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81
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6
Diagnostic and Statistical Manual of Mental Disorders,
4thedition (DSM - IV h TRTM)
Dementia*
A : The development of multiple cognitive deficits manifested by both
(1) Memory impairment (impaired ability to learn new information or to recall previously
learned information)
(2) one (or more) of the following cognitive disturbances:
(a) Aphasia (language disturbance)
(b) Apraxia (impaired ability to carry out motor activities despite intact motor
function)
(c) Agnosia (failure to recognize or identify objects despite intact sensory function)
(d) Disturbance in executive functioning (i.e., planning, organizing, sequencing,
abstracting)
B: The cognitive deficits in Criteria A1 and A2 each cause significant impairment in social or
occupational functioning and represent a significant decline from a previous level of
functioning.
C: The deficits do not occur exclusively during the course of a delirium.
D: The deficits may be associated with mental disorders such as anxiety mood delusions,
hallucinations, personality change wandering agitation. The cognition disturbance may be
accompanied by a clinically significant behavior disturbance
E: Dementia may be progressive, stable, remitting
American Psychiatry Association. Diagnostic and Statistic Manual of Mental Disorders.4th Edition
91
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2
#?"1#
1. Prayurahong B, Chanjanakijskul S, Supawan P, et al. Vitamin B12, Folic Acid and
Hematological status in elderly thais. J Med Assoc Thai 1993:76;71-78.
2. Assantachai P, Yamwong P, Chongsuphaijaisiddhi T. Relationship of vitamin B1, B12m Folate
and the cognitive ability of the Thai rural elderly. J Med Assoc Thai 1997;80:700-705.
"
3.3 Management of caregivers
1. New Zealand Guidelines Group New Zealand Guidelines Completed: Guide.(19982003),Site Development and Management by ENIGMA.
2. Brien J., Ames D,Burns A. eds. Dementia:Family Carers for People with Dementia.2nd ed.
London:Arnold,2000.
3. % q !%h%. "V(#. :V%: ;(:':": ,2537
4. /"L q .L& *%# $ )
:%"
$:(*V,^(
27,[ (
3,%% 2537.
5. Alzheimer , Association . Alzheimer , s Disease Guidelines: A Summary for Patients,Family
and Friends.American Academy of Neurology.
"
3.4 >zQ%{Q
1. Mender MF. Cummings TL. Dementia: A Clinical Approach. Elsevier: Butterworth
Heinemann, 2003
2. Spar TE, Rue AL. Clinical Mann cal of Geriatric Psychiatry. Washington, DC: A Mercian
Psychiatric Publishing. Inc. 2006.
3. $%' L
(Clinical Practice Guideline for Dementia). [ (
1
4. http://www. Inet.nswo.moph.go.th. `V$: ! 19-36, 420-437. &
29
'%. 2551.
99
"
3.5
|}~|X
% O (Physical rehabilitation)
1. Teri L, Gibbons LE, McCurry SM, Logsdon RG, Buchner DM, Barlow WE, et al. Exercise plus
behavioral management in patients with Alzheimer disease: a randomized controlled trial.
JAMA. 2003 ; 290 :2015-22.
2. Arkin SM. Alzheimer rehabilitation by students: interventions and outcomes. Neuropsychol
Rehab 2001; 11 : 273-317.
3. Josephsson S, Backman L, Borell L, Bernspang B, Nygard L, Ronnberg L. Supporting everyday
activities in dementia: an intervention study. Int J Geriatr Psychia 1993; 8 : 395-400.
4. Farina E, Fioravanti R, Chiaveri L, Imbornone E, Alberoni M, Pomati S, et al. Comparing two
programs of cognitive training in Alzheimers disease: a pilot study Acta Neurol Scand
2002 ; 105: 365-371.
5. Woolham J, Frisby B, Quinn S, Smart W, Moore A. The Safe at Home Project: using
technology to support the care of people with dementia in their own homes. London:
Hawker Publications Ltd; 2002.
