Signs and symptoms preceding the diagnosis of Alzheimer's disease: a systematic scoping review of literature from 1937 to 2016.
Signs and symptoms preceding the diagnosis of Alzheimer's disease: a systematic scoping review of literature from 1937 to 2016.
复制标题
DOI：
10.1136/bmjopen-2016-015746
复制
发表时间：
2017-08-28
期刊：
影响因子：
2.9
通讯作者：
Pappas Y
中科院分区：
文献类型：
--
作者：
Bature F;Guinn BA;Pang D;Pappas Y
阿尔茨海默病（AD）的晚期诊断可能是由于诊断的不确定性。我们的目的是确定在随后被诊断为AD的人中出现既定早期体征和症状的顺序和时间。我们使用系统回顾的方法来调查现有的文献。2016年5月，使用以下数据库对文章进行了审查：MEDLINE、PsycINFO、CINAHL、英国护理索引、PubMed central和科克伦图书馆，无语言限制。纳入文献的数据由两位作者独立提取，并使用质量评估和诊断准确性工具-2（QUADAS工具-2质量评估工具）进行质量评估。我们发现，抑郁症和认知障碍是最先出现的症状，在98.5%和99.1%的晚发性AD（LOAD）和9%和80%，分别在早发性AD（EOAD）的研究中。记忆丧失出现较早，在LOAD中临床定义的AD痴呆之前12年就已出现。然而，快速进展的晚发性AD主要表现为35个未确定的局灶性症状和体征，包括肌阵挛（75%），步态紊乱（66%）和僵硬。所有病例均被误诊为克雅氏病（Creutzfeldt-Jacob disease，CJD）。简易精神状态检查得分最低的25分参与者保持稳定2年，这与健康家庭成员的得分一致。这篇综述的结果表明，神经和抑郁行为是早期发生在EOAD与抑郁和认知症状的语义记忆和概念形成的措施负荷。将快速进展型AD误诊为CJD和家族记忆评分可能是确诊时的混杂因素。然而，这项研究的局限性在于，每一项发现都是基于一项研究。
Late diagnosis of Alzheimer’s disease (AD) may be due to diagnostic uncertainties. We aimed to determine the sequence and timing of the appearance of established early signs and symptoms in people who are subsequently diagnosed with AD. We used systematic review methodology to investigate the existing literature. Articles were reviewed in May 2016, using the following databases: MEDLINE, PsycINFO, CINAHL, British Nursing Index, PubMed central and the Cochrane library, with no language restriction. Data from the included articles were extracted independently by two authors and quality assessment was undertaken with the quality assessment and diagnostic accuracy tool-2 (QUADAS tool-2 quality assessment tool). We found that depression and cognitive impairment were the first symptoms to appear in 98.5% and 99.1% of individuals in a study with late-onset AD (LOAD) and 9% and 80%, respectively, in early-onset AD (EOAD). Memory loss presented early and was experienced 12 years before the clinically defined AD dementia in the LOAD. However, the rapidly progressive late-onset AD presented predominantly with 35 non-established focal symptoms and signs including myoclonus (75%), disturbed gait (66%) and rigidity. These were misdiagnosed as symptoms of Creutzfeldt-Jacob disease (CJD) in all the cases. The participant with the lowest mini-mental state examination score of 25 remained stable for 2 years, which is consistent with the score of the healthy family members. The findings of this review suggest that neurological and depressive behaviours are an early occurrence in EOAD with depressive and cognitive symptoms in the measure of semantic memory and conceptual formation in LOAD. Misdiagnosis of rapidly progressive AD as CJD and the familial memory score can be confounding factors while establishing a diagnosis. However, the study was limited by the fact that each one of the findings was based on a single study.
登录
查看更多内容
影响因子：
14
作者：
Jones, Roy W.;Romeo, Renee;Lacey, Loretto
通讯作者：
Lacey, Loretto
影响因子：
7
作者：
Palmer, Katie;Backman, Lars;Fratiglioni, Laura
通讯作者：
Fratiglioni, Laura
影响因子：
9.9
作者：
FLICKER, C;FERRIS, SH;REISBERG, B
通讯作者：
REISBERG, B
DOI：
10.1523/jneurosci.5794-10.2011
发表时间：
2011-05-04
期刊：
The Journal of neuroscience : the official journal of the Society for Neuroscience
影响因子：
--
作者：
Braskie MN;Jahanshad N;Stein JL;Barysheva M;McMahon KL;de Zubicaray GI;Martin NG;Wright MJ;Ringman JM;Toga AW;Thompson PM
通讯作者：
Thompson PM
DOI：
10.1111/j.1532-5415.1996.tb02942.x
发表时间：
1996-09-01
影响因子：
6.3
作者：
Jost, BC;Grossberg, GT
通讯作者：
Grossberg, GT