混合型認知症:新興概念と治療上の影響
Kenneth M Langa1, Norman L Foster, Eric B Larson
1Division of General Medicine, Department of Medicine, University of Michigan Medical School, Ann Arbor, USA. klanga@umich.edu
JAMA
|December 16, 2004
まとめ
アルツハイマー病 (AD) と血管性認知症 (VaD) を組み合わせた混合型認知症は,薬剤による効果が限られている. 心血管疾患のリスク要因の管理は,予防と進行を遅らせるための鍵です.
科学分野:
- 神経学 神経学とは
- ゲリアトリクス ゲリアトリクス
- 薬理学 薬理学とは
背景:
- アルツハイマー病 (AD) と血管性認知症 (VaD) の同時発生である混合認知症は,高齢化人口のためにますます流行しています.
- ADとVaDの相互作用を理解することは,効果的な管理に不可欠です.
研究 の 目的:
- 混合認知症におけるADとVaDの診断,病理生理学,および相互作用をレビューする.
- 混合認知症における薬物療法に関する証拠を体系的に検討する.
主な方法:
- "認知症"の体系的なレビューのコクランデータベースを検索しました.
- "混合認知症"",アルツハイマー病"+"脳血管疾患"+"薬物療法"および"血管性認知症"+"薬物療法"に関する英語の記事 (過去10年) をMEDLINEで検索しました.
主要な成果:
- 混合型認知症は老化とともに一般的であり,しばしばADと血管損傷の共存を示します.
- コリンエステラゼ阻害剤を含む薬理学的治療法は,AD治療に匹敵する,混合認知症に対する控えめな利点を提供します.
- 高血圧などの心血管疾患の危険因子を管理することは,予防と進行を遅らせるための有望な戦略です.
結論:
- 現在の薬は,既定の混合型認知症に対して,限られた臨床的利点を提供します.
- 心血管疾患の危険因子 (高血圧,高脂血症) をコントロールし,脳卒中を予防することは,混合型認知症の管理に不可欠です.
- 治療目標と患者および家族の期待を一致させ,医薬品の使用を最適化するためにさらなる研究が必要です.
関連する概念動画
Taste Buds and Receptors
5.6K
Gustation, or the sense of taste, is intrinsically linked to the anatomical structures located on the tongue. This organ's surface, along with the entirety of the oral cavity, is adorned with stratified squamous epithelium. Evident on the tongue are elevated structures known as papillae (singular = papilla), which house the mechanisms for the transduction of gustatory stimuli. Four distinct types of papillae exist, each identified by their unique morphological attributes: the circumvallate,...
5.6K
Psychosis: Goals of Pharmacotherapy
706
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
706
Alzheimer's Disease: Treatment
1.3K
Alzheimer's Disease (AD), a neurodegenerative disorder, is pathologically identified by amyloid plaques and neurofibrillary tangles composed of tau protein. AD pharmacotherapy aims to manage cognitive symptoms, delay disease progression, and treat behavioral symptoms. The treatment is primarily symptomatic and palliative, with no definitive disease-modifying therapy available. Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), are...
1.3K
Theoretical Approaches to Psychological Disorder
1.1K
The development of psychological disorders, which are characterized by deviant, maladaptive, and personally distressing behaviors, has been explored through several theoretical approaches.
Biological approach
The biological approach posits that internal, organic factors are the primary causes of such disorders. This perspective emphasizes brain structure and function, genetic predispositions, and neurotransmitter imbalances. For example, schizophrenia has been associated with both genetic...
Biological approach
The biological approach posits that internal, organic factors are the primary causes of such disorders. This perspective emphasizes brain structure and function, genetic predispositions, and neurotransmitter imbalances. For example, schizophrenia has been associated with both genetic...
1.1K
Positive Symptoms Schizophrenia: Hallucinations and Delusions
1.1K
Schizophrenia is a complex psychiatric disorder characterized by a range of symptoms that significantly impact cognition, behavior, and emotional regulation. Among these, the positive symptoms stand out as they involve the addition or exaggeration of normal mental functions, deviating markedly from typical behavior and perception. Hallucinations and delusions are prominent positive symptoms, each profoundly affecting the individual's experience of reality.
Hallucinations
Hallucinations in...
Hallucinations
Hallucinations in...
1.1K
Drug Therapy
449
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
449


