ผู้ใช้:Drgarden/ห้องทดลอง2

    จากวิกิพีเดีย สารานุกรมเสรี

    ข้อความในหน้านี้เป็นหน้าทดลองที่ยังไม่เป็นบทความเสร็จสมบูรณ์ กรุณางดนำไปใช้อ้างอิง (รุ่น 11 เมษายน 2009)

    History[แก้]

    ในคริสต์ศตวรรษที่ 20 การวินิจฉัยว่าเป็นโรคอัลไซเมอร์นั้นใช้เมื่อผู้ป่วยมีอายุระหว่าง 45 ถึง 65 ปีและมีอาการสมองเสื่อม จนได้มีการเปลี่ยนแปลงความหมายหลังจากการประชุมเกี่ยวกับโรคอัลไซเมอร์ในปี พ.ศ. 2520 (ค.ศ. 1977) ซึ่งสรุปว่าอาการแสดงทางคลินิกและพยาธิสภาพของภาวะสมองเสื่อมก่อนวัย และในวัยชรานั้นคล้ายคลึงกัน แม้ว่าผู้เขียนจะระบุด้วยว่า

    For most of the twentieth century, the diagnosis of Alzheimer's disease was reserved for individuals between the ages of 45 and 65 who developed symptoms of dementia. The terminology changed after 1977 when a conference on AD concluded that the clinical and pathological manifestations of presenile and senile dementia were almost identical, although the authors also added that this did not rule out the possibility of different aetiologies.[1] This eventually led to the diagnosis of Alzheimer's disease independently of age.[2] The term senile dementia of the Alzheimer type (SDAT) was used for a time to describe the condition in those over 65, with classical Alzheimer's disease being used for those younger. Eventually, the term Alzheimer's disease was formally adopted in medical nomenclature to describe individuals of all ages with a characteristic common symptom pattern, disease course, and neuropathology.[3]

    Society and culture[แก้]

    Social costs[แก้]

    Dementia, and specifically Alzheimer's disease, may be among the most costly diseases for society in Europe and the United States,[4][5] while their cost in other countries such as Argentina,[6] or South Korea,[7] is also high and rising. These costs will probably increase with the ageing of society, becoming an important social problem. AD-associated costs include direct medical costs such as nursing home care, direct nonmedical costs such as in-home day care, and indirect costs such as lost productivity of both patient and caregiver.[5] Numbers vary between studies but dementia costs worldwide have been calculated around $160 billion,[8] while costs of Alzheimer in the United States may be $100 billion each year.[5]

    The greatest origin of costs for society is the long-term care by health care professionals and particularly institutionalisation, which corresponds to 2/3 of the total costs for society.[4] The cost of living at home is also very high,[4] especially when informal costs for the family, such as caregiving time and caregiver's lost earnings, are taken into account.[9]

    Costs increase with dementia severity and the presence of behavioural disturbances,[10] and are related to the increased caregiving time required for the provision of physical care.[9] Therefore any treatment that slows cognitive decline, delays institutionalisation or reduces caregivers' hours will have economic benefits. Economic evaluations of current treatments have shown positive results.[5]

    Caregiving burden[แก้]

    ข้อมูลเพิ่มเติม: [[:Caregiving and dementia]]

    The role of the main caregiver is often taken by the spouse or a close relative.[11] Alzheimer's disease is known for placing a great burden on caregivers which includes social, psychological, physical or economic aspects.[12][13][14] Home care is usually preferred by patients and families.[15] This option also delays or eliminates the need for more professional and costly levels of care.[15][16] Nevertheless two-thirds of nursing home residents have dementias.[17]

    Dementia caregivers are subject to high rates of physical and mental disorders.[18] Factors associated with greater psychosocial problems of the primary caregivers include having an affected person at home, the carer being a spouse, demanding behaviours of the cared person such as depression, behavioural disturbances, hallucinations, sleep problems or walking disruptions and social isolation.[19][20] Regarding economic problems, family caregivers often give up time from work to spend 47 hours per week on average with the person with AD, while the costs of caring for them are high. Direct and indirect costs of caring for an Alzheimer's patient average between $18,000 and $77,500 per year in the United States, depending on the study.[9][21]

    Cognitive behavioural therapy and the teaching of coping strategies either individually or in group have demonstrated their efficacy in improving caregivers' psychological health.[12][22]

    Notable cases[แก้]

    ข้อมูลเพิ่มเติม: [[:Alzheimer's in the media]]
    Charlton Heston and Ronald Reagan at a meeting in the White House. Both of them would later develop Alzheimer's disease.

