阿茲海默氏症之非認知症狀

Noncognitive Symptoms of Alzheimer's Disease

阿茲海默氏症除認知功能障礙外，亦常伴隨情緒、行為、精神病症狀等非認知症狀（noncognitive symptoms）。這些症狀會讓個案產生更多的不適感，也是照顧者主要的壓力來源。非認知症狀包括憂鬱、妄想、錯認、幻覺、及其他精神行為障礙。高達七、八成的阿茲海默氏症個案在其病程中會產生非認知症狀。本文除回顧相關文獻，亦將台灣兩團隊對此主題之研究作一整理。結果顯示，國人阿茲海默氏症患者併發非認知症狀的比例不亞於國外報告。在我國即將步入高齡社會，阿茲海默氏症盛行率日益升高之際，是一項值得住意的課題。

Noncognitive symptoms are commonly reported in patients with Alzheimer's disease(AD). They cause dysphoria of the patient, and are major sources of caregiver stress. Depression, delusions, misidentifications, hallucinations, sleep disturbance, aggression, apathy, eating disorders, inappropriate sexual behaviors, wandering, are all considered as noncognitive symptoms. Noncognitive symptoms can be found in up to 70-80 % of AD patients during the course of illness. They are important contributors to the decision to institutionalize the AD patients. In the present article, the authors reviewed the literature on this issue. Data from two research teams in Taiwan: Department of Geriatric Psychiatry, Veterans General Hospital-Taipei (leaded by Professor Jen-Ping Hwang), and Neurological Institute, Veterans General Hospital--Department of Psychiatry, Chang Gung Memorial Hospital Joint Program (leaded by Professor Hsiu-Chih Liu) are also discussed.