Royall D R, Polk M
Department of Psychiatry, South Texas Veterans Healthcare System, San Antonio, USA.
J Am Geriatr Soc. 1998 Jan;46(1):98-105. doi: 10.1111/j.1532-5415.1998.tb01022.x.
There are distinct qualitative differences between the dementias that present with and without posterior cortical features. These can be utilized in dementia assessment. This paper reviews the validity and potential utility of a dichotomy based on generalized cortical (Type 1) versus isolated frontal system pathology (Type 2). These syndromes are associated with distinct differentials and problem behaviors. They may also result in different caregiving burdens or treatment responses. Alzheimer's disease (AD) is by far the most common cause of the Type 1 syndrome. Type 2 presentations select for potentially reversible non-AD conditions. Common cognitive screening instruments are insensitive to Type 2 cases. However, the Type 1/Type 2 distinction can be made reliably using qualitative clinical rating scales. We will review these instruments and discuss their application in clinical settings.
伴有和不伴有后皮质特征的痴呆症之间存在明显的质性差异。这些差异可用于痴呆症评估。本文回顾了基于广泛性皮质病变（1型）与孤立性额叶系统病变（2型）二分法的有效性和潜在实用性。这些综合征与不同的鉴别诊断和问题行为相关。它们还可能导致不同的护理负担或治疗反应。阿尔茨海默病（AD）是迄今为止1型综合征最常见的病因。2型表现提示可能为可逆转的非AD疾病。常见的认知筛查工具对2型病例不敏感。然而，使用质性临床评定量表可以可靠地区分1型和2型。我们将回顾这些工具并讨论它们在临床环境中的应用。
