Definition 定义 By Mayo Clinic staff 梅奥医疗中心 Alzheimer's disease causes brain changes that gradually get worse. It's the most common cause of dementia — a group of brain disorders that cause progressive loss of intellectual and social skills, severe enough to interfere with day-to-day life. In Alzheimer's disease, brain cells degenerate and die, causing a steady decline in memory and mental function. 阿尔兹海默症（又称老年痴呆症）导致大脑逐渐恶变。最常见引起痴呆——一组可造成智力和社交技能进行性衰退的脑部疾病，发展到足够严重时会影响日常生活。在老年痴呆症，脑细胞退化并死亡，引起记忆和心理功能的持续下降。 Current Alzheimer's disease medications and management strategies can temporarily improve symptoms, maximize function and maintain independence. It's also important to seek social services and tap into your support network to make life better. Research efforts aim to discover treatments that prevent Alzheimer's or slow its progression. 目前老年痴呆症药物和处理方法可以暂时改善症状，使功能最大化并维持独立性。寻求社会服务以及挖掘你的支持网络来改善生活也是重要的。研究努力的目标是发现预防老年痴呆症或延缓其进展的治疗。 Symptoms 症状 The first symptoms of Alzheimer's disease you may notice are increasing forgetfulness and mild confusion. Over time, the disease has a growing impact on your memory, your ability to speak and write coherently, and your judgment and problem solving. If you have Alzheimer's, you may be the first to notice that you're having unusual difficulty remembering things and organizing your thoughts. Or you may not recognize that anything is wrong, even when changes are noticeable to your family members, close friends or co-workers. 你可注意到的老年痴呆症的最初症状是越来越健忘和轻微糊涂。一段时间后，疾病进展为影响你的记忆力，说话和写字条理性的能力，以及判断力和解决问题的能力。如果你患有老年痴呆症，你首先应该注意到在记事情和组织思路方面出现了异常的困难。即使家人、亲友或同事都已经注意到这种变化，你有可能仍没有意识到身体出现了问题。 Brain changes associated with Alzheimer's disease lead to growing trouble with： 与老年痴呆症相关的脑部改变会造成以下能力地逐渐下降： Memory 记忆力 Everyone has occasional memory lapses. It's normal to lose track of where you put your keys or forget the name of an acquaintance. But the memory loss associated with Alzheimer's disease persists and gets worse. People with Alzheimer's may: 每个人偶尔会有记忆缺失。忘记钥匙发在何处或某个熟人的名字是正常的。但老年痴呆症相关的记忆丧失是持续的，而且越来越严重。老年痴呆症患者可能出现： ·Repeat statements and questions over and over ·说话重复，一遍又一遍地问问题； ·Forget conversations, appointments or events, and not remember them later ·忘记谈话内容、约会或重要事情，而且事后想不起来； ·Routinely misplace possessions, often putting them in illogical locations ·常将东西放错地方，经常把它们放在不该放的地方； ·Eventually forget names of family members and everyday objects ·最终忘了家人和各种东西的名称 Disorientation and misinterpreting spatial relationships 定向力障碍，不能正确辨别空间方位 People with Alzheimer's disease may lose their sense of what day it is, the time of year, where they are or even their current life circumstances. Alzheimer's may also disrupt your brain's ability to interpret what you see, making it difficult to understand your surroundings. Eventually, these problems may lead to getting lost in familiar places. 老年痴呆症患者会不记得是那一天，一年中的哪个季节，他们在哪，甚至他们当时所处的生活环境。老年痴呆症也可破坏大脑解释所见事物的能力，从而使你对周围环境的判断产生困难。最终，这些问题会使你在熟悉的环境里迷失。 Speaking and writing 说话和写字 Those with Alzheimer's may have trouble finding the right words to identify objects, express thoughts or take part in conversations. Over time, the ability to read and write also declines. 老年痴呆症患者在用正确的词语描述事物，表达想法或与人交谈时会遇到困难。随着时间的推移，阅读和写字的能力也会下降。 Thinking and reasoning 思考和判断力
老年痴呆症会造成注意力集中和思考力有困难，特别是对于抽象概念例如数字。许多人发现管理他们的资金，平衡账目，记住账单即时还款有很大挑战。这些困难会进展为不能识别和处理数字。 Making judgments and decisions 做判断和决定 Responding effectively to everyday problems, such as food burning on the stove or unexpected driving situations, becomes increasingly challenging. 对日常问题做出有效的回应，如炉子上的食物或开车时突发情况，会越来越困难。 Planning and performing familiar tasks 计划和完成熟悉的任务 Once-routine activities that require sequential steps, such as planning and cooking a meal or playing a favorite game, become a struggle as the disease progresses. Eventually, people with advanced Alzheimer's may forget how to perform basic tasks such as dressing and bathing. 在疾病的进展期，对于需要相继步骤才能完成的日常行为，如做计划、熟饭或进行一项非常喜欢的运动，会有困难。最终，老年痴呆症晚期患者会忘记最基本的技能，如穿衣或洗澡。 Changes in personality and behavior 性格和行为的改变 Brain changes that occur in Alzheimer's disease can affect the way you act and how you feel. People with Alzheimer's may experience: 在老年痴呆症，脑部改变可影响你的行为和情绪。老年痴呆症患者可有以下经历： ·Depression ·沮丧 ·Anxiety ·焦虑 ·Social withdrawal ·不合群 ·Mood swings ·情绪起伏 ·Distrust in others ·对他人缺乏信任 ·Increased stubbornness ·脾气更加倔强
