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15万老人坐在家中慢慢变"痴" 预防要常聊天多八卦

2015-9-28 19:25| 发布者: steven| 查看: 18933| 评论: 304|原作者: steven


武汉老年痴呆病人就诊者不足一成  15万老人坐在家中慢慢变“痴”
  判断很简单:让他试着画个钟 预防也不难:常聊天多八卦
  本报记者刘璇 通讯员高婷 张方方 杨敬慈
  昨天是“世界老年痴呆日”。 “老年痴呆在60岁以上老年人中发病率为10%。”武汉大学中南医院神经内科肖劲松副教授告诉武汉晚报记者,保守推算,武汉至少有15万“老年痴呆”患者。“遗憾的是,来医院就诊的人寥寥无几。”
  随后,记者走访武汉协和医院、武大人民医院、武大中南医院、市一医院、市中心医院、市三医院、市精神卫生中心近10家医院发现,接诊老年痴呆最多的协和医院一年也只有200个病人,绝大多数医院一年只接诊二三十人。
  武汉有25家三甲医院,按此推算,一年因“老年痴呆”就诊者不足千人。
  温顺太婆脾气突然变古怪
  家住水果湖的程太婆今年63岁,一儿一女都已经成了家,在街坊眼里她是出了名的好脾气和能干人。
  老伴去世得早,她一直跟儿子住在一起。两年前,儿子媳妇发现她像变了一个人:炒菜时放作料经常“失手”,做饭时电饭煲总是忘了摁,出门不记得关门,炉子上烧着水炖着汤她跑出去买菜了……更让他们受不了的是,经常为一点小事她就开骂。“家庭战争”不断升级,儿子决定把母亲送到妹妹家暂住。
  哪知住了不到半年,女儿女婿也大呼“受不了”。“怎么人老了,脾气变得这‘拐’?”两兄妹一商量,给母亲买了套房子让她单独住,隔段时间去看看她。
  上个月,女儿去探望,一进门就哭了:老人起夜时滑倒了,躺在床上已经两天了。“你怎么不跟我们打电话啊?”女儿又是心疼又是埋怨。程太婆告诉女儿,开始准备打电话的,可是怎么都想不起来电话号码了。女儿这才意识到不对,赶紧带着母亲找到了中南医院神经内科。一系列检查后,确诊老人患有老年痴呆,已经比较严重了。
  肖劲松说,程太婆原来能做好的事情突然做不好了,说明生活能力下降,性格和行为上也发生了很大变化,这些都是老年痴呆的早期症状。可惜的是,很多人都以为人老了,脾气坏点,做事不利索是正常的。等到察觉不对再上医院,往往很严重了,医生也没办法。
  就诊者不足1% 早期易被忽略
  武大中南医院是武汉最早开设“记忆门诊”的医院,肖劲松是主要坐诊专家之一。“我们医院面对全省的病人,一年下来也只能接诊四五十人。”他坦言。
  协和医院神经内科2008年也开设了“记忆门诊”,是目前武汉规模最大的老年痴呆专病门诊,以湖北省内病人为主。“我每周接诊的病人都是个位数。”该门诊负责人梁直厚副教授告诉记者,老年痴呆疾病的临床治疗用药只有3种,他每年都会对医院的药品销售情况进行统计。“能正规并坚持接受治疗的老年痴呆病人还不到200人。”
  梁直厚给记者算了一笔账:武汉60岁以上老人有150万人左右,老年痴呆发病率为10%,由此推算,武汉目前至少有15万的老年痴呆病人。“各大医院加起来一年新接诊的病人也不到1000人,连1%都不到。”
  肖劲松研究老年痴呆症多年。他分析认为,大家不来医院主要是轻度的老年痴呆没有引起家人重视。
  除了老年痴呆的早期表现容易被忽略,梁直厚认为,药品治疗效果不好和治疗费用高也是大家放弃治疗的主要原因。
  判断老年痴呆可“画钟测试”
  很多人会把老年痴呆当成是老人的一些正常表现。武汉大学人民医院老年痴呆专家谭来勋副教授说,上次遇到一个68岁的婆婆,开始是经常找不到东西,家人觉得她是年纪大了,健忘;后来,老人把外面的垃圾捡回家,家人认为是节俭,她想把垃圾积攒到一起卖,也没有放在心上;直到最后,老人经常半夜跑到女儿房间里大小便,这才觉得老人有问题,带她来看病。
  “其实,老年痴呆和老糊涂很好区分。”谭来勋介绍,老年痴呆的人最早出现的就是记忆力下降,只要和同龄人比,有明显的不正常,就应该引起警觉。这种人往往伴有生活能力下降、性格的突变和精神行为的异常。比如原来他能做的事情现在做起来有困难了;出现不检点行为,比如随地大小便;还有很多老人有囤积病,比如会到外面捡垃圾;有的还会出现妄想症,妄想着老伴跟他人有私情,会跟踪老伴、打老伴等。
  梁直厚表示,如果发现家里的老人反复问同一个问题,反复说同一件事情;总买一些不着调的东西或是他以前从来都不会买的东西;经常弄不清楚时间,家里人的电话、名字都记不得了;不知道怎么花钱,算不清楚账;吃药也吃不清楚了,不会坐车了,这些都是在提示他可能老年痴呆了,应该尽早就医。
  肖劲松有个很简单的方法来自测老年痴呆:让老人做“画钟测试”。拿出手表先让他说出几点几分,再在纸上画出一个闭合的圆,写上12个数字,以及长短针指向。有老年痴呆的人,肯定会画错,严重的人可能连圆都画不了。
  “这就是认知功能的丧失。”他说,很多患病的老人从表面上看跟正常老人毫无差别。但你要是问问他现在是什么年份、几月几号、什么季节、家在哪里,随便挑一个问,他多半答不出来。
  鼓励老人常聊天多八卦
  肖劲松告诉记者,虽然目前老年痴呆不可逆转,但是越早干预,越能延缓痴呆的发展进程。“有个武汉大学的教授,老伴发现他记忆力变差,算账也有点问题后,马上意识到不对,就带他上医院,检查后确诊是早期老年痴呆。到现在已经治疗了6年,老人现在一个人可以上街买菜,生活完全可以自理。”
  梁直厚坦言,目前,医学尚未发现可有效预防老年痴呆的方法。不过,家人可多鼓励老人多参加社会活动,多培养广泛的兴趣爱好,经常到户外去锻炼身体,多说点家长里短的事情和别人的八卦,打麻将、下棋、听音乐、读书看报等都可激荡脑力,都能刺激神经细胞活力,尽量少让老人窝在家里看电视。
  在饮食上,不妨多吃富含纤维素的食物,如谷类、麦类。蔬菜中芹菜、黄花菜都有益于大脑的健康保护。苹果等富有维生素的水果也是被推荐的食品。富含卵磷脂的食物:如大豆类制品、磨菇。卵磷脂是神经细胞代谢修复的重要物质。以及各类坚果,如花生、核桃、松子、榛子、葵花籽也含丰富的亚油酸,对神经细胞有保护作用。
  邱昕提醒说,门诊观察发现,很多早期老年痴呆病人在遭遇家里比较大的变故后,会突然出现病情加重的情况,子女在这个时候一定要注意观察老人的变化,尽早就医。对于年轻时生活比较辛苦,经历比较坎坷的老人,上了年纪以后,子女一定要给他找些事情做,让他多和外界接触。近两年,门诊中血管性痴呆的发病率上升很快。这种痴呆往往发生在中风之后,只要按医嘱吃药,是完全可以预防的。
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