Cpg dementia 2008 http://pni.go.th/cpg/dementia-2008.pdf

3. !#$
% $''%
(!%#)*

4. $ '
+,#
'%%
$

5. -

6. $
$./ *

7. '*

8. )0* 1

9. '
2 $.'! *
1 3 '
##)
(!%*

10. 2,
%
*

11. $4'% . 0
$4)00% %$ 20 %*'
7
# .*#)0
8%

12. 9
0
$
$
$4

13. (!% :9*
+22
.
$4'%)0$
#9 .*#%% $#%#
7
%3 (!%1
$

14. %
#* ;

15. ($
$291
#2$
22! *#

16. 2 # #%
3 .#! !0)0
8%#$
'% *#
%3$
% 12!

17. *#
)0
8% ,

18. (!%$%%

19. )0!0)0
8%
'!

20. 4 %* !0 :92$.*#)0
8%$

21. !
9 )0!001 $9*2* !0)0
8%

22. ! (
=?=0.#
)0
8%'!
*##$
2!. !0)0
8%
%!%

23. 2

24. %% #

25. %% (%
$1
/ @ $ 2
$4
:9
0 ., $! !* $2!.
! 2
).A2 *#

26. ! !0)0
8%'!
%
* 2

27. $1
+,#.,/ *#
)0'!
) $
%4 %
1
$

28. % #
%%

29. # !0)0
8%
2$
., .#
%3 '!
$(% 30!2$
.'
* '!2

30. *

31. $2.'
(%%3%- )
)0.% 1
$

32. %

33. #
. 1
$. * 3
.# .$. 4
# @ 4

34. 9 $.*)0
8%$ (strength of recommendation : + +) 9

35. '9 $.*)0
8%$ (strength of recommendation : - -) 15
1 :
$

36. $ 2 % 16
2 2#

37. 21
3 ['
(general management) 28
3.1

38. 2
$2. (acitivities of daily living : ADL) 28
3.2

39. ! (environment) 30
3.3 )0!0 (caregivers) 31
3.4 =?=0)0
8%( (rehabilitation) 32
3.5 !0)0
8%$%$!% (palliative and end-of- life care) 41
3.6
+,#! f#% (legal issue) 42
4 Management of cognitive impairment 46
4.1 [(!%'* % (non-pharmacological management) 46
4.2 [(!%* % (pharmacological management) 50
5 [
+,#i

40. $ 2

41. 55
(management of behavior and psychological symptoms of dementia)

42. ()
#
)
1. 0'
71
• $'
• (':3
- (':3$'
- %%

43. !(':3
-
$!
(':3
- % [()$'(':3
- [(':3'* %: 1 + 1 2
- [3(':3
- !0)0!0 [)0
8%(':3
-
!0 [(':3
• $%$( : a circular diagram
• -3 MCI $ AD
% $ MMSE score
• Activities of daily living : ADL
2. )0
8%% aphasia, apraxia, agnosia 82
3. Mild cognitive impairment 85
4. Neurodegenerative disorders 87
5. Reversible dementias 89
6. Diagnosis and Statistical Manual of Mental Disorders, 4th edition 91
(DSM t IV t TRTM)
7. .# .$. (strength of recommendation) 92

44. 99
!
MMSE 105
TMSE 106
MMSE-Thai 2002 107
! )0$

45. !':32 ,

46. #)0!0 110
% 111

47. #
)0

48. 1

49. 2%$ 6
)0

50. 2 !0 [ 7
)0

51. 3 Management of hallucinations / delirium 8
)0

52. 4 1!1% ADL $%$( 78
)0

53. 5 -3$# MCI $ AD
%$ MMSE score 79

54. !#

55. $%
1. .2[f ( !.
9 [
2. .%-
9 [
3. . % ($
9 [
4. 4..
$

56. @
,

57. !
$-
5. ,.4%3

58. i-

59. 4 !

60. x
$-
6. 4.,.

61. $.
7. )4..2

62. , [3' % $.
8. .2

63. - $.
9. )4..

64. !3
$!

65. [@ $.
10. 4.!.2y -

66. 3 $.
11. 4.. %

67. 0y3 $.
12. 4..-% %

68. %3; $.
13. 4.,. 3 $.
14. 4..
$

69. @ % $.
15. 4.,.2

70. #-43 $.
16. .[3 -% i[f3 $.
17. . -,,$

71. 2'4 $.
18. ,.

72. 4

73. ,2 $.
19. ,.(

74. ' $.
20. .4 !

75. x -

76. - $.
21. .,..0 ( 4

77. %3 $.
22. ..2

78. (3 $.
23. .;

79. % $.
24. ,.,3 #);4

80. 25. .-4

81. 23 )0 %
26. ..

82. )0 %

83. 1

84. !!#$%
'()
*##+,+-.
+$/
%+-00'
50 +3

85. 4%
%'
+!#$%+( 45-50 +3

86. #$%
.
%!
$
0
7 0/890%$+$/$* 4

87. 23 0 %
!
/
=)
)
%' $%= $
?(
'

88. +
$$%+$/#$%
!$$%='$@+3 2543 0+!/89$* 37,157

89. #

90. 4%
%'

91. #$%$ 68.81 +3
!% 68.67 +3
.

92. !'
% 11.4 %/ .0+,!%

93. % 13.9
!%+,
% 8.0 #

94. #$%$
%# $
#
%##
$
0
+780%

95. **

96. G8/
$%8 6,122 %
+( 1 6
+!$*
)*

97. .
!
$)+H%$
%0+,
$%=
?(
'
#$%$ 8* $

98. 4%
%'
!#$% +3 2545 +, 69.9 +3
/!% 74.9 +3
.

