Late-onset attention-deficit/hyperactivity disorder as a differential diagnosis of dementia: a case report.
Late-onset attention-deficit/hyperactivity disorder as a differential diagnosis of dementia: a case report.
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DOI：
10.1186/s12888-020-02949-7
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发表时间：
2020-11-23
期刊：
影响因子：
4.4
通讯作者：
Takebayashi M
中科院分区：
文献类型：
--
作者：
Sasaki H;Jono T;Fukuhara R;Yuki S;Ishikawa T;Boku S;Takebayashi M
虽然成人注意力缺陷/多动障碍最近得到了越来越多的关注，很少有关于注意力缺陷/多动障碍的报告，在老年人或老年人已经出版。在这里，我们介绍了一名注意力缺陷/多动障碍患者的病例，随着年龄的增长，她逐渐出现痴呆样症状，这最初使她的病情难以与早发性阿尔茨海默病区分。这份报告说明，某些类型的注意力缺陷/多动症可能被误诊为痴呆症。患者是一名58岁的女性。虽然她从小就表现出注意力不集中和健忘的倾向，但在咨询前她没有精神病史。在52岁左右，她的注意力不集中和健忘逐渐发展，在57岁时，她变得注意力不集中和健忘，这干扰了她的工作和日常生活。例如，她忘记了与重要客户的会议，将钱转移到错误的银行账户;这些失败导致她的公司管理不善。在家里，她越来越难以记住以前与家人的承诺，也越来越难以将家人注意到的物品放错地方。她的家人和员工担心她患有痴呆症，在他们的鼓励下，她来到了我们的记忆诊所，在那里她被怀疑患有早发性阿尔茨海默病。然而，神经心理学测试和脑成像评估没有发现任何明显的异常。在排除了各种可能的诊断后，包括痴呆、其他器质性疾病、情绪障碍和谵妄，我们诊断她患有注意力缺陷/多动障碍。开始使用18 mg哌醋甲酯治疗，几天内观察到症状显著改善;例如，她不再丢失东西，能够长时间集中注意力，并且可以完成比治疗前更多的任务。自开始治疗以来，她已重返工作岗位，能够毫无困难地进行日常活动。该病例支持了一些迟发性注意力缺陷/多动障碍患者可能在老年前期和老年阶段逐渐出现痴呆样症状。因此，临床医生应考虑晚发性注意力缺陷/多动障碍作为某些类型痴呆的鉴别诊断。
Although adult attention-deficit/hyperactivity disorder has recently gained increased attention, few reports on attention-deficit/hyperactivity disorder in the pre-elderly or elderly have been published. Here, we present the case of a patient with attention-deficit/hyperactivity disorder who gradually developed dementia-like symptoms as she aged, which initially made her condition difficult to distinguish from early onset Alzheimer’s disease. This report illustrates that some types of attention-deficit/hyperactivity disorder may be misdiagnosed as dementia. The patient was a 58-year-old woman. Although she presented with a tendency for inattentiveness and forgetfulness since childhood, she did not have a history of psychiatric disorders prior to consultation. Around the age of 52 years, her inattentiveness and forgetfulness gradually progressed, and at 57 years of age, she became inattentive and forgetful that it interfered with her work and daily life. For example, she forgot meetings with important clients and transferred money to the wrong bank account; these failures resulted in poor management of her company. At home, she experienced increasing difficulties with remembering prior commitments with her family and misplacing items, which her family members noticed. With the encouragement of her family and employees, who worried that she was suffering from dementia, she visited our memory clinic, whereby she was suspected of having early onset Alzheimer’s disease. However, neuropsychological tests and brain imaging evaluations did not reveal any significant abnormalities. After dismissing various possible diagnoses, including dementia, other organic diseases, mood disorders, and delirium, we diagnosed her with attention-deficit/hyperactivity disorder. Treatment with 18 mg of methylphenidate was initiated, and significant improvements in her symptoms were observed within a few days; for example, she stopped losing her things, was able to concentrate for long durations, and could complete more tasks than she could before treatment. Since initiating treatment, she has returned to work and has been able to perform her daily activities without difficulty. This case supports that some patients with late-onset attention-deficit/hyperactivity disorder may gradually develop dementia-like symptoms during the pre-elderly and elderly stages of life. Therefore, clinicians should consider late-onset attention-deficit/hyperactivity disorder as a differential diagnosis of some types of dementias.
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影响因子：
--
作者：
Klein, Rachel G.;Mannuzza, Salvatore;Olazagasti, Maria A. Ramos;Roizen, Erica;Hutchison, Jesse A.;Lashua, Erin C.;Castellanos, F. Xavier
通讯作者：
Castellanos, F. Xavier
DOI：
10.1056/nejmcp1212625
发表时间：
2013-11-14
期刊：
The New England journal of medicine
影响因子：
--
作者：
Volkow ND;Swanson JM
通讯作者：
Swanson JM
影响因子：
2.6
作者：
Hechtman, L
通讯作者：
Hechtman, L
影响因子：
5.9
作者：
Hinshaw, Stephen P.;Owens, Elizabeth B.;Zalecki, Christine;Huggins, Suzanne Perrigue;Montenegro-Nevado, Adriana J.;Schrodek, Emily;Swanson, Erika N.
通讯作者：
Swanson, Erika N.
影响因子：
17.7
作者：
Sibley, Margaret H.;Rohde, Luis A.;Stehli, Annamarie
通讯作者：
Stehli, Annamarie