·易激怒，武断 ·Changes in sleeping habits ·睡眠习惯发生改变 ·Wandering ·精神错乱 Causes 病因 Scientists believe that for most people, Alzheimer's disease results from a combination of genetic, lifestyle and environmental factors that affect the brain over time. 科学家认为对于大多数人而言，老年痴呆症是由于遗传、生活方式和环境等影响大脑因素共同作用所致。 Less than 5 percent of the time, Alzheimer's is caused by specific genetic changes that guarantee a person will develop the disease. 由于某人由于特殊基因改变而患老年痴呆症的概率不足5%。 While the causes of Alzheimer's are not yet fully understood, its effect on the brain is clear. Alzheimer's disease damages and kills brain cells. A brain affected by Alzheimer's disease has many fewer cells and many fewer connections among surviving cells than does a healthy brain. 虽然老年痴呆症的原因尚未完全搞清楚，但它对大脑的影响是显然的。老年痴呆症损伤并杀死脑细胞。因这种疾病受累的大脑比正常大脑细胞少得多，而且活细胞之间的联系也比正常大脑少许多。 As more and more brain cells die, Alzheimer's leads to significant brain shrinkage. When doctors examine Alzheimer's brain tissue under the microscope, they see two types of abnormalities that are considered hallmarks of the disease: 随着越来越多的脑细胞的死亡，老年痴呆症造成明显的脑萎缩。当医生在显微镜下对这种疾病的脑组织进行检查时，他们发现被认为是这种疾病标志的两种异常类型： ·Plaques. These clumps of a protein called beta-amyloid may damage and destroy brain cells in several ways, including interfering with cell-to-cell communication. Although the ultimate cause of brain-cell death in Alzheimer's isn't known, abnormal processing of beta-amyloid is a prime suspect. ·斑块。这些被称作β淀粉样蛋白团块儿可通过几种方式损伤和破坏脑细胞，包括干扰细胞和细胞之间的交流。虽然在老年痴呆症，脑细胞死亡的最终原因尚不清楚，但β淀粉样变时最可疑的。 ·Tangles. Brain cells depend on an internal support and transport system to carry nutrients and other essential materials throughout their long extensions. This system requires the normal structure and functioning of a protein called tau. In Alzheimer's, threads of tau protein twist into abnormal tangles, leading to failure of the transport system. This failure is also strongly implicated in the decline and death of brain cells. ·结。脑细胞依靠内部支持和传输系统来运送营养及其他必须物质。这个系统需要的正常结构和功能的蛋白称为τ。在老年痴呆症，τ蛋白丝缠绕成异常的结，导致运输系统衰退。在脑细胞减少和死亡时，这种衰退格外显著。 Risk factors 风险因素 Age 年龄 Increasing age is the greatest known risk factor for Alzheimer's. Alzheimer's is not a part of normal aging, but your risk increases greatly as you grow older. After you reach age 65, your risk of developing the disease doubles about every five years. Nearly half of those over age 85 have Alzheimer's. 年龄的增加是患老年痴呆症最引人关注的风险因素。老年痴呆症不是正常老龄化的一部分，而是随着你年龄的增长你患这种病的风险越来越高。超过65岁以后，患这种病的风险每5年增加1倍。85岁以上的老年人几乎有一般患有老年痴呆症。 People with rare genetic changes that guarantee they'll develop Alzheimer's often begin experiencing symptoms in their 40s or 50s. 确实是因为罕见的基因改变而患阿尔兹海默症的人经常是在40或50岁开始表现出症状。 Family history and genetics 家族史和遗传 Your risk of developing Alzheimer's appears to be somewhat higher if a first-degree relative — your parent, sibling or child — has the disease. Scientists have identified rare changes (mutations) in three genes that guarantee a person who inherits them will develop Alzheimer's. But these mutations account for less than 5 percent of Alzheimer's disease. Most genetic mechanisms of Alzheimer's among families remain largely unexplained. The strongest risk gene researchers have found so far is apolipoprotein e4 (APOE-e4). Other risk genes have been identified but not conclusively confirmed. 如果直系亲属如你的父母、同胞兄弟姐妹或孩子患这种病，那么你患这种病的风险似乎会稍微高一些。科学家已经确定了在遗传中三种罕见的改变（突变）会使人们因遗传而患病。但这些突变仅占阿尔兹海默症的不足5%。大多数家庭成员中的阿尔兹海默症遗传机制仍在很大程度上无法解释。研究者迄今发现，最显著的遗传风险因素是载脂蛋白e4 (APOE-e4)。虽然还发现了其他遗传风险因素但没有得到明确的证实。 Sex 性别 Women may be more likely than are men to develop Alzheimer's disease, in part because they live longer. 女性比男性更易患阿尔兹海默症，部分原因是她们的寿命更长。 Mild cognitive impairment 轻微认知障碍 People with mild cognitive impairment (MCI) have memory problems or other symptoms of cognitive decline that are worse than might be expected for their age, but not severe enough to be diagnosed as dementia. Those with MCI have an increased risk — but not a certainty — of later developing dementia. 轻微认知障碍（MCI）者有记忆问题或其他认知能力下降的症状可能会比他们实际年龄所预测出的结构糟糕，但并没有严重到被确诊为痴呆。这些MCI患者晚期进展为痴呆的风险增加，但并不一定。 Lifestyle and heart health 生活方式和心脏病 There's no lifestyle factor that's been conclusively shown to reduce your risk of Alzheimer's disease. 还没有明确证实的能降低阿尔兹海默症风险的生活方式因素。 However, some evidence suggests that the same factors that put you at risk of heart disease may also increase the chance that you'll develop Alzheimer's. Examples include: 然而，然而有些证据提示与引发心脏病相同的因素也可增加患阿尔兹海默症的几率。