認知症の診断と治療 ―Alzheimer病を中心に
「はじめに」わが国の高齢化のスピードは世界でもまれにみるスピードで進行している. 認知症の患者数は2012年に約462万人, 2025年に約675万人, 2050年には1000万人を上回ると推定されている. 筆者らは石川県七尾市中島町において認知症の疫学研究を継続している(なかじまプロジェクト). 中島町で行った認知機能の全数調査の結果(2016～2018年), 65歳以上の住民の17.5%が認知症, 20.0%が軽度認知障害(mild cognitive impairment: MCI)であった. 年齢階層ごとでは, 5歳年齢が上がると認知症の有病率は倍増し, 認知症とMCIとを合わせると8...
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| Published in | 神経治療学 Vol. 41; no. 4; pp. 473 - 477 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本神経治療学会
2024
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0916-8443 2189-7824 |
| DOI | 10.15082/jsnt.41.4_473 |
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| Abstract | 「はじめに」わが国の高齢化のスピードは世界でもまれにみるスピードで進行している. 認知症の患者数は2012年に約462万人, 2025年に約675万人, 2050年には1000万人を上回ると推定されている. 筆者らは石川県七尾市中島町において認知症の疫学研究を継続している(なかじまプロジェクト). 中島町で行った認知機能の全数調査の結果(2016～2018年), 65歳以上の住民の17.5%が認知症, 20.0%が軽度認知障害(mild cognitive impairment: MCI)であった. 年齢階層ごとでは, 5歳年齢が上がると認知症の有病率は倍増し, 認知症とMCIとを合わせると80歳代後半では住民の70%以上, 90歳以上では85%以上に達する. 認知症の内訳では, Alzheimer病(Alzheimer disease: AD)が69.6%と最も頻度が高く, 以下, 血管性認知症12.9%, Lewy小体型認知症6.8%となっていた. |
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| AbstractList | 「はじめに」わが国の高齢化のスピードは世界でもまれにみるスピードで進行している. 認知症の患者数は2012年に約462万人, 2025年に約675万人, 2050年には1000万人を上回ると推定されている. 筆者らは石川県七尾市中島町において認知症の疫学研究を継続している(なかじまプロジェクト). 中島町で行った認知機能の全数調査の結果(2016～2018年), 65歳以上の住民の17.5%が認知症, 20.0%が軽度認知障害(mild cognitive impairment: MCI)であった. 年齢階層ごとでは, 5歳年齢が上がると認知症の有病率は倍増し, 認知症とMCIとを合わせると80歳代後半では住民の70%以上, 90歳以上では85%以上に達する. 認知症の内訳では, Alzheimer病(Alzheimer disease: AD)が69.6%と最も頻度が高く, 以下, 血管性認知症12.9%, Lewy小体型認知症6.8%となっていた. |
| Author | 小野, 賢二郎 |
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| References | 22) Barakos J, Sperling R, Salloway S et al : MR imaging features of amyloid–related imaging abnormalities. AJNR Am J Neuroradiol 34 : 1958–1965, 2013 8) 和田健二，中島健二：アルツハイマー型認知症の診断と治療．医と薬学 72 : 1153–1162, 2015 13) Yamada M : Senile dementia of the neurofibrillary tangle type (tangle–only dementia) : neuropathological criteria and clinical guidelines for diagnosis. Neuropathology 23 : 311–317, 2003 14) Jack CR Jr, Bennett DA, Blennow K et al : NIA–AA Research Framework : Toward a biological definition of Alzheimer's disease. Alzheimers Dement 14 : 535–562, 2018 4) Hardy J, Selkoe DJ : The amyloid hypothesis of Alzheimer's disease : progress and problems on the road to therapeutics. Science 297 : 353–356, 2002 12) Saito Y, Ruberu NN, Sawabe M et al : Staging of argyrophilic grains : an age–associated tauopathy. J Neuropathol Exp Neurol 63 : 911–918, 2004 20) Cummings J, Apostolova L, Rabinovici GD et al : Lecanemab : Appropriate Use Recommendations. J Prev Alzheimers Dis 10 : 362–377, 2023 7) 小野賢二郎：認知症の診断と治療 ―アルツハイマー病を中心に―．神経治療 40 : 233–236, 2023 16) Sevigny J, Chiao P, Bussière T et al : The antibody aducanumab reduces Aβ plaques in Alzheimer's disease. Nature 537 : 50–56, 2016 17) https://www.alzforum.org/therapeutics/aduhelm 2) Noguchi–Shinohara M, Yuki S, Dohmoto C et al : Differences in the prevalence of dementia and mild cognitive impairment and cognitive functions between early and delayed responders in a community–based study of the elderly. J Alzheimers Dis 37 : 691–698, 2013 19) van Dyck CH, Swanson CJ, Aisen P et al : Lecanemab in Early Alzheimer's Disease. N Engl J Med 388 : 9–21, 2023 6) 浦上克哉：認知症の診断と治療．