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阿尔茨海默病前期主观认知下降的检测与干预研究
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Abstract:
阿尔茨海默病(Alzheimer’s Disease, AD)是多发于老年群体的神经退行性疾病，是一种不可逆转的疾病，与其他神经退行性疾病一样，AD缺乏任何有效的治疗方法，尽管近年来对AD的研究大有人在，但可惜到目前为止也没有研发出可以彻底治疗AD的药物。AD是如今造成老年人死亡的重要病症之一。因此，在AD的早期进行检测和干预就尤为重要，尽早发现，尽早干预。主观认知下降(Subjective Cognitive Decline, SCD)是AD第一临床表现，也是AD临床前阶段，主要表现为个人感到自身认知功能持续下降，而认知评价却显示正常。研究发现SCD与AD生物标志物相关，磁共振(MRI)和正电子发射断层扫描图像上的结构和功能改变，使患有SCD的个体中轻度认知障碍和失智的风险增加。研究发现，较高的教育程度和智力活动浓度与晚年较好的认知表现之间存在关联。所以，在早期，对SCD的检测识别和采取干预措施可以降低发展为AD的风险。以“Subjective Cognitive Decline”为关键字，搜寻数据库，由SCD的诊断预测因子来看，通过SCD的药物干预和非药物干预阻止或减少这些危险因子，可在一定程度上有效减少SCD的发生，进而减少患AD的可能性。也从中发现了不论是在预测诊断方面还是在干预方面都依旧存在争议，需要更多的研究来证实正确的说法。总之，在早期进行SCD的检测和干预有可能降低AD的发生。
Alzheimer’s disease (Alzheimer’s disease, AD) is common in the elderly neurodegenerative diseases, and is an irreversible disease. As with other neurodegenerative diseases, AD lacks any effective treatment. Although there has been a lot of research on AD in recent years, it is a pity that so far no drug has been developed that can completely treat AD. AD is one of the most important diseases that cause death in the elderly today. Therefore, it is particularly important to diagnose and intervene in the early stage of AD, and to detect and intervene as early as possible. Subjective cognitive decline (SCD) is the first clinical manifestation in the AD continuum, and it is also the preclinical stage of AD, mainly manifested by individuals who feel a continuous decline in their cognitive function, while the cognitive evaluation shows normal. Studies have found that SCD is associated with AD biomarkers: structural and functional changes on magnetic resonance and positron emission tomography images, resulting in an increased risk of mild cognitive impairment and dementia in individuals with SCD. An association between higher education and intellectual activity levels and better cognitive performance later in life was found. Therefore, in the early stage, diagnostic identification of SCD can reduce the risk of developing AD. Using “Subjective cognitive decline” as the keyword, searching for the database, judging by the diagnostic predictors of SCD, preventing or reducing these diagnostic predictors through drug intervention and non-drug intervention of SCD can effectively reduce the occurrence of SCD to a certain extent, and then reduce the likelihood of developing AD. It is also found that there is still a controversy in both the prediction of the detection and the intervention, and more research is needed to confirm the correct statement. In conclusion, performing the detection and intervention of SCD early on has the potential to reduce the occurrence of AD.
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