99. 4%
%'
$*
/

100. 4%
%'

101. #$%$0+,

102. )+H%
+$/#$%
8*
%
%
!
$#$% 8+-00'%$9

103. *%$
$' %#$
'+$
!+I
$!+J
(Clinical Practice Guideline for Dementia : $
!+J) +,#

104. .
+$/#$%
?(
' #$% $$04%
)9)
+,_%$*+$/$%$

105. %_
%+$/ +,+J$$'`H%#+%!= $*
)+H%
$%=
?(
' #$% %4

106. '(%)9
)+H%

107. 2
+$!+J4$8%$%=
.G8+,)+J$
%$#+!'!0 168

108. %)$
0

109. #

110. 4%

111. 0%
*
% 90 #+!+%!=
% 80
)$0+$!+J4$8+,

112. .
a$!+J4$
$

113. '(

114. % 8*
#+!+J#
%
+
$$% $%= $
?(
' !

115. #$%

116. +
$$%+$/#$% 08#+,a$!+J4$
*$
%0$$!+J4$8
5 +3
%

117. %
%
!$%%
%'$%=+$/#$% !$%%0$%=+$/#$%

118. (
$%/
= )%
$#$ !+J4$
$

119. '(

120. 70
)(=%
$
+-00'+$/#$%%

121. $%=

122. %4+
$$%=
0$%=$

123. )

124. !.)9)+H%
% )+H%
.08%
%)%)
%'$%=
$%=$+J%!'!
0*04%
%+,

125. =

126. )+J$8G8*
%
GG
04% +J$70%
%#$
% a$!+J4$
*08%8

127. =

128. )
!+J$
!'!

129. #$%+-00'
$!+J4$
*# *
%

130. )(=% 8*
# bcdb)
%0 ))+H%%
'$% !%)+H%%
%
'$% G80+,+%!=
)+H%
)$)9)+H%
% 8*
#+

131. ()0$

132. 3

133. CPG
!
% $! CPG 4*)

134. $0#

135. =

136. )

137. !.! CPG
$) 8*
% 0$$
8 CPG
100% +, 0(%) $0
0 CPG 4*#
$*
CPG
$

138. )
$ +I%
CPG

139. 04%$
)
)9

140. ! CPG
!$
$
( 0'7+f)%
%/89
) ( 0'* G8
0+,

141. $*
+
$% !

142. 0

143. /$=4 aphasia, apraxia,
agnosia, neuropsychological tests ! MMSE

144. $8G8*#+
*
CPG *

145. %) 2

146. 04%
)$ 1
+,$
)9 G8)$ 2 +,$ )0$+J
% *
%+

147. 0!
+-.
*
$
*
$ 1 /89

148. CPG * %+f)*8
'$%
0( *
$*
#
%)$
*
$ 2 /89)$ 1,2 0 )*+,$*$
*
0)!00$ 0 *
$*#% 8*
*
$ 3
$%
%08#++f

149. $

150. !

151. 0

152. *
$ 4
! CPG 4*
% 0 0#% 8* $
'
0+J%#
)
)*%

153. 4
#

154. $
(strength of recommendation)
#

155. ++ %8

156. 0

157. $
%)
) $
+%!=
%%
)+H%

158. '

159. (cost effective) $
!
#

160. + %8

161. 0

162. $
%)+
0$
0+%!=
)+H%0
0

163. '

164. 6!
#

165. +/- %8

166. 0%#%

167. 0$
0
0#+%!=
)+H% #
%
)+H%
8*
0#

168. '

169. 0$ 8*
%)+-00%
9
#
:6!
#

170. - %8

171. 0

172. $
%)+
0$
#+%!=
)+H%#

173. '

174. #0+, :66!
#

175. - - %8

176. 0

177. $
%)
) $
0$9
%
)+H% :6$
!
$;=#

178. ? (quality of evidence)
E 1 %8 _$#0$$ (systematic review) 0
/89'
'
%-

179. ' (randomize-controlled clinical
trials)
/89'
'
%-

180. '$

181. '(%%
%
% 1 4 (a well-designed, randomize-controlled, clinical trial)
E 2 %8 _$#0$$
/89

182. '#
'
% (non-randomized, controlled, clinical trials)
/89

183. '
#
'
% (well-designed, non-randomized, controlled clinical trial)
_$#00%$

184. $!)+0%
0%+%!=
$90+J9$! (!
cohort study, case-control study)
E 3 %8 _$#0/89( (descriptive studies)
/89

185. '$

186. '(
! (fair-designed, controlled clinical trial)
E 4 %8 _$#0

187. 7
4$ (consensus)

188. ()!%!.
%
')+H%0/89+!'

189. ()
/89

190. (
%
% 2 4
J KJE
LK

191. #E#

192. $
EM$N

193. 7

217. 28
K 3

218. EM

219. Q : (general management)
3.1

220. 9
9 (activities of daily living : ADL)
00+0 8*
%)

221. '

222. !
% $ (%

223. 6
•

224. %
00$##
• 0%
*
$
$

225. • $0
*
$
$/

226. % %'%

227. #
• +(+(
•
$0
+
• !
0
.
• )
'()
• +
•
`I) (+$
%

228. #
0
7#

229. 0!
-
#)
0)!#+,

230. • 0%
'+(=
•

231. !+0
• !
'+(=$

232. '

233. %
#
GG
• *
• +f
)+H%#
$
$
'
`I
%$
0 8* (
*

234. %0
)

235. %

236. X6J

237. #
• 0

238. 0+0 *
• +
%

239. #+8
%)##0$+0
• +
* 0+0
)+H%
• *+-
##
0#+
*+,%0%#)
8++-

240. 29

241. J

242. E

243. $ :#
6

244. J
• $

245. % %4
$
• 0

246. #
)+H%
•
$+
%
'
• +f
)+H%# #

247. #%
%#
!
'+(=!%
$
'$$0$#
)+H%
%
% !

248. '
(=
%

249. 0%
• % ## ## )+H%

250. #%%7+%!=
)+H%
%
•
8%$0+,
!
'+(=!%

251. !
'+(=!%$#
GG
• !%
0$%
%% +, *
$*
%

252. EM
;=
$Y
1.
)
!#

253. $* 5 ) +-.$
%)+H%

254. +

255. serum albumin
% 3.6 mg%
%
3.0 mg% )+H%% $ *
$ '$
7#a
+
!!%%
+$ *
# $*
080
+(
$*
#0

256. $
%

257. )#+
%

258. #
+0)#+.
!+, $)+H%
+
2.

