醫週譯: Dementia/失智症

Wikipedia:WikiProject_Medicine/Translation_task_force/RTT/Simple_dementia

失智症英語:Dementia、德語:Demenz),其英文Dementia一字來自拉丁語de-意指「遠離」 + mens意指「心智」);是一種因腦部傷害或疾病所導致的漸進性認知功能退化,且此退化的幅度遠高於正常老化的進展。

特別會影響到記憶注意力語言、解題能力。嚴重時會無法分辨人事時地物。失智症可分為可逆或不可逆,視疾病成因而異。只有不到10%的失智症是可逆的。失智症是個不特定的概括名詞。也稱癡呆症。    

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Dementia is a broad category of brain diseases that cause a long term and often gradual decrease in the ability to think and remember such that a person’s daily functioning is affected.[1] Other common symptoms include emotional problems, problems with language, and a decrease in motivation.[1][2] A person’s consciousness is not affected.[1] For the diagnosis to be present it must be a change from a person’s usual mental functioning and a greater decline than one would expect due to aging.[1][3]These diseases also have a significant effect on a person’s caregivers.[1]

                

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失智症是[[腦部疾病]]的其中一類,此症導致[[思考能力]]和記憶力長期而逐漸地退化,並使個人日常生活功能受到影響[1]。其他常見症狀包含情緒問題、[[語言]]問題、還有[[行動能力]]降低[1][2],但個人[[意識]]卻不會受到影響[1]。診斷失智症有兩個要點,一是心智功能出現退化;二是退化的程度比一般老化的情形更嚴重[1][3]這些疾病也常帶給照顧者相當大的影響[1]。

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The most common type of dementia is Alzheimer’s disease which makes up 50% to 70% of cases. Other common types include vascular dementia (25%), Lewy body dementia (15%), and frontotemporal dementia.[1][2] Less common causes include normal pressure hydrocephalus, Parkinson disease, syphilis, and Creutzfeldt–Jakob disease among others.[4] More than one type of dementia may exist in the same person.[1] A small proportion of cases run in families.[5] In the DSM-5, dementia was reclassified as a neurocognitive disorder, with various degrees of severity.[6] Diagnosis is usually based on history of the illness and cognitive testing with medical imaging and blood work used to rule out other possible causes.[7]The mini mental state examination is one commonly used cognitive test.[2] Efforts to prevent dementia include trying to decrease risk factors such as high blood pressure, smoking, diabetes and obesity.[1]Screening the general population for the disease is not recommended.[8]

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最常見的失智症類型是[[阿茲海默症]],阿茲海默症患者佔所有失智症患者人數的50%到70%,其他常見的種類還包括[[血管性痴呆|血管型失智症]](佔25%)、[[路易氏體型失智症]](佔15%)、以及{{link-en|額顳葉型失智症|frontotemporal dementia}}。 [1][2]相對少見的失智成因則有{{link-en|常壓型水腦症|normal pressure hydrocephalus}}、[[帕金森氏症]]、[[梅毒]]、以及[[克雅二氏病|庫賈氏症]]等。[4]同一個人可以同時得到超過一種失智症。[1] 有少部分的失智症起因於家族遺傳。[5] 在{{link-en|精神疾病診斷與統計手冊第五版|DSM-5}}中失智症被視為一種{{link-en|認知障礙|DSM-5#neurocognitive_disorders}},並再依其嚴重程度分類。[6]失智症的診斷通常根據患者的病史,以及經過一系列{{link-en|心理衡鑑|cognitive testing}}與[[醫學影像]]檢查,並搭配抽血檢查,來找出可能的病因。[7] [[簡短智能測驗]]j是其中一種常用於初步評估的工具。[2] 預防失智症的方式,主要是減少常見的風險因子,比如說[[高血壓]]、[[吸菸]]、[[糖尿病]]、以及[[肥胖症]]等。[1] 目前並不建議全面進行一般民眾的失智症篩檢。[8]

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There is no cure for dementia.[1] Cholinesterase inhibitors such as donepezil are often used and may be beneficial in mild to moderate disease.[9][10][11] Overall benefit, however, may be minor.[11][12] For people with dementia and those who care for them many measures can improve their lives.[1] Cognitive and behavioral interventions may be appropriate.[1]Educating and providing emotional support to the caregiver is important.[1] Exercise programs are beneficial with respect to activities of daily living and potentially improve outcomes.[13] Treatment of behavioral problems or psychosis due to dementia with antipsychotics is common but not usually recommended due to there often being little benefit and an increased risks of death.[14][15]

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失智症目前無法治癒[1]。{{link-en|多奈派齊|donepezil}}等{{link-en|乙醯膽鹼酯酶抑制劑|cholinesterase inhibitors}}類藥物經常用於治療輕至中度失智症[9][10][11],但這些治療的幫助終歸有限[11][12]。對於失智症患者與照護者而言,有些方法可以改善他們的生活品質[1],例如[[認知行為療法]]可能有所助益[1];另外,對於[[監護工|照護者]]的衛教與情感支持亦相當重要[1]。運動對於病患的[[日常生活活動]]功能有幫助,並可能改善[[預後]][13]。失智症引起的行為問題或[[思覺失調]]症狀經常以[[抗精神病藥]]治療,但一般而言不建議這麼做,因為這樣的治療幫助有限,並可能增加病人的死亡風險[14][15]。

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Globally dementia affects 36 million people.[1] About 10% of people develop the disease at some point in their lives.[5] It becomes more common with age.[16]About 3% of people between the ages of 65–74 have dementia, 19% between 75 and 84 and nearly half of those over 85 years of age.[17] In 2010 dementia resulted in about 486,000 deaths.[18] As more people are living longer, dementia is becoming more common in the population as a whole.[16] For people of a specific age; however, it may be becoming less frequent, at least in the developed world, due to a decrease in risk factors.[16] It is one of the most common causes of disability among the old.[2] It is believed to result in economic costs of 604 billion USD a year.[1] People with dementia are often physically or chemically restrained to a greater degree than necessary, raising issues of human rights.[1]Social stigma against those affected is common.[2]

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失智症影響全球三千六百萬人口。[1]大約10%的人口,會在有生之年中發病。[5]失智症與年齡(老化)息息相關,[16]約3%的人口在65到74歲之間得到失智症,另外19%的人口則在75到84歲之間,而將近一半的人口超過85歲得到失智症。[17]失智症於2010年造成約48萬6千人死亡。[18]隨著老年人口逐漸增加,失智症也變得越來越常見,[16] 但如果考慮特定年齡層的失智症盛行率,盛行率的數字卻可能隨著時間下降。這樣的現象至少可以在已開發國家見到,原因是在這些國家中風險因子的控制較良好。[16]失智症是世界上最常見的老人[[身心障礙|失能]]原因,[2]在美國每年會造成六千零四十億美元的經濟損失。[1]失智症患者通常會因為照護需要或是{{link-en|用藥|chemical restraint}}而被限制人身自由,這也引起了違反[[人權]]的疑慮。[1]患者也經常苦於疾病的{{link-en|汙名化}social stigma}}。[2]

2015-01-28 已整合中文維基百科「失智症」的引言頁面

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