    As Alzheimer's disease is highly prevalent, many notable people have developed it. Well-known examples are former United States President Ronald Reagan and Irish writer Iris Murdoch, both of whom were the subjects of scientific articles examining how their cognitive capacities deteriorated with the disease.[23][24] Other notable cases include the retired footballer Ferenc Puskas,[25] the former Prime Ministers Harold Wilson (Great Britain) and Adolfo Suárez (Spain) ,[26][27] the actress Rita Hayworth,[28] the actor Charlton Heston,[29] and the novelist Terry Pratchett.[30]

    AD has also been portrayed in films such as: Iris (2001) ,[31] based on John Bayley's memoir of his wife Iris Murdoch;[32] The Notebook (2004) ,[33] based on Nicholas Sparks' 1996 novel of the same name;[34] Thanmathra (2005) ;[35] Memories of Tomorrow (Ashita no Kioku) (2006) ,[36] based on Hiroshi Ogiwara's novel of the same name;[37] and Away from Her (2006) , based on Alice Munro's short story "The Bear Came over the Mountain".[38] Documentaries on Alzheimer's disease include Malcolm and Barbara: A Love Story (1999) and Malcolm and Barbara: Love’s Farewell (2007) , both featuring Malcolm Pointon.[39]

    Research directions[แก้]

    ดูบทความหลักที่: Alzheimer's disease clinical research

    As of 2008, the safety and efficacy of more than 400 pharmaceutical treatments are being investigated in clinical trials worldwide, and approximately one-fourth of these compounds are in Phase III trials, which is the last step prior to review by regulatory agencies.[40]

    One area of clinical research is focused on treating the underlying disease pathology. Reduction of amyloid beta levels is a common target of compounds under investigation. Immunotherapy or vaccination for the amyloid protein is one treatment modality under study. Unlike preventative vaccination, the putative therapy would be used to treat people already diagnosed. It is based upon the concept of training the immune system to recognise, attack, and reverse deposition of amyloid, thereby altering the course of the disease.[41] An example of such a vaccine under investigation was ACC-001,[42][43] although the trials were suspended in 2008.[44] Another similar agent is bapineuzumab, an antibody designed as identical to the naturally-induced anti-amyloid antibody. [45] Other approaches are neuroprotective agents, such as AL-108,[46] and metal-protein interaction attenuation agents, such as PBT2.[47] A TNFα receptor fusion protein, etanercept has showed encouraging results.[48]

    In 2008, two separate clinical trials showed positive results in modifying the course of disease in mild to moderate AD with methylthioninium chloride (trade name rember) , a drug that inhibits tau aggregation,[49][50] and dimebon, an antihistamine.[51]

    References[แก้]

