《皮肤美容技术》课件-ENG 阿尔茨海默病

SummaryofClinicalDiseasesSubject:Alzheimer'sdisease职业教育康复治疗技术专业教学资源库《临床疾病概要》1Definition,etiopathology2Symptoms,signs,anddiagnosis3Treatmentprinciples,healtheducation目录康复治疗技术专业教学资源库1.1Alzheimer'sdisease(Alzheimer'sdisease,AD)Alsoknownasseniledementia.Itisadegenerationdiseaseofthecentralnervoussystemcharacterizedbymemorylossandcognitivedysfunction.Andaccompaniedbyavarietyofmentalandbehavioralsymptoms.Alzheimer'sdisease康复治疗技术专业教学资源库1.1

TheonsetofADisinsidiousanddelayedtreatmentcanappearprogressiveaggravation.

Withthecontinuousprogressofthedisease,patientsgraduallylosetheabilitytotakecareofthemselves,andcompletelyrelyonothersinthelatedailylife,whichcausesahugeburdenonpatientsthemselves,theirfamiliesandsociety.Alzheimer'sdisease康复治疗技术专业教学资源库1.1epidemiology:TheprevalenceofADhasincreasedyearbyyear.Accordingtothesurvey,by2020,theprevalenceofADpatientsovertheageof60inChinareached3.94%,withatotalof9.83millionADpatients,accountingfor65.23%ofallpatientswithdementia［1，2］。Alzheimer'sdisease［1］JiaL，DuY，JiaJP，etal．Prevalence，riskfactors，andmanagementofdementiaandmildcognitiveimpairmentinadultsaged60yearsorol_x0002_derinChina:across-sectionalstudy［J］．LancetPublicHealth，2020，5(12):e661-e671．［2］JiaL，QuanM，JiaJP，etal．DementiainChina:epidemiology，clini_x0002_calmanagement，andresearchadvances［J］．LancetNeurol，2020，19（1）：81-92.康复治疗技术专业教学资源库1.2◎βAmyloidhypothesisandevolution.◎Tauproteinhypothesisandevolution.◎AβinsynergywithTauproteininADpathogenesis.◎Excitotoxicityhypothesis(glutamateexcitotoxicityisoneofthemoreclassicpathologiesofAD).◎Oxidativestresshypothesis.◎Theoestrogenhypothesis.ThepathogenesisofAD康复治疗技术专业教学资源库1.2◎Geneticandriskfactors:1.

Genemutations.2.Riskfactors:Vascularriskfactorsincludehypertension,diabetesmellitus,dyslipidemia,overweightorobesity,smokingorharmfulalcoholconsumption,andcardiovascularandcerebrovasculardiseases.Peoplewithdepressivedisordersandsleepdisorders.ThepathogenesisofAD康复治疗技术专业教学资源库1.3PathologyofADMajorpathologicalfindingsinclude:◎encephalanalosis◎senileplaquesformedbycerebralamyloiddeposits(senileplaque,SP)◎

neurofibrillarytangles(neurofibrillarytangles,NFTs)◎reduced

synapses◎degenerationanddeathoftheneurons.康复治疗技术专业教学资源库1.3PathologyofADMainlesionsite:

Hippocampalsitesaremostcommonlyinvolved.Parietalandfrontallobeatrophy.康复治疗技术专业教学资源库Case

Thepatient,male,was65yearsold.Memorydeclinedformorethan1year,theperformanceoftherecentmemorydeclined,buthecanrecognizethewayhome.Hequicklyforgotwhathejustsaidorforgotwheretoputtheitems.Thismonthheappearedgrumpy,likedtocurse.Poorsleepatnight.Physicalexamination:clearconsciousness.Thereactionwasslightlyslow,theanswerwasnormal,computationalpowerdecreased.1.Howisthepatient’sdiagnosis?2.Whatinspectionneedtobeimproved?康复治疗技术专业教学资源库2.1Alzheimer'sdisease(Alzheimer'sdisease,AD)Itsmainclinicalmanifestationisthelastingandcomprehensivedeclineofmemoryandcognitivefunction.Clinicalfeaturesareinsidiousonset,progressiveintelligenceloss,andmanyassociatedwithpersonalitychanges.SymptomsofADClinicalsymptoms:memoryimpairment,cognitiveimpairment,andmentalsymptoms.康复治疗技术专业教学资源库2.2SignsofAlzheimer'sdisease(assessment)Scaleevaluation:theMMSEscale,theMOCAscale康复治疗技术专业教学资源库2.2SignsofAlzheimer'sdisease(assessment)MMSE：

Itisoneofthemostcommonlyusedscreeningtoolsforcognitiveimpairmentintheworld.Thereare30itemsinthescale,includingmemory,attention,orientation,language,executionandsoon.Participantsneedtocompleteproblemssuchasyear,month,100minus7,anddrawing,withscoresbetween0and30.Thelowerthescore,theheavierthecognitivedamage,and3isthesignificantdifference.Thecut-offvalueofcognitiveimpairmentdeterminedbyeducationlevelwas17pointsforilliteracy(noeducation),20pointsforprimaryschoolgroup(6yearsofeducation),and24pointsformiddleschoolandabovegroup(yearsofeducation>6years).Scaleassessment康复治疗技术专业教学资源库康复治疗技术专业教学资源库2.2SignsofAlzheimer'sdisease(assessment)

