精神医学65巻11号

2023年11月発行

特集 精神疾患回復の時間経過を見通す

認知症疾患の長期経過

著者： 繁田雅弘¹

所属機関： ¹東京慈恵会医科大学精神医学講座

ページ範囲：P.1521 - P.1528

抄録
　アルツハイマー型認知症，レビー小体型認知症，前頭側頭葉変性症，血管性認知症などを取り上げて長期経過に関する知見を概観した。ビタミン欠乏症や甲状腺疾患，身体疾患，薬物などに伴う認知機能低下といった，いわゆる“治療可能な認知症（treatable dementia）”ないし“可逆性の認知症（reversible dementia）”は取り扱わなかった。本特集のテーマである「回復過程の時間経過」という表現には馴染まない内容となったが，認知症疾患が本来，慢性・進行性の不可逆的経過をとるものなので，やむを得ない。また長期予後を考える場合，認知機能低下の進行程度や行動心理症状の重症度，日常生活動作の喪失程度に加え，生命予後と施設入所を指標とすることができるが，調査ごとに測定指標や測定方法が異なるので，一定の指標について複数の疾患を比較することは困難であった。

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