AD的诊断标准新进展(陈璇)解析.ppt

背 景 阿尔茨海默病 Alzheimer’s Disease 1907 Alois Alzheimer 老年人痴呆最常见形式 US：4.5 million (2000年) 13.2 million (2050年) 65岁：15% 85岁：50% 进展性 致命性 神经变性疾病 A β沉积 ？ 病 理 Footnote 2: Standard neuropsychological testing by a qualified neuropsychologist showing a significant decline (defined by statistically meaningful/reliable change in test scores) in a pattern of domains and at a rate consistent with AD-related change. Alternatively, clear-cut decline on a standardized bedside mental status examination could provide sufficient evidence for documented decline, provided the amount of decline meets local standards for clinically relevant decline. * * * Gary--I would change the display range so they can more easily see the deficits in ther normal memory APOE-4 patient. They only get a quick look need to easily see this. A 14 6 % change is a big one should seen easily in the was it is displayed. * Key Points Over the years, the medical community’s attitude and approach to dementia and its treatment has evolved immensely. Prior to the late 1800s, dementia was considered a part of the normal aging process. Senility, as it was referred to then, was expected to occur in every individual, should they live long enough to experience it. By the end of the 19th century, opinions on senility and dementia were starting to shift. It was recognized that dementia was in fact an abnormal process. And in the first few years, it was thought to be due to heart disease and atherosclerosis. Arteriosclerotic dementia became synonymous with senile dementia, albeit incorrectly. Cortical atrophy in the elderly was thought to result from declining cerebral perfusion causing neuronal death due to hypoxia.1 Vasodilators were therefore used to treat this condition. By the mid 1970s, AD was demonstrated to be the main cause of cerebral atrophy and dementia.1 Slightly later, the cholinergic hypothesis of AD became widely accepted together with the suggestion that cholinomimetics might be useful for