6. Bach D, Bach M, Bohmer F, Fruhwald T, Grilc B. Reactivating Occupational Therapy: A
Method to improve Cognitive Performance in Geriatric Patients. Age and Ageing 1995 ;
24 : 222-226.
7. Gitlin LN, Corcoran M, Winter L, Boyce A, Hauck WW. A randomized, controlled trial of a
home environmental intervention: effect on efficacy and upset in caregivers and on daily
function of persons with dementia. Gerontologist 2001 ; 41 : 4-14.
"
3.6 %& !% (end of life care)
1. World Health Organization. Definition of palliative care. Geneva: WHO, 2002.
www.who.int/cancer/palliative/definition/en/
2. Sachs GA, Shega JW, Cox-Hayley D. Barriers to excellent end-of-life care for patients with
dementia. J Gen Intern Med 2004; 19: 1057-63
3. Monias A, Meier DE. Palliative care in early, moderate, and advanced dementia. In: Cassel CK,
ed. Geriatric medicine: An evidenced-based approach. New York: Springer, 2003: 343-58
4. Lyness JM. End-of-life care: Issues relevant to the geriatric psychiatrists. Am J Geriatr
Psychiatry 2004; 12: 457-72
100
101
8. Patten BM : The Ancient Art of Memory usefulness in treatment. Arch Neurol 26:25-31,
1972.
9. Piaget J. The Construction of Reality in Child. New York, Basic Book, 1954.
10. Pinkney L, Sarker P : Snoezelen : an Evaluation of An Environment Used by, People
Who Are Elderly and Confused , in Sensations and Disability. Edited by Hutchinson
R, Kewin J. Chesterfield , UK, Robinson and Sons, 1994, pp 172-182.
11. Teri L. Uomoto J. Reducing excess Disability in Dementia Patients : Waiving
caregivers to manage patient depression Clinical Genealogist 10 : 49-63, 1991.
12. Schoffer G, Poon L : Individual Variability in Memory Training with the Elderly. Educ
Gerostol 8 :217-229, 1982.
"
4.2 (% ) (pharmacological management)
Rogers SL, Farlow MR, Doody RS, et al. A 24-week, double-blind, placebo-controlled trial of
donepezil in patients with Alzheimers disease. Neurology 1998;50:136-45.
Rogers SL, FriedhoffLT, for the Donepezil Study Group. The efficacy and safety of donepezil in
patients with Alzheimer's disease: results of a US multicentre, randomized, double-blind,
placebo-controlled trial. Dementia 1996;7:293-303.
Cummings JL, Donobue JA, Brooks RL. The relationship between donepezil and behavioral
disturbances in patients with Alzheimer's disease. J geriatr Psychiatry 2000;8:134-140.
Feldman H, Gauthier S, Hecker J, et al. A 24-week, randomized, double-blind study of donepezil
in moderate to severe Alzheimers disease. Neurology 2001;57:613-20.
Corey-Bloom J, Anand R, Veach J. A randomized trial evaluating the efficacy and safety of ENA 713
(rivastigmine tartrate), a new acetylcholinesterase inhibitor, in patients with mild to
moderately severe Alzheimers disease. Int J Geriatr Psychopharmacol 1998;1:55-65.
Rosler M, Anand R, Cicin-Sain A, et al. Efficacy and safety of rivastigmine in patients with
Alzheimers disease: international randomised controlled trial. BMJ1999;318:633-40.
Rosler M, Retz W, Retz-Junginger P, Dennler HJ. Effects of two-year treatment with the
cholinesterase inhibitors rivastigmine on behavioural symptoms in Alzheimer's disease.
Behavioural neurology 1998/1999;11:211-6.
102
Wilcock GK, Lilienfeld S, Geans E. Efficacy and safety of galantamine in patients with mild to
moderate Alzheimers disease: multicentre randomised controlled trial. BMJ 2000;321 :
1-7.
Tariot PN, Solomon PR, Morris JC, et al. A 5-month, randomized, placebo-controlled trial of
galantamine in AD. Neurology 2000;54:2269-76.
