跳到主要內容

臺灣博碩士論文加值系統

(35.172.223.30) 您好!臺灣時間:2021/07/25 12:21
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果 :::

詳目顯示

: 
twitterline
研究生:卓良珍
研究生(外文):Chuo, Liang-jen
論文名稱:老人認知功能之研究
論文名稱(外文):The Study of Cognitive Function in Elderly
指導教授:吳淑姿吳淑姿引用關係
指導教授(外文):Wu, Shwu-Tzy
口試委員:賴德仁吳淑姿鄭啟清張基郁凃耀國
口試委員(外文):Te-Jen LaiWu, Shwu-TzyJeng, Kee-ChingChang, Chi-YueTwu,Yawokuo
口試日期:2012-07-19
學位類別:博士
校院名稱:大葉大學
系所名稱:生物產業科技學系
學門:生命科學學門
學類:生物科技學類
論文種類:學術論文
論文出版年:2012
畢業學年度:100
語文別:中文
論文頁數:195
中文關鍵詞:認知功能減退輕度知能減退脂蛋白E4阿茲海默氏症藝術治療失智症單一核苷酸變異多樣性
外文關鍵詞:Cognitive declineMild cognitive impairment / MCIApoE4Alzheimer's Disease / ADArt therapyDementiaUbiquilin 1
相關次數:
  • 被引用被引用:5
  • 點閱點閱:1226
  • 評分評分:
  • 下載下載:136
  • 收藏至我的研究室書目清單書目收藏:3
老年人精神狀態與認知功能減退之研究,發現年齡、曾經頭部外傷和腦中風者是失智症及認知功能減退的危險因子。有運動習慣者精神狀態較正常,而失智症是最缺乏運動習慣者,患有腦中風者失智組最多。老年認知功能減退之調查中,第三年追蹤97位輕度知能減退(MCI)的有效樣本,滿兩年之後有29.9%演變成失智症(皆為疑似阿茲海默氏症)相當於Dr. Peterson表示的,平均每年12.37 %演變成失智症(AD),有14.43% 發展成憂鬱症;有9.28%恢復認知功能至正常狀態;有46.39% 仍然呈現MCI。
脂蛋白E4(ApoE4)對偶基因是影響認知功能退化成MCI及失智症的危險因子,ApoE4 對偶基因在正常及憂鬱樣本的比率少於失智症的Odds ratio (OR)=5.74,亦少於MCI的OR =5.5。高密度脂蛋白膽固醇 (HDL-C) 的含量在失智症組低於MCI組及正常組,顯然對偶基因ApoE4的存在與HDL-C含量太低,可能是造成阿茲海默氏病的相關危險因子。經由AD-8極早期失智症篩檢,可以早期防治失智症等認知功能頹退的困擾。
UBQLN1(Ubiquilin 1)基因的多態性(UBQ-8i) 之研究,在187名受試者均具有AA同型基因,而沒有G對偶基因;因此我們推論UBQ-8i的單一核苷酸變異多樣性(基因突變點的變異)SNP並不符合Hardy–Weinberg定律,它在台灣是一種很稀有的突變。所有的受試者在rs12344615位置上的UBQLN1基因均為同型的A對偶基因;研判台灣人與白種人在UBQLN1基因的UBQ-8i位置上具有遺傳差異。
輕度認知減退的介入性研究-藝術治療,有效樣本兩組的平均年齡沒有差異,各為82.83 ± 3.703(實驗組)與82.89 ± 3.367(對照組),P = 0.956。實施16週之視覺表達性藝術治療活動的成果顯示,參加藝術治療者認知功能只要四個月的活動時間,即可改善其認知功能達到統計上的意義,P = 0.009,特別是語言功能P = 0.001。
The study of cognitive decline and mental status in elderly person showed that age, head trauma and stroke were the risk factors for dementia and mild cognitive impairment (MCI). We found that normal subjects had often habits of physical exercise while dementia person lacked physical exercise. In our survey of declined cognition in elderly we found that almost all dementia patient had stroke. Ninety-seven valid MCI cases were followed up, and about 29.9% becoming to dementia (probable Alzheimer’s disease) in third year. This was similar to Dr. Peterson’s predication that 12.37% of MCI deteriorated to dementia (AD) every year. 14.43% of patient with MCI developed to depression, and 9.23% recover to normal status, and around 46.3% remained in MCI status.
ApoE4 allele is a known risk factor of cognitive regression to MCI and dementia. We found that ApoE4 allele in the depression and normal groups was smaller than in the dementia group with a odds ratio (OR)=5.74 and in the MCI group OR=5.5. The serum level of high-density lipoprotein cholesterol (HDL-C) was lower in the dementia group than in the MCI and normal groups. This suggests that the presence of ApoE4 allele combine with a low serum level of HDL-C could be the risk factors for Alzheimer’s disease. Therefore, the prevention and treatment of dementia or others cognitive decline could be done by very earlier AD-8 dementia screening.
In study of UBQLN1 (Ubiquilin 1) gene polymorphism (UBQ-8i), all 187 subjects were AA-type gene without G allele. Therefore, we concluded that this gene mutation in Taiwan was rare and the single nucleotide polymorphism (SNP) of UBQ-8i was not compatible with Hardy-Weinberg law. Since all UBQLN1 gene of rs12344615 site were AA-type allele, we suspected that there was a ethnic genetic difference between Taiwanese and Caucasians in UBQLN1 gene of UBQ-8i site.
In intervention study of MCI with Art therapy, the mean age of the experimental and control groups were 82.83±3.703 and 82.89±3.367 respectively, P=0.956. After 16 weeks of intervention with visual expression art therapy, participants from the experimental group improved their cognitive function significantly, P=0.009, especially with the language function P=0.001.
目錄

