Forette F, Bouchacourt P, Hervy M P, Henry J F
Hôpital Broca, Paris.
Rev Epidemiol Sante Publique. 1987;35(3-4):282-6.
The difficulty of defining a precise nosologic framework for mental decline is linked, on the one hand, to the contradictions surrounding the term normalcy as age increases, and, on the other, to the fact that mental decline has been mired for years under a term that must be definitively proscribed: "psycho-compartmental disorders of senescence". In this catch-all++ proscribed: "psycho-compartmental disorders of senescence". In this catch++-all it is, in fact, essential to identify diseases whose nature, prognosis and, above all, therapeutic approaches differ fundamentally one from the other; to confuse them is to risk dramatic consequences. Standardization of diagnostic criteria through the combined use of clinical data, the DSM III classification, scored tests (MMS, Hachinsky, etc.), as well as scannography, presently makes it possible to arrive at the diagnosis of dementia with reasonable accuracy. This standardization++ has its limits and is not necessarily useful in atypical cases. It is nevertheless an indispensable tool for epidemiological studies and therapeutic trials.
为智力衰退定义一个精确的疾病分类框架存在困难，一方面与随着年龄增长围绕“正常”一词的矛盾有关，另一方面与智力衰退多年来一直深陷于一个必须明确摒弃的术语之下这一事实有关：“衰老的心理分隔障碍”。在这个涵盖一切的术语中，实际上，识别那些本质、预后尤其是治疗方法彼此根本不同的疾病至关重要；将它们混淆会带来严重后果。通过综合运用临床数据、《精神疾病诊断与统计手册》第三版分类、评分测试（简易精神状态检查表、哈金斯基缺血量表等）以及扫描成像技术来实现诊断标准的标准化，目前能够以合理的准确性得出痴呆症的诊断结果。这种标准化有其局限性，在非典型病例中不一定有用。然而，它对于流行病学研究和治疗试验而言是不可或缺的工具。
