Early life circumstances and late life Alzheimer's disease.
Early life circumstances and late life Alzheimer's disease.
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早年生活环境和晚年阿尔茨海默病。
DOI：
10.1097/00001648-200107000-00005
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发表时间：
2001
期刊：
影响因子：
5.4
通讯作者：
M. Breteler
中科院分区：
文献类型：
--
作者：
M. Breteler
痴呆症是老年人中最常见和最具破坏性的神经系统疾病。大约三分之二有痴呆症状的患者被诊断患有阿尔茨海默病（AD）。尽管深入的研究努力和积累的一些病理生理机制的见解1-3其原因仍然是未知的。阿尔茨海默氏病可以在60岁之前表现出来，但这种情况很罕见，通常涉及单基因常染色体显性遗传疾病。大多数发生在晚年的病例是多因素和异质性病因。我们在临床上诊断为阿尔茨海默病的疾病实际上可能是一种复杂的疾病病理学混合物，而不是一种疾病。4虽然阿尔茨海默病的病因在很大程度上是模糊的，但它们必须在疾病发作之前发挥作用。不幸的是，发病很难确定。通常认为阿尔茨海默病的临床前阶段持续数年，甚至数十年。发病机制的主要原因似乎是淀粉样β蛋白（A β）的积累，无论是通过增加产量还是减少清除。理论上，这种异常表明，任何直接或间接干扰正常淀粉样蛋白加工的因素都可能导致疾病的风险。7它还表明，迟发性阿尔茨海默病是内源性和外源性因素共同造成的损害终生累积的结果。
Dementia is the most frequent and devastating neurologic disorder in the elderly. Approximately two thirds of all patients who have symptoms of dementia are diagnosed with Alzheimer’s disease (AD). Despite intensive research efforts and accumulating insights into some of the pathophysiologic mechanisms involved, 1–3 its causes are still largely unknown. Alzheimer’s disease can manifest itself before 60 years of age, yet such instances are rare and concern usually monogenetic, autosomal dominant disorders. Most cases that occur in later life are of multifactorial and heterogeneous etiology. What we have come to diagnose clinically as Alzheimer’s disease may actually be a complex mixture of disease pathology rather than one disease. 4Although the causes of Alzheimer’s disease are largely obscure, they must exert their effects before the onset of disease. Unfortunately, onset is difficult to pinpoint. It is commonly assumed that the preclinical stages of Alzheimer’s disease extend over years, maybe even decades. 5 The central culprit in the pathogenesis appears to be accumulation of the amyloid beta-protein (A beta), either through increased production or decreased clearance. 6 Theoretically, this abnormality suggests that any factor that directly or indirectly interferes with normal amyloid processing may contribute to risk of disease. 7 It also suggests that late onset Alzheimer’s disease is the result of life-long accumulation of damage from a combination of endogenous and exogenous factors.
影响因子：
6.3
作者：
Brunner, E;Shipley, MJ;Marmot, MG
通讯作者：
Marmot, MG