Thal L J, Grundman M, Klauber M R
Neurology Service, VA Medical Center, San Diego, CA 92161.
Neurology. 1988 Jul;38(7):1083-90. doi: 10.1212/wnl.38.7.1083.
We evaluated in a standard fashion 375 patients presenting with complaints of memory loss. Etiology of memory loss included senile dementia of the Alzheimer type (SDAT)-70%, vascular dementia-5%, mixed dementia (SDAT + vascular)-9%, and other etiologies-16%. Incontinence, transient symptoms, and gait disturbances occurred more frequently in vascular dementia than in SDAT. A history of cardiovascular disease and stroke was more common in vascular dementia than SDAT. Disturbances of gait, bradykinesia, and pyramidal tract findings were commonly seen in vascular dementia. Advanced technology aided diagnosis in only 6% of patients and CT was the most useful of such tests. An earlier age of onset was noted in those with a positive family history of SDAT. Duration of symptoms at presentation for SDAT patients varied inversely with the rate of progression of dementia 15 to 55 months later, suggesting that individuals who progress more slowly require more time to elapse before the family or patient realizes the need for medical attention.
我们以标准方式评估了375例主诉记忆力丧失的患者。记忆力丧失的病因包括阿尔茨海默型老年痴呆症（SDAT）——70%，血管性痴呆——5%，混合性痴呆（SDAT + 血管性）——9%，以及其他病因——16%。血管性痴呆患者出现失禁、短暂症状和步态障碍的频率高于SDAT患者。血管性痴呆患者有心血管疾病和中风病史的情况比SDAT患者更常见。步态障碍、运动迟缓以及锥体束征在血管性痴呆中很常见。先进技术仅在6%的患者中辅助了诊断，CT是这类检查中最有用的。有SDAT家族史阳性的患者发病年龄更早。SDAT患者就诊时症状持续时间与15至55个月后痴呆进展速度呈反比，这表明进展较慢的个体在家庭或患者意识到需要医疗关注之前需要更长时间。
