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Tratamiento de enfermedades no demenciales en pacientes con demencia
D J Brauner1, J C Muir, G A Sachs
1The University of Chicago Hospitals, Department of Medicine, 5841 S Maryland, MC 6098, Chicago, IL 60637, USA. dbrauner@medicine.bsd.uchicago.edu
JAMA
|June 24, 2000
Resumen
El cuidado de los pacientes con demencia tipo Alzheimer requiere una cuidadosa consideración de los tratamientos de enfermedades no demencia. La demencia altera significativamente las relaciones riesgo-beneficio del tratamiento, lo que requiere una toma de decisiones ajustada para una atención óptima del paciente.
Área de la Ciencia:
- Geriatría La geriatría es la especialidad de la geriatría.
- Neurología Neurología.
- Medicina interna es la medicina interna de las enfermedades.
Sus antecedentes:
- Los médicos brindan atención primaria para una creciente población de demencia de tipo Alzheimer.
- La atención de la enfermedad no demencial en pacientes con demencia recibe una atención limitada.
- La demencia altera la relación riesgo-beneficio de los tratamientos médicos comunes.
Objetivo del estudio:
- Ilustre cómo la demencia afecta las decisiones de tratamiento para enfermedades comunes.
- Resaltar los desafíos en el manejo de las condiciones no demenciales en pacientes con demencia.
- Proporcionar orientación para optimizar la atención y la toma de decisiones.
Principales métodos:
- Estudio de caso de un paciente con demencia con efectos adversos de los medicamentos.
- Vinjetas compuestas de escenarios clínicos similares.
- Discusión de los factores de toma de decisiones en la atención de la demencia.
Principales resultados:
- La presencia de demencia requiere evaluaciones de riesgo-beneficio modificadas del tratamiento.
- Los efectos adversos pueden ser graves en pacientes con demencia.
- El deterioro cognitivo afecta la adherencia al tratamiento y la notificación de eventos adversos.
Conclusiones:
- La demencia influye significativamente en las opciones de tratamiento para las afecciones coexistentes.
- La mejora de la comunicación y el cribado son vitales para la atención del paciente con demencia.
- Se necesitan cambios de políticas para incluir a los pacientes con demencia en los ensayos clínicos.
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