ALCOHOL, AGING AND DEMENTIA--NEUROPSYCHOLOGICAL EFFECTS

痴呆症是一个术语，适用于许多疾病，其特征是 智力功能逐渐衰退，超过正常年龄 进程。痴呆症的诊断并不意味着有任何特定的病因，但 适用于许多疾病，包括阿尔茨海默病(AD)( 最常见的痴呆症)、血管性痴呆症和皮克氏病。 长期饮酒也与智力缺陷有关。 在老年人中发挥作用的比例很高。这一术语 “酒精痴呆症”被用来描述这种障碍。 临床上被认为是可逆的，至少部分地，如果个人 保持节制。酒精痴呆症与科萨科夫痴呆症无关 被认为是局灶性遗忘症而不是 一种痴呆症。在老年人群体中， 共同患有精神错乱并有酗酒史(但没有 Korsakoff综合征)临床上很难区分 由AD引起的痴呆症患者与痴呆症患者 是由大量酗酒引起的。这一困难无疑已经 导致缺乏对酒精痴呆症的研究。事实上，它是 不清楚酒精痴呆症是否作为一个单独的实体存在 明显区别于阿尔茨海默病或血管性痴呆。给定 阿尔茨海默病、血管性痴呆和酒精性痴呆的重叠存在 老年人误诊的可能性很高。能够 阿尔茨海默病与酒精性痴呆的鉴别不仅具有理论意义 但显然具有重大的现实和公共卫生意义，因为 酒精性痴呆的预后可能与酒精性痴呆截然不同 阿尔茨海默氏症。 一项为期五年的横断面和前瞻性研究被提出以验证 酒精性痴呆的分类--认知缺陷的表征 与该障碍有关，区分该障碍与AD，以及 记录自然历史。在这个横截面的组件中 第一个建议，我们将描述和描绘神经心理学 区分酒精痴呆和阿尔茨海默病的特征。在纵向上 认知缺陷的进展情况将在 戒酒和非戒酒的老年人和阿尔茨海默病患者。 酒精组和AD组之间的比较，以及 对两年内认知变化的评估将使随访成为可能； 1)对表现为酒精性痴呆的酗酒者进行辨别；2) 描述与酒精性痴呆相关的认知特征；以及 3)效度、特异度、病原学和自然度调查 酒精性痴呆分类学分类的历史与长期 禁欲对疾病进程的影响。

Dementia is a term applied to many disorders that are characterized by a gradual decline in intellectual functioning exceeding the normal aging process. The diagnosis dementia does not imply any specific etiology, but applies to a number of disorders including Alzheimer's disease (AD) (the most frequent cause of dementia), Vascular dementia and Pick's disease. Long-term use of alcohol is also associated with deficits in intellectual functioning in a high percentage of elderly individuals. The term "Alcohol Dementia" has been used to describe this disorder which is clinically thought to be reversible, at least in part, if the individual remains abstinent. Alcohol Dementia has been dissociated from Korsakoff's syndrome which is considered to be a focal amnestic disorder rather than a dementia. Within the population of elderly individuals who are conjointly demented and have a history of alcohol abuse (but not Korsakoff's syndrome) it is clinically difficult to differentiate those individuals whose dementia is caused by AD from those whose dementia is caused by significant alcohol abuse. This difficulty has undoubtedly contributed to the lack of research on Alcohol Dementia. In fact, it is not clear that Alcohol Dementia exists as a separate entity that is clearly distinguishable from AD or Vascular dementia. Given the overlapping presence of AD, Vascular dementia and Alcohol Dementia in the elderly the likelihood of misdiagnosis is high. Being able to differentiate AD and Alcohol Dementia is not only of theoretical interest but clearly has major practical and public health significance as the prognosis for Alcohol Dementia is likely very different from that for Alzheimer's disease. A five-year cross-sectional and prospective study is proposed to validate the taxonomy of Alcohol Dementia, characterize the cognitive deficits associated with the disorder, differentiate the disorder from AD, and document the natural history. In the cross-sectional component of this FIRST proposal we will characterize and delineate the neuropsychological features which distinguish Alcohol Dementia from AD. In the longitudinal component the progression of cognitive deficits will be contrasted in abstinent and nonabstinent elderly alcoholics and individuals with AD. Comparisons between the alcoholic groups and the AD group, together with evaluation of cognitive changes over the two year follow-up will enable; 1) discrimination of alcoholics exhibiting Alcohol Dementia; 2) delineation of cognitive profiles associated with Alcoholic Dementia; and 3) investigation of the validity, specificity, etiology and natural history of the taxonomic category of Alcoholic Dementia and the long-term implication of abstinence on the disease process.