発達障害と認知症

Developmental Disorders and Dementia

発達障害の老化と認知症との関連に関する文献と自験例を紹介した。自閉症スペクトラムは，ライフイベントでの変化に弱いが，高齢期の診断は一般的ではないため，高齢期に不適応が生じた場合，前頭側頭型認知症と診断されている場合もある。一方で，注意欠陥／多動性障害はレヴィ小体病と，学習障害は原発性進行性失語症との関連が報告されている。これらは神経伝達物質や神経ネットワークの脆弱性を反映していると考えられている。

Abstract

This article reviews the relationship between developmental disorders and dementia with ageing. Persons with autistic spectrum disorder (ASD) are vulnerable to life events, even in their old age. In certain cases, senile persons with undiagnosed ASD, who developed maladaptive behaviors after negative life events, were considered as having a behavioral variant of frontotemporal dementia (bvFTD). However, to our knowledge, there are no reports on the relationships between ASD and bvFTD. Alternatively, there are only a limited number of reports, which address the relationships between developmental disorders and dementia. One such relationship is that in patients with dementia with Lewy bodies (DLB) and those with Parkinson's disease (PD), who also show a tendency for having attention-deficit/hyperactivity disorder (ADHD) at a younger age. Another such relationship is seen in patients with primary progressive aphasia (PPA) who show a high occurrence of learning disability (LD) among their first-degree relatives. These results imply that the neurotransmitter pathway or language network in the brain is vulnerable in some subjects. These retrospective studies have demonstrated a possible relationship between developmental disorders and dementia; however, no study has shown a causality of developmental disorders and dementia.