259. '*_ BMI
3.
%

260. )+H%
4. )!%
9

261. $)+H%+,
%)

262. 88 drug interaction
%$0!9)+H% Alzheimer
5. +I

263. $G
! *
$+-
$
6. %

264. )$+,# #

265. %%! (
7. )
' 0 %0$0

266. 8

267. %
8. 0$

268. ! #
.
0
$)+H%!
07
!#

269. 30
3.2
E (environment)

270. 9E
E
$ EJ
• !b
=0
=$

271. # %
$
• $ * #
• +I
#b# *
0
'+(= ! +–#b
'+(=#bbI —

272. $*
• %

273. 07#$!
• 7
!*7 $
0
+0) G8
0$
%#
•
*

274. %
+3%
+I
'+(=
*

275. %)
%
!
0 %8 #?(+)
$
*
J

276. eJ
J

277. #
•
%)
$

278. '

279. %
• %%0
•

280. +,
$%
% #%
! mild to moderate dementia #

281. %%$
%)
/%
+%%

282. 0$)+H%
8*

283. %

284. 31
3.3 NMEM
(caregivers)
•

285. ) *_% %
- $)9
- %(=

286. - 0

287. )+H%
-
0

288. )

289. ))% 0

290. ))

291. #+
(=0% #)
#

292. %
•

293. - )
'
%
- %%'$?=+J
)+H% G8
0$
(=v
)+H% 8*
- )(/9 ! $
%%
$
0
• ?# +-.

294. %1.3
- 0
!'

296. !
+,

297. *

298. - )$
)%

299. )
8
# G8# $%= %
'
. )+H%%
- $0

300. !
%'

301. !%
0)
- 0
(=
7#!
! ? '

302. //
)
8
%0
- +-.%'%$# ##*

303. $#
- 0
!
#+ $'.$ )%= G *

304. - ?

305. %

306. % ! +)#
%7+-
% )$$/=
-
#+J .%)
8

307. % $%=$)

308. %'
%8 %#
!.

309. %#
0
+890$%=

310. 32
3.4

311. [][MNMTJ
3.4.1

312. [][MNMTJ E

313. J= (physical rehabilitation)
%$#+bcdb) (rehabilitation) %8 $%%$)+H%
0%
%40$
)+H%
$.
4 +7

315. • % (physical)
•
' 0 (mental)
•

316. (social)
• +
! (vocational)
0
$

317. #G8

318. * #!
*70
+
$?$
%70#
0bcdb)
# %bcdb)
!%0$
%#+ 8*
bcdb)

319. %)+H%
00
'

320. 0+0 %$$
)+H%
#% 8* !%+I
''$
00 8*#
%)+H%'*
bcdb)$+
$?
$
%
$* ($
%)% $
bcdb)$)+H%!'! '

321. $$%=.
)+H% $*)!

322. 8

323. .#++J
%00
bcdb)

324. %

325. $+,$
!! (multidisciplinary team)
0)+H%
.+-.
' #+

326. *

327. 0+0

328. 08 '

329. $
bcdb)08

330. +

331. $0
)+H%
$+-.$+,
'+

332. !%
08bcdb)
0+I%
bcdb)

333. )+H%.))
#+ +$%!
)+H%
)
)
%' 2 +$ #

334. $0 * *_

335. $
0 *
)

338. 35
-
0%+,%
!%)+H%
%#%

339. !%b-
(hearing aid)
-
!%)+H%
)
#
- +
$
)+H%
. '+
$
)
)+H%% 0
')
)+H%%
$!
+$ +%
% +,

340. 70
`Ž
%)$

341. `Ž%

342. $'`H%$%
3.

343. ;#K

344. 9

345. $ :#
0''%
%
9 #
1.

346. %
(range of motion exercise)
2.

347. 7
*
(strengthening exercise)
3.

348. $
*
(muscle endurance)
4.

349. 7
#%
(cardiovascular endurance exercise)
5. a+
+
$ *
$
(balance exercise)
/89$8
bcdb)%?)+H%
+, 6
!
! (occupational therapy) % (physiotherapy)
(speech therapy)

350. $+,%')+H%
%
$0$+,

351. 7.+%!=
)
$
(=
)+H% 8*
$*

352. 7
% (physical fitness) )+H%
%
.))+H%0v
)+H%
$)+H%
%

353. #% 8*
0G8/)+H%7 0
)+H%#+8 2 +37 %$#+ bcdb)
)+H%
)
%'?$!%
! #
3.1 % (physical therapy)
)+H%

354. # *
0$$
+I
(joint contracture) `Ž'0%
$
*#
.!%
`Ž!
'+(=$!% ! #$

355. !% (walker) 7 G89
0+
%??
(hydrotherapy) 8 *
(traction) +

356. %7 !

357. %
(sound diathermy) '%#bbI (transcutaneous electrical nerve
stimulation)

358. 3.2
! (occupational therapy)
)+H%+J0+0#
$
'%`Ž!
`Ž+
$
%

359. $
!
0+0 ! )+) !

360. .+
)+H%
!%
#$
36
3.3 $ (recreational therapy) ($)+H%
%)%

361. =+,

362. 0)+H%0'

363. $ !
0' 0 0 $/+ *+,'$
%+J
?='

365. %0
0''%
%
9 #
1.

366. %
(range of motion exercise)
2.

367. 7
*
(strengthening exercise)
3.

368. $
*
(muscle endurance)
4.

369. 7
#%
(cardiovascular endurance exercise)
5. a+
+
$ *
$
(balance exercise)
4.