例如： ·Lack of exercise ·缺乏锻炼 ·Smoking ·吸烟 ·High blood pressure ·高血压 ·High cholesterol ·高胆固醇 ·Poorly controlled diabetes ·没有得到控制的糖尿病 These risk factors are also linked to vascular dementia, a type of cognitive decline caused by damaged blood vessels in the brain. Many people with cognitive decline have brain changes characteristic of both Alzheimer's disease and vascular dementia. Some researchers think that each condition helps fuel the damage caused by the other. 这些风险因素也能引起血管性痴呆，一种因脑部血管损伤导致的认知减退类型。许多伴有认知能力减退的人脑部改变特征既有阿尔兹海默症也有血管性痴呆。一些研究者认为每种疾病都加剧另一种疾病的恶化。 Working with your health care team on a plan to control these factors will help protect your heart — and may also help reduce your risk of dementia. 和你的健康护理小组合作制定一个控制这些因素的计划将有助于保护你的心脏——也可以减少患痴呆症的风险。 Lifelong learning and social engagement 终生学习及参加社交活动 Studies have found an association between lifelong involvement in mentally and socially stimulating activities and reduced risk of Alzheimer's disease. 研究显示终生参加心理和社会健康促进活动与降低阿尔兹海默症之间有关联。 Factors that may reduce your risk of Alzheimer's include: 降低患阿尔兹海默症风险的因素包括： ·Higher levels of formal education ·较高水平的正规教育 ·A stimulating job ·令人振奋的工作 ·Mentally challenging leisure activities, such as reading, playing games or playing a musical instrument ·智力上具有挑战性的休闲活动，例如阅读、做游戏或演奏乐器 ·Frequent social interactions ·频繁的社交活动 Scientists can't yet explain this link. One theory is that using your brain develops more cell-to-cell connections, which protects your brain against the impact of Alzheimer-related changes. Another theory is that it may be harder to measure cognitive decline in people who exercise their minds frequently or who have more education. Still another explanation is that people with Alzheimer's disease may be less inclined to seek out stimulating activities years before their disease can be diagnosed. 科学家还不能解释这些关联。一种理论认为使用你的大脑可以促进细胞和细胞之间的联系，从而保护大脑避免阿尔兹海默症相关改变的影响。另一种理论认为衡量经常用脑或接受教育较多的人认知能力下降可能较困难。另外，还有一种解释是在阿尔兹海默症患者确诊前，他们可能不会去寻求一些刺激的活动。 Complications 并发症 Memory loss, impaired judgment and other cognitive changes caused by Alzheimer's can complicate treatment for other health conditions. A person with Alzheimer's disease may not be able to: 对于其他身体疾病，因阿尔兹海默症引起的记忆丧失，判断力受损以及其他认知改变使治疗更加困难。阿尔兹海默症的患者可能不能： ·Communicate that he or she is experiencing pain — for example, from a dental problem ·传达他或她所经历的疼痛——例如，牙疼 ·Report symptoms of another illness ·诉说另一种疾病的症状 ·Follow a prescribed treatment plan ·遵照医嘱的治疗计划 ·Notice or describe medication side effects ·注意或描述药物的副作用 As Alzheimer's disease progresses, brain changes begin to affect physical functions such as swallowing, balance, and bowel and bladder control. These effects can increase vulnerability to additional health problems such as: 随着阿尔兹海默症的进展，脑部改变开始影响身体功能，例如吞咽、平衡能力以及直肠和膀胱控制。这些影响会增加出现其他健康问题的风险，例如： ·Pneumonia and other infections. Difficulty swallowing may cause people with Alzheimer's to inhale (aspirate) food or liquid into their airways and lungs, which can lead to pneumonia. Inability to control emptying of the bladder (urinary incontinence) may require placement of a tube to drain and collect urine (urinary catheter). Having a catheter increases your risk of urinary tract infections, which can lead to more-serious, life-threatening infections. ·肺炎和其他感染。吞咽困难使阿尔兹海默症患者将食物或液体吸入（吸出）到气管或肺中，导致肺炎。不能控制膀胱排空（尿失禁）可能需要置入导尿管收集尿液（尿管）。插导管增加了患尿道感染的风险，造成更严重威胁生命的感染。 ·Injuries from falls. People with Alzheimer's become increasingly vulnerable to falling. Falls can lead to fractures. In addition, falls are a common cause of serious head injuries, such as concussion or bleeding in the brain. ·跌倒造成的损伤。阿尔兹海默症患者易跌倒。跌倒造成骨折。另外，跌倒是引起头部损伤的常见原因，例如脑震荡或出血。 Preparing for your appointment 就诊前需做的准备 You may decide you want to talk to your doctor about memory loss or other cognitive changes, or you may seek care at the urging of a family member who arranges your appointment and goes with you. You'll probably start by seeing your family doctor or general practitioner, who may refer you to a neurologist, psychiatrist or neuropsychologist for further evaluation. 你可能决定要找你的医生咨询一下关于记忆衰退或其他认知改变，或者在家人帮你预约了门诊并和你一起去看医生的督促下，你可能要寻求帮助。你开始可能会去找你的家庭医生或全科医生，他们会将你转诊到神经可医生、精神医生或神经心理专家做进一步评估。 