封面內頁
簽名頁
中文摘要iii
英文摘要v
誌謝vii
目錄ix
圖目錄xii
表目錄 xiv

1. 緒論1
2. 文獻回顧3
2.1 社會結構的改變3
2.2 老年人的綜合症候群6
2.3 老年認知功能15
2.3.1 認知功能的定義15
2.3.2 失智症的定義20
2.4 阿茲海默氏病23
2.4.1 憂鬱症常常是認知功能退化的早期症狀38
2.5 UBQLN 1基因檢測41
2.5.1 UBQLN 1基因是兩型AD的危險因子41
2.5.2 UBQLN 1與泛蛋白ubiquitin42
2.5.3 ubiqilin與γ分泌酶43
2.6 AD-8極早期失智症篩檢44
2.6.1 老化與失智症44
2.6.2 AD早期診斷的重要性45
2.6.3 失智症評估工具的侷限46
2.6.4 個體內比較與個體間比較47
2.6.5 AD-8中文版量表48
2.7 藝術治療50
2.7.1 藝術治療的定義52
2.7.2 藝術治療發展史53
2.7.3 藝術治療的目的55
2.7.4 藝術治療的功效55
2.7.5 藝術治療使用在老年族群的功效56
2.7.6 藝術治療的評估機制57
3. 材料與方法58
3.1 老年人精神狀態與認知功能減退58
3.1.1 選取樣本的條件58
3.1.2 研究工具及進行步驟58
3.2 衰弱住院老人的精神狀態及其相關危險因子62
3.2.1 選取樣本的條件62
3.2.2 研究工具及進行步驟62
3.3 AD-8極早期失智症篩檢69
3.3.1 選取樣本的條件69
3.3.2 研究工具及進行步驟70
3.3.2.1 收集基本資料70
3.3.2.2 樣本評估第一階段篩檢70
3.3.2.3 第二階段評估71
3.3.2.4 第三階段評估71
3.3.3 「輕度知能減退」MCI診斷標準71
3.3.4 失智症診斷流程72
3.4 UBQLN1基因的多態性(UBQ-8i)74
3.4.1 收集樣本DNA74
3.4.2 UBQLN 1基因檢測74
3.4.3 統計方法75
3.5 輕度認知減退的介入性研究-藝術治療75
4. 結果與討論80
4.1 老年人精神狀態與認知功能減退之研究80
4.1.1 老年精神狀態80
4.1.2 老年認知功能減退之調查92
4.2 衰弱住院老人的精神狀態及其相關危險因113
4.3 AD-8極早期失智症篩檢方法之探討121
4.4 UBQLN1基因的多態性(UBQ-8i) 之研究132
4.5 輕度認知減退的介入性研究-藝術治療136
5. 結論163
參考文獻166
附錄173