370. K J
E
+,

371. .$$)+H%
!#
#%

372. +
% ! 0
%)
* +f
$##!
#

373. 0+,
)+H% )+
!%)+H%00#% #!
+)7

374. 0
$'

376. #
#+!%
# !˜$ .
7
#!0 +,
0* 0
%

377. .$+I
''$
00 8*
# ! +I
#)+H% #+!—
+I
+f*$*# +I
#
• *
#b!+f 8*
%
(' $
%
•
'+(=

378. ($
%)$$0+,
7

379. %)
)0 *
7#% #%%$
%
• %
*

380. )
#*%#+
• %%)+H%
/%$!*
($)+H%0+,
8*!*
$#

381. 0
*#

387. 42
3.6 ~g#E

388. c#J (legal issue)
)+H%
%4)+H%

389. Alzheimer
%

390. $0
+-.. v !+0 8*%07+H%
+%+$ 8*
0

391. 0
v$+
#
0

392. %%$%=
*

393. $
?'0
$%=)9

394. $

395. )+H% . ))$
#
%
$%=
8

396. %%$
0 8*0$)+H%$%.))#$ !
$
$%=
)
%
+,)

397. *+
* +,

398. !

399. !!*
$$%=
$
%#)
$%=)9

400. 0

401. )+H%
0
%
'
)
)+H%#
$0$
%* %'

403. $+

404. =0 #*'

406. $)+H%#0$
'+,))0$%=
$*+,)
)+H%%

407. +, 8*0)+H%#

408. $
##
)+H%.))

409. +89$%

410. %
%
%)
'
%+-.
0

411. %.
)+H%%
8+-.$0
$%=)9%)+H%
#+J_))+H%

413. 44
* $%
)+H%
%% $%= )+H%$0$*0
+!..$ (
$%%4 orientation # delusive thought
0

414. %+

415. +$
0_$

416. '9#
%))9
)+H%0
$ +
$%=

417. '(

418. $%=
'%
$%=
%0%$%=
)+H%0
$8

419. ?=)
'$
'
$%

420. $?$% %$%=))_%
#+%!=$#0* %

421. $+
!!$*
%! )+H% ($$*0

422. )
8

423. 08

424. $07+H%
%)

425. +,#+

426. %
'$% )+H%0
0

427. +

428. = !
9$#
! $ CPR
$
%0
(tracheostomy) $
$
%$0)
9$0!%)+H%!% % 8*%$)+H%#+

429. = )+H%
''

431. $0+,#+

432. +

433. =
** +-.%$ # +-.*
0$
.. %%
%
%
!%+,_$

434. .$/00(
$
..
)+H%+,™%
™ +% 29 30
*** +-.

435. . +,+-.%$%$9*'$9 0

436. '
+! +-.$0+-.$0 (BPSD) # $%%
$/ % )

437. */0
#$9 )+H%
%)
0 _$$%=
**** )$9=

438. )#*0/+,)
0))+H%! )
$%=
)+H% +,)
!
($)+H%#$$% 8*$
07+H%
#
%$0)$
• *$#%/

439. *$)+H%0

440. +

441. =# (%
+!..
% ' .!
$
%

442. • /0

443. *)$9=
)+H%#9+,'

445. #

446. •

447. /*)$9=7$
'
+I
+-.$
0 8*#
)+H%

448. ' 8*0#
0#%
*****
$%= #

449. 7 )+H%+, ‹'

451. #

452. Π/
45
$*$
09+7*

464. -
!%#+

465. +?=+,% $*+
$?

466. %
- ++%

467. #$$
'
- !

468. !
% +( 1/3
½
+).

469. % %+ %
.!%$0!9
+-.v
(=
$0)+H%
!
%
)+H%0!%
-
!#+?9%#!%
-
00!%

470. #%%
?%)+H%
.)
0 0#!%
#
9
v
(=
$0)+H%

471. 0(
!?%#!%+
#' #
#+,$
0080(!%
*+,
+,
$ !
+,
%

472. )

473. 0
?%.
)) 0$*

474. ' 0 )0)
+,
$0+,
LK

475. EM

476. Q~g#=€

477. ABCs

478. %%
9+-.v*

479. A.
' (antecedent)
#
'(=+,
'$$
v$+
B. v$+
C. $0v (consequences) $

480. '
)+H%.
))
%#
%
%!

481. - ++-00%
'$$+-. !

482. *
00
+
+3%4 $)+H%#
% 7%'
% +,
G8+,
$
# #%
- +

483. (delirium) G8/
-

484. '(=$
0$)+H%
%%0
$
*
-
'0)+H%

485. )
8$

486. %?
$#

487. '
?
#
0
0!%$#
- %%$0+
57

488. -

489. ).
)) $

490. )+H% ! )
*
+%

491. % #0

492. %!+%

493. $GG
%

494. %

495. %%
%
')+H% )! !
0
)
%
G*

496. *
%
$0)
?%
%
)+H%) %!
)+H% %%
%9%
9
$$$8

497. 0

498. +, ! %* % %%
9$$
)+H%
0

499. %
%%
%)+H%

500. $+
LK

501. $$ J6 LK

502. :6J
-

503. 0)+H%#+%0
$
- !

504. %

505. - !0$
!
G8/ %%0$
)+H%

506. $# ' 0
')+H%$ 8*
%)
%

507. '

508. %%

509. 0
%)
$

510. '

511. % !
!%
- '(=
%')+H% !
* +)

512. %%0

513. 0 )+H%!.
%!

514. %+,

515. %#+
-

516. )

517. 0.
))
?%0$
# 0
# 8*
)+H% 0
% #
0
v
%
8

518. 07+
%
* +,
- %%!9%
9$$)+H%)
8
' +
%

519. %)%
- %%0)+H%$ #0+,0% %
!
#+

520. - )

521. ' % !
7
%
- )+H%
0
% ! %
$ $
)+H%

522. )
8

523. )
8

524. '(

525. - %%+
)
-
%))+H%%#0+,
58

538. 71
1

539. •
•

540. -

541. -

542. !#

543. - $ #

544. %$

545. -

546. '
()!