Because appointments can be brief and there's often a lot of ground to cover, it's a good idea to prepare ahead of time. Here are some suggestions to help you get ready for your appointment and understand what to expect from your doctor. 因为就医时间短暂，而且通常涉及范围很广，提前准备是个好主意。这里有一些建议帮助你做好就医的准备，了解你希望从医生那里得到的信息。 What you can do 你能做的： ·Be aware of any pre-appointment restrictions. When you make your appointment, ask if you need to fast for blood work or if you need to do anything else to prepare for diagnostic tests. ·了解就医前的各种限制规定。在就医时，问问你是否要禁食以做血液检查或是否要为其他的诊断检验而做准备。 What you can do 你能做的： ·Write down all of your symptoms. Your doctor will want to know details about what's causing your concern about your memory or mental function. Make notes about some of the most important examples of forgetfulness or other lapses you want to mention. Try to remember when you first started to suspect that something might be wrong. If you think your difficulties are getting worse, be ready to explain why. ·写下你所有的症状。你的医生可能想知道造成你对记忆和精神功能焦虑的详细情况。记录下重要的健忘例子，或其他你想谈及的失忆。试着回想你第一次开始怀疑出现问题的时间。如果你觉得情况越来越严重，应该做好解释原因的准备。 ·Make a list of your other medical conditions. Your doctor will want to know if you're currently being treated for diabetes, heart disease, past strokes or any other conditions. ·将你的其他内科疾病列成表。你的医生可能想知道你目前是否在治疗糖尿病、心脏病、既往的脑梗或其他疾病。 ·Make a list of all your medications, including over-the-counter drugs and vitamins or supplements. ·将你所有的药物列成表，包括非处方药物和维生素或补剂。 Questions to ask your doctor 问医生的问题 Because time with your doctor is limited, writing down a list of questions will help you make the most of your appointment. If you're seeing your doctor regarding concerns about Alzheimer's disease, some questions to ask include: 因为和医生交流的时间有限，列出要问的问题可帮助充分利用就医的时间。如果你想让医生讲一下阿尔兹海默症的注意事项，应问以下问题： ·Do I have a memory problem or other cognitive changes? ·我是否有记忆问题或其他认知改变吗？ ·Do you think my symptoms are due to Alzheimer's disease? ·你认为我的症状是由阿尔兹海默症引起的吗？ ·What tests do I need? ·我需要做哪些化验？ ·Do I need to see a specialist? What will that cost? Will my insurance cover it? ·我用不用看专家？费用有多少？可以用我的保险支付吗？ ·If my diagnosis is Alzheimer's disease, will you or another doctor manage my ongoing care? Can you help me get a plan in place for ongoing care? ·如果我确诊为阿尔兹海默症，你或其他医生能继续给我治疗吗？你能帮我制定一个后续治疗的合理计划吗？ Are treatments available? 能治疗吗？ ·Is there a generic alternative to the medicine you're prescribing? ·对于您所开的处方药有没有可以替代的非专利药？ ·Are there any clinical trials of experimental treatments I should consider? 有没有我可以考虑的正处于治疗试验阶段的临床试验吗？ ·What should I expect to happen over the long term? ·我能期待怎样的远期治疗结果？ ·Will my new symptoms affect how I manage my other health conditions? ·这些新的症状是否会影响我对其他疾病的治疗？ ·Do I need to follow any restrictions? ·有没有我必须遵守的制约? ·Do you have any brochures or other printed material I can take home with me? What websites and support resources do you recommend? ·您有一些我可以带回家的小册子或印刷资料吗？有哪些网站推荐呢？ In addition to the questions you've prepared ahead of time, don't hesitate to ask your doctor to clarify anything you don't understand. 除了你提前准备的这些问题，如果有不明白之处应毫不犹豫地让医生来解释。 What to expect from your doctor 医生期望了解的 Your doctor is also likely to have questions for you. Being ready to respond may free up time to focus on any points you want to talk about in-depth. Your doctor may ask: 你的医生可能也有一些问题要问。做好回答问题的准备可以节省时间来关注你想要深入了解的话题。你的医生可能会问： ·What kinds of memory difficulties and mental lapses are you having? When did you first notice them? ·你有哪些记忆困难和记忆丧失？这些情况从什么时候开始引起你的注意？ ·Are they steadily getting worse, or are they sometimes better and sometimes worse? ·这些症状是越来越严重，还是时好时坏？ ·Do you feel any sadder or more anxious than usual? ·你是否比平时觉得更加沮丧或焦虑？ ·Have you gotten lost lately on a driving route or in a situation that's usually familiar to you? ·最近你开车时有没有迷路或在一个通常比较熟悉的情况下走失呢？ ·Has anyone expressed unusual concern about your driving? ·有没有人对你的驾驶技术表达出异常的担忧？ ·Have you noticed any changes in the way you tend to react to people or events? ·你是否发现你对某人或某事的反应发生了改变？ ·Do you have more energy than usual, less than usual or about the same? ·你感觉经历比平常充沛，不如原来，还是与以前一样呢？ ·What medications are you taking? Are you taking any vitamins or supplements? ·你服用哪些药物、维生素或补剂？ ·Do you drink alcohol? How much? ·你喝酒吗？喝多少？ ·What other medical conditions are you being treated for? ·你有哪些其他的内科疾病正在接受治疗？ ·Have you noticed any trembling or trouble walking? ·你是否注意到颤抖或走路困难？ ·Are you having any trouble remembering your medical appointments or when to take your medication? ·记住就诊或服药时间有困难吗？ ·Have you had your hearing and vision tested recently? ·你最近检查过视力和听力吗？ ·Did anyone else in your family ever have memory trouble? Was anyone ever diagnosed with Alzheimer's disease or dementia? ·你家还有其他人有记忆困难吗？有没有人被确诊为阿尔兹海默症或痴呆呢？ Tests and diagnosis 检验和诊断 There's no specific test today that confirms you have Alzheimer's disease. Your doctor will make a judgment about whether Alzheimer's is the most likely cause of your symptoms based on the information you provide and results of various tests that can help clarify the diagnosis. 目前尚没有特异性检验能肯定你患了阿尔兹海默症。你的医生会根据你提供正信息以及各种能够帮助诊断的化验结果来做出判断，是否是阿尔兹海默症造成了你的症状。 Doctors can nearly always determine whether you have dementia, and they can accurately identify whether your dementia is due to Alzheimer's disease about 90 percent of the time. Alzheimer's disease can be diagnosed with complete accuracy only after death, when microscopic examination of the brain reveals the characteristic plaques and tangles. 医生几乎总是能诊断出你是否患痴呆，但他们能准确判断你是否因阿尔兹海默症造成痴呆的几率约为90%。只有在死后才能完全准确地确定阿尔兹海默症，这时可以通过显微检查来显示脑部特征性的斑块和结。 To help distinguish Alzheimer's disease from other causes of memory loss, doctors now typically rely on the following types of tests. 为了帮助鉴别记忆丧失是因阿尔兹海默症引起的还是其他原因造成的，目前医生主要借助于以下类型的检验。 Physical and neurological exam 体检和神经系统检查 Your doctor will perform a physical exam, and is likely to check your overall neurological health by testing your: 医生会做一个体检，通过检查来评估你各项神经系统健康情况： ·Reflexes ·反射 ·Muscle tone and strength ·肌肉强健程度 ·Ability to get up from a chair and walk across the room ·从椅子上站起或在屋内走路的能力 ·Sense of touch and sight ·触摸和视觉感 ·Coordination ·协调性 ·Balance ·平衡感 Lab tests 实验室检验 Blood tests may help your doctor rule out other potential causes of memory loss and confusion, such as thyroid disorders or vitamin deficiencies. 血检能帮助医生除外其他引起记忆丧失和糊涂的潜在原因，如甲状腺疾病或维生素缺乏。 Mental status testing 心理测试 Your doctor may conduct a brief mental status test to assess your memory and other thinking skills. Short forms of mental status testing can be done in about 10 minutes. Commonly used tests include the following tasks and questions: 你的医生可能会做一个简短的心理测试来评估你的记忆和其他思考能力。大约10分钟完成一个小的心理测试。常见使用的检验包括以下任务和问题： ·Draw a clock face with the hands showing a time specified by the examiner. ·用手做一个表盘示出检查者要求的具体时间。 ·Name today's date and your location. ·说出今天的日期及你所在的位置。 ·Copy a design, such as two intersecting pentagons. ·复制一个图案，如两个相交的五边形。 ·Follow a three-step command. ·完成一个三个步骤的指令。 ·Remember a list of three words spoken to you by the examiner. ·记住检查者说的一些三个字母的单词。 ·Follow a written instruction. ·完成一个书写指令。 ·Write down a complete sentence. ·写一个完整的句子。 ·Count backward from 100 by sevens. ·七个七个的从一百倒着数数 Neuropsychological testing 神经心理检验 Your doctor may recommend a more extensive assessment of your thinking and memory. Longer forms of neuropsychological testing, which can take several hours to complete, may provide additional details about your mental function compared with others' of a similar age and education level. This type of testing may be especially helpful if your doctor thinks you may have a very early stage of Alzheimer's disease or another dementia. These tests may also help identify patterns of change associated with different types of dementia. 你的医生可能要对你的思考和记忆进行更全面的评估。较长的神经心理测验，可能需要花几个小时来完成，这可以提供关于你与有着相似背景的同龄人相比的精神功能的详细信息。如果你的医生认为你患早期的阿尔兹海默症症或其他痴呆，这种类型的检验将非常有帮助。这些检验有助于鉴别与不同痴呆类型相关的改变。 Brain imaging 脑部成像检查 Images of the brain are now used chiefly to pinpoint visible abnormalities related to conditions other than Alzheimer's disease — such as strokes, trauma or tumors — that may cause cognitive change. New imaging applications — currently used primarily in major medical centers or in clinical trials — may enable doctors to detect specific brain changes caused by Alzheimer's. 目前使用的脑部成像主要针对与其他疾病相关的可见的异常，而不是阿尔兹海默症，例如脑卒中、外伤或肿瘤，这些可引起认知改变。目前在大型医疗机构或临床试验阶段使用的新型影像技术可帮助医生发现因阿尔兹海默症造成的特异性脑部改变。 Brain-imaging technologies include: 脑部成像技术包括： ·Computerized tomography (CT). For a CT scan, you'll lie on a narrow table that slides into a small chamber. X-rays pass through your body from various angles, and a computer uses this information to create cross-sectional images, or slices, of your brain. This test is painless and takes about 20 minutes. It's currently used chiefly to rule out tumors, strokes and head injuries. ·计算机断层扫描（CT）。