2019 年 36 巻 3 号 p. 191-193
The incidence of dementia and epilepsy in the elderly have increased steadily over the last few decades. Though little is known about the relation between dementia and epilepsy so far, seizure occurrence in Alzheimer's disease (AD) is more common than in the age–matched control in the recent study. On the other hand, of 10–20% of the etiological diagnosis in the elderly with new–onset epilepsy is neurodegenerative diseases, such as AD and Dementia with Lewy bodies. Subclinical epileptiform activity is detected by long–term video–electroencephalography (EEG), and accelerates cognitive deterioration in AD patients.
Sleep apnea was found to be more common among the elderly, and was more prevalent and severe in male than in female. According to the several studies, SA is associated with an earlier age at mild cognitive impairment or AD–dementia onset. Moreover, SA patients showed lower cerebrospinal fluid β–amyloid42 concentration compared to controls and SA treated by continuous positive airway pressure (CPAP). SA may induce cognitive decline early, but is modified by using CPAP in SA patients.
Adverse drug effects causing cognitive impairment are the important problem in the elderly, however, it is not easy to identify the causing drug accurately. The onset of dementia after taking anticholinergic drugs are different between preclinical stage of AD and the elderly. The patients with preclinical stage of AD are exposed to the fewer number of anticholinergic drugs compared with the elderly. We should monitor the drug therapy carefully to minimize this problem.
