Diagnosis and Management of Senile Dementia / 日本農村医学会雑誌

ABSTRACT

Due to increase of population of elderly patients, dramatic increase of patients with dementia is becoming a serious social problem in Japan. At the moment it is being estimated that more than one million patients suffer from dementia in Japan. Among the patients with dementia, Alzheimer's disease and cerebrovascular dementia are the leading cause for dementia. In clinical practice, it is important to make a correct diagnosis for dementia. Special attention should be made not to misdiagnose “treatable dementia”.<BR>On the basis of a genetic view point, Alzheimer's disease can be classified into familial Alzheimer's disease as a single gene disease, and sporadic Alzheimer's disease as a polygenic disease. The causative genes for familial Alzheimer's disease have been found to be amyloidprecursor protein gene on chromosome 21, presenilin I on chromosome 14 and presenilin II on chromosome 1. As a genetic risk factor for sporadic Alzheimer's disease as well as late-onset Alzheimer's disease, an isoform of apolipoprotein E (ApoE4) has been found to play an important role for the pathogenesis of Alzheimer's disease. Given the genes which are involved in the pathogenesis of Alzheimer's disease, the elucidation of the mechanisms of Alzheimer's disease and the development of strategies for the treatment of Alzheimer's disease should become a reality in the near future.