对于CT扫描，你躺在狭窄的检查台上，然后滑入一个小的房间。X线将以不同角度射入你的身体，计算机用这些信息得到脑部的横断面成像或切片。这项检查是无痛的，大约需要20分钟。目前主要用于排除脑肿瘤、脑卒中和头部损伤。 ·Magnetic resonance imaging (MRI). An MRI uses radio waves and a strong magnetic field to produce detailed images of your brain. You lie on a narrow table that slides into a tube-shaped MRI machine, which makes loud banging noises while it produces images. The entire procedure can take an hour or more. MRIs are painless, but some people feel claustrophobic inside the machine and are disturbed by the noise. MRIs are currently used primarily to rule out other conditions that may account for cognitive symptoms. In the future, they may be used to measure the volume of your brain tissue and whether shrinkage in brain regions implicated in Alzheimer's disease has occurred. ·磁共振成像（MRI）。MRI使用无线波和强磁场来产生脑部的细节影像。你躺在狭窄的检查台上，滑入一个管状的MRI机器中，当生成图像时会发出猛烈的噪音。全部过程要一个多小时。MRI是无痛的，但一些人在机器内会感到恐惧，被噪音所困扰。目前主要用MRI除外出现认知症状的其他疾病。将来，可用这种技术评估脑组织的体积以及能提示患阿尔兹海默症的脑部区域的萎缩。 ·Positron emission tomography (PET). During a PET scan, you'll be injected in a vein with a low-level radioactive tracer. You'll lie on a table while an overhead scanner tracks the tracer's flow through your brain. The tracer may be a special form of glucose (sugar) that shows overall activity in various brain regions. This can show which parts of your brain aren't functioning well. New PET techniques may be able to detect your brain level of plaques — one hallmark abnormality linked to Alzheimer's. ·正电子发射断层扫描（PET）。做PET扫描时，在你的经脉会置入一个低级无线探针。你躺在检查台上，头顶的扫描仪会标记出通过你的大脑的示踪剂流动。示踪剂是一种特殊类型的葡萄糖（糖），它可以示出各种脑部区域的整体活动。它能够显示出你脑部功能不正常的部分。新型PET技术可检测你脑部的斑块程度——一种与阿尔兹海默症相关的标志性异常。 Future diagnostic tools 未来的诊断工具 Researchers are working with doctors to develop new diagnostic tools to help clinch the diagnosis of Alzheimer's. Another important goal is to detect the disease before it causes the symptoms targeted by current diagnostic techniques — at the stage when Alzheimer's may be most treatable as new drugs are discovered. New tools under investigation include: 研究者正与医生合作来开发新型的诊断工具以帮助最终明确阿尔兹海默症的诊断。另一个重要的目标是借助目前的诊断技术在疾病引起症状前检测到它——阿尔兹海默症最有可能用新研制的药物治疗的时期。正在研发的新技术包括： ·Additional approaches to brain imaging ·脑部成像的其他方法 ·Measuring levels of key proteins or protein patterns in blood or spinal fluid ·测量血液或脊髓中的重要蛋白质或蛋白质类型水平 ·More-sensitive mental status tests ·敏感性更高的心理测试 Treatments and drugs 治疗和药物 Drugs 药物 Current Alzheimer's medications can help for a time with memory symptoms and other cognitive changes. Two types of drugs are currently used to treat cognitive symptoms: 目前用于阿尔兹海默症症的药物可以暂时改善记忆和其他认知改变。目前用于治疗认知症状的两种类型的药物包括： ·Cholinesterase inhibitors. These drugs work by boosting levels of a cell-to-cell communication chemical depleted in the brain by Alzheimer's disease. Commonly prescribed cholinesterase inhibitors include donepezil (Aricept), galantamine (Razadyne) and rivastigmine (Exelon). The main side effects of these drugs include diarrhea, nausea and vomiting. ·胆碱酯酶抑制剂。这些药物通过刺激因阿尔兹海默症造成的化学上已经耗尽的细胞与细胞之间交流来起作用。胆碱酯酶抑制剂的常见处方药包括多奈哌齐（Aricept）、加兰他敏(Razadyne) 和利斯的明（Exelon)。这些药物的主要副作用包括：腹泻、恶心和呕吐。 ·Memantine (Namenda). This drug works in another brain cell communication network. It's sometimes used in combination with a cholinesterase inhibitor. Memantine's most common side effect is dizziness. ·美金刚 (Namenda)。这种药物的原理是用另一脑细胞交流网络。有时与胆碱酯酶抑制剂联合使用。这种药物最常见的副作用是眩晕。 Creating a safe and supportive environment 营造一个安全以及支持的环境 Adapting the living situation to the needs of a person with Alzheimer's is an important part of any treatment plan. You can take these steps to support a person's sense of well-being and continued ability to function: 营造一个满足阿尔兹海默症患者需要的生活环境是任何治疗计划的重要组成部分。你可以采取以下步骤来支持患者的健康感并继续功能锻炼： ·Remove excess furniture, clutter and throw rugs. ·移除多余的家具、杂物，扔掉小毯子 ·Install sturdy handrails on stairways and in bathrooms. ·在楼梯和浴室安装牢固的扶手 ·Ensure that shoes and slippers are comfortable and provide good traction. ·确保鞋子舒适，防滑 ·Reduce the number of mirrors. People with Alzheimer's may find images in mirrors confusing or frightening. ·减少镜子的数量。阿尔兹海默症患者可能会对镜子中的形象感到困惑或害怕。 Exercise 锻炼 Regular exercise is an important part of everybody's wellness plan — and those with Alzheimer's are no exception. Activities like a daily 30-minute walk can help improve mood and maintain the health of joints, muscles and your heart. Exercise can also promote restful sleep and prevent constipation. Make sure that the person with Alzheimer's carries identification if she or he walks unaccompanied. 