547. -

548. '

549. %(
*
: 1 + 1 2
-

550. '/

551. - # $)
# $

552. ')
0

553. -

554. # $

555. '

556. • %$
: a circular diagram
•

557. :

558. %; MCI $ AD

559. $ MMSE score
• Activities of daily living : ADL

560. 72
L(
ML:N%#!%
O%P Q
#

561. (
O% / RQQ

562. %

563. L(
O% *%#(!
*%

564. #S 3-4 V

565. M
M%

566. W%%$MX

567. W% # *%
!
%
M
Q$#*V
VS%O%)#! #
%QN #
%:Y! QV
Z

568. !% V#
%/ QO%:(#
%*##
%V%X
% V:
P

569. %V#
%S#

570. !
MQ

571. W%!
%MX

572. W%#
Q
S %$%
XW%

573. RQQ

574. !
%V!
M
O%

575. (
#

576. '#
[:
#N%%QO% 5-6 ^ *%/(%WQO% ½- 2 ^ W

577. #

578. SQ#V 1-2

579. #V V%(W O%!
%
M;L:N%QO%!` aLaw of cerebral
dissolution : In case of brain damage, loss of higher cerebral function will happen first and before
primitive brain function cognitive function first and before motor control activityg
M
N#
V!*#S! N%(
#XW%*%V

580. :

581. h%Q(
VM#M% N%(
#XW%*%$V($!N%# `%(W
%: #
$:(
(
(#
%

582. %V%X
John Hughlings Jackson
M
*V

583. W% !QN$%NZ

584. ! :
# $

585. ')
0

586. L(
a)
g MV

587. O% a#S%
;#Pg *V(V%X

588. W O%#S*%#
%N% #
%QN !

589. #%*Q
:Y! /*%
!
% $#
%
%W*%: # !

590. #%
% %

591. $

592. MR/QQ*%#
%(
a
;#g *%
%(W(#( a%#$%WNV%

593. )
0g :
#
O%$S % $VV(
#
V%%W
aL
g O%m

594. :(
*
*%/((
V!

595. (
(

596. #Q%
QO%%W
%# W HIV/AIDS Wop

597. VV!
%P
V!

598. #Q%$
Q( a
g

599. 73
V

600. #S%N

601. qP (
%%
*%r%(
O%%V%X
m

602. O%W

603. %#V%X
(
%$
N $!%
N*V
N%(
VS%$%#
#$
VV#L*% 5-6 ^ $$#(
)#! #
%QN
:Y! /

604. #

605. $!#N%%
( (

606. Q V!
% % %W VWop
! #$%
#$$#

607. (

608. :

609. %;

610. *%

611. N%#%(W*
%%*#

612. $%

613. #
%%O%^ QO% 5 ^ 10 ^ V%%
%(WS#
Q
Z*V
VS%
60 ^XW%

614. !Z*V
VS%
LV

615. 60 ^ Q:
XW%$ ( / 5 ^ Q%MX 80 V 90 ^
60 - 64 ^ : 1-2% V 1-2 *% 100 %
70 - 74 ^ : 12% V 1 *% 8 %
80- 84 ^ : 31% V 1 *%P 3 % *%

616. %(W
(
S #
Q%Q

617. *%%L*!
X
O%:)V mongolian S
$ ( / %#(

618. (
: *%%

619. % X
O%:) caucasian 60%
V 1 *%P 2 %(
( 85 ^XW%
%
!'
:
*V
!
*Q$Z

620. !!)
0

621. *%

622. W%!
%$ O% 3
(
N%q$
$ *V
3 O% 5 V 7 S#
$ :
(#
%QN :Y! / Q*%V%
(
% V*%

623. $)%Z

624. !% %(
$

625. %Q
(%%W%(
*
Q%
%
;#P

626. 74
:
(# $%

627. %!

628. % %WN $oR%

629. M $!

630. %V
#
:
( #% % !

631. QNq!(
*
# QN
!

632. $$#L'!

633. *
$!*
%%O%^ Q( (

634. %$##

635. %
#
$

636. %

637. #Q% V%(
%#'
(
#
(
*

638. '
#! *%RQQ

639. %( 2 *Vq
cholinesterase
inhibitors $ NMDA receptor antagonist V%(W $
#N%% $%(
)
0

640. QQ (!L*% 5-6 ^ V%
%
%: %(WSO% 10 ^ V 15 ^ N*V
LQ# $

641. ')
0#$
#[:*%$$ #N%% %#
)
0!

642. #
#
$
*
QQ#

643. W 2 %(WMV#

644. W$Q

645. #:;L:(
N*V
#

646. #
*%(
#)
0

647. S!
Q (!V%

648. %% #
L$
% #[:
!#W ;%; #($%V

649. rO%!

650. (

651. #Q%(
#
NV

652. %(W %((! #
10+ ^ LV

653. QmO%%O%%(W
(
) : 1+1 2

654. '

655. SV%

656. '

657. (V

658. N

659. q 2 V

660. V

661. $%(
*
$(V

662. V%X
%(
*
*

663. W 2 V

664. :

665. % )

666. :;(
#
Q

667. '(
%
%:(%*#%V%X
%

668. W% %(
N; 1+1 2

669. '#

670. %(
*
(V#S%
%WN : #
*V
:(:*%V%X

671. % *V
#
[(
QN%%R
*%$!

672. %%
1500 .
V : *V

673. W 5 V #[:V!(%(
Q
$
:

674. %W*%

675. M
#!(%
%WQ$S$
%$ $
%W%

676. W%Q#

677. !
%M !
$
!S(
!V

678. $:

679. N

680. : :

681. '#

682. M*%
%V !

683. $
N Q:
V!%
*V
#
%%(
#
%

684. % #% !
:(:(
Q!
%
%W#

685. *V
$:

686. #
75
• #% : :
:
/L:%%V

687. $)%!X
(# #%N*V
$%%:Q%MXQ#(
X
V%
V%
SV# $VV%
S#%!Q%
XV%
( N%(W

688. % M
MN#
Q*V
MX
Q#(
V%
%

689. % 1-2

690. W M
!

691. #(
WN% #% *
%WN$%#

692. : : #

693. %V

694. q! V:
%%
%#VQ(
(
M%

695. #: N%#(

696. q! V

697. :
%%S#
(
%M%(
: :

698. m%mX'$)%!X(# %
#%
1-2

699. W M
MN#
(.'

700. O%(
$V#
( (

701. W

702. P#
%
%
%

703. :! S

704. '/(
###%(
V%* $(*V%
/
0 1
##0 1
2 $# !0 1
% 3 $!%
(#[:q!(
!

