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Transcription:

no.588 vol.57 no.588 574588 CODE CN1588

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Göteborg Kuopio Nun Göteborg leukoaraiosis Rotterdam CLINICIAN 10 NO. 588 4

Skoog Snowdon Ott Kivipelto Solomon Bennet Göteborg study BP AD VD BP BP Nun study MMSE n AD Rotterdam study DM AD DM AD VD AD VD Kuopio studyad SBPTch AD AD Kuopio study Tch AD MCI Tch MCI Religious Orders study NIA/Reagan AD Stage ADVDMMSESBP TchMCI 5 CLINICIAN 10 NO. 588

ε4 Kuopio Göteborg CLINICIAN 10 NO. 588 6

Kuopio Bennet Skoog, I., et al. : 15-year longitudinal study of blood pressure and dementia. Lancet, 347, 1141 1145(1996) Kivipelto, M., et al. : Midlife vascular risk factors and Alzheimer s disease in later life : longitudinal, population based study. BMJ, 322, 1447 1451(2001) Whitmer, R.A., et al. : Midlife cardiovascular risk factors and risk of dementia in late life. Neurology, 64, 277 281(2005) Snowdon, DA., et al. : Brain infarction and clinical expression of Alzheimer disease : the Nun study. JAMA, 277, 813 817(1997) 7 CLINICIAN 10 NO. 588

Solomon, A., et al. : Serum cholesterol changes after Med., 11, 383 392(2007) membrane rafts, isoprenoids and statins. J. Cell Mol. Reid, P. C., et al. : Alzheimer s disease : cholesterol, and aging. Am. J. Epidemiol., 156, 445 453(2002) a prospective analysis from the Canadian study of health Lindsay, J., et al. : Risk factors for Alzheimer s disease : nerve system. Neurosci. Biobehav., 25, 311 323(2001) Park, C. R. : Cognitive effects of insulin in the central 74(2006) 1942(1999) Biessels, G. J., et al. : Risk of dementia in diabetes mellitus : a systematic review. Lancet Neurol., 5, 64 dementia : the Rotterdam study. Neurology, 53, 1937 Ott, A., et al. : Diabetes mellitus and the risk of without cognitive impairment from two communitybased studies. Neurology, 66, 1837 1844(2006) Bennett, D. A., et al. : Neuropathology of older persons Neurol., 58, 498 504(2001) impairment and dementia in elderly persons. Arch. Laurin, D., et al. : Physical activity and risk of cognitive Neurology, 67, 1370 1376(2006) consumption with age-related cognitive change. Morris, M.C., et al. : Associations of vegetable and fruit Aging, 24, 589 596(2003) dementia : the Honolulu-Asia aging study. Neurobiaol. Tyas, S. L., et al. : Mid-life smoking and late-life midlife and late-life cognition : twenty-one-year followup study. Neurology, 86, 751 756(2007) CLINICIAN 10 NO. 588 8

dementia depression delirium 9 CLINICIAN 10 NO. 588

abcd A A A A CLINICIAN 10 NO. 588 10

α attenuation 11 CLINICIAN 10 NO. 588

American Psychiatric Association : Diagnostic and Statistical Manual of Mental Disorders-IV(DSM-IV). (1994) CLINICIAN 10 NO. 588 12

13 CLINICIAN 10 NO. 588

T1 CLINICIAN 10 NO. 588 14

secondary NPH : snph idiopathic NPH : inph CSH CSH 15 CLINICIAN 10 NO. 588

Evans Index0.3 Evans Index= aba b CLINICIAN 10 NO. 588 16

inph 17 CLINICIAN 10 NO. 588

Iseki, C., et al. : Asymptomatic ventriculomegaly with features of idiopathic normal pressure hydrocephalus on MRI (AVIM) in the elderly : a prospective study in a Japanese population. J. Neurol. Sci., 277, 54 57(2009) Ogino, A., Kazui, H., et al. : Cognitive impairment in patients with idiopathic normal pressure hydrocephalus. Dement. Geriatr. Cogn. Disord., 21, 113 119(2006) Kitagaki, H., et al. : CSF spaces in idiopathic normal pressure hydrocephalus : morphology and volumetry. AJNR Am. J. Neuroradiol., 19, 1277 1284(1998) CLINICIAN 10 NO. 588 18

Reisberg Global Deterioration Scale (GDS) Stage 3 Petersen 19 CLINICIAN 10 NO. 588

Petersen Dubois Va Dubois Va CLINICIAN 10 NO. 588 20

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Dubois CLINICIAN 10 NO. 588 22

Roman Mild Prichep, LS., et al. : Prediction of longitudinal cognitive decline in normal elderly with subjective complaints 23 CLINICIAN 10 NO. 588

