. 65. (sulci), lipofuscin, (central synapse delay), choline acetyltransferase. GABA. monoamine oxidase (MAO) 1 3 ).
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1 : ). 65, % 291, % 690 1) , ), 85., % 1), )..,,. :, , , Tel: (02) , Fax: (02) % 4 ). (sulci),. 10% 60% 5 ). 6 ). (senile plaque) (neurofibrillary tangle) 7 )., lipofuscin, 8 ),, 9 )., 1 0 ), (central synapse delay), 1 1 ).., choline acetyltransferase (ChAT) 12 ), catecholamine GABA. monoamine oxidase (MAO) 1 3 ).
2 ......?.,,.,.,., 14 ),,,.. 1..,.,,,,.,.. 2..,. (Barthel index, 1), Instrumental ADL.,.,, ) 2)
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4 2. : :,, ; 1999 (mini mental status examination; MMSE) 1 5 ). 1) (consciousness), (confusion), (lethargy), (semicoma), (unconsciousness), (coma)...,.,.,,, 1 6 ).,,,,. 3)..,,,,,, (orientation),,,,.,. 2) (affect ) (m ood).,,,. 3) (attention), (memory), (executive function), (visuo-spatial processing) (language) 17 ).,
5 3. Bell : Snout (palmomental) Type II (fast-twitch) fiber. 1 8 )... (self report),. 19 ). ( 3864), (immediate memory span).,..,..,,,, ,.. 20.,,,,. 2.,,. (convergence), Bell, 2 0,2 1 ).
6 ., %, 2 4 )..,.. (Glabellar), (Sucking),. (snout), (palmomental) (grasp) (cortical release 3. sign) (primitive reflex),. 2 5 )., 2 6 ). Kaye,,, 70, 2 20%, 85 44% (Type II (fast-twitch) fiber) 2 2 ). 21% 9% 2 7 ).. Bennette Boston, %, 85 50%, 2 3 ), %. 2 4 ), 85, 90%, 2 3 ). (postural reflex) ( 3 ).,,., 4..,.,, 5., 70,
7 ,. 1 6 ).,,.,,,,,,,.,.., 2 8 ).,,,,.,,,,. 1),,,,, : 1998,, ; ) ) Guralink JM, LaCroix.AZ, Everett DF: Aging in the eighties: the prevalence of comorbidity and its association with disability. Advanced Data from Vital and Health Statistics of the National Center for Health Statistics. Number 170. USA ) Tomlinson BE, Corsellis JAN: Aging and the dementias. In: Adams JH, Corsellis JAN, Duchen LW, editors, Greenfield's Neuropathology. 4th ed. NewYork; Wiley, p ) Coleman PD, Flood DG: Neuron numbers and dendritic extent in normal aging and Alzheimer's disease. Neurobiol Aging 8: , ) Lippa CF, Hamos JE, Pulaski-Salo D, GeDennaro LJ, Drachman DA: Alzheimer's disease and aging: effects on perforant pathway perikarya and synapses. Neurobiol 13: , ) Katzman R, Terry RD, DeTeresa R: Clinical, pathological, and neurochemical changes in dementia: a subgroup with preserved mental status and numerous neocortical plaques. Ann Neurol 23: , ) Cutler RG: Human longevity and aging: possible role of reactive oxygen species. Ann NY Acad Sci 621:1-28, ) Rothman SM, Olney JW: Excitotoxicity and the NMDA receptor. Trends Neurosci 10: , ) Malamed E, Lavy S, Bentin S, Cooper G, Rinot Y: Reduction in regional blood flow during normal aging in man. Stroke 11:31-35, ) Celesia GG, Kaufman D, Cone S: Effects of age and sex on pattern electroretinograms and visual evoked potentials. Electroencephlogr Clin Neurophysiol 68: , 1987
8 12) Muller WE, Stoll L, Schubert T, Gelbmann CM: Central cholinergic functioning and aging. Acta Psychiatr Scand 366(suppl):34-39, ) Spark DL, Woeltz VM, Markesberry WR: Alternation in brain monoamine oxidase activity in aging, Alzheimer's disease and Pick's disease. Arch Neurol 48: , ) Sprott RL: Age-related variability. Ann NY Acad Sci 515: , ) :, 3:37-60, ) : (1) ) :. -,. : ; p35-61, ) Albert MS, Kaplan EF: Organic implications of neurological deficits in the elderly, In: Poon LW, Fozard JL, Cermak LS et al. editors. New directions in Memory and Aging. NJ: Hillsdale; p ) Drachman DA, Long RR, Swearer JM: Neurological evaluation of the elderly patient. In: Albert ML, Knoefel JE, editors. Clinical Neurology of Aging. 2nd ed. New York: Oxford University Press; p , ) Olney RK: The neurology of aging. In: Aminoff MJ, editor. Neurology and General Medicine. 2nd ed. New York: Churchill Livingstone; p , ) Jenkyn LR, Reeves AG, Warren T, Whiting KW, Clayton RJ, Moore WW, Rizzo A, Tuzun IM, Bonnett JC, Culpepper BW: Neurologic signs in senescence. Arch Neurol 42: , ) Knopman DS, Knoefel J, Kaye JA, Elble Jr. RJ, Bennettt DA, Odenheimer GL: Geriatric Neurology; Continum, lifelong learning in neurology. Vol 2(5). AAN. Advanstar communications; p7-27, ) Bennett DA, Beckett LA, Murray AM, et al: Prevalence of parkionsonian signs and associated mortality in community population of older people. N Eng J Med 334:71-76, ) Odenheimer G, Funkenstein HH, Beckett L, Chown M, Pilgrim D, Evans D, Albert M: Comparison of Neurologic changes in successfully aging' person vs total aging population. Arch Neurol 51: , ) Huff FJ, Boller F, Lucchelli F, Querriera R, Beyer J, Belle S: The neurologic examination in patients with probable Alzheimer's disease. Arch Neurol 44: , ) Jacobs L, Gossman MD: Three primitive reflexes in normal adults. Neurology 30: , ) Kaye JA, Oken BS, Howieson DB, Howieson J, Holm LA, Dennison K: Neurologic evaluation of the optimally healthy oldest old. Arch Neurol 51: , ) :.. : p52-61.
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