診断と治療 102 : 193–205, 2014 25) Manzano S, Agüera L, Aguilar M et al : A Review on Tramiprosate (Homotaurine) in Alzheimer's Disease and Other Neurocognitive Disorders. Front Neurol 11 : 614, 2020 10) 松田博史：早期アルツハイマー型認知症診断支援システム VSRAD®︎について．日放線技会誌 62 : 1066–1072, 2006 15) Holmes C, Boche D, Wilkinson D 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 18) Abbasi J : Promising Results in 18–Month Analysis of Alzheimer Drug Candidate. JAMA 320 : 965, 2018 3) 小野賢二郎：将来の認知医療を見据えて 認知症領域におけるプロテイノパチーの病因解明 up to date．老年精医 31 (増刊号–I) : 39–45, 2020 1) 小野賢二郎：特集 “認知症＋併存疾患” アプローチの最前線 特集のねらい．内科 129 : 1240–1241, 2022 9) Fujiwara Y, Suzuki H, Yasunaga M et al : Brief screening tool for mild cognitive impairment in older Japanese : validation of the Japanese version of the Montreal Cognitive Assessment. Geriatr Gerontol Int 10 : 225–232, 2010 26) Kocis P, Tolar M, Yu J et al : Elucidating the Aβ42 Anti–Aggregation Mechanism of Action of Tramiprosate in Alzheimer's Disease : Integrating Molecular Analytical Methods, Pharmacokinetic and Clinical Data. CNS Drugs 31 : 495–509, 2017 21) Sperling RA, Jack CR Jr, Black SE et al : Amyloid–related imaging abnormalities in amyloid–modifying therapeutic trials : recommendations from the Alzheimer's Association Research Roundtable Workgroup. Alzheimers Dement 7 : 367–385, 2011 23) https://www.alzforum.org/therapeutics/alz-801 24) Tolar M, Hey J, Power A et al : Neurotoxic Soluble Amyloid Oligomers Drive Alzheimer's Pathogenesis and Represent a Clinically Validated Target for Slowing Disease Progression. Int J Mol Sci 22 : 6355, 2021 5) Ono K : Alzheimer's disease as oligomeropathy. Neurochem Int 119 : 57–70, 2018 11) Morinaga A, Ono K, Ikeda T et al : A comparison of the diagnostic sensitivity of MRI, CBF–SPECT, FDG–PET and cerebrospinal fluid biomarkers for detecting Alzheimer's disease in a memory clinic. Dement Geriatr Cogn Disord 30 : 285–292, 2010 |
| References_xml | – reference: 15) Holmes C, Boche D, Wilkinson D 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 – reference: 16) Sevigny J, Chiao P, Bussière T et al : The antibody aducanumab reduces Aβ plaques in Alzheimer's disease. Nature 537 : 50–56, 2016 – reference: 26) Kocis P, Tolar M, Yu J et al : Elucidating the Aβ42 Anti–Aggregation Mechanism of Action of Tramiprosate in Alzheimer's Disease : Integrating Molecular Analytical Methods, Pharmacokinetic and Clinical Data. CNS Drugs 31 : 495–509, 2017 – reference: 18) Abbasi J : Promising Results in 18–Month Analysis of Alzheimer Drug Candidate. JAMA 320 : 965, 2018 – reference: 3) 小野賢二郎：将来の認知医療を見据えて 認知症領域におけるプロテイノパチーの病因解明 up to date．