有规律的锻炼对于每个人的健康都很重要，阿尔兹海默症患者也不例外。例如像每天30分钟的步行锻炼能够改善情绪，保持关节、肌肉和心脏的健康。锻炼也能改善睡眠状况，预防便秘。阿尔兹海默症患者单独出行时应确保他（她）随身携带有效证件。 People with Alzheimer's who develop trouble walking may still be able to use a stationary bike or enjoy chair exercises. You may be able to find exercise programs geared to older adults on TV or on DVDs. 对于不能行走的阿尔兹海默症患者可能仍可以使用固定的自行车或在椅子上做运动。你可能会在电视或DVD上找到适合老年人的锻炼节目。 Nutrition 营养 People with Alzheimer's may forget to eat, lose interest in preparing meals or not eat a healthy combination of foods. They may also forget to drink enough, leading to dehydration and constipation. 阿尔兹海默症患者可能会忘记吃饭，对做饭不感兴趣或不吃健康食品。他们也可能忘记喝水，造成脱水和便秘。 Offer: 提议： ·High-calorie, healthy shakes and smoothies. You can supplement milkshakes with protein powders (available at grocery stores, drugstores and discount retailers) or use your blender to make smoothies featuring your favorite ingredients. ·高能量、健康的奶昔和思慕雪。你可以补充含有蛋白质粉的奶昔（可以在杂货店、药店或折扣店买到）或用搅拌器制作符合自己口味的思慕雪。 ·Water, juice and other healthy beverages. Try to ensure that a person with Alzheimer's drinks at least several full glasses of liquids every day. Avoid beverages with caffeine, which can increase restlessness, interfere with sleep and trigger frequent need to urinate. ·水、果汁和其他健康饮料。尽力确保阿尔兹海默症患者每天至少喝几杯水。避免饮料中还有咖啡因，这可加重心神不宁，影响睡眠，引起尿频。 Certain nutritional supplements are marketed as "medical foods" specifically to treat Alzheimer's disease. The Food and Drug Administration (FDA) does not approve products marketed as medical foods. Despite marketing claims, there's no definitive data showing that any of these supplements is beneficial or safe. 某些营养补充剂，也就是市场上售卖的针对阿尔兹海默症的“医疗保健食品”。食品和药品管理局（FDA）没有批准这些产品作为医疗食品销售。尽管市场上有各种声明，但没有明确的数组证实这些补剂的有效性和安全性。 Lifestyle and home remedies 生活方式和家庭治疗 Study results have been mixed about whether diet, exercise or other healthy lifestyle choices can prevent or reverse cognitive decline. But these healthy choices promote good overall health and may play a role in maintaining cognitive health, so there's no harm in including these strategies in your general wellness plan: 关于饮食、锻炼还是其他健康生活方式能否预防或逆转认知下降的研究结果已经进行了混合研究。但这些健康选择促进了整体的健康，对于保持认知健康也起到了积极的作用，因此在常规的健康计划中纳入以下方法没有害处： ·Regular exercise has known benefits for heart health and may also help prevent cognitive decline. There's also some evidence that exercise may help improve mood in those with Alzheimer's. ·众所周知，有规律的锻炼对于心脏健康有益，而且有助于预防认知下降。也有证据显示锻炼能改善阿尔兹海默症患者的情绪。 ·A diet low in fat and rich in fruits and vegetables is another heart-healthy choice that also may help protect cognitive health. 低脂肪、富含水果和蔬菜的饮食是对心脏健康的另一个选择，同时也有助于维持认知健康。 ·Omega-3 fatty acids are good for the heart. Most research showing a possible benefit for cognitive health uses fish consumption as a yardstick for the amount of omega-3 fatty acids eaten. ·ω3脂肪酸对心脏有好处。许多研究显示，用吃鱼的量来衡量摄入ω3脂肪酸的量对认知健康可能有益。 ·Social engagement and intellectual stimulation may make life more satisfying and help preserve mental function. ·社会活动和智力刺激可使生活更加称心如意，有助于保护心理功能。 Alternative medicine 可供选择的药物 Various herbal mixtures, vitamins and other supplements are widely promoted as preparations that may support cognitive health or prevent or delay Alzheimer's. The National Institutes of Health (NIH) convened an expert panel that concluded current evidence doesn't support any benefit from taking vitamin B, vitamin C, vitamin E, folic acid or beta carotene. 大范围的生产各种草药混合物、维生素和其他补剂作为维持认知健康或预防、推迟阿尔兹海默症的药物。国家健康研究所（NIC）召开了专家小组会议，指出目前的证据尚不能支持服用维生素B、维生素C、维生素E、叶酸或β胡萝卜素对已经有益。 Omega-3 fatty acids ω3脂肪酸 The NIH panel concluded there is somewhat stronger data — but not definitive evidence — that omega-3 fatty acids in fish oil may help prevent cognitive decline. NIH专家小组认为有较有力的数据治疗但尚不能肯定的证据表明鱼油中的ω3脂肪酸对预防认知下降有帮助。 Vitamin E 维生素E Some physicians prescribe high doses of vitamin E to help treat Alzheimer's disease, based on a federally funded study showing that vitamin E delayed loss of ability to carry out daily activities and placement in residential care for a few months. Since that study, other research has associated taking vitamin E with an increased risk of death. No one should take vitamin E except under a doctor's supervision.一些医生开了大剂量的维生素E以帮助治疗阿尔兹海默症，这是基于联邦基金研究显示维生素E对于每日活动以及居住在社区的能力下降有延缓的作用。