Hidden Factors in Diagnosing Alzheimer’s Disease

Linda Maguire, Gary L. Kreps
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Abstract

Diagnoses of Alzheimer’s, dementia and other mental health conditions using the “family history method” can often be inaccurate, biased and possibly ill-motivated. Definitive clinical testing and/or biological tests rarely exist for most mental illnesses. Even when tests (such as PET scans or excess Abeta42 in cerebral spinal fluid indicating presence of neuronal plaques, for example) and other suggestive biomarkers are "positive", there are often no outward cognitive-behavioural symptoms or symptomatic evidence associated with the alleged mental illness (and vice-versa). Furthermore, environmental stressors, dehydration and other fully curable illness and treatable issues such as urinary tract infections, delirium, drug interactions and insomnia can quickly create outward ‘false’ symptoms of mental illnesses, often mistaken for true mental health diagnoses. Therefore, a comprehensive consideration of ex parte narratives, experience, familiarity and also possible underlying motivations, of even the most well-meaning family members in the “family history method” of mental illness diagnoses, currently used by doctors and other professionals, should be revisited.
诊断阿尔茨海默病的隐藏因素
使用“家族史方法”诊断阿尔茨海默氏症、痴呆症和其他精神健康状况往往不准确、有偏见,而且可能动机不良。对于大多数精神疾病,明确的临床测试和/或生物学测试很少存在。即使测试(例如PET扫描或脑脊液中过量的Abeta42表明神经元斑块的存在)和其他暗示性生物标志物是“阳性”的,通常也没有与所谓的精神疾病相关的外部认知行为症状或症状证据(反之亦然)。此外,环境压力因素、脱水和其他完全可以治愈的疾病和可治疗的问题,如尿路感染、谵妄、药物相互作用和失眠,可以迅速产生精神疾病的外在“虚假”症状,经常被误认为是精神疾病的诊断。因此,在医生和其他专业人员目前使用的精神疾病诊断的“家族史方法”中,应该重新考虑即使是最善意的家庭成员的单方面叙述、经验、熟悉程度和可能的潜在动机。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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