2025 年 08 月 26 日 
圖說：失智症衛教記者會與會貴賓-由左至右：台灣臨床失智症學會-徐榮隆理事長、台灣失智症協會-徐文俊理事長、雙和醫院失智症中心顧問醫師暨臺北醫學大學醫學院-胡朝榮院長
台灣於2025年正式邁入超高齡社會，且每年失智症新增個案數持續攀升，對家庭與社會造成沉重負擔，相關照護與醫療支出也逐年增加。今年台灣正式取得新型抗類澱粉蛋白標靶治療 (Amyloid-Targeted Therapy, ATT）的藥物許可，為阿茲海默症治療迎來二十年來的重大突破。此治療透過針對大腦中異常累積的類澱粉蛋白進行清除，首次在臨床上證實能有效延緩病程，為病友與家屬帶來希望。這不僅是阿茲海默症藥物研發歷程的里程碑，更象徵著治療從「症狀治療藥物」邁向「改變病程治療」的新時代。
台灣失智症人口逐年上升 高齡化社會挑戰加劇 防治刻不容緩
隨著人口高齡化加劇，失智症已成為全社會必須正視的公共健康議題。根據衛生福利部委托國家衛生研究院進行的「全國社區失智症流行病學調查」，台灣2024年65歲以上失智人口約為35萬人，佔同齡人口近8%；且年齡層越高，失智症盛行率越高。依國家發展委員會的中華民國人口（中）推估（民國113年至130年）資料，預估2041年，失智人口恐近68萬人，盛行率近10%，成長幅度驚人，對醫療照護資源與人力勢必將帶來重大的衝擊。
台灣失智症協會徐文俊理事長說明，失智症類型中以阿茲海默症最為常見，占比約六成（56.88%）1。許多年長者在早期出現記憶力退化、理解能力變差等症狀時，常誤以為只是正常老化。多數病友在察覺方向感變差、記憶力衰退、情緒起伏明顯等異常後才就醫，平均延誤約3.5年。如出現警訊，應立即就醫，及早與專業醫師討論。
新型標靶治療清除「大腦毒素」 有效延緩疾病進展 改寫阿茲海默症治療格局
台灣臨床失智症學會徐榮隆理事長指出，阿茲海默症是失智症中最常見1，且屬於可早期進行精準診斷與標靶治療的失智症類型，主要成因為腦內毒性類澱粉蛋白異常堆積，形成斑塊並干擾腦神經，導致腦部結構改變與萎縮，進而影響記憶力與認知功能。過去傳統藥物治療雖無法延緩病程，但在控制症狀上仍扮演重要角色。無論病程在哪一階段，照護者所面臨的身心負擔始終沉重，應予以關注。
令人振奮的是，現階段已有新型抗類澱粉蛋白標靶治療問世，針對疾病根本機轉介入，直接鎖定毒性蛋白，活化免疫細胞清除斑塊，減少對腦神經的傷害，進而延緩疾病惡化。此治療有助病友延長維持認知與生活能力的時間，是提升健康餘命的關鍵。這項突破不僅為病友與家屬帶來新的曙光，也改寫了阿茲海默症的治療格局，堪稱是二十年來的重要里程碑。
徐榮隆理事長進一步強調，新型標靶治療主要適用於早期階段的輕度認知障礙以及輕度阿茲海默症病友，並非所有病友皆適用，需經四項關鍵檢查，確認是否適合：認知功能評估、類澱粉蛋白檢測、腦部核磁共振、以及APOEε4基因檢測。
精準診斷輕度認知障礙 把握黃金治療期 早期介入延緩惡化
雙和醫院失智症中心顧問醫師暨臺北醫學大學醫學院胡朝榮院長指出，最新國際期別指引結合臨床評估以及病理報告，將阿茲海默症分為六期：第1、2期為臨床前期，腦內毒性類澱粉蛋白開始堆積；第3期為輕度認知障礙（Mild Cognitive Impairment, MCI），毒性蛋白堆積，開始引起症狀；第4期轉為輕度失智，毒性蛋白堆積到影響日常生活；第5、6期則為中、重度失智，毒性蛋白擴散至整個大腦，導致神經細胞受損，加速大腦退化。
MCI惡化至輕度失智平均僅需3至5年，每年約有10%至15%的病友會進展為失智症，惡化速度不容忽視。由於阿茲海默症為不可逆的疾病，早期診斷是關鍵。胡朝榮院長指出，除常規認知測驗、血液檢查與核磁共振造影（MRI）、電腦斷層（CT）等影像檢查，亦可透過生物標記檢測進行精準診斷，如正子斷層掃描（PET）觀察腦內斑塊分布，或腰椎穿刺分析腦脊髓液（CSF）中的毒性蛋白含量。
胡朝榮院長即分享一名70歲退休男性科技業工程師，幾年前出現短期記憶力衰退並確診為阿茲海默症輕度認知障礙，在接受治療並積極參與非藥物介入活動後，病情尚趨穩定，甚至公司在他屆齡退休後還聘請他擔任了兩年公司顧問。今年初，開始頻繁出現重複提問的症狀且心情時常感到低落，讓太太既憂心與不捨。所幸，在經過認知功能測驗與PET檢查後，確認他還維持在輕度認知障礙，並無退化為輕度失智症。在專業評估下，他加入了新型標靶治療的臨床試驗，並積極投入社交活動與認知訓練，夫妻倆更一同報名參加社區繪畫班，也讓生活多了色彩與節奏。目前已將定期回診納入生活常規，太太也感動地說：「他心情好，我就開心！」而他除了感謝太太對他的忍耐與包容外，也堅定地相信自己一定會越來越好。
及早診斷有助醫師準確掌握病程，把握黃金治療期，提供合適的治療建議，對病友維持生活品質與自主能力至關重要。
藥物與非藥物治療雙管齊下，多元策略延緩病程惡化
失智症風險因子並非不能改變，徐文俊理事長提醒，若能從日常生活中著手改善14項風險因子，有助於預防或延遲45%的失智症個案的發生。改善方式包含提升教育程度、矯正聽力與視力、妥善控制高膽固醇、糖尿病與高血壓等慢性疾病、維持健康體重、預防憂鬱與腦部外傷。避免抽菸與過度飲酒、養成規律運動習慣、保持良好社交互動，以及遠離空氣污染，都是促進大腦健康的重要行動。
除了積極預防，及早發現徵兆同等重要。失智症的十大警訊包括：記憶力減退影響生活、計畫或解決事情困難、無法勝任熟悉的事務、對時間與地點感到混淆、對視覺影像與空間關係理解困難、言語表達或書寫困難、物品亂放且無法找回、判斷力減弱、不參與社交活動，以及情緒與個性發生明顯改變。徐文俊理事長呼籲，若自己或親友出現上述警訊，請儘早就醫、諮詢專業醫師，讓關心成為守護的第一步。
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