老年精医 31 (増刊号–I) : 39–45, 2020 – reference: 5) Ono K : Alzheimer's disease as oligomeropathy. Neurochem Int 119 : 57–70, 2018 – reference: 19) van Dyck CH, Swanson CJ, Aisen P et al : Lecanemab in Early Alzheimer's Disease. N Engl J Med 388 : 9–21, 2023 – reference: 22) Barakos J, Sperling R, Salloway S et al : MR imaging features of amyloid–related imaging abnormalities. AJNR Am J Neuroradiol 34 : 1958–1965, 2013 – reference: 2) Noguchi–Shinohara M, Yuki S, Dohmoto C et al : Differences in the prevalence of dementia and mild cognitive impairment and cognitive functions between early and delayed responders in a community–based study of the elderly. J Alzheimers Dis 37 : 691–698, 2013 – reference: 7) 小野賢二郎：認知症の診断と治療 ―アルツハイマー病を中心に―．神経治療 40 : 233–236, 2023 – reference: 13) Yamada M : Senile dementia of the neurofibrillary tangle type (tangle–only dementia) : neuropathological criteria and clinical guidelines for diagnosis. Neuropathology 23 : 311–317, 2003 – reference: 17) https://www.alzforum.org/therapeutics/aduhelm – reference: 25) Manzano S, Agüera L, Aguilar M et al : A Review on Tramiprosate (Homotaurine) in Alzheimer's Disease and Other Neurocognitive Disorders. Front Neurol 11 : 614, 2020 – reference: 23) https://www.alzforum.org/therapeutics/alz-801 – reference: 4) Hardy J, Selkoe DJ : The amyloid hypothesis of Alzheimer's disease : progress and problems on the road to therapeutics. Science 297 : 353–356, 2002 – reference: 1) 小野賢二郎：特集 “認知症＋併存疾患” アプローチの最前線 特集のねらい．内科 129 : 1240–1241, 2022 – reference: 8) 和田健二，中島健二：アルツハイマー型認知症の診断と治療．医と薬学 72 : 1153–1162, 2015 – reference: 11) Morinaga A, Ono K, Ikeda T et al : A comparison of the diagnostic sensitivity of MRI, CBF–SPECT, FDG–PET and cerebrospinal fluid biomarkers for detecting Alzheimer's disease in a memory clinic. Dement Geriatr Cogn Disord 30 : 285–292, 2010 – reference: 6) 浦上克哉：認知症の診断と治療．診断と治療 102 : 193–205, 2014 – reference: 14) Jack CR Jr, Bennett DA, Blennow K et al : NIA–AA Research Framework : Toward a biological definition of Alzheimer's disease. Alzheimers Dement 14 : 535–562, 2018 – reference: 20) Cummings J, Apostolova L, Rabinovici GD et al : Lecanemab : Appropriate Use Recommendations. J Prev Alzheimers Dis 10 : 362–377, 2023 – reference: 12) Saito Y, Ruberu NN, Sawabe M et al : Staging of argyrophilic grains : an age–associated tauopathy. J Neuropathol Exp Neurol 63 : 911–918, 2004 – reference: 9) Fujiwara Y, Suzuki H, Yasunaga M et al : Brief screening tool for mild cognitive impairment in older Japanese : validation of the Japanese version of the Montreal Cognitive Assessment. Geriatr Gerontol Int 10 : 225–232, 2010 – reference: 10) 松田博史：早期アルツハイマー型認知症診断支援システム VSRAD®︎について．日放線技会誌 62 : 1066–1072, 2006 – reference: 24) Tolar M, Hey J, Power A et al : Neurotoxic Soluble Amyloid Oligomers Drive Alzheimer's Pathogenesis and Represent a Clinically Validated Target for Slowing Disease Progression. Int J Mol Sci 22 : 6355, 2021 – reference: 21) Sperling RA, Jack CR Jr, Black SE et al : Amyloid–related imaging abnormalities in amyloid–modifying therapeutic trials : recommendations from the Alzheimer's Association Research Roundtable Workgroup. Alzheimers Dement 7 : 367–385, 2011 |
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| Title | 認知症の診断と治療 ―Alzheimer病を中心に |
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