    1. Katzman Robert, Terry Robert D, Bick Katherine L (editors) (1978). Alzheimer's disease: senile dementia and related disorders. New York: Raven Press. p. 595. ISBN 0-89004-225-X.CS1 maint: multiple names: authors list (link) CS1 maint: extra text: authors list (link)
    2. Boller F, Forbes MM (1998). "History of dementia and dementia in history: an overview". J. Neurol. Sci. 158 (2): 125–33. doi:10.1016/S0022-510X (98) 00128-2 Check |doi= value (help). PMID 9702682. Unknown parameter |month= ignored (help)
    3. Amaducci LA, Rocca WA, Schoenberg BS (1986). "Origin of the distinction between Alzheimer's disease and senile dementia: how history can clarify nosology". Neurology. 36 (11): 1497–9. PMID 3531918. Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
    4. 4.0 4.1 4.2 อ้างอิงผิดพลาด: ป้ายระบุ <ref> ไม่ถูกต้อง ไม่มีการกำหนดข้อความสำหรับอ้างอิงชื่อ pmid15685097
    5. 5.0 5.1 5.2 5.3 อ้างอิงผิดพลาด: ป้ายระบุ <ref> ไม่ถูกต้อง ไม่มีการกำหนดข้อความสำหรับอ้างอิงชื่อ pmid9543467
    6. Allegri RF, Butman J, Arizaga RL; และคณะ (2007). "Economic impact of dementia in developing countries: an evaluation of costs of Alzheimer-type dementia in Argentina". Int Psychogeriatr. 19 (4): 705–18. doi:10.1017/S1041610206003784. PMID 16870037. Unknown parameter |month= ignored (help); Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
    7. Suh GH, Knapp M, Kang CJ (2006). "The economic costs of dementia in Korea, 2002". Int J Geriatr Psychiatry. 21 (8): 722–8. doi:10.1002/gps.1552. PMID 16858741. Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
    8. Wimo A, Jonsson L, Winblad B (2006). "An estimate of the worldwide prevalence and direct costs of dementia in 2003". Dement Geriatr Cogn Disord. 21 (3): 175–81. doi:10.1159/000090733. PMID 16401889.CS1 maint: multiple names: authors list (link)
    9. 9.0 9.1 9.2 Moore MJ, Zhu CW, Clipp EC (2001). "Informal costs of dementia care: estimates from the National Longitudinal Caregiver Study". J Gerontol B Psychol Sci Soc Sci. 56 (4): S219–28. PMID 11445614. Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
    10. Jönsson L, Eriksdotter Jönhagen M, Kilander L; และคณะ (2006). "Determinants of costs of care for patients with Alzheimer's disease". Int J Geriatr Psychiatry. 21 (5): 449–59. doi:10.1002/gps.1489. PMID 16676288. Unknown parameter |month= ignored (help); Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
    11. อ้างอิงผิดพลาด: ป้ายระบุ <ref> ไม่ถูกต้อง ไม่มีการกำหนดข้อความสำหรับอ้างอิงชื่อ metlife.com
    12. 12.0 12.1 อ้างอิงผิดพลาด: ป้ายระบุ <ref> ไม่ถูกต้อง ไม่มีการกำหนดข้อความสำหรับอ้างอิงชื่อ pmid17662119
    13. อ้างอิงผิดพลาด: ป้ายระบุ <ref> ไม่ถูกต้อง ไม่มีการกำหนดข้อความสำหรับอ้างอิงชื่อ pmid10489656
    14. Murray J, Schneider J, Banerjee S, Mann A (1999). "EUROCARE: a cross-national study of co-resident spouse carers for people with Alzheimer's disease: II--A qualitative analysis of the experience of caregiving". Int J Geriatr Psychiatry. 14 (8): 662–7. doi:10.1002/(SICI) 1099-1166 (199908) 14:8<662::AID-GPS993>3.0.CO;2-4 Check |doi= value (help). PMID 10489657. Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
    15. 15.0 15.1 Zhu CW, Sano M (2006). "Economic considerations in the management of Alzheimer's disease". Clin Interv Aging. 1 (2): 143–54. doi:10.2147/ciia.2006.1.2.143. PMID 18044111.
    16. Gaugler JE, Kane RL, Kane RA, Newcomer R (2005). "Early community-based service utilization and its effects on institutionalization in dementia caregiving". Gerontologist. 45 (2): 177–85. PMID 15799982. Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
    17. อ้างอิงผิดพลาด: ป้ายระบุ <ref> ไม่ถูกต้อง ไม่มีการกำหนดข้อความสำหรับอ้างอิงชื่อ pracGuideAPA
    18. Ritchie K, Lovestone S (2002). "The dementias". Lancet. 360 (9347): 1759–66. doi:10.1016/S0140-6736 (02) 11667-9 Check |doi= value (help). PMID 12480441. Unknown parameter |month= ignored (help)
    19. Brodaty H, Hadzi-Pavlovic D (1990). "Psychosocial effects on carers of living with persons with dementia". Aust N Z J Psychiatry. 24 (3): 351–61. doi:10.3109/00048679009077702. PMID 2241719. Unknown parameter |month= ignored (help)
    20. Donaldson C, Tarrier N, Burns A (1998). "Determinants of carer stress in Alzheimer's disease". Int J Geriatr Psychiatry. 13 (4): 248–56. doi:10.1002/(SICI) 1099-1166 (199804) 13:4<248::AID-GPS770>3.0.CO;2-0 Check |doi= value (help). PMID 9646153. Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
    21. "The MetLife Study of Alzheimer's Disease: The Caregiving Experience" (PDF). MetLife Mature Market Institute. 2006. สืบค้นเมื่อ 2008-02-12. Unknown parameter |month= ignored (help)