在这项研究后，又有一项研究指出服用维生素E与死亡风险增加有关。除非在医生的监督下，否则任何人不应该服用维生素E。 Ginkgo 银杏 Ginkgo is a plant extract containing several substances believed to be of possible benefit in Alzheimer's. But a large study funded by the NIH found no effect in preventing or delaying Alzheimer's disease. 银杏是一种植物萃取物，被认为还有对阿尔兹海默症可能有改善的几种物质。但NIH资助的一项大型研究发现，在预防或延缓阿尔兹海默症方面并没有效果。 Huperzine A 石杉碱 A This extract from a type of Chinese moss has effects similar to the cholinesterase inhibitors, one class of drugs approved for Alzheimer's disease. But a large federally funded study found huperzine A didn't help treat mild to moderate Alzheimer's disease. 一种中国藓类萃取物，与胆碱酯酶抑制剂有相似的疗效，后者是一类被证实对阿尔兹海默症有效的药物。但大型联邦资助研究发现石杉碱 A对于治疗轻中度阿尔兹海默症没有帮助。 Supplements promoted for cognitive health can interact with medications you're taking for Alzheimer's disease or other health conditions. Work closely with your health care team to create a treatment plan that's right for you. Make sure you understand the risks and benefits of everything it includes. 对于改善认知健康的补剂可以和你服用的治疗阿尔兹海默症或其他疾病的药物相互作用。与你的健康护理组合作制定一个适合自己的治疗计划。你务必要了解所包含的各种药品的风险和益处。 Coping and support 处理和支持 People with Alzheimer's disease experience a mixture of emotions — confusion, frustration, anger, fear, uncertainty, grief and depression. 阿尔兹海默症患者有着复杂的情绪——糊涂、沮丧、愤怒、害怕、嘀咕、悲伤和沮丧。 You can help a person cope with the disease by being there to listen, reassuring the person that life can still be enjoyed, providing support, and doing your best to help the person retain dignity and self-respect. 你能通过倾听来帮助患者处理疾病，让患者觉得生活很享受，提供帮助，尽力维护患者的尊严。 A calm and stable home environment can help reduce behavior problems. New situations, noise, large groups of people, being rushed or pressed to remember, or being asked to do complicated tasks can cause anxiety. As a person with Alzheimer's becomes upset, the ability to think clearly declines even more. 平和稳定的家庭环境能帮助降低行为问题。新环境、噪音、众多的人、忙碌或强迫记忆或被要求完场复杂的任务能引起焦虑。由于患者心烦意乱，他的思考力显然会下降得更快。 Caring for the caregiver 护理人员的照顾 Caring for a person with Alzheimer's disease is physically and emotionally demanding. Feelings of anger and guilt, frustration and discouragement, worry and grief, and social isolation are common. But paying attention to your own needs and well-being is one of the most important things you can do for yourself and for the person with Alzheimer's. If you're a caregiver for someone with Alzheimer's, you can help yourself by: 护理患者既需要体力支持也需要情感呵护。愤怒和负罪感，沮丧和气馁，焦虑和悲伤，社会孤独感常见。但是注意到自己的需要和健康是你能为自己做的最重要的事情也是为阿尔兹海默症患者做的最重要的事情。如果你是这类患者的护理人员，你能通过以下方法来帮助自己： ·Learning as much about the disease as you can ·尽量多的了解这种疾病 ·Asking questions of doctors, social workers and others involved in the care of your loved one ·向医生、社工和其他参与照顾你所心爱的人的人员 ·Calling on friends or other family members for help when you need it ·在你需要帮助时打电话给朋友或其他家人 ·Taking a break every day ·每天要适当休息 ·Spending time with your friends ·花些时间和朋友在一起 ·Taking care of your health by seeing your own doctors on schedule, eating healthy meals and getting exercise ·定期的检查身体，健康饮食，锻炼身体 ·Joining a support group ·加入一个支持组织 Many people with Alzheimer's and their families benefit from counseling or local support services. Contact your local Alzheimer's Association affiliate to connect with support groups, doctors, resources and referrals, home care agencies, residential care facilities, a telephone help line, and educational seminars. 许多患者和其家人可以通过咨询或地方的支持服务受益。与你当地的阿尔兹海默症协会联盟联系以获得支持组织、医生、资源和转诊、家庭护理机构、设区护理机构、帮助热线和教育研讨会的信息。 Prevention 预防 Right now, there's no proven way to prevent Alzheimer's disease. Research into prevention strategies is ongoing. The strongest evidence so far suggests that you may be able to lower your risk of Alzheimer's disease by reducing your risk of heart disease. Many of the same factors that increase your risk of heart disease can also increase your risk of Alzheimer's disease and vascular dementia. Important factors that may be involved include high blood pressure, high cholesterol, excess weight and diabetes. 目前，还没有被证明的阿尔兹海默症预防措施。关于预防方法的研究正在进行中。迄今最有力的证据提示可以通过减少心脏病的风险来降低这种疾病的风险。许多增加心脏病的风险因素同样能提高患阿尔兹海默症和血管性痴呆的风险，其中重要的因素包括：高血压、高胆固醇、肥胖和糖尿病。 Keeping active — physically, mentally and socially — may make your life more enjoyable and may also help reduce the risk of Alzheimer's disease. 积极参加体育、身心和社会活动可使你的生活更加美好，也能帮助降低阿尔兹海默症的风险。 |
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