Dubois, B., et al. : Research criteria for the diagnosis of 352, 1 10(2005) treatment of mild cognitive impairment. N. Eng. J. Med., Petersen, RC., et al. : Vitamin E and donepezil for the Psychogeriatr., 1, 1 9(2008) disease in a community : The Osaki-Tajiri Project. Int. metabolism in converters from CDR 0.5to Alzheimer s Ishii, H., Meguro, K., et al. : Decreased cortical glucose Tajiri Project. Neuroepidemiology, 33, 103 110(2009) converters to dementia in a community : The Osaki- function tests can screen mild cognitive impairment and Nakata, E., et al. : Combined memory and executive Sci., 260, 175 182(2007) (2004) Meguro, K., et al. : Incidence of dementia and associated risk factors in Japan : The Osaki-Tajiri Project. J. Neurol. Alzheimer s disease? Lancet Neurol., 3, 246 248 Dubois, B., Albert, ML. : Amnestic MCI or prodromal 303 308(1999) clinical characterization and outcome. Arch. Neurol., 56, Petersen, RC., et al. : Mild cognitive impairment : 27, 471 481(2006) using electrophysiological imaging. Neurobiol. Aging, 59, 23 30(2000) vascular dementia in clinical trials. J. Neural. Transm., Erkinjuntti, T., et al. : Research criteria for subcortical vascular dementia. J. Neurol. Sci., 226, 81 87(2004) 746(2007) Roman, GC., et al. : Vascular cognitive disorder : a new category updating vascular cognitive impairment and criteria-a Position Paper. Lancet Neurology, 6, 734 Alzheimer s disease : Revising the NINCDS-ADRDA CLINICIAN 10 NO. 588 24

Mini-Mental State Examination MMSE Alzheimer s disease : AD Frontotemporal dementia : FTD Dementia with Lewy bodies : DLB Vas- 25 CLINICIAN 10 NO. 588

cular dementia : VaD Test Your Memory Verbal fluency category fluency semantic fluency letter fluency mild cognitive impairment : MCI DLB+VaD Alzheimer sdisease Assessment Scale cog Wechsler Memory Scale-revised verbal fluency Verbal fluency category fluency letter fluency category fluency CLINICIAN 10 NO. 588 26

letter fluency category fluency letter fluency category fluency 27 CLINICIAN 10 NO. 588

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Folstein, MF., et al. : Mini-Mental State ; a practical method for grading the cognitive state for the clinician. J. Psychiatr. Res., 12, 189 198(1975) O Bryant, SE., et al. : Detecting dementia with the Mini- Mental State Examination in highly educated individuals. Arch. Neurol., 65, 963 967(2008) Hanyu, H., et al. : The 1-minute mental status examination in the memory clinic. J. Am. Geriat. Soc, 57, 1130 1131(2009) Hanyu, H., et al. : Differentiation of dementia with Lewy bodies from Alzheimer s disease using the Frontal Assessment Battery test. Int. J. Geriatr. Psychiatry, 24, 1034 1035(2009) Solomon, PR., et al. : A 7 minute neurocognitive screening battery highly sensitive to Alzheimer s disease. Arch. Neurol., 55, 349 355(1998) Brown, J., et al. : Self administered cognitive screening test (TYM) for detection of Alzheimer s disease : cross sectional study. Brit. Med. J., 338, 1426 1428(2009) 29 CLINICIAN 10 NO. 588

Alzheimer s disease Ach Ach CLINICIAN 10 NO. 588 30

31 CLINICIAN 10 NO. 588

pre synaptic neuron pre-sn pre-sn pre-sn Ach CLINICIAN 10 NO. 588 32

pre-sn Honma, A., et al. : Donepezil treatments with severe Alzheimer s disease in a Japanese populations : results from a 24-week, double-blind, placebo-controlled, randomized trial. Dement. Geriatr. Cog. Disord., 25, 399 407(2008) Honma, A., et al. : Long-term safety and efficacy of Donepezil in patients with severe Alzheimer s disease : results from a 52-week, opne-label, multicenter, extension study in japan. Dement. Geriatr. Cog. Disord., 27, 232 239(2009) donepezil Nozawa, M., et al. : Clinical effects of high dose of donepezil for patients with Alzheimer s disease in Japan. Psychogeriatrics, 9, 50 55(2009) donepezil 33 CLINICIAN 10 NO. 588

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Clinical Dementia CLINICIAN 10 NO. 588 40

Rating CDR CDR CDR very mild AD 41 CLINICIAN 10 NO. 588

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donepezil (Suppl 1)113(2009) CLINICIAN 10 NO. 588 46

Neuropsychiatric Inventory NPI 47 CLINICIAN 10 NO. 588

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Rodda Lyketsos, C., et al. : Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment. Results from the cardiovascular health study. JAMA, 288, 1475 1483(2002) Lövheim, H., et al. : Sex differences in the prevalence of behavioral and psychological symptoms of dementia. International Psychogeriatrics, 21, 469 475(2009) Liperoti, R., et al. : Antipsychotics for the treatment of behavioral and psychological symptoms of dementia (BPSD). Current Neuropharmacology, 6, 117 124 (2008) Gauthier, S., et al. : Improvement in behavioural symptoms in patients with moderate to severe Alzheimer s disease by memantine : a pooled data analysis. Int. J. Geriatr. Psychiatry, 23, 537 545(2008) CLINICIAN 10 NO. 588 52

