Dental care for the patient with Alzheimer's disease.
Dental care for the patient with Alzheimer's disease.
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阿尔茨海默病患者的牙科护理。
DOI：
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发表时间：
1985
期刊：
影响因子：
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通讯作者：
B. Gurian
中科院分区：
文献类型：
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作者：
L. Niessen;J. A. Jones;M. Zocchi;B. Gurian
1痴呆症是美国第五大死因。1在65岁以上的人群中，15%的人被认为患有某种程度的痴呆症或认知功能丧失。2其中，不到三分之一的人严重受损。2约占原发性痴呆症患者的65%，阿尔茨海默氏病影响着0.5到150万美国人。3这种疾病是老年人严重智力障碍的最常见原因。3在过去的15年里，我们社会对老年人的关注越来越多。在社会、经济和健康水平上，由于老年人的迫切需要，社会正面临着满足老年人需要的任务。在牙科方面，我们开始培训牙科医生、牙医和助手--在学校期间，通过继续教育，在某些情况下，通过博士后项目--以认识和满足65岁以上老人的特殊需求。随着他们人数的增加，牙科专业人员将越来越多地遇到患有阿尔茨海默病的患者。在长期护理机构与这些患者的接触将变得更加普遍。重要的是，从业者熟悉这种疾病的体征，症状和临床过程。本文旨在简要回顾Alzheimer病的类型，提出一个快速评估Alzheimer病的指标，并对Alzheimer病患者的牙科护理和治疗计划提出建议。阿尔茨海默氏症型痴呆是一种病因不明的脑退行性疾病。其特征在于在尸检过程中存在细胞外神经炎或老年斑，脑内神经纤维缠结，与正常受试者相比，颗粒空泡变性改变的数量更多，且发生在不同的解剖部位。4.大脑皮层中大神经元的缺失与树突树的显著减少相关，这表明由这些神经元供养的潜在突触网络减少了。皮质下异常包括杏仁核Meynert基底核和蓝斑神经元数量减少。
1 ementia is the fifth leading cause of death in the United S ta tes .1 Among people who are older than 65, 15% are thought to have some degree of dementia or loss of cognitive function.2 Of these, less than a third are severely impaired.2 Representing roughly 65% of people with primary dementias, Alzheimer’s disease affects .5 to 1.5 million Americans.3 This disorder is the most common cause of se vere intellectual impairment in elderly individuals.3 In the past 15 years, there has been a growing concern for the older adults in our society. On social, economic, and health levels dictated by the geriatric im perative, society is facing the task of ad dressing the needs of its older citizens. In dentistry, we are beginning to train den tists, hygienists, and assistants— during school, through continuing education, and, in some instances, via postdoctoral programs— to recognize and meet the special needs of people older than 65. As their numbers increase, dental pro fessionals will increasingly encounter pa tients with Alzheimer’s disease in prac tice. Contacts with these patients in long term care institutions will become even more common. It is important that practi tioners become familiar with the signs, symptoms, and the clinical course of this disease. The purpose of this paper is to review briefly Alzheimer’s type of de mentia, propose an index for rapid evalu ation, and suggest approaches to dental care and treatment planning for patients with Alzheimer’s disease. Alzheimer’s type of dementia is a cere bral degenerative disease of unknown cause. It is characterized during postmor tem examination by the presence of extra cellular neuritic or senile plaques, intra ce llu lar neu rofibrillary tangles, and granulovacuolar degenerative changes in greater numbers and in different ana tomic sites from normal subjects.2-4 A significant decrease in the dendritic tree associated with a loss of large neurons in the cerebral cortex suggests that the po tential synaptic network fed by those neurons is decreased. Subcortical abnor malities include reduction of the num bers of neurons in the nucleus basalis of Meynert in the amygdala and in the locus ceruleus.2