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我是失智症的高危險族群嗎?
國際失智症協會提出十大警訊,提醒民眾及早注意:
1. 記憶衰退到影響日常生活
一般人偶爾忘記開會、朋友來電,但過一會兒或經提醒會再想起來。但失智症患者忘記的頻率比較高,而且即使經過提醒也無法想起,尤其常忘記最近發生的事。
2. 無法勝任原本熟悉的事務
如英文老師不知「book」是什麼意思;自年輕就開車的司機伯伯現在經常走錯路;銀行行員數鈔票有困難;家庭主婦不知怎麼開瓦斯、用電鍋、洗衣機等。
3. 說話表達出現問題
一般人偶爾會想不起某個字眼或詞不達意,失智症患者想不起來的機會更頻繁,甚至以替代方式說明簡單的辭彙,如以「送信的人」表示「郵差」,「用來寫字的(筆)」等;說話常停頓;用的字詞變少,有些患者會不能理解別人在說什麼。
4. 喪失對時間、地點的概念
一般人偶爾會忘記今天是幾日,在不熟的地方也可能會迷路。但失智患者會搞不清年月、白天或晚上,在自家周圍也會迷路,找不到回家的路。
5. 判斷力變差、警覺性降低
開車常撞車或出現驚險畫面、過馬路不看左右紅綠燈、借錢給陌生人、聽信廣告買大量成藥、一次吃下一週的藥量、買不新鮮的食物、同樣的東西重複買、亂買股票等。
6. 抽象思考出現困難
無法理解言談中抽象意涵,而有錯誤反應。如無法理解微波爐、遙控器、提款機等日常生活電器的操作說明;無法按照計劃做事(比如看著食譜做菜),也不能處理較複雜的事,如投票、辦理過戶、繳稅等。
7. 東西擺放錯亂
一般人偶爾會任意放置物品,但失智症患者更頻繁,或錯得非常離譜,如衣櫥裡放水果、被子裡放拖鞋、皮夾或遙控器放進冰箱、到處塞衛生紙等,而且不記得也不承認是自己做的。
8. 行為與情緒改變
失智患者的情緒轉變較快,一下子哭起來或生氣罵人,或憂鬱、躁動不安,情緒的改變不一定有可理解的原因。失智者也有可能出現異於平常的行為,如隨地吐痰、拿店中物品卻沒付錢、穿著睡衣就出門等;或出現幻覺,比如看到一群人在他的房間、地板上有水,事實上並沒有。
9. 個性改變
一般人年紀大了,性格也會有少許改變,失智患者可能會更明顯,如疑心病重(懷疑配偶外遇、有人在飯菜下毒)、口不擇言、過度外向、失去自我克制或沈默寡言,或本來脾氣好的,變得愛發脾氣。
10. 喪失活動及開創力
一般人偶爾會不想做家事、不想上班,失智患者變得更被動,睡得比以前久,需要許多催促誘導才會參與事務。原本的興趣嗜好也不想去做了,遇到親友婚喪喜慶,變得漠不關心或有不合宜的行為。
懷疑不對勁,就去檢查
雖然這些警訊很重要,但有些定義看起來還是有點模糊,台北榮總特約醫師劉秀枝認為,「只要懷疑,就去看醫生」,讓醫生判斷。 澳洲阿茲海默症協會也提醒,誠實且開放地告訴醫生自己的擔心,包括出現這些症狀多久了?
台北榮總精神科主治醫師黃正平特別指出,所謂記憶喪失是指和自己過去相比,並非和同年紀的一般人比,許多教育程度高的人因年輕時腦力儲存高,以致雖然表面上生活功能並沒有喪失,但就醫時已經失智。也可以請家人或朋友陪病人一起去,家人的角色很重要,可以提供更多訊息供醫生判斷。
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