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阿尔茨海默病的7个阶段

2016-06-25 佚名 阿尔茨海默病

如今,全世界最常用的阿尔茨海默病分级体系为纽约巴里·瑞斯贝格(Dr.Barry Reisberg)博士开发的总体衰退量表(GDS),将其分为七个阶段。阿尔茨海默病可分为7个阶段:第一级:无认知功能减退  无主观叙述记忆不好,临床检查无记忆缺陷的证据。 第二级:非常轻微的认知功能减退  自己抱怨记忆不好,通常表现为以下几个方面: ① 忘记熟

如今,全世界最常用的阿尔茨海默病分级体系为纽约巴里·瑞斯贝格(Dr.Barry Reisberg)博士开发的总体衰退量表(GDS),将其分为七个阶段。

阿尔茨海默病可分为7个阶段:



第一级:无认知功能减退
 
 无主观叙述记忆不好,临床检查无记忆缺陷的证据。
 
第二级:非常轻微的认知功能减退
 
 自己抱怨记忆不好,通常表现为以下几个方面:
 ① 忘记熟悉的东西放在什么地方;
 ② 忘记熟人的名字,但临床检查无记忆缺陷的客观证据。就业和社交场合无客观的功能缺陷,对症状的关心恰当。
 
第三级:轻度认知功能减退
 
 最早而明确的认知缺陷。存在下述两项或两项以上的表现:
 ① 病人到不熟悉的地方迷路;
 ② 同事注意到病人的工作能力相对减退;
 ③ 家人发现病人回忆词汇的名字困难;
 ④ 阅读一篇文章或一本书后记住的东西甚少;
 ⑤ 记忆新认识的人名能力减退;
 ⑥ 可能遗失贵重物品或放错地方;
 ⑦ 临床检查有注意力减退的证据。
 只有深入检查,才有可能获得记忆减退的客观证据。可有所从事的工作和社交能力的减退。
 病人开始出现否认,伴有轻、中度焦虑症状。
 
第四级:中度认知功能减退
 
 明显的认知缺陷表现在以下几个方面:
 ① 对目前和最近的事件知识减少;
 ② 对个人经历的记忆缺陷;
 ③ 从作连续减法可以发现注意力不能集中;
 ④ 旅行、管理钱财等的能力减退。
 
 但常无以下三方面的损害:
 ① 时间和人物定向;
 ② 识别熟人和熟悉的面孔;
 ③ 到熟悉的地方旅行的能力。
 不能完成复杂的工作;心理防御机制中的否认显得突出,情感平淡,回避竞争。
 
第五级:重度认知功能减退
 
 病人的生活需要照顾,检查时半天不能回忆与以前生活密切相关的事情。例如,地址、使用了多年的电话号码、亲属的名字(如孙子的名字)、本人毕业的高中或大学的名称、或地点定向障碍。受过教育的人,作40连续减4或20连续减2也有困难。
 在此阶段,病人尚保留一些与自己或他人有关的重要事件的知识。知道自己的名字,通常也知道配偶和独生子女的名字。进食及大小便无需帮助,但不少的病人不知道挑选合适的衣服穿。

第六级:严重认知功能减退
 
 忘记配偶的名字、最近的经历和事件大部分忘记。保留一些过去经历的知识,但为数甚少。通常不能认识周围环境、不知道年份、季节等。作10以内的加减法可能有困难。日常生活需要照顾,可有大小便失禁,外出需要帮助,偶尔能到熟悉地方去。日夜节律紊乱。几乎总能记起自己的名字。常常能区分周围的熟人与生人。

 出现人格和情绪改变,这些变化颇不稳定,包括:
 ① 妄想性行为,如责备自己配偶是骗子,与想象中的人物谈话,可与镜子中的自我谈话;
 ② 强迫症状,如:可能不断重复简单的清洗动作;
 ③ 焦虑症状,激越,甚至出现以往从未有过的暴力行为;
 ④ 认知性意志减退,如:因不能长久保持一种想法以决定有的行为,致使意志能力丧失。

第七级:极严重认知功能减退

 丧失言语功能。常常不能说话,只有咕哝声。小便失禁,饮食及大、小便需要帮助料理。丧失基本的精神性运动技能,如:不能走路,大脑似乎再也不能指挥躯体。常出现广泛的皮层性神经系统症状和体征。

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    2017-06-24 Julie W

    如今,全世界最常用的阿尔茨海默病分级体系为纽约巴里·瑞斯贝格(Dr.Barry Reisberg)博士开发的总体衰退量表(GDS),将其分为七个阶段。

    0

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content=文章不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Mon Jun 27 07:57:00 CST 2016, time=2016-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=91270, encodeId=1af9912e06f, content=这个很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Mon Jun 27 07:56:00 CST 2016, time=2016-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=91170, encodeId=a82e911e0e2, content=好文章,值得收藏!, beContent=null, objectType=article, channel=null, level=null, likeNumber=174, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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    2016-10-11 ylzr123

    好文值得点赞!继续关注学习。

    0

  4. 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content=文章不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Mon Jun 27 07:57:00 CST 2016, time=2016-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=91270, encodeId=1af9912e06f, content=这个很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Mon Jun 27 07:56:00 CST 2016, time=2016-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=91170, encodeId=a82e911e0e2, content=好文章,值得收藏!, beContent=null, objectType=article, channel=null, level=null, likeNumber=174, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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    2016-06-30 早茶月光

    学习了,总结得不错

    0

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    2016-06-27 oo902

    阿尔兹海默病真的好可怕

    0

  7. 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  8. 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    2016-06-27 milkshark

    文章不错

    0

  9. 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content=文章不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Mon Jun 27 07:57:00 CST 2016, time=2016-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=91270, encodeId=1af9912e06f, content=这个很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Mon Jun 27 07:56:00 CST 2016, time=2016-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=91170, encodeId=a82e911e0e2, content=好文章,值得收藏!, beContent=null, objectType=article, channel=null, level=null, likeNumber=174, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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    2016-06-27 milkshark

    这个很好

    0

  10. 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    2016-06-26 jaysppr

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