DevelopedbyNasreddineetal.basedonclinicalexperienceandreferringtotheMMSE,thefinalversionwasdeterminedinNovember2004andisaratingtoolforrapidscreeningofcognitivefunctionabnormalities.Itincludes11inspectionitemsin8cognitivedomainsincludingattention,concentration,executivefunction,memory,language,visualstructureskills,abstractthinking,computationanddirectionalforce.Thetotalscoreis30,and

≥26isnormal,withhighsensitivity,coveringimportantcognitiveareas,shorttesttimeandsuitableforclinicaluse.However,itisalsoaffectedbytheeducationallevel,thedifferencesinculturalbackground,theskillsandexperienceofMoCAusedbytheexaminer,theenvironmentandtheemotionalandmentalstateofthesubjectswillallaffectthescore.Itismoresensitivetothescreeningofmildcognitivedysfunction(MIC).Scaleassessment康复治疗技术专业教学资源库MoCA：康复治疗技术专业教学资源库2.2SignsofAlzheimer'sdisease(assessment)Scaleassessment:康复治疗技术专业教学资源库2.2Alzheimer'sdiseasediagnosisclinlcalsymptomImagingfindingsPathologicalmanifestationsAlzheimerdiseaseHiddenonset,continuousprogressiveintelligencedecline,memory,cognitiveimpairmentwithmentalsymptomsencephalanalosissenileplaques,neuronalfibrillarytangles,granularvacuolardegenerationofhippocampalpyramidalcells,andneuronallossFronto-temporaldementia(pickdisease)Personalityandmentaldisordersappearearly;forgettingappearslaterFrontalandtemporallobebrainatrophySilver-stainedintracytoplasmicinclusions(pickbodies)appearedintheneuralcellsoftheneocortexandhippocampusvasculardementiaAcuteorsubacuteonsetofsymptomswithsignsofneurologicallocalization.Mainlymanifestatedbyexecutivedysfunction.MultiplelesionsofcerebrovasculardiseaseFocalordiffuseischemicbrainwhitematterlesions.LouiebodydementiaVolatifluctuatingcognitiveimpairment,repeatedvisualhallucinations,andspontaneousextrapyramidaldysfunctionWhole-brainatrophy,enlargedventricles,andwhitematterdegenerationLewybodies:spherical,erosmophilicinclusionsinthecytoplasmofneurons.Clinicaldifferentialdiagnosisofvariousdementias康复治疗技术专业教学资源库3.1PrinciplesofADtreatment康复治疗技术专业教学资源库drugsnon-drugtherapy3.11.

cholinergicsystemdrugs:tacrine,donepezil,carbabatinandgalantamine.2.NMDAreceptorantagonist:easytimesapplication.

Onlyatransientimprovementofpatients'cognitivesymptoms,butcannotreversethediseaseprocessPrinciplesofADtreatment康复治疗技术专业教学资源库drugs3.1PrinciplesofADtreatmentNovelanti-ADdrugs:AβtargetsSolanezumab:Sorizumab;Gantenerumab:GengLucumab;Aducanumab:Adunatumab;Crenezumab:Kremonomab;Lecanemab:Lenainecumab;Donanemab:Donecumab.康复治疗技术专业教学资源库drugs3.1PrinciplesofADtreatmentNovelanti-ADdrug:Tau,aproteintargetSemorinemab:Seronumab;Bepranemab:Benonumab康复治疗技术专业教学资源库drugs3.1PrinciplesofADtreatmentθTargetofneuroinflammationθBrainmetabolictargets康复治疗技术专业教学资源库drugs3.1PrinciplesofADtreatmentCognitiveintervention:cognitivestimulation,cognitiverehabilitation,andcognitivetrainingReality-orientedtherapyNostalgiatherapymethodMultisensorytherapymusicaltherapy康复治疗技术专业教学资源库non-drugtherapy3.1PrinciplesofADtreatmentNostalgiatreatmentmethodMultisensorytherapy康复治疗技术专业教学资源库non-drugtherapy3.1PrinciplesofADtreatment康复治疗技术专业教学资源库non-drugtherapy3.1PrinciplesofADtreatmentDietaryregulation:supplementvitamins,traceelementsandothernutrients.aerobicexercise.Non-invasivebrainstimulationtechnologycurrentlyusetranscranialmagneticstimulation(transcranialmagneticstimulation,TMS),transcranialdirectcurrentstimulation(transcranialdirectcurrentstimulation,tDCS)technologyandγ-frequencysensorystimulation.康复治疗技术专业教学资源库non-drugtherapy3.2AD'sHealthEducationandPreventio