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检测华裔年长人士的早期痴呆症征状Detection of mild dementia in community living Chinese older adults Linda CW Lam Department of Psychiatry The Chinese University of Hong Kong 香港中文大学精神科学系 林翠华教授 Hong Kong - A rapidly ageing population香港:一个急速老化的人口 Dementia epidemic老年痴呆症的流行性 Commonest neurodegenerative disorder of old age. 最常见的老年神经退化失调 Over 25% of subjects will suffer from dementia in the 8th decade of life. 八十岁或以上长者,超过四分一患有痴呆症 Current scene for Dementia Care痴呆症照顾 - 现況 HK Dementia Prevalence Study香港痴呆症流行病学研究(2006) Over 80% of community dwelling persons with demented are mild. 逾八成在社区的痴呆症患者的病况属轻微 Only 11% had been diagnosed as dementia. 只有11%曾被诊断为患上痴呆症 Caregivers are not well informed of the diagnosis. 照顾者大多对诊断没有认识 Most moderately and severely demented subjects are not cared at home. 大部份的中度及严重的痴呆症患者都不是在家中接受照料 Dementia Care 痴呆症照顾 Cognitive states in aging elders老年人的认知状态 Normal aging 正常老化 Successful aging 成功老龄 Preservation of intact cognition, functioning and mood stability 保持良好的认知功能，活动功能和情绪稳定 Physiological aging 生理记忆功能衰退 Degree of cognitive deterioration not associated with functional impairment 某程度的认知衰退与,大致并不影响生活功能? Mild Cognitive impairment 轻度认知障碍 Dementia 老年痴呆症 From Preclinical to Clinical AD…临床前期痴呆症诊断… Mild Cognitive Impairment轻度认知障碍 Subjective Memory complaints 主观性的记忆投诉 Objective memory impairment 客观性的记忆缺损 认知功能测验中,记忆表现有初期衰退的征状 Cognitive function better than demented subjects 其他认知功能尚算正常 Relatively preserved ADL 仍能保持一定的自我照顾能力 Clinically not demented 不符合临床痴呆症诊断的标准 Mild Cognitive Impairment轻度认知障碍 A high risk condition with progression to clinical dementia, mostly AD. 轻度认知障碍患者属高危一族 Annual progression rate about 10% in a clinic sample 在门诊个案中，每年转化为痴呆症的患病率约10% Why do we need early detection of dementia? 检测华裔年长人士的早期痴呆症征状 Public health perspective公众健康观点 Dementia is an age related disorder. 老年痴呆症是一种年龄有关的疾病。 Prevalence doubles every 5 years after the age of 65. 65岁以后，流行病率会每5年增加一倍。 Intervention that delay the onset of clinical dementia will have positiv