Резюме
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- presença de fatores de risco
- perda de memória
- desorientação
- disfasia nominal
- colocar itens no lugar errado/se perder
- apatia
- declínio das atividades da vida diária e atividades instrumentais da vida diária (AIVDs)
- alteração de personalidade
- exame físico inicial normal
Другие диагностические факторы
- alterações no humor
- má qualidade do pensamento abstrato
- dispraxia construtiva
- prosopagnosia
- autoprosopagnosia
Факторы риска
- idade avançada
- história familiar
- genética
- Síndrome de Down
- doença cerebrovascular
- fatores de estilo de vida e medicamentos
- Escolaridade inferior ao ensino secundário
- lesão cerebral traumática
- depressão
- perda auditiva
- hiperlipidemia
- sexo feminino
- nível elevado de homocisteína no plasma
- consumo de refrigerantes adoçados artificialmente
Диагностические исследования
Исследования, которые показаны в первую очередь
- testes cognitivos à beira do leito
- Hemograma completo
- perfil metabólico
- hormônio estimulante da tireoide (TSH) sérico
- vitamina B12 sérica
- exame de urina para detecção de drogas
- tomografia computadorizada (TC)
- RNM
Исследования, проведение которых нужно рассмотреть
- Análise do líquido cefalorraquidiano (LCR)
- reagina plasmática rápida/teste Venereal Disease Research Laboratory (VDRL) séricos
- vírus da imunodeficiência humana (HIV) sérico
- testes neuropsicológicos formais
- teste genético
- PET com fluordeoxiglicose (FDG-PET)
- TC por emissão de fóton único (SPECT)
- eletroencefalograma (EEG)
Неотложные исследования
- tomografia por emissão de pósitrons (PET) do amiloide
Алгоритм лечения
todos os pacientes
Составители
Авторы
Judith Neugroschl, MD
Associate Professor of Psychiatry
Alzheimer's Disease Research Center
Icahn School of Medicine at Mount Sinai
New York
NY
Раскрытие информации
JN participates in research funded by National Institutes for Health (NIH) grants. The Alzheimer's Disease Research Center is a site for clinical research but JN is not the site Principal Investigator, has no role in purchasing nor choosing the studies, and gains no compensation if they succeed. JN helps to edit the Focus on Healthy Aging Alzheimer's yearly report.
Выражение благодарностей
Dr Judith Neugroschl would like to gratefully acknowledge Dr Brandy R. Matthews, Dr Asif S. Bhutto, and Dr Julie K. Gammack, the previous contributors to this topic.
Раскрытие информации
BRM, ASB, and JKG declare that they have no competing interests.
Рецензенты
Roy J. Goldberg, MD, FACP, AGSF, CMD
Medical Director
Kings Harbor Multicare Center
New York
NY
Раскрытие информации
RJG declares that he has no competing interests.
Philip Scheltens, MD, PhD
Professor of Neurology
Department of Neurology/Alzheimer Center
VU University Medical Center
Amsterdam
The Netherlands
Раскрытие информации
PS declares that he has no competing interests.
Список литературы
Основные статьи
GBD 2016 Dementia Collaborators. Global, regional, and national burden of Alzheimer's disease and other dementias, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019 Jan;18(1):88-106.Полный текст Аннотация
Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020 Aug 8;396(10248):413-46.Полный текст Аннотация
Fink HA, Linskens EJ, Silverman PC, et al. Accuracy of biomarker testing for neuropathologically defined Alzheimer disease in older adults with dementia. Ann Intern Med. 2020 May 19;172(10):669-77. Аннотация
Birks JS, Harvey RJ. Donepezil for dementia due to Alzheimer's disease. Cochrane Database Syst Rev. 2018 Jun 18;(6):CD001190.Полный текст Аннотация
Birks JS, Chong LY, Grimley Evans J. Rivastigmine for Alzheimer's disease. Cochrane Database Syst Rev. 2015 Sep 22;(9):CD001191.Полный текст Аннотация
McShane R, Westby MJ, Roberts E, et al. Memantine for dementia. Cochrane Database Syst Rev. 2019 Mar 20;(3):CD003154.Полный текст Аннотация
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Delirium
- Depression
- Demência vascular
Больше ОтличияРекомендации
- Clinical guidance in neuropalliative care: an AAN position statement
- Ethical considerations in dementia diagnosis and care: an AAN position statement
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