Raskind MA, Peskind ER, Wessel T, et al. Galantamine in AD: A 6-month randomized, placebocontrolled trial with a 6-month extension. Neurology 2000;54:2261-8.
Donepezil-Treated Patients with Probable Vascular Dementia Demonstrate Cognitive Benefits,
Annals New York Academy of Sciences. 2002;977:513-22.
Donepezil in Vascular Dementia : A randomizwd, placebo controlled study, Neurology. 2003
Aug 26;61(4):479-86.
Efficacy and tolerability of donepezil in vascular dementia. Positive results of a 24-week,
Multicenter, International, Randomized, Placebo-controlled Clinical Trial, Stroke. 2003
Sep 11.
"
5
(>zQO#$
&?$#
(Management of behavior & psychological symptoms of dementia)
Alistair Burns, Bengt Winblad, Wiley. Bright light therapy. severe dementia, John wiley & sons
Ltd.
Satlin A, Volicer L, Ross V, Herz L, Campbell S (1992): Bright light trial of Behavioral & sleep
disturbance in patients with dementia ,Am J Psychiatry 149(8):1028-1032.
Skjeerve A, Holstein F, Agrsland D, Improvement in behavioral symptoms and advance of activity
acrophone acter short steam bright light treatment in severe dementia
Small wood J, Brown R, Coulter F, Irvine E, copland C (2001) Aromatherapy and behavior
disturbance in dementia; a randomized controlled trial Int J Geriatr psychiatry, 16
(10):1010-1013.
Lord TR, Garner JE (1993) Effects of music therapy on Alzheimer patients Percept Mot skill,
76(2) : 451-455.
#
Schneider LS et al. Risk of death with atypical antipsychotic drug treatment for dementia: metaanalysis of randomized placebo-controlled trials. JAMA 2005 Oct 19;294(15):1934-43.
103
1
Larrieu S, Letenneur L, Orgogozo JM. Et al. Incidence and outcome of mild cognitive impairment
in a population based propective cohort. Neurology 2002; 59:1594-9.
4 Reversible dementia
Martyn C, Gale C: The British Medical Association.London: Dorling kindersley, 2002
5 Diagnostic and Statistical Manual of Mental Disorders,4thedition (DSM - IV h TRTM)
American Psychiatry Association. Diagnostic and statistic manual of mental disorders.
(DSM-IV-TRTM) 4th edition. Washington (DC): American Psychiatric Press; 2000.
&""%"
1. Folstein MF, Folstein SE, Mc Hugh PR. Mini Mental State: a practical method for grading the
cognitive state of patient for the clinician. J Psychiatr Res 1975;12:189-98.
2. /N% (%":%; :"% ;%). Train the Brain Forum (Thailand). Thai Mini
Mental State Examination (TMSE). Siriraj Hosp Gaz 1993;45:359-74.
3. M %m!)
$: ;/&. $ # L:
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AD
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CAG
=
ChEIs
=
CJD
=
CNS
=
CPG
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CVD
=
CYP
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=
EEG
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fMRI
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MCI
=
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MMSE
=
MOCA
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=
NPH
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Acetylcholine
Acetylcholine esterase
Alzheimerxs disease
Activities of daily living
Amyloid precursor protein
Butyrylcholine esterase
Cerebral autosomal dominant arteriopathy with subcortical
infarcts and leukoencephalopathy
Cytosine arginine - guanine
Cholineesterase inhibitors
Creutzfeldt Jakob disease
Central nervous system
Clinical practice guideline
Cerebrovascular disease
Cytochrome
Dementia with Lewy bodies
Dentatorubropallidoluysian atrophy
Electroencephalography
Extrapyramidal side effects
functional Magnetic resonance imaging
Frontotemporal dementia
Lumbar puncture
Mild cognitive impairment
Mini - Mental State Examination : Thai version 2002
Mini - Mental State Examination : Folstien et al 1975
Montreal cognitive assessment
Magnetic resonance imaging
Normal pressure hydrocephalus
Negative correlation
111
PC
PDD
PET
SCA
SPECT
TMSE
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=
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Parkinsonxs disease dementia
112
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