衰弱与血管性痴呆

衰弱(Frailty)是与年龄相关的、涉及多个生理系统储备与功能下降引起的临床综合征[1].临床上有两个常用的衰弱定义.Rockwood等[2]提出衰弱定义(1994)的实质是一个累计负担指数,包括健康状况和缺陷(包含认知损害).Fried等[3](2001)提出衰弱应满足以下标准中的至少3条:握力下降;疲劳感;步行速度减慢;躯体活动降低;无预期的体质量减轻.

适用于中国人群的痴呆筛查和评估框架

There are no standard diagnostic criteria for Alzheimer′s disease (AD) in China. The copied international criteria has led to a high rate of missed diagnosis due to issues such as translation and cultural discrepancy. Under the principles of semantic equivalence, content equivalence and performance equivalence, the research group of Alzheimer′s Disease Chinese (ADC) adopted several effective methods, such as two-way translation, content conversion, performance evaluation, etc. to systematically study the cognitive, behavioral, functional, and general assessment techniques in dementia screening and diagnosis, as well as their screening thresholds and diagnostic values. We also established a dementia screening and assessment framework in clinical practice through systematic reviews and group consensus. It has improved the early diagnosis rate of dementia in China, been accepted by home and abroad academic institutions, which is of great significance for early diagnosis and treatment of dementia.

The Alzheimer’s disease model in Wistar rats was established by injection of amyloid β-peptide (Aβ1-42 ) into the hippocampal CA1 region. Rats were treated with suspended moxibustion on Baihui (GV20) and Shenshu (BL23) acupoints. Prior to and post Aβ1-42 exposure. Results showed no evidence of apoptosis in hippocampal neurons, a significantly reduced apoptosis rate of neurons and improved learning and memory abilities were observed in the Alzheimer’s disease model. In particular, moxibustion prior to Aβ1-42 exposure was more effective than moxibustion after Aβ1-42 exposure in protecting the neuronal structure and lowering the apoptosis rate. Our findings indicate that a combination of preventive and therapeutic moxibustion has a beneficial effect for the tion of Alzheimer’s disease development.

Current evidence shows that apolipoprotein E (APOE), apolipoprotein CI (APOC1) and low density lipoprotein receptor-related protein (LRP) variations are related to late-onset Alzheimer’s disease. However, it remains unclear if genetic polymorphisms in these genes are associated with cognitive decline in late-onset Alzheimer’s disease patients. We performed a 30-month longitudi-nal cohort study to investigate the relationship between Alzheimer’s disease and APOE, APOC1, and LRP. In this study, 78 Chinese Han patients with late-onset Alzheimer’s disease were recruit-ed form Guangxi Zhuang Autonomous Region in China. APOE, APOC1, and LRP genotyping was performed using polymerase chain reaction-restriction fragment length polymorphisms. The Mini-Mental State Examination and Clinical Dementia Rating Scale were used to assess pa-tients’ cognitive function. After a 30-month follow-up period, we found a signiifcant reduction in Mini-Mental State Examination total score, a higher proportion of patients fuliflling cognitive impairment progression criteria, and a higher proportion of APOC1 H2 carriers in APOEε4 carriers compared with non-carriers. In addition, the APOEε4 allele frequency was signiifcantly higher in the cognitive impairment progression group compared with the non-cognitive im-pairment progression group. In conclusion, APOEε4 plays an important role in augmenting cognitive decline, and APOC1 H2 may act synergistically with APOEε4 in increasing the risk of cognitive decline in Chinese patients with late-onset Alzheimer’s disease.

利培酮口服液在老年期痴呆患者中的应用

目的:探究利培酮药物在老年痴呆中的临床疗效.方法:选取2001例患者,随机分组,观察组予利培酮治疗100例;对照组予氟哌啶醇治疗100例.结果:BPRS减分率分析:观察组:显效60例,良好22例,无效18例,好转率(显效+良好):88%;对照组显效54例,良好20例,无效26例,好转率:74%;CMAI减分率分析:观察组:显效55例,良好33例,无效12例,好转率(显效+良好):88%;对照组显效45例,良好31例,无效24例,好转率:76%;观察组:消化道不适、头晕、失眠14例,占14%;锥体外系症状12例,占12%.对照组:消化道不适、头晕、失眠21例,占21%;锥体外系症状33例,占33%.结论:利培酮口服液在老年期痴呆患者临床治疗起到积极作用.

New Spectacle on Dementia——Concern together brain healthy of humanity

Dementia is a syndrome due to brain disease and is characterized by a progressive, global deterioration in intellectual abilities, including memory, learning, orientation, language, comprehension, and judgment. Alzheimer's disease, in particular, is progressive and fatal. It mainly affects older people, especially those over aged 65. From this age, dementia prevalence doubles every five years. Dementia is one of the major causes of disability in late-life. Alzheimer's disease is the most common cause of dementia, vascular dementia, dementia with Lewy bodies, and frontotemporal dementia are the next most common.