705. LQ
# $

706. ')
0 Q(
X(
!

707. %
:# $

708. ')
0(
O%%(WO%%(
V%

709. V%

710. # $(W# #S
S$*%V

711. Z

712. !% % *V
V %WN $!!

713. # $
#V

714. M yz

715. %! L*%$L%
%
%# $#S$#SSQ P L*% 2-3 ^
#S: ##
$
!

716. #
$Q L*% 4-5 ^ $!%# $)
0

717. QO%*%m(
!

718. %
O%%% LQ
# $
$V%

719. XW% $(

720. %Q W%Q%QMX%(#
(!)
0
%% (caregivers)
# $

721. '

722. O%%(
V%

723. %% WN $%
V% M
)
# $
#N

724. *Q(
QN% /L:# $

725. 'Q#((
:

726. ':

727. Q!*Q)
# $
)
# $(V#:

728. )% :
(
% m !X(# V
N;Q%!

729. (
QNO%%
#% 1-2

730. W %
# $

731. '

732. %(WO%
%(
V%

733. $%% M
$)%Z

734. !%*V
#( )
# $QV#N

735. *QO%
S
V% V Xm
mental depression #
!$;# )
0

736. %

737. LQ
# $

738. '%(W
#!#
S
V%)

739. #(
%:
#L%O%

740. WO%
!%
$
N Q%MX%(#
)
0
'
%(
: ??!#

741. / (
%(W VMX %*%

742. *%%#

743. V
% !N NL
76
Q

744. V

745. # $#

746. m
*%RQQ

747. %[(
%

748. Wm% 70 ^ X
O% (mean) NV

749. %
*%#L

750. W:m $:mVq

751. *%%!QO%

752. %
$$%%%!
(

753. )
0

754. #

755. O% aL

756. #(
%

757. (
# NV

758. *%RQQ

759. %$
*%%!g :%(WMX!

760. V
O%
)
0%
$
O%%(WQP
$
S
V%

761. XW%(

762. %(W (*O% $!S(;(
QZ; VV((
:RQQ

763. %

764. ( (

765. #Q%(
Q*
z

766. %*V
O%%(W N%Q

767. :
VN!
(
M !
(

768. %(WO%
(
%
$!
*
%%
$V
$N
*Q*V
M$

769. O%% (
Q$
RqV
%(W a$

770. g O%
(
M !
$V

771. %NV

772. %%(

773. #

774. (
Q($
$#%(W

775. h%; *%#(!$RQQ

776. %O%

777. (
WN%NV

778. %

779. $
)
0
(
#($(/Vm $
:M %
%
V
)
*Vq
$!

780. q} !

781. W$!O%#SSP : $ 0 !

782. %:-
a
O%#S : $ (W# #((
: $

783. %

784. O%#S*V(

785. WV%X
:# $ : $ V%

786. (
: $ N*V
O%
#S$#SS O%$#!

787. q} !:$$ : ' ) q%(WQ!$$

788. 77
!#!

789. !# *%%!M
O%
SQ#

790. Z

791. !# $

792. '
%#(

793. %g
%%!

794. %

795. '

796. h%;$:/((
#($#%(W
*V
%%(
#
(
QMN#
RQQ

797. %

798. h%;
%(W
QQ$# :Lm'rQN*V
%
#[:*% $

799. #(
XW% M
%M

800. '

801. h%;%(W
#
L'!N

802. q#

803. SQ#N

804. %!#
aEvery home is a nursing home for ageing people Alzheimer€sdiseaseg
- # $(
*VqV
% / !N O%#

805. Q

806. V

807. # (city nursing home)
#

808. L (state/regional nursing home) V#

809. m V%(
O% *%

810. m
!

811. %! O%
(
%%V((
:
%(WN

812. O%RqV;/(
*Vq
V%X
m*%

813. !

814. %! RqV*Vq *
QNV

815. # $

816. ')
0
Q%

817. r

818. V !
V#L
%(W#:)

819. #

820. %*V
%

821. VQ

822. #

823. %#

824. rQ

825. # /%

826. %% % %Q%(W

827. (RqV
/L:
# $##( QQ
)
# $*V
XW%SN#
:$%L%(W (*
%L%(W V%N$%SO%

828. WS%#(

829. % $RqV
QN%%!((
: :QN%%)
0
:
XW%%
#S $
##V( / !
%%O%#% VO%^Q#

832. 80
Activities of daily living (ADL)
ADL O%#

833. %( (W(
#((
#*%%Q[

834. !#! $%%$L
ADL (*%%Q[

835. L
MMSE V
V!)(
O%%%(W : /(
%'((! QNO%!
%
(
#% $(
Z

836. :

837. %;

838. (
!

839. !# QO% %
$#
$V!/*%;Q

840. VQ

841. ! QN

842. %%!

843. % %WN $oR% $!!

844. %V # (( %
V%

845. :: †† V!/VQ !
*
(

846. QN V
!

847. #%*Q $N QM !
%*V
QN *V
# *V

848. %!#

849. %VP

850. W memory circuits *%

851. W main $ minor V satellite circuits QM # $
#
( Q%QQ Q

852. !QN

853. %
MX%% #
• ADL # N%

854. %V

855. $

856. #VV

857. W !
• MMSE # N%*%(
N :( 15-30 %( %

858. W%
%N ADL *
*%%Q[

859. dementia QNO%!
N*V
M V

860. $O%

861. W%O%!%
1. !
S
ADL )
0(

862. Q(L
*V
$ /(
#
!

863. W$!)
0O%!

864. (RqVL
$!#(
(L
• S Q)
0#!
• S Qq! )
*
# )
# $
• Q

865. !QS 0V (%
2. ( (
ADL
)
0O%!

