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Alzheimer症十大预警信号
http://www.100md.com 2001年5月8日
     Ten Warning Signs of Disease

    PHILADELPHIA (Reuters Health) - Early recognition and diagnosis of Alzheimer's disease is becoming increasingly important given an ``explosion of information'' of the memory-robbing disorder in recent years, experts at the American Academy of Neurology announced here on Monday at their annual meeting.

    While once considered to be a disease that could only be reliably diagnosed by autopsy after death, the group said this is no longer true. The group last issued treatment guidelines on Alzheimer's disease in 1994.
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    ``The main message for physicians to take home is that Alzheimer's disease can be reliably diagnosed,'' Dr. James C. Stevens, of the Indiana University School of Medicine in Bloomington, told Reuters Health.

    About 95% of patients with Alzheimer's disease can be accurately diagnosed with the disease while they're living, Stevens added. ``This is important as treatments are becoming available that seem to impact disease as far as cognitive function, standard of living and behavioral function go.''
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    And while the disease is incurable, there are treatment options. The group issued a list of early warning signs of the disease, including:

    -- memory loss that affects job skills, -- difficulty performing familiar tasks, -- language problems, -- getting lost, or being disoriented as to time and place, -- poor judgment, -- problems with abstract thinking, -- misplacing objects, -- changes in mood and behavior, -- personality changes, -- loss of initiative.
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    To better rule out other causes of memory loss or dementia, brain imaging, whether it is computed tomography (CT) or magnetic resonance imaging (MRI), is now recommended, according to the group. Genetic testing, however, has not been found to be particularly useful and is not recommended. Some genes have been found to increase the risk of the disorder.

    ``Patients and their caregivers are better prepared to deal with the disease if diagnosis is made earlier than later,'' said Dr. Steven T. DeKosky, of the University of Pittsburgh, at the American Academy of Neurology's annual meeting. ``We believe public health issues of early detection and diagnosis will help in the development of more effective treatment.''
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    Drugs known as cholinesterase inhibitors appear to be a promising way to delay the progression of Alzheimer's disease, said Dr. Jeffrey L Cummings, of the University of California at Los Angeles.

    In addition, the evidence is strong that antipsychotic medications are useful in the treatment of Alzheimer's-related agitation and psychosis--a loss of contact with reality. The evidence is ``fair'' that ``antidepressants should be used for Alzheimer's disease patients with depressive symptoms,'' Cummings added.
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    The guidelines also highlight the finding that the use of music and exercise therapy in later stages of the disease are effective in managing behavior.

    The guidelines incorporate the new information that has come to light in recent years, Stevens said. ``It says that patients who come into a doctor's office complaining of mild cognitive impairment should no longer to be dismissed and reassured that nothing is wrong. That patient needs to be evaluated and followed.''
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    The multidisciplinary panel of 21 experts that developed the guidelines examined more than 1,000 studies. Their efforts have resulted in a list of 43 ``action-oriented'' clinical recommendations.

    ``Our challenge is to increase the public's knowledge, that losing one's memory in old age is no longer just to be expected,'' DeKosky said. ``Alzheimer's disease is clearly different from normal aging. People need no longer accept that they will lose their thinking ability as they grow older.'', 百拇医药