圖目錄

圖2.1 60歲以上世界人口比例4
圖2.2 世界各國老年人口從7%升至14%所需的年數表8
圖2.3 神經血管反應的生理改變9
圖2.4 腦血管血流傳輸系統10
圖2.5 與年齡相關之慢性疾病12
圖2.6 失能與死亡率有相關的疾病14
圖2.7 輕度認知功能減退MCI分類圖19
圖2.8 ApoE2,E3 脂蛋白可以棄除Aβ42(A)。ApoE4脂蛋白無法棄除Aβ42(B)25
圖2.9 類澱粉蛋白連鎖反應之三,類澱粉斑形成導致發炎反應 26
圖2.10 神經細胞樹狀突蛋白合成的流程28
圖2.11 阿茲海默氏病發作的症狀型態30
圖2.12 類澱粉蛋白斑導致纏結形成33
圖2.13 廣泛神經/觸突、功能異常、神經傳導缺陷,神經凋零神經纖維纏結類澱粉蛋白斑破壞神經細胞內、外功能,神經凋零細胞逐漸死亡34
圖2.14 類澱粉前軀蛋白演變成類澱粉蛋白流程35
圖2.15 主要乙醯鹼酸激素精油腦幹投射37
圖2.16 神經生長因子促神經細胞復生40
圖2.17 成人海馬迴神經細胞生成圖51
圖4.1 脂蛋白E對偶基因出現頻率之比較99


表目錄

表2.1 台灣人口結構百分比5
表2.2 失能與死亡率有相關的疾病之百分比13
表4.1 精神狀態分類四組間年齡的Kruskal Wallis 檢定結果81
表4.2 精神狀態分類四組之間生活習性的卡方檢定結果83
表4.3 精神狀態分類四組之間身體疾病的卡方檢定87
表4.4 精神狀態分類四組間量表的Kruskal Wallis檢定結果89
表4.5 精神狀態分類四組間生理生化檢驗的Kruskal Wallis 檢定結果91
表4.6 脂蛋白E 之基因型97
表4.7 脂蛋白E 對偶基因之出現頻率98
表4.8 Cystatin C 之基因型100
表4.9 Cystatin C多型性對偶基因頻率101
表4.10 總膽固醇之量測結果102
表4.11 三酸甘油脂之量測結果103
表4.12 腎功能 (BUN) 之量測結果104
表4.13 腎功能 (Creatinine) 之量測結果105
表4.14 高密度脂蛋白 (HDL-C) 之量測結果106
表4.15 總膽固醇/高密度脂蛋白 (Chol-HD_C) 之量測結果107
表4.16 糖化血色素 (HbA1c) 之量測結果108
表4.17 高血壓病史109
表4.18 心臟病病史110
表4.19 糖尿病史111
表4.20 高膽固醇病史112
表4.21 三組之平均年齡116
表4.22 憂鬱症 20人 (輕、中度憂鬱症14人、重度憂鬱症6人)117
表4.23 正常組與MCI組平均數之比較118
表4.24 正常組與失智症組平均數之比較119
表4.25 MCI組與失智症組ADL、IADL及Braden平均數之比較120
表4.26 各據點之平均年齡122
表4.27 台中榮民總醫院老年心理衛生門診AD-8分數大於或等於2分者124
表4.28 台中榮民總醫院老年心理衛生門診AD-8分數小於或等級1者126
表4.29 兩組前測之MMSE平均分數比較128
表4.30 兩組後測之MMSE平均分數比較130
表4.31 兩組之年齡平均數比較137
表4.32 兩組實驗前之MMSE平均分數比較139
表4.33 兩組實驗後之MMSE平均分數之比較141
表4.34 實驗組於藝術治療前、後MMSE平均分數之比較143
表4.35 對照組於實驗前、後其MMSE平均分數之比較145
表4.36 兩組於實驗前、後其GDS平均分數之比較147
表4.37 對照組於實驗前、後其GDS平均分數之比較149
表4.38 實驗組於實驗前、後GDS平均分數之比較151
表4.39 兩組於實驗前IADL平均分數之比較153
表4.40 兩組於實驗後IADL平均分數比較155
表4.41 對照組實驗前、後IADL平均分數157
表4.42 實驗組實驗前、後IADL平均分數159