    22. Pusey H, Richards D (2001). "A systematic review of the effectiveness of psychosocial interventions for carers of people with dementia". Aging Ment Health. 5 (2): 107–19. doi:10.1080/13607860120038302. PMID 11511058. Unknown parameter |month= ignored (help)
    23. Garrard P, Maloney LM, Hodges JR, Patterson K (2005). "The effects of very early Alzheimer's disease on the characteristics of writing by a renowned author". Brain. 128 (Pt 2): 250–60. doi:10.1093/brain/awh341. PMID 15574466. Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
    24. Sherman FT (2004). "Did President Reagan have mild cognitive impairment while in office? Living longer with Alzheimer's Disease". Geriatrics. 59 (9): 11, 15. PMID 15461232. Unknown parameter |month= ignored (help)
    25. "Hungary legend Puskas dies at 79". BBC News. 2006-11-17. สืบค้นเมื่อ 2008-01-25.
    26. "Prime Ministers in History: Harold Wilson". London: 10 Downing Street. สืบค้นเมื่อ 2008-08-18.
    27. ""Mi padre no reconoció al Rey pero notó el cariño"". Madrid: El País. 2008. สืบค้นเมื่อ 2008-10-01.
    28. "Chicago Rita Hayworth Gala". Alzheimer’s Association. 2007. สืบค้นเมื่อ 2008-01-25.
    29. "Charlton Heston has Alzheimer's symptoms". CNN. 2002-08-09. สืบค้นเมื่อ 2008-01-25.
    30. Pauli Michelle (2007-12-12). "Pratchett announces he has Alzheimer's". Guardian News and Media. สืบค้นเมื่อ 2008-08-18.
    31. "Iris". IMDB. 2002-01-18. สืบค้นเมื่อ 2008-01-24.
    32. Bayley John (2000). Iris: a memoir of Iris Murdoch. London: Abacus. ISBN 9780349112152. OCLC 41960006.
    33. "The notebook". IMDB. สืบค้นเมื่อ 2008-02-22.
    34. Sparks Nicholas (1996). The notebook. Thorndike, Maine: Thorndike Press. p. 268. ISBN 078620821X.
    35. "Thanmathra". Webindia123.com. สืบค้นเมื่อ 2008-01-24.
    36. "Ashita no kioku". IMDB. สืบค้นเมื่อ 2008-01-24. Unknown parameter |originallanguage= ignored (help)
    37. Ogiwara Hiroshi (2004). Ashita no Kioku (ภาษา(ญี่ปุ่น)). Tōkyō: Kōbunsha. ISBN 9784334924461. OCLC 57352130.CS1 maint: unrecognized language (link)
    38. Munro Alice (2001). Hateship, Friendship, Courtship, Loveship, Marriage: Stories. New York: A.A. Knopf. ISBN 9780375413001. OCLC 46929223. Unknown parameter |chaptertitle= ignored (help)
    39. Malcolm and Barbara:
    40. "Clinical Trials. Found 459 studies with search of: alzheimer". US National Institutes of Health. สืบค้นเมื่อ 2008-03-23.
    41. Vaccination:
    42. "Study Evaluating ACC-001 in Mild to Moderate Alzheimers Disease Subjects". Clinical Trial. US National Institutes of Health. 2008-03-11. สืบค้นเมื่อ 2008-06-05.
    43. "Study Evaluating Safety, Tolerability, and Immunogenicity of ACC-001 in Subjects With Alzheimer's Disease". US National Institutes of Health. สืบค้นเมื่อ 2008-06-05.
    44. "Alzheimer's Disease Vaccine Trial Suspended on Safety Concern". Medpage Today. 2008-04-18. สืบค้นเมื่อ 2008-06-14.
    45. "Bapineuzumab in Patients With Mild to Moderate Alzheimer's Disease/ Apo_e4 non-carriers". Clinical Trial. US National Institutes of Health. 2008-02-29. สืบค้นเมื่อ 2008-03-23.
    46. "Safety, Tolerability and Efficacy Study to Evaluate Subjects With Mild Cognitive Impairment". Clinical Trial. US National Institutes of Health. 2008-03-11. สืบค้นเมื่อ 2008-03-23.
    47. "Study Evaluating the Safety, Tolerability and Efficacy of PBT2 in Patients With Early Alzheimer's Disease". Clinical Trial. US National Institutes of Health. 2008-01-13. สืบค้นเมื่อ 2008-03-23.
    48. Etanercept research:
    49. Wischik Claude M, Bentham Peter, Wischik Damon J, Seng Kwang Meng (2008). "Tau aggregation inhibitor (TAI) therapy with remberTM arrests disease progression in mild and moderate Alzheimer's disease over 50 weeks". Alzheimer's & Dementia. Alzheimer’s Association. 4 (4): T167. doi:10.1016/j.jalz.2008.05.438. สืบค้นเมื่อ 2008-07-30. Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
    50. Harrington Charles, Rickard Janet E, Horsley David; และคณะ (2008). "Methylthioninium chloride (MTC) acts as a Tau aggregation inhibitor (TAI) in a cellular model and reverses Tau pathology in transgenic mouse models of Alzheimer's disease". Alzheimer's & Dementia. Alzheimer’s Association. 4: T120–T121. doi:10.1016/j.jalz.2008.05.259. Unknown parameter |month= ignored (help); Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
    51. Doody RS, Gavrilova SI, Sano M; และคณะ (2008). "Effect of dimebon on cognition, activities of daily living, behaviour, and global function in patients with mild-to-moderate Alzheimer's disease: a randomised, double-blind, placebo-controlled study". Lancet. 372 (9634): 207–15. doi:10.1016/S0140-6736 (08) 61074-0 Check |doi= value (help). PMID 18640457. Unknown parameter |month= ignored (help); Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)

    Further reading[แก้]