Clinical Diagnosis of Dementia: Core Clinical Features and Diagnostic Criteria
DLK Dai, GHY Wong, YL Dai, K Wang
Hong Kong J Radiol 2015;18:87-90
DOI: 10.12809/hkjr1414277
In dementia of the elderly, the majority of patients with onset around the eighth decade have typical Alzheimer’s disease; diagnostic workup is usually simple, and a plain computed tomography brain is sufficient to exclude pathology other than generalised brain atrophy. Advanced neuroimaging is often required when onset occurs at a younger age to confirm a major neurocognitive disorder and non-Alzheimer’s disease. The prognosis and trajectory of the latter differs to that of Alzheimer’s and, because of the younger age, has important psychosocial implications. Particular clinical features often suggest a non-Alzheimer’s diagnosis, and although clinical criteria play a vital role, functional neuroimaging helps reach a definitive diagnosis. A simplified diagnostic chart at the end of this article aims to assist such diagnosis.
中文摘要
老年癡呆症的臨床診斷：主要臨床特徵和診斷標準
戴樂群、黃凱茵、戴毓玲、王琪
大多數發病年齡在80歲左右的老年癡呆症患者會有典型病徵，其診斷檢查通常較為簡單，只需進行一項簡單的電腦斷層掃瞄，並排除是否罹患典型腦萎縮以外的病變便可。而年輕發病的患者往往須要較先進的腦神經影像學檢查，以確認主要病因是神經認知障礙或非阿爾茨海默氏病。非阿爾茨海默氏病的預後和病程發展與阿爾茨海默氏症不同，非阿爾茨海默氏病的年輕患者會承受很大的社會心理壓力。特殊的臨床表現通常傾向於非阿爾茨海默氏症的診斷。需承認臨床表現對診斷很重要，但腦功能影像學檢查卻能使診斷更為明確。本文結尾一個簡化圖表將有助對阿爾茨海默氏症進行診斷。