參考文獻

1.人文取向藝術治療。2008。國立台中教育大學。
2.內政部統計處。1975~2012。戶籍登記現住人口數按五歲、十歲年齡組分。
3.內政部統計處。2011。內政統計通報,第二週。
4.江學瀅譯。2004。兒童藝術治療。心理出版社。台北。
5.阿恩海姆﹙Rudolf Arnheim﹚:《藝術與視知覺》,﹙北京:中國社會科學出版社,1984年版﹚
6.卓良珍、林志堅、闕清模。1997。台中市老年人精神狀態之研究。台中榮民總醫院民國86年研究報告TCVGH-860101D。
7.郭乃文、劉秀枝等。1989。中文版「簡短式智能評估」(MMSE) 之簡介,臨床醫學:23(1)。台北榮總。
8.陸雅青。2005。藝術治療繪畫詮釋,從美術進入孩子的心靈世界。心理出版社。台北。
9.陸雅青、周怡君、林純如、張梅地、呂煦宗等譯。2008。藝術治療,心理專業者實務手冊。學富文化事業有限公司。台北。
10.黃月霞譯。1990。兒童諮商與實務。五南圖書出版社。台北。
11.楊淵韓、李明濱、劉景寬:極早期阿茲海默氏失智症之篩檢。台灣醫界,Vol.52, No.9:P8-10,2009。
12.蘇東平、卓良珍。1981。生活改變之壓力量化研究。中華醫學雜誌28(4):405-415。
13.聯合國秘書處經濟與社會事務部人口科2006年修正版,
http://esa.un.org/unpp
14.聯合國世界人口預測表2000年修正版,1940年後。
15.American Psychiatric Association. 1994. Multiaxial Assessment. Diagnostic And Statistical Manual of Mental Disorders. 4th edition. (DSM-IV). American Psychiatric Association: 25-31.
16.Arieti, S. 1976. Creative: The magic synthesis, New York: Basic Books Art Therapy(n.d.)from The Geroge Washington University Art Therapy Graduate Program: History Web site: http://www.gwu.edu/~artx/history/index.cfm
17.Barker, A., R. Jones., C. Jennison. 1995. A prevalence study of age-associated memory impairment. Br J Psychiatry 167: 642~648.
18.Bedford F. K., J. T. Kittler, E. Muller, P. Thomas, J. M. Uren, D. Merlo, W. Wisden, A. Triller, T. G. Smart, and S. J. Moss. 2001. GABA(A) receptor cell surface number and subunit stability are regulated by the ubiquitin-like protein Plic-1. Nat Neurosci;4:908-916.
19.Berg, L., 1988. Alzheimer's and Parkinson's Disease and The Aging Brain 55: 87.
20.Bertram L, M. Hiltunen, M. Parkinson, M. Ingelsson, C. Lange, K. Ramasamy, K. Mullin, R. Menon, A. J. Sampson, M. Y. Hsiao, K. J. Elliott, G. Velicelebi, T. Moscarillo, B. T. Hyman, S. L. Wagner, K. D. Becker, D. Blacker, and R. E. Tanzi. 2005. Family-based association between Alzheimer's disease and variants in UBQLN1. N Engl J Med. Volum352: 884-894.
21.Blazer, D. 1989. The Epidemiology of Psychiatric Disorder in Late Life. Geriatric Psychiatry, American Psychiatric Press 9: 235-237, 254-257.
22.Blessed G, B. E. Tomlinson and M. Roth. 1968. The association between quantitative measures of dementia and senile change in the cerebral grey matter of elderly subjects. British Journal of Psychiatry, 114: 797-811.
23.Blazer, D. G.., C. David and W. Ewald. 2006. Geriatric psychiatry. American Psychiatric Publishing, Inc. USA.
24.Brookmeyer R, E. Johnson, K. Ziegler-Graham and M. H. Arrighi. 2007, Forecasting the global burden of Alzheimer's disease. Alzheimer's and Dementia. 3(3):186–91.
25.Chuo, L. J., W. Sheu, M. C. Pai, and Y. M. Kuo. 2007. Genotype and plasma concentration of cystatin C in patients with late-onset Alzheimer disease. Dement. Geriatr. Cogn. Disord. 23:251-257.
26.Crook T., R.T. Bartus, S. H. Ferris, P. Whitehouse, G. D.Cohen and S. G. Gershon. 1986. Age-associated memory impairment: proposed diagnostic criteria and measures of clinical change - report of a National Institute of Mental Health work group. Developmental Neuropsychology, 2, 261-76.
27.Dembner, A., 2005. Alzheimer’s disease appears to have multiple causes, and scientists are slowly unraveling them.boston.com News.
28.Ebly, E. M., Hogan, D. B., Kluger, A. 1995. Cognitive impairment in the nondemented elderly. Archives of Neurology 52: 612-619.
29.Folstein, M. F., S. E. Folstein and P. R. McHugh. 1975. Mini-Mental State: a practical method for grading the cognitive state of patients for the Clinician. J Psychiatr Res 12: 189-198.
30.Galvin J. E., C. M. Roe and K. K. Powlishta. 2005. The AD8: A brief informant interview to detect dementia. Neurology, 65:559-564.
31.Gardner, H. 1993a. Creating minds. New York: BasicBooks.
