Myakotnykh V S
Ural state medical University, 3 Repin str., Yekaterinburg 620028, Russian Federation; e-mail:
Adv Gerontol. 2019;32(1-2):112-120.
The article deals with the important issue of diagnosis and treatment of Alzheimer's disease in the elderly and senile age. Despite the fact that this disease is considered, of course, age-associated pathology, which is the main cause of senile dementia, its diagnosis in Russia is exhibited rather rarely compared with dementia, for example, of vascular origin. This is due, in the author's opinion, not only with the difficulties of in-vivo diagnosis of Alzheimer's disease, but, first of all, with the characteristic of the elderly and senile multiplicity of pathological processes. A significant part of these pathologic processes, as well as Alzheimer's disease, can cause increasing cognitive disorders. Under this condition, dementia is already considered as a multi-factorial disease even in cases where Alzheimer's disease is the leading factor. This position, in turn, requires the expansion of the diagnostic search even in cases of full confidence in the diagnosis of Alzheimer's disease in the elderly and senile age to determine the possible role of other pathological processes in the formation and development of dementia. Ultimately, with limited opportunities for treatment of Alzheimer's disease, this will help in the selection of treatment methods aimed at reducing the role of other etiological and pathogenic moments in the development of dementia of mixed Genesis in the elderly and senile.
本文探讨了老年期阿尔茨海默病的诊断与治疗这一重要问题。尽管这种疾病当然被认为是与年龄相关的病理状态,是老年痴呆的主要原因,但与血管性痴呆等相比,其在俄罗斯的诊断率相对较低。作者认为,这不仅是因为阿尔茨海默病活体诊断存在困难,更主要的是老年期病理过程具有多样性的特点。这些病理过程中的很大一部分,与阿尔茨海默病一样,会导致认知障碍不断加重。在这种情况下,即使阿尔茨海默病是主要因素,痴呆也已被视为一种多因素疾病。反过来,这一观点要求即使在对老年期阿尔茨海默病诊断完全有信心的情况下,也要扩大诊断范围,以确定其他病理过程在痴呆形成和发展中可能起到的作用。最终,鉴于阿尔茨海默病的治疗机会有限,这将有助于选择旨在减少其他病因和致病因素在老年期和高龄期混合性痴呆发展中作用的治疗方法。