AD to distinguish it from other psychiatric illnesses. The number of pharmacologic treatments for NPS that are safe as well as efficacious remains limited, yet non-pharmacologic interventions have clear clinical utility. In addition to searching for more successful pharmacological treatments, further research should focus on novel diagnostic tests and non-pharmacologic therapies.
探讨阿尔茨海默病（AD）患者神经精神症状（NPS）有效诊断和治疗的最新进展。
使用神经精神问卷（NPI）有助于 AD 患者 NPS 的临床诊断。CT 和 MRI 扫描可用于检测表明 AD 的结构变化。其他有前途的诊断方法在临床环境中使用较少，包括正电子发射断层扫描（PET）用于检测淀粉样蛋白和血液测试用于检测血清生物标志物。已经研究了许多药物来治疗 NPS，抗精神病药常用于治疗激越，但也有显著的副作用。非药物干预，如怀旧疗法和描述、调查、创造、评估（DICE）方法，可能能够提供没有这种副作用的治疗。AD 和合并的 NPS 的诊断主要仍是临床工作，有时会使用 CT 和 MRI 扫描，但越来越多的证据表明，使用其他成像方式和不同的实验室测试可以方便地进行 AD 的经验诊断，将其与其他精神疾病区分开来。安全有效的 NPS 治疗药物数量仍然有限，但非药物干预具有明显的临床实用性。除了寻找更成功的药物治疗方法外，还应进一步研究新的诊断测试和非药物治疗方法。