32.Gräsel E, S. Cameron and S. Lehrl. 1990. What contribution can the Hachinski Ischemic Scale make to the differential diagnosis between multi-infarct dementia and primary degenerative dementia? Arch Gerontol Geriatr. Jul-Aug;11(1):63-75.
33.Hachinski V. S., L. D. Iliff and E. Zilkha. 1975. Cerebral blood flow in dementia. Arch Neurol 32: 632-637.
34.Huang. H. M. and L. J. Chuo. 2002. Apolipoprotein E polymorphism in various dementias in Taiwan Chinese population. Journal of Neural Transmission 109: 1415-1421.
35.Hughes, C. P., L. Berg, W. L. Danziger, L. A. Coben and R. L. Martin. 1982. A new clinical scale for the staging of dementia. Br J Psychiatry 140: 566-572.
36.Kahn-Denis, B. K. 1997. Art Therapy with Geriatric Dementia Clients. Art Therapy Journal of the American Art Therapy Association 14(3): 194-199.
37.Koenig, H. G., K. G. Mcador, H. J. Cohen and D. G. Blazer. 1988. Self-rated depression scales and screening for major depression in the older hospitalized patient with medical illness. Journal of the American Geriatrics Society, 36, 699-706.
38.Kral, V. A. 1958. Neuro-Psychiatric Observations In An Old People’s Home. Journal of Gerontology. 13(2): 169-176
39.Kral, V. A. 1962. Senescent forgetfulness:Benign and malignant. Canadian Medical Association Journal. vol. 86: 257-260.
40.Lane, F. and J. Snowdon. 1989. Memory and dementia: A longitudinal survey of suburban elderly: Lovibond P, Wilson P(eds).Clinical and abnormal psychology, Elsevier, Amsterdam: 365-376.
41.Launer, L. J. 2002. Demonstrating the case that AD is a vascular disease: epidemiologic evidence. Ageing Res. Rev 1: 61-77.
42.Lawton, M. P. and E. M. Brody. 1969. Assessment of older people: Self-maintaining and instrumental activities of dailyliving. Gerontologist. 9:179-186.
43.Lawton, M. P. 1972. The dimensions of morale. In Kent, D.P., Kastenbaum, R., & Sherwood, S. (Eds.). Research, planning and action for the elderly, pp. 144-165. New York: Behavioral Publications, Inc.
44.Levy, R. 1994. Aging-associated cognitive decline. International Psychogeriatrics. 6(1): 63-68.
45.Lin, C., S. T. Wang., C. W. Wu., L. J. Chuo and Y. M. Kuo. 2003. The association of cystatin C gene polymorphism with late-onset Alzheimer’s disease and vascular dementia. Chinese Journal of Physiology 46(3).
46.Liu C. K., M. C. Chou and C. L. Lai. 2009. Application of AD-8 to screen very mild dementia in Taiwan. International Conference of Alzheimer’s Disease, 1-51.
47.Loeb, C and C. Gandolfo. 1983. Diagnostic evaluation of degenerative and vascular dementia. Stroke. 14:399-401.
48.Mah A. L., G. Perry, M. A. Smith and M. J. Monteiro. 2000. Identification of ubiquilin, a novel presenilin interactor that increases presenilin protein accumulation. J Cell Biol;151:847-862. Mondell, E. J. 2005. Gene Mutation May Help Cause Alzheimer’s disease-it’s only the second gene with proven links to late-onset disease. HON-News:, Health On the Net Foundation.
49.Massey, L. K., A. L. Mah and M. J. Monteiro. 2004. Ubiquilin Regulates Pressenilin Endoproteolysis and Modulates γ-secretase Components, Pen-2 and Nicastrin, Biochemical Journal as manuscript BJ20050491.
50.Mondell, E. J. 2005. Gene Mutation May Help Cause Alzheimer’s disease-it’s only the second gene with proven links to late-onset disease. HON-News:, Health On the Net Foundation.
51.Morris, J. C., D. W. McKeel, and M. Storandt. 1991. Very mild Alzheimer’s disease: informant-based clinical, psychometric, and pathological distinction from normal aging. Neurology 41: 469-478.
52.National Center for Health Statistics, Data Warehouse on Trends in Health and Aging. http:// www.senescence.info/definitions.html
53.Naumburg, M. 1974. Studies of “free” art expression of behavior problem children and adolescents as a Means of Diagnosis and therapy. New York:Grune & Stratton.
