失智症之診斷與治療

Diagnosis and Treatment of Dementia

10.6530/YYN/2017.5.6

陳韋良(Wei-Liang Chen)；張耀文(Yaw-Wen Chang)；高東煒(Tung-Wei Kao)

失智症 ； 診斷 ； 治療 ； dementia ； diagnosis ； treatment

源遠護理

11卷2期（2017 / 07 / 01）

12 - 17

繁體中文

台灣65歲以上人口已在1993年達7%，正式進入高齡化社會的時代，截至2009年8月已達243萬5千餘人，占總人口的0.55%。由於台灣老年人口的快速增加，盛行於老年人的失智症人數也隨之增加。失智症的特徵是漸進性認知功能減退，包括記憶力會受到影響，並且其症狀會使一個人正常生活的能力受損。美國精神醫學會於2013年所出版的精神疾病診斷與統計手冊第五版中，將失智症更名為重度神經認知症（major neurocognitive disorder）。在其診斷標準中，認知功能要有至少一項以上衰退，包括整體注意力、執行功能、學習能力、記憶力、語言功能、知覺動作功能或社會人際認知等。希望藉由更了解失智症的病生理機轉，衛教病人與家屬知道失智症，在早期可以預防及發現失智症，在晚期可以照顧病人，並且可以善終。

In 1993, with more than 7% of total population were aged 65 years old and more, the era of aging society had begun in Taiwan. The elderly population had reached to 2,435 thousand in August 2009, accounted for 10.55% of the total population. Because of rapidly increased aged population in Taiwan, the dementia patients who were prevalent in aged people also increase rapidly. Dementia was a syndrome characterized by progressive deterioration in cognitive function, including memory, which impairs a person’s capacity to function normally. In the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), ＂dementia＂ in the previous edition was replaced by ＂major neurocognitive disorder＂. The criteria for major neurocognitive disorder include ＂significant cognitive decline from a previous level of performance in one or more cognitive domains (complex attention, executive function, learning and memory, language, perceptual- motor, or social cognition)＂. Improving understanding of pathophysiologic mechanism for dementia and integrating education helped patients and family to detect the early stages of dementia and promote the quality of care in the advanced stage of dementia.

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