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www.Health120Years.com Sticky
Note///http://www.health120years.com/120.pdf
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Diagnosis of Dementia
-
De-mentia
= Deletion of Mental function
-
:
..
(delirium)
( (DSM-VI))
-
: ~5%
AdministratorHighlight
-
(I)
( Alzheimers disease )
( Dementia with Lewy
bodies )
( Fronto-temporal lobar dementia )
etc.
(Reversible)
< 5~10%
AdministratorHighlight
-
(II)
Drug*
Emotion
Metabolic*
Endocrine/Electrolyte *
/
Ex. Thyroid function
Nutrition
Ex. Vit. B12, Folic acid
Tumor/Trauma
/
Infection/Inflammation
Ex. Neurosyphilis
HIV
Alcoholism
-
Who ?
Where ?
When ?
AD8
*
*
AD8:1.:
2.3.4.
:
()5.6.
:
7.8.
-
Physical ability
Mental ability
Aging
AgingDementia
-
Encephalopathy
Dementia
Mental retardation
-
(Age-Associated Memory Impairment; AAMI)
50
()
(Crook et. al.; 1986; NIMH)
: 18~85%
(Benign senescent forgetfulness)
-
Mild Cognitive Impairment; MCI
( R. Peterson; Mayo Clinic; 1999 )
10%15%
(amnestic) (non-amnestic)
-
Depression
pseudo-dementia
-
Presenile
dementia
-
: Dementia disorders
-
Alzheimers disease (AD)
65
:
: 8~10
: 5%~10%
APP (ch21)
PS1 (ch14)
PS2 (ch1)
-
: Amyloid
cascade theory
(Senile plaque)
- amyloid
(Neurofibrilary
tangle)
Tau Hyperphosphorylation
Tau protein
Bulbar degeneration
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wandering
lostconfabulation
delusion
hallucinationmisidentification
/
(Sun-down phenomenon)
-
:
-
:(PET)Amyloid
PET
FDDNP PIBAV45
-
:
MCI
AD
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Dementia with Lewy
Bodies; DLB
10%
70
:
fluctuated
:
REM sleep disorder
(-)
-
(I)
Parkinson disease dementia
6
(rigidity)
(postural instability)(gait disturbance)
()
(Mild cognitive impairmentMCI)
-
(II)
(attention)(execution)(visuo- spatial function)
(rapid eye movement sleep behavior disorders)
8 2-5
()
-
(Frontotemporal
Lobar Degeneration, FTLD)
10%
50
:
Primary progressive aphasia
Semantic dementia
(Frontal variant)
(~50%)
-
:
-
Vascular Dementia
Post-stroke vascular dementia
3
Dementia with small vessel diseases
5%
25%
(patch lesion)
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Treatment of Dementia
-
-
-
ABC
(Ability)
(Behavior)
(Cognition)
-
: Cholinesterase inhibitor
donapezil
(Aricept)*
5-10mg HS
rivastimine
(Exelon)
* * 3-6mg Bid
galantamine
(Reminyl)
4-8mg Bid
*
* *
NMDANMDA anatagonist
Memantine
10mg Bid
Ebixa
Witgen
Manotin
-
CoreyCorey--Bloom et al., 1998Bloom et al., 1998*p
-
Beta-secreataseGemma-secreatase
Tauaggregationinhibitor
Mitochondrialstabilizer NMDA
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AdministratorHighlight
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(Exercise)
(Cognitive training)
BMI
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(ChEI) (Memantine)
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The End Many Thanks for
Your Attention
--: ///http://www.health120years.com/120.pdf
Diagnosis of Dementia: ~5%
(I)< 5~10%
(II) Depression: Dementia disorders : -amyloid
:(PET): (I) (II): Vascular Dementia - :
The EndMany Thanks for Your Attention
