当前位置： SCI文献检索 > INTERNATIONAL PSYCHOGERIATRICS期刊下所有文献 > The ABC of Alzheimer's disease: cognitive changes and their management in Alzheimer's disease and related dementias.

The ABC of Alzheimer's disease: cognitive changes and their management in Alzheimer's disease and related dementias.

Abstract：

:Cognitive decline, commonly first recognized as memory impairment, is a typical feature of Alzheimer's disease (AD). Neuropathological changes in the cerebral cortex and limbic system lead to deficits in learning, memory, language, and visuospatial skills. The precise nature of cognitive dysfunction reflects the distribution of pathological changes in AD. These will vary along the disease severity continuum and may also depend on where the disease sits in the spectrum of dementia. For example, AD-related disorders such as Lewy body dementia (LBD) and Parkinson's disease dementia (PDD) also show symptoms of cognitive decline and share several pathological features, including degeneration of cortical cholinergic and striatal dopaminergic neurons. In vascular dementia (VaD), there is often an unequal distribution of cognitive deficit, with severe impairment in some functions and relative sparing of others. Cholinesterase (ChE) inhibitors, which help restore acetylcholine levels in the brain, are licensed for the symptomatic treatment of AD and have shown additional benefit in related dementias. Physiological correlates of cholinergic function/dysfunction in the brain include regional cerebral blood flow, glucose metabolism, and cerebrospinal fluid levels of ChE enzymes. These variables represent valuable markers of the clinical efficacy of ChE inhibitors. However, direct assessment of cognitive improvement, stabilization or decline is usually considered the key efficacy parameter in clinical studies of ChE inhibitors in AD and related dementias. Large-scale, placebo-controlled clinical studies of ChE inhibitors have demonstrated efficacy in treating the cognitive impairments associated with AD. Randomized comparative studies of ChE inhibitors are now under way to directly compare symptomatic efficacy and effects on disease progression. Clinical trial data of the cognitive effects of ChE inhibitors in AD, LBD, PDD, and VaD are discussed in detail in this article. The benefits of long-term treatment on symptomatic improvement in cognition and further potential disease-modifying effects are highlighted.

journal_name

Int Psychogeriatr

journal_title

International psychogeriatrics

authors

Corey-Bloom J

doi

10.1017/s1041610203008664

keywords:

subject

Has Abstract

pub_date

2002-01-01 00:00:00

pages

51-75

eissn

1041-6102

issn

1741-203X

journal_volume

14 Suppl 1

pub_type

杂志文章,评审

在线工具

The ABC of Alzheimer's disease: cognitive changes and their management in Alzheimer's disease and related dementias.