54.Ohm T. G., M. Kirca., J. Bohl, H. Scharnagl, W. Gross and W. M/irz. 1995. Apolipoprotein E polymorphism influences not only cerebral senile plaque load but also Alzheimer-type neurofibrillary tangle formation. Neuroscience 66, 583-587.
55.Pantoni, L. and D. Inzitari. 1983. Hachinski's ischemic score and the diagnosis of vascular dementia: a review. Ital J Neurol Sci, 14, 539-546.
56.Pasley, B. N. and R. D. Freeman. 2008. Scholarpedia, 3(3):5340.
57.Petersen, R. C. 2004. Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine 256: 183-94.
58.Petersen, R.C. and S. Negash. 2008. Mild cognitive impairment: an overview. CNS Spectr.Jan;13(1):45-53. Review.
59.Petersen, R. C., G. E. Smith, S. C. Waring, R. J. Ivnik, E. G. Tangalos and E. Kokmen. 1999. Mild cognitive impairment: clinical characterization and outcome. Archives of Neurology 56: 303-308.
60.Ravid-Horesh, R. H. 2004. “A temporary guest”: the use of art therapy in life review with an elderly woman. The Arts in Psychotherapy 31: 303-319.
61.Regier D. A. , J. H. Boyd, J. D. Burke, D. S. Rae, J. K. Myers, M. Kramer, L. N. Robins, L. K. George, M. Karno and B. Z. Locke. 1988. One-month prevalence of mental disorders in the United States. Based on five Epidemiologic Catchment Area sites. Arch Gen Psychiatry. Nov; 45(11): 977–986.
62.Reisberg, B., S. H. de Ferris, and M. J. Leon. 1998. Stage specific behavioral, cognitive, and in vivo changes in community residing subjects with age-associated memory impairment (AAMI) and primary degenerative dementia of the Alzheimer type. Drug Development Research 15: 101-114.
63.Reisberg, B., S. H. de Ferris, M. J. Leon and T. Crook. 1982. The global deterioration scale for assessment of primary degenerative dementia. American Journal of Psychiatry 139: 1136-1139.
64.Rosen, W. G., R. D. Terry, P. A. Fuld, R. Katzman and A. Peck. 1980. Pathological verificationof ischemic score in differentiation of dementias. Ann Neurol. 7:486-488.
65.Shore, A. 1997. Promoting Wisdom: The Role of Art Therapy in Geriatric Setting. Art Therapy Journal of the American Art Therapy Association 14(3): 172-177.
66.Spaniol, S. 1997. Guest Editorial-Art Therapy with Older Adults: Challenging Myths, Building Competencies. Art Therapy Journal of the American Art Therapy Association: 158-160.
67.Stephen, M. S. 2008. Stahl’ s Essential Psychopharmacology. Third Edition. Cambridge University Press. New York.
68.Wald, J. 1989. Art Therapy for patients with Alzheimer’s Disease and Related Disorders. Advances in Art Therapy: 204-221.
69.Waller, D. and A. Gilroy. 1994. Art therapy: a handbook, Buckingham & Philadelphia: Open University Press.
70.Wadeson, H. 1980. Art psychotherapy.
71.Wimo A. 2007. An estimate of the total worldwide societal costs of dementia in 2005. Alzheimers Dement 3:81-91.
72.Wu A. L. , J. Wang, A. Zheleznyak and E. J. Brown. 1999. Ubiquitin-related proteins regulate interaction of vimentin intermediate filaments with the plasma membrane. Mol Cell;4:619-625.
73.Wu, S, A. Mikhailov, H. Kallo-Hosein, K. Hara, K. Yonezawa and J. Avruch. 2002. Characterization of ubiquilin 1, an mTOR-interacting protein. Biochim Biophys Acta;1542:41-56.
74.Yang Y.H., S. H. Chen and C. L. Lai. 2009. Concentration of donepezil tp therapeutic response in Alzheimer’s disease. International Conference of Alzheimer’s Disease,2-218.
75.Zeiger, B. L. 1976. Life review in art therapy with the aged. American Journal of art Therapy 15: 47-50.
76.Zhan, L. 1992. Quality of life: Conceptual and measurement issue. Journal of Advanced Nursing 17(7): 795-800.
77.Zlokovic, B. and M. Apuzzo. 1998. Strategies to Circumvent Vascular Barriers of the Central Nervous System. Neurosurgery 43, 877-878.

QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top