老年期痴呆的诊断

The Diagnosis of Dementia in Elderly

一、老年期痴呆（一）老年期按世界卫生组织规定，发达国家为６５岁以上，发展中国家６０岁以上。（二）痴呆痴呆是一种以智能减退，行为及人格改变为主的临床综合征；是指病人有（近和远）记忆障碍，认知功能损害，如：失语、失用、失认、抽象思维或判断力损害：包括计划...

Elderly dementia(ED)is increasingly becoming one of the most serious social problems all over the world,especially in China ED is generally classified as Alzheimer′s dementia(AD),vascular dementia(VD),and other dementia(OD) Etiologically,AD is heterogeneous and can be produced by mutations of chromosomes 1,14,19 and 21 as well as by as yet unrecognized causative factors Clinical variations are common including differences in rate of progression,pattern of neuropsychological deficits, and occurrence of noncogitive neuropsychiatric symptoms Pathologically,characteristic findings include neuronal loss,neurofibrillary tangles,neuritic plaques,and amyloid angiopathy Thus,AD exhibits etiological,clinical and pathological diversity The widely used diagnostic criteria(ICD 10,DSM ⅢIVand NINCDS)for AD and their limitation are discussed critically The diagnostic accuracy of current clinical criteria for identification of AD is acceptable,but remains to be improved The improving recommendation of AD diagnostic criteria,the procedures in clinical diagnostic practice and in clinicopharmacologic research are proposed according to our own experience