《精神病学 Psychiatry》课程教学课件（PPT讲稿）Psychiatry of old age

Psychiatry of old age

Psychiatry of old age

OverviewPsychiatric illness similarto that seen in youngeradults-DepressionPsychiatric illnessparticular to zhe elderly-Alzheimer' s disease-Lewy body disease-Vasculardementia-frontal lobe dementia-Subcortical dementia

Overview Psychiatric illness particular to zhe elderly -Alzheimer＇s disease -Lewy body disease -Vascular dementia -frontal lobe dementia -Subcortical dementia Psychiatric illness similar to that seen in younger adults -Depression

Psychiatric illness similar to that seen in younger adultsDepression:Themostcommoncondition.Somatic,symptoms,hypochondriasis,andrthoughts about death are more common in zheelderly.Maiordepressive disorderinzheelderlycanbecomplicated byanunderlying organic brainsyndrome.Thedevelopmentofadepressive illnesscanbezhe first sign of a dementia

Psychiatric illness similar to that seen in younger adults Depression • The most common condition • Somatic,symptoms,hypochondriasis,and rthoughts about death are more common in zhe elderly. • Maior depressive disorder in zhe elderly can be complicated by an underlying organic brain syndrome. • The development of a depressive illness can be zhe first sign of a dementia

Manargement ofdepressionAim :treat zhe depressive disorder and addresszhe precipiating maintain factors.Drugtreatment.Psychosocialtherapy.Othertreatment

Manargement of depression Aim :treat zhe depressive disorder and address zhe precipiating maintain factors • Drug treatment • Psychosocial therapy • Other treatment

Disorders particual to older peopleChronic brain syndromes(dementias)Alzheimer'sDisease1.DiscribedbyAloisAlzheimerin19072.Conception:acquired.comprehensive.andprogressivecognitivedysfunction（认知功能障碍）>1）：Acquired（获得性）-智能正常BeforeAD：normalintelligenceAndnoconsciousnessdisorder（无意识障碍）>Comprehensive（全面性）--comprehensiverecessionofcognition（认知的综合衰退）Progressive（进行性）--ThecourseofADisunreversibility（病程不可逆）Dgenerative一neuronatrophy（神经元菱缩）、Cellderease（细胞减少）

Disorders particual to older people Chronic brain syndromes(dementias) Alzheimer’s Disease 1. Discribed by Alois Alzheimer in 1907 2.Conception：acquired、comprehensive、and progressive cognitive dysfunction（认知功能障碍). ➢1). Acquired（获得性）-智能正常Before AD：normal intelligence And no consciousness disorder（无意识障碍） ➢Comprehensive（全面性）- comprehensive recession of cognition（认知的综合衰退） ➢Progressive（进行性）-The course of AD is unreversibility （病程不可逆） ➢Dgenerative—neuronatrophy（神经元萎缩）、Cell derease （细胞减少）

Alzheimer Disease（阿尔茨海默病）seienceFirst patient of ADMostfamous patienthenersDiseaseAASAloisAlzheimer,1907

2026/2/26 6 Alzheimer Disease (阿尔茨海默病) Alois Alzheimer，1907 First patient of AD Most famous patient

EpidemiologyofADChinaEUmilllor100NA2.8millionmlondiaAfriaLatinA0.8millon2001TOTAL:24.3millionAfricaNAfrica&MiddleEastPacificIndiaLatinAmerieaEuropeN AmericaWEuropsChina'248061012&DevelopingWestemPacificRegion.FromFemietal.Lancet2005:366:2112-2117

N A 3.4 million Afria 0.5 million N A 1.0 million W U 4.9 million India 1.8 million W P 1.5 million Latin A 1.8 million 2001 TOTAL: 24.3 million E U 2.8 million China 6.0 million * & Developing Western Pacific Region. From Ferri et al, Lancet 2005;366:2112–2117. 0 2 4 6 8 10 12 C hina* W Europe N A merica E Europe Lat in A merica India & S A sia W Pacif ic N A f rica & M iddle East A f rica Epidemiology of AD

EpidemiologyofADChniaEUmlllonO0NA3.9millionGmuondiaAfricaLA0.1nmillion2020TOTAL:42.3millionAfricaNAfrica&MiddleEastPacificIndia&SLatin AmericaEuropeNAmericaw EuropsChina'8246100126&DevelopingWestemPacificRegion.FromFemietal.Lancet2005:366:2112-2117

5 N A 5.1 million Africa 0.9 million N A 1.9 million W U 6.9 million India 3.6 million W P 2.9 million L A 4.1 million 2020 TOTAL: 42.3 million E U 3.9 million Chnia 11.7 million * & Developing Western Pacific Region. From Ferri et al, Lancet 2005;366:2112–2117. 0 2 4 6 8 10 12 C hina* W Europe N A merica E Europe Lat in A merica India & S A sia W Pacif ic N A f rica & M iddle East A f rica Epidemiology of AD

EpidemiologyofADGhinaEUmillonONA6.0million9.2milliondiaAfricaLA.1nmilllon2040TOTAL:81.1millionAfriciNAfricaMiddieEasPacificIndia&LatinAmerieiEuropNAmericwEurope26.1China24F81012n6&DevelopingWestemPacificRegion.FromFemietal.Lancet2005:366:2112-2117

6 N A 9.2 million Africa 1.6 million N A 4.7 million W U 9.9 million India 7.5 million W P 4.3 million L A 9.1 million 2040 TOTAL：81.1 million E U 6.0 million China 26.1 million 0 2 4 6 8 10 12 C hina* W Europe N A merica E Europe Lat in A merica India & S A sia W Pacif ic N A f rica & M iddle East A f rica 26.1 * & Developing Western Pacific Region. From Ferri et al, Lancet 2005;366:2112–2117. Epidemiology of AD

Etiology and pathogenesisUncertain.It may relate to genetic and environmental factors.>Amyloidproteindeposited abnormallyin the brain（脑内β样淀粉蛋白异常沉积）DysfunctionofNeurotransmitter（神经递质功能障碍）Contain withtheactivityloseofAChE.depresslevelofAch)genetic factorsAPP.PSl,PS2Gene mutationcause-FamilialDementiaAPOE4ALLELIC GENE-LateonsetADMenvironmental factorsVirus infection 病毒感染>Heavymetal poisoning重金属中毒Abnormallipidmetabolism脂质代谢异常2026/2/2610

2026/2/26 10 Etiology and pathogenesis U ncertain.It m a y r e late t o g e netic a n d e n vironmental f a ctors. ➢ A m y l oid p r o t ein d e p osi ted a b n o rmal ly i n t h e b r a i n（脑内β样淀粉蛋白异常沉积） ➢ Dysfunction of Neurotransmitter（神经递质功能障碍）C o n t ain w i t h t h e a c t iv ity l o s e of AChE、 depress level of Ach ) ➢g enetic f actors ➢ APP、PS1、PS2 Gene mutation cause –Familial Dementia ➢ APOE4 ALLELIC GENE – Late onset AD ➢e nvironmental f actors ➢ V i r u s i n f e c t i o n 病毒感染 ➢ H e a v y m e t a l p o i s o n i n g 重金属中毒 ➢ A b n o r m a l l i p i d m e t a b ol i s m 脂质代谢异常