866. (
(RqVL
M
#
*% 3 #S%!%(W $# )
0(

867. %(W /
3
• ADL )
0 : / )#:# %?
• )#:#*% ADL :
XW%
P %?
• X
()#:#*% ADL V%

868. W% ($!q!
$
:%

869. W%
V%

870. XW% XW%
P)
#AX
'$%O%) ADL '# Y%Y$
!' 'A $% A0. 1?'' /
3
*%!N
Q$ ADL O% 2 %# instrumental ADL (iADL)

871. basic ADL (bADL)

872. 81
bADL O%
personal care % %WN $oR% $!!

873. %V
iADL O%Q*%(!QN

874. %(

875. % % N#
%

876. %
V iADL Q(%*%!
%P dementia % bADL Q(*%
P
Pseudodementia
A reversible neuropsychological disorder : depression
Aphasia
Problem with language ((m

877. :L'

878. Y'(
*
( V$ / receptive/
expressive, sensory/motor, fluent/non fluent, wermicke/broca)
Apraxia
Inability to carry out purposeful movements even though there is no motor and sensory
paralysis or impairment
Agnosia
Failure to recognize, people, part of body, object, etc.
Disturbance of executive function
Impaired initiation, planning, reasoning, sequential organization, and judgement

879. 82
2
X # aphasia, apraxia, agnosia
)
0!%(W

880. #

881. N%Q[

882. Q$:O%
$!Q* O%
subtype CVA ( lesion /
% %V% internal capsule $)
0( aphasia, apraxia,
agnosia ;#P A Q`
X # 1% `
1 Motor aphasia (nonfluent, Brocabs, anterior)
Vq / 50 ^ !
%
XW% : ##
$
$!N#( oR
( $%%$V #%#
V%%!

883. '#

884. %V! #
#(!#
(RqV
QN
CT scan brain : Broca€s area infarct
2 Sensory aphasia (fluent, Wernickebs, posterior)
60 ^ (#m('XW%

885. %( (
%
Q(% VV#! V

886. Q
%

887. W%oR%
(: #
*Q !

888. %#
(% : #O%#
(V!
#S%
!#S%
($%%$ V QN#(!#
CT scan brain : lobar hemorrhage (
left cerebral hemisphere / Wernicke€s area
3 Conduction aphasia
Vq 55 ^ X'$:(

889. L'

890. ##%!!:#
V#
#
N O%XW%

891. %( )
0: #Q!
! #
$#( V%%! %
(% S! $!*V
: #! a: ; #(g : #

892. %(#
!
%*V
*
:
: # S: #!#!!

893. !P V%P : ##
N N: #
%

894. W%P P
# S(RqV%#(

895. % )
0O%#

896. %V! $!

897. 'QQ

898. (RqV
L'VQN%
CT scan brain: lesion (
arcuate fasciculus : fiber tract (
motor

899. sensory
speech centers (Broca ƒ Wernicke connecting tract)
4 Alexia without agraphia
Vq 59 ^ O%#

900. %V! $!#

901. ' !
%
XW%%V%

902. !O%%%V%

903. #
S$ :((:O%Q
%V%

904. (
$%%$ VRqV
QN%

905. 83
# L'
- : #Q !
! #
$ O%!
- *V
%V%

906. :: %#
$
$!N#(
-
V%

907. ::(
%#
*V
(% ((%N ) (%#
M !
N
-

908. %((
(%
N Q
%

909. W%*V
% %#
( !
CT scan : lesion (
splenium of corpus callosum *% hemisphere
5 Agraphia
/ 58 ^ O%%

910. $!%$(% % %(
(%
V
#(P (#m('
%
Q(% $!V#! #%#
*
/
Q

911. #
! (O%%M%

912. #) $!(%V%

913. #
(RqV
QN)#!VV
# L'
- : #Q !
! #
V%%!
- *V
(%
!(
VS% %V%

914. :: − (%#
(%O%!

915. '#
2-3 !

916. $!O%NVL'(
(V
- *V
(%!(
#
% ((%N ) SN#
CT scan brain : ( small hematoma (
left frontoparietal area O% lobar hemorrhage
6 Apraxia
)
0 51 ^ X'$:#
aN%!(
!
g
O%XW%

917. %(
2-3 #%%

918. #(XW% %V%
%(W*
%#
O%! O%%
M%

919. #
# N%$%
- :

920. %W$%-
!: no weakness
- Basic sensory perception : pain, touch, joint sense − !
- : #Q!
! #
O%!
* V() : Q

921. V(#
$! aNV()#
g
*$oR% : Q

922. $(oR%#
$! aN$oR%#
g
*V
:N SNM P )#P

923. WV() $$oR%
CT scan : left parietal infarct

924. 84
7 Agnosia h aphasia
)
0 61 ^ : $:#
RqV(

925. : # a(
M g O%XW%

926. %(
2

927. #V% %V%
%(W(RqV(

928. (
O%#

929. %
V! %%$!S #
#(!#
#
- : #Q!
! #
#( ($%%$ V
* *V
# M%(
)
0: #N ag #
#
$!$#
%(W*
NV

930. (%
*(W(
(%% :
NM %(
)
0! O%N: # a%g
#
$!

931. $#N(O%L'*
%(W *
N
* *V
a $%g V a $%
g (
NM (right-left
disorientation)
* (W(
%W)
0(%W $
*V
(%WO%%W )
0
M
%W(
N

932. M (W #

933. W
$
* *V
ƒ V

934. #( N#

935. WP (
%V%
%(W ƒ 2-3
V

936. SN#
$
CT scan : left parietal, angular gyrus
)
0O% typical Gerstmann€s syndrome (
- finger agnosia
- nominal aphasia
- right-left confusion
- acalculia
8 Agnosia: prosopagnosia
/ 80 ^ O%%[

937. [ QN#( : # V

938. Q!
(W( hip
fracture !
%% / 3 #% QN#
%!(
% V%(
p#
! (#

939. /QM

940. %(*(
M
V%(: # /QQN
#
O%*

941. W(
%V%
*
P !/

942. #( Q

943. %-

944. %V#
%

945. %((
VV%(: # #!
/Q
V%#
M !
% ()#:#
/O%)
0!

