每7 秒新增1 位失智症患者

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1、失智症簡介民眾醫院院長張淑鳳醫師部定副教授屏東縣失智症服務協會常務理事2008年10月諸行無常58歲的銀行經理,覺得近來記憶比較差,有時會記不住客戶的名字,擔心自己有失智症,前來門診就醫失智症的診斷失智症的定義:成年人於心智成熟後，在清醒的意識狀態下，因腦部疾病而引起心理及智力功能退步，並影響到生活及工作能力。臨床上失智症無法直接由實驗室數值（例如：肝炎可測肝功能）來診斷，必須靠醫師依疾病史及臨床經驗來診斷。DSM-IV失智症的診斷條件A.客觀證據顯示記憶力減退。B.有下面任一項目:失語症(aphasia)失用症(apraxia)認識不能(ag

2、nosis)執行功能失常(executivedysfunction)C.減退到足以干擾其社交或工作能力。D.意識並不迷糊。E.必需排除非器質性精神疾病，如憂鬱症。引起失智症的原因阿滋海默氏失智症血管性失智症頭部外傷有關之失智症巴金森氏症有關失智症中樞神經感染引起之失智症其他腦退化引起之失智症藥物或化學製品引起之失智症酗酒、吸入劑、鎮定劑、催眠劑、或焦慮劑、其他或未知物質全身系統性狀況引起之失智症甲狀腺功能低下症、維生素或葉酸缺乏症、菸鹼缺乏症、高血鈣CausesofdementiaPrimaryneurodegenerativedisorder

3、sleadingtodementiaAlzheimer’sdiseaseDementiawithLewybodiesFrontotemporaldementiaDown’ssyndromeFrontallobedegenerationProgressivesubcorticalgliosisProgressiveaphasiaProgressiveapraxia…..CausesofdementiaPrimaryneurodegenerativedisorderssometimesleadingtodementiaParkinson’sdis

4、easeProgressivesupranuclearpalsyHuntington’sdiseaseCorticobasaldegenerationCerebellardegenerationMultiplesystematrophyCausesofdementiaCerebralpathologyVasculardementiaTraumaBraintumorMeningitis(TB,Cryptococus)Encephalitis(Herpes,JBE)Creutzfelt-JacobdiseaseNormalpressurehydro

5、cephalusCausesofDementiaSystemicillnessB12,FolatedeficiencyAddison’sdiseaseCushing’ssyndromeHypo/hyperthyroidismCancer(paraneoplastic)SubstanceabuseSyphilis,AIDS,Wilson’sdiseaseNeuropathologicallesionscapableofproducingvasculardementia(1)MultiinfarctdementiaMultiplelargecom

6、pleteinfarctscortico-subcorticalinlocationStrategicinfarctdementiaAsinglebraininfarct,oftenlacunarinsize,damagesfunctionallycriticalareasofthebrain(angulargyurs,thalamus,basalforebrain,PCA,ACAterritories)Neuropathologicallesionscapableofproducingvasculardementia(2)Small-vess

7、eldiseaseswithdementiaSubcoritcalBinswangerdiseaseCADASIL(CerebralAutosomalDominaltArteriopathywithSubcorticalInfarctsandLeukoencephalopathy)LacunardementiaorlacunarstateCorticalandsubcorticalHypertensiveandarterioscleroticangiopathyAmyloidangiopathiesCollagen-vasculardiseas

8、ewithdementiaNeuropathologicallesionscapableofproducingvasculardementia(3)I