International Psychogeriatrics, 21, 813 824(2009) trials of donepezil, rivastigmine and galantamine. systematic review of randomized, placebo-controlled symptoms of dementia in Alzheimer s disease? A in the management of the behavioral and psychological Rodda, J., et al. : Are cholinesterase inhibitors effective 53 CLINICIAN 10 NO. 588

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amantadine Notch 55 CLINICIAN 10 NO. 588

Notch modulator Flurizan CLINICIAN 10 NO. 588 56

active immunization passive immunization Bapineuzumab Vasogenic Edema 57 CLINICIAN 10 NO. 588

Solanezumab symptomatic treatment disease modification symptomatic treatment disease modification symptomatic treatment disease modification CLINICIAN 10 NO. 588 58

disease modification 59 CLINICIAN 10 NO. 588

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Announcement by Neurochem and Ellan, The 8th International Montreal/Springfield Symposium on Advances in Alzheimer Therapy, April 14 17 2004, Montreal, Canada http : //phx.corporate ir.net/phoenix.zhtml?c=78193&p= irol newsarticle&id=1272545&highlight= Holmes, C., et al. : Long-term effects of Aβ42 immunisation in Alzheimer s disease : follow-up of a randomised, placebo-controlled phase I trial, Lancet, 372, 216 223(2008) 61 CLINICIAN 10 NO. 588

common disease Common disease CLINICIAN 10 NO. 588 62

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common disease 65 CLINICIAN 10 NO. 588

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Cognition and Dementia Geriatric Medicine CLINICIAN 10 NO. 588 70

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a b c CLINICIAN 10 NO. 588 72

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tap-test shunt LP-shunt VP-shunt shunt CLINICIAN 10 NO. 588 74

shunt ope LP VP LP LP LP LP Tap test F.I. F.K. M.S. A.S. K.K. Y.K. I.D. A.Y. H.O. T.S. 75 CLINICIAN 10 NO. 588

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85 CLINICIAN 10 NO. 588 invariant

CLINICIAN 10 NO. 588 86 Airway HyperReactivity : AHR Umetsu CD1d /, Jα18 / alfa-galactosylceramide α-galcer Ig Holtzman

87 CLINICIAN 10 NO. 588 Umetsu CD1d tetramer invariant T New England Journal of Medicine NEJM

CLINICIAN 10 NO. 588 88 Dukanovic Fc α-galcer C-glycoside Akbari, O., et al. : Nat. Med., 9, 582 588(2003) Meyer, E.H., Goya, S., et al. : Proc. Natl. Acad. Sci. U. S. A., 103, 2782 2787(2005) Pichavant, M., Goya, S., et al. : J. Exp. Med., 205, 385

1422(2007) (2006) Vijayanand, P., et al. : N. Engl. J. Med., 356, 1410 Akbari, O., et al. : N. Engl. J. Med., 354, 1117 1129 Kim, E.Y., et al. : Nat. Med., 14, 633 640(2008) 393(2008) 89 CLINICIAN 10 NO. 588

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magazine 93 CLINICIAN 10 NO. 588

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PIONET PIONET CLINICIAN 10 NO. 588 98

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MDCT MRI PCI CTOPCI PCI ACS PCIMDCT ST PCI ACLS CLINICIAN 10 NO. 588 106

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JPS NEWS http://www.nils.go.jp/ department/dgp/index-dgp-j.htm 111 CLINICIAN 10 NO. 588

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A BPSD A A B D ROT D Validation 113 CLINICIAN 10 NO. 588

p p p p p p p ns p p ns ns ns NA = not available ns ns NA ns NA NA NA ns ns ns p ns ns CLINICIAN 10 NO. 588 114

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Geriatric Medicine, 45, 1073 1075(2007) CLINICIAN 10 NO. 588 116

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B12 CLINICIAN 10 NO. 588 118

FAST staged AD 119 CLINICIAN 10 NO. 588

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follow up follow up follow up 125 CLINICIAN 10 NO. 588

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Onozato, Y., et al. : Endoscopic submucosal dissection for early gastric cancers and large flat adenomas. Endoscopy, 38(10), 980 986(2006) Onozato, Y., et al. : Endoscopic submucosal dissection for rectal tumors. Endoscopy, 39(5), 423 427(2007) Onozato, Y., et al. : Endoscopic management of duodenal diverticular bleeding. Gastrointest. Endosc., 66(5), 1042 1049(2007) Onozato, Y., et al. : Feasibility of endoscopic submucosal dissection for elderly patients with early gastric cancers and adenomas. Digestive Endoscopy, 20, 12 16(2008) Prog. Digest. Endosc., 68, 62 66(2006) Prog. Digest. Endosc., 72, 94 95(2008) 129 CLINICIAN 10 NO. 588

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