946. (
QNV%
%#
(
( prosopagnosia
CT scan : right occipitotemporal infarct.

947. 85
3
Mild cognitive impairment
*%)
% Q(RqV#
%QN%!*%

948. #(

949. % $!S
MX

950. L
(L%(W cognitive function :S%
(mild cognitive
impairment V MCI) L%(WQ VL
(dementia)

951. LV%
! (normal forgetfulness) X
(
10-15 *%)
$!*%%(
( MCI
)
0Q
(
%

952. %%

953. #V(
N

954. q P $Q#XW% P Q% %
N%V(!QN

955. % $!Q q(V%
(
N% #N%%(! !

956. #%*Q *
V!) O%!
% %Q[

957. QN#
%Q
#
Q%
((
Q
#!%
#

958. %

959. W%NQN

960. # MCI )
0(RqV#
%QN

961. !Q cognitive
function : (QN : $!N*V
q(V%
(
N%V%*%)
0
#LQN :%(WQ%!(
*%

962. #(

963. % $mX'#

964. %
N

965. q MCI L%(WO% (syndrome) * ()
0 MCI
QN%%V%X
(
$(
%O%

966. /
10-15 !^ #[:
%#(
(QN :#% (amnestic MCI) )
0 MCI %

967. O%!(L MCI
V#!
*
$ %S

968. O% MCI V%#
(%^
$ !%
.j$$?k YQ MCI of Alzheimer-type
- (RqV#
%QN

969. WQq!$)
0
- O%XW%
P (progressive onset)
- V%
(
N%! V)#!:(S%
- Amnestic syndrome of the ahippocampal typeg defined by:
very poor free recall despite adequate (and controlled) encoding;
decreased total recall because of insufficient effect of cueing or
impaired recognition;
numerous intrusions
- QN :

970. !#

971. % cognitive function O%P
-

972. O%L
- #
#QL
%P (
QQN*V
QN :

973. 86
RQQ

974. %

975. ( V

976. r%(

977. #Q%(
%

978. %%*V

979. 'L MCI %(W $!
$%%N*V
!Q cognitive function O%P :
yz

980. L

981. 87
4
Neurodegenerative disorders
L
*% neurodegenerative disorders %(W Q(%$:;L:
:
XW%
P !)
0 %
Q

982. (

983. 'V(
MV##N%%
#
S! $:)
# $:
%*V
$%

984. # )
0%QQS 0#
*#
*%%(W :
*V
)
0#

985. '(
M !
$V
Alzheimer bs disease
O%V!(
: (
#*% neurodegenerative disorders #XW%%
QV!
:

986. %;

987. RQQ

988. $#
N*V
#:;L:(
QN:QQ(
%W %Wy0
S #[(
)
0%(WQ((! #
(/ 8 ƒ 10 ^ V

989. #

990. %Q[

991. $! S
Q #
MX 20 ^ (#/RQQ

992. %()
0%(W

993. MX 4
%% #(
/ 0.5% (
65 ^$Q:
XW%O%P 5 ^(
:
XW%Q 65 ^
V

994. !/ 360,000 !^ X
!

995. %(WQ:
XW%
#(XW%
) %(W!!

996. )
0

997. $

998. %(

999. W*%#
%L: /L:
(! $ q(m'rQ (N%/*
Q*%# $)
0%(W!^MX 18,408
#

1000. % $:
O% 30,096 Q%MX 36,132 #

1001. % *%/()
0(
(%$
S%
% $%$!N#

1002. %Q[

1003. (
$%

1004. #QX!
!Q:;
L:%W X
N#
*%Z

1005. !

1006. %Q[

1007. QX!
*
/’%Q[

1008. (

1009. '/%$!QQ!! P #(QN
(
P O%XW%(%
P
O%#% $
!#
#

1010. !Rqq#
%
%P (
M!

1011. %

1012. !Q
(
! %Q[

1013. %#

1014. (RqV*%Z

1015. !
#
$
1.

1016. '/%
%
Q$!V!$
Q
X

1017. % *%#
%
q(QN$!Rqq $!S(

1018. '/(
%$(
$!!

1019. %!!N$V%
:;L: !
m

1020. !#N%%(
M !
$%NQ)
0$q!V)
# $
2. !
N
%$VV!
%P L
% X
QO%

1021. W*%
VV! %
Q)#! !P *%
3. (!QV
Z

1022. !%#*#%#V%X
(
QN:QQ!%(W %Q%

1023. W%
!Q(
QNO%S($:V(*
$:V*%:W%(
m
4. /’%Q[

1024. *%%(
%*
$:V(V/’

1025. 5. %Q[

1026. (
/!
m

1027. !Q:; X
!QW%%WN#
*%Z

1028. !
$
RQQ

1029. %((
!P)
0*V
#XW%
$!# $)
0$

1030. W#
%:Y! N

1031. #

1032. m
$#
y“Z

1033. !Q

1034. !QN

1035. %
!#Q%V)
# $)
0 S

1036. O%
N

1037. q
(
Q

1038. '/L:(!

1039. W)
0
$)
# $
Frontotemporal dementia
O% (
(RQQ

1040. #
%:

1041. %;N*V
#L
#

1042. '/
88
#%#
$ (:Y!(
%$ (Z

1043. :

1044. %;

1045. (
$#
!

1046. )
0#

1047. W#V%*%#(! q(

1048. O%!

1049. !

1050. V%(WQ
P O%XW% Q%N*V
)
0 q(M*%*
L'
Dementia with Lewy bodies
O% (
(:;L:QN:(
( Lewy bodies *%
)
0

1051. (V%#[:VS%L:V% (
%V
%#(

1052. )
0(
(L parkinsonism N*V
)
0V
#
#

1053. !Rqq!P S
M#M
!N#

1054. $!P V%(WQ$#

1055. '/(
(
%$(