痴呆病的诊断标准。有什么新鲜事吗?

Edith Labos, Claudia Verónica Bavec, Diana Cristalli, Florencia Deschle, Cristian Isaac, Guido Dorman, Juan Ollari, Valeria Rubiño, María Julieta Russo
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摘要

主要影响认知和行为的神经退行性疾病的范围从无症状的临床前疾病到非常轻微的认知障碍再到坦率的痴呆。阿尔茨海默病(AD)是导致认知能力下降的最常见原因。此外,这是一种毁灭性的疾病,会影响到患者及其照顾者的整个家庭,造成巨大的经济困难。诊断可能会因其他形式的痴呆症而变得复杂,这些痴呆症的症状和病理与阿尔茨海默病相似。了解每种痴呆症的主要特征和病理可以帮助患者准确诊断,因此他们将接受适合其病情的治疗和支持服务,并保持日常生活中尽可能高的功能和生活质量。根据临床标准、神经病理学和生物标志物,将阿尔茨海默氏症及其非典型变体与其他常见痴呆(包括路易体痴呆、血管性认知障碍、额颞叶变性和不常见的认知障碍)区分。现在,对痴呆症进行准确和早期的诊断对于做出有关治疗、支持和护理的重要决定越来越重要。一旦获得诊断,非药物和药物干预都应开始。识别阿尔茨海默病的生化标志物在该病的新诊断标准和AD的最新生物学定义中发挥着核心作用。这篇综述文章介绍了关于阿尔茨海默病和相关疾病的最新诊断标准的最新数据,强调了其在常规临床实践中的实用性。
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Diagnostic criteria in dementing illness. What's new?

The spectrum of neurodegenerative diseases that primarily affect cognition and behaviorspreads from asymptomatic preclinical disease to very mild cognitive impairment to frank dementia. Alzheimer's disease (AD) is the most common cause of a decline in cognitive ability. Also, it is a devastating condition that affects patients and their entirefamilies of caregivers, exacting tremendous financial hardships. Diagnosis may be complicated by other forms of dementia that have symptoms and pathologies similar to AD. Knowing the key features and pathology of each type of dementia can help in the accurate diagnosis of patients, so they will receive the treatment and support services appropriate for their condition and maintain the highest possible functioning in daily life and quality of life. Differentiate, based on clinical criteria, neuropathology, and biomarkers, AD and its atypical variants from other common dementias including Dementia with Lewy Bodies, Vascular Cognitive Impairment, Frontotemporal Degeneration, and less frequent cognitive disorders. The importance of getting an accurate and early diagnosis of dementiais now increasingly significant to make important decisions about treatment, support, and care. Nonpharmacological as well as pharmacological interventions should be initiated once the diagnosis is obtained. Biochemical markers to identify Alzheimer's disease play a central role in the new diagnostic criteria for the disease and in the recent biological definition of AD. This review article presents up-to-date data regarding the recent diagnostic criteria of Alzheimer´s disease and related disorders, emphasizing its usefulness in routine clinical practice.

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