Chirwere
Holistic Alzheimer's Care Approach
Profile
Chirwere cheAlzheimer's (AD), chakadimburirwa kubva pashoko racho rechiRungu, imhando yedementia inonyanyozivikanwa muvanhu vakura. Kunokanganisa kufunga kwomurwere, kuyeuka, uye kuzvimirira, zvichikanganisa mararamiro uye kufa.
US Food and Drug Administration (FDA) yakarondedzera se "chirwere chinoparadza." Pasi rose, maererano neWorld Alzheimer Report 2018 yakaburitswa neAlzheimer's Disease International (ADI), parizvino kune vangangoita mamirioni makumi mashanu varwere vedementia pasi rese. Pakazosvika 2050, inofungidzirwa kusvika 152 miriyoni, uye ingangoita 60% -70% yezviitiko vari varwere veAlzheimer's disease.
Dambudziko mukurapa Alzheimer riri pakuti chirwere chechirwere chacho hachinyatsonzwisiswi. Parizvino, zvinogamuchirwa zvakanyanya kuti kusaenzana pakati pechizvarwa uye kucheneswa kwe β-amyloid (Aβ) kunoonekwa sechinhu chinotangisa neurodegeneration uye kutanga kwedementia. Mamwero asina kujairika e-β-amyloid anoumba plaques pakati pemitsipa yeuropi, iyo iri neurotoxic uye inotungamira kune neuronal degeneration.
Etiology
Chirwere chacho chinogona kunge chiri boka rakasiyana-siyana remamiriro ezvinhu, rinomuka pasi pesimba rezvinhu zvakasiyana-siyana (kusanganisira biological and psychosocial factors). Tsvagiridzo inoratidza zvinopfuura makumi matatu zvingangoitika zvinhu uye fungidziro, senge nhoroondo yemhuri, murume kana mukadzi, kukuvadzwa musoro, kuderera kwedzidzo, chirwere chethyroid, zera raamai kana kunonoka, hutachiona hwehutachiona, nezvimwe.
Clinical Featur
Kutanga kwehosha yacho kunononoka kana kuti kwakavanzika, kunowanzoomera varwere nemhuri dzavo kuti vaone. Inowanzoonekwa muvanhu vanopfuura makore makumi manomwe (avhareji yezera rekutanga ndeye 73 yevarume uye 75 yevakadzi). Muzviitiko zvishomanana, zviratidzo zvinokurumidza kuoneka mushure mekurwara kwemuviri, kuputsika, kana kushushikana kwepfungwa. Chirwere ichi chakanyanya kuvakadzi (3: 1 ratio kune varume). Zviratidzo zvikuru zvinosanganisira kudzikira zvishoma nezvishoma mukushanda kwenjere, zviratidzo zvepfungwa, kuvhiringika kwemaitiro, uye kurasika zvishoma nezvishoma kwehupenyu hwezuva nezuva. Kufambira mberi kwakakamurwa kuita nhanho nhatu zvichienderana nekuipa kwekugona kwekuziva nekuita kwemuviri.
Mild dementia stage (1-3 makore). Zviratidzo zvinosanganisira kurasikirwa nekuyeuka, kunyanya muzviitiko zvemazuva ano; kuderera kwekutonga, nekunetseka kuongorora, kufunga, uye kubata matambudziko akaoma; kusava nehanya mubasa kana mabasa epamba, kutadza kutarisira kutenga kana nyaya dzemari wakazvimirira, uye matambudziko enzanga. Kunyange zvazvo murwere achikwanisa kuita mabasa emazuva ose anojairika, vanonetsekana nezviitiko zvitsva, vanoratidza kusava nehanya mupfungwa, kupokana, uye kazhinji kufungidzira. Pane kunetsana nekutarisa nguva uye kuomerwa mukunzwisisa nzvimbo dzenzvimbo. Mazwi mashoma uye matambudziko ekudoma akajairika zvakare.
Pakati nepakati dementia nhanho (2-10 makore). Zviratidzo zvinosanganisira kukanganisa kwakanyanya mune zvese zvenguva pfupi uye yenguva refu yekuyeuka, kuderera kwekuona nzvimbo yekugona kwezvimiro zvakapfava, uye kuomerwa nenguva nenzvimbo. Varwere vanotarisana nematambudziko mukugadzirisa matambudziko, kusiyanisa kufanana uye kusiyana pakati pezvinhu, uye vanovimba nerubatsiro rwemabasa ekunze, kupfeka, utsanana hwemunhu, uye kushambidzika. Vanorasikirwa nekukwanisa kwavo kuverenga uye kuratidza zvakasiyana-siyana zviratidzo zvetsinga se aphasia, apraxia, uye agnosia. Kusava nehanya mupfungwa kunoshandura kuva kusagadzikana, kutenderera nguva dzose, uye kusazvidzora.
Yakanyanya dementia nhanho (8-12 makore). Varwere vanotsamira chose kune vanovachengeta, vachiona kurasikirwa kukuru kwendangariro nezvidimbu zvendangariro zvasara. Vanove vasingakwanise kubata zviitiko zvehupenyu hwezuva nezuva, kusangana nekusagadzikana mumatumbo uye kudzora dundira. Vanogona kuratidza kunyarara, kuoma, uye kuongorora kwemuviri kunogona kuratidza zviratidzo zvakanaka zvekubatanidzwa kwepiramidhi, mafungiro echinyakare sekubata kwakasimba, kutsvanzvadzira, uye kuyamwa. Pakupedzisira, vanogona kutsvedza mucoma uye kazhinji vanokurirwa nezvinetso zvakaita sehutachiona.
Examination
Kuongorora kwekuziva: Kusanganisira maturusi akadai seMini-Mental State Examination (MMSE) yekuongorora yekuziva basa.
Zvidzidzo zvekufungidzira: Brain MRI uye CT scans inoshandiswa kutonga kunze kwezvimwe zvikonzero zvekukanganisika kwekuziva uye kuona shanduko muhutano hwehuropi.
Electroencephalogram (EEG): Inotarisa kuchinja kwehutano hwemagetsi europi.
Biomarkers: Imwe ropa kana cerebrospinal fluid biomarkers inogona kubatsira mukuongororwa.
Kuongororwa
Kuongororwa kwechirwere cheAlzheimer kunowanzo sanganisira kusasanganisa zvimwe zvingakonzeresa kukanganisa kwekuziva uye kunobva pazviratidzo zvemurwere, kuongororwa kwekiriniki, uye zvidzidzo zvekufungidzira. Parizvino, kuongororwa kwepathological kuchiri kudikanwa kuti usimbise kuongororwa kwechirwere cheAlzheimer.