Beware that this "eraser in the mind" may be inherited...

Source: Yangtze Evening News

Beware of this "eraser in the mind" that may be inherited...

"Lately, I've always forgotten things, I can't remember if I've locked the door, I can't find where the key is..." Recently, 57-year-old Aunt Guo (pseudonym) has always been troubled by her "forgetfulness". On the morning of September 18, at the scene of the large-scale consultation activity of the "World Alzheimer's Day" in Nanjing Drum Tower Hospital, the reporter met many elderly people like Aunt Guo who were troubled by memory loss and slow response, and came to consult. Professor Zhao Hui, chief physician of the Department of Neurology of Nanjing Drum Tower Hospital, said that it is very important for the early diagnosis of Alzheimer's disease, and early differential diagnosis can clarify the different causes of cognitive impairment and help effectively take individualized interventions.

Correspondent Xu Gaofeng

Yangzi Evening News/Purple Cow News trainee reporter Lu Yanlin

Two specialized scales can be used to assess patients with early stage dementia

"Do you know what day of the month it is?" "100-7, how many?" ...... At the scene of the event, the reporter noticed that in addition to consultation, eye diagnosis, and tongue diagnosis, many experts conducted two scale evaluations for the citizens and friends who came to consult. Can such a scale diagnose "Alzheimer's disease"? Professor Zhao Hui, chief physician of the Department of Neurology of Nanjing Drum Tower Hospital, introduced that the MMSE scale Chinese named the simple mental state evaluation scale, "In addition to assessing memory, this table also evaluates time orientation and location orientation, attention, computing, recall function, language function, etc." ”

It is understood that the MMSE scale has a full score of 30 points. However, Professor Zhao Hui said that according to the different levels of education, there are different standards for scoring, and it is not normal to have a full score. Another that looks slightly more complicated is the MoCA scale, the Montreal Cognitive Assessment Scale. Zhao Hui said that the MoCA scale is mainly used to screen patients with mild cognitive impairment and patients with early dementia, and the assessment content includes time and executive function, as well as naming ability, language, delayed recall, attention and so on.

Director Zhao Hui stressed that whether it is the MMSE scale or the MoCA scale, only trained doctors can evaluate, "the results of their own direct scales do not represent the true level of cognition." ”

Ultra-early intervention, early diagnosis and early treatment 20 years in advance Bai Feng, chief physician of the Department of Neurology, told reporters that there are many people like Aunt Guo who can find performance of memory decline, but the scale evaluation is still within the normal range of middle-aged and elderly friends, "This is subjective cognitive impairment, which may be an earlier manifestation than mild cognitive impairment." According to Bai Feng, subjective cognitive impairment progresses to mild cognitive impairment, usually in 10 to 15 years, and from mild cognitive impairment to The stage of Alzheimer's disease (AD), or "Alzheimer's disease", it may take another 10 years.

"So we hope that these people can be found as early as 20 years before the onset of Alzheimer's disease, and giving some drugs in the ultra-early stage, or non-drug functional training such as nootropics, can greatly reduce the development of such people to Alzheimer's disease."

Be careful, this "eraser in your head" will be inherited, "Alzheimer's disease itself has a certain rate of heredity." Bai Feng introduced that the genetic probability of Alzheimer's disease in immediate family members is high, and the APOE ε4 gene, which is currently the most harmful, has been confirmed to be closely related to "Alzheimer's disease". "In such a population we would recommend doing a genetic test." If there is a problem, further lumbar puncture CSF examination should be done. Bai Feng pointed out that the examination index of cerebrospinal fluid is the core criterion for diagnosing whether the elderly are demented, so for the immediate family with Alzheimer's disease, genetic testing can be done first, and then lumbar puncture examination can be done, which can provide precise intervention for follow-up diagnosis and treatment.

Director Zhao Hui reminded that the noteworthy performance is more than "forgetfulness". "Sometimes it's a problem with judgment and some bad decisions are made. It may also be a decrease in interest and a change in hobbies. I usually like to do a lot of things, but now I don't want to go out and communicate with people, and my daily activities have decreased. This situation also deserves attention. At the same time, Director Zhao Hui pointed out that the performance of some elderly people is to constantly repeat the same thing, repeatedly nagging and nagging, but also to attract attention. When the family observes these "signals", the patient can be taken to a regular hospital for early screening.