老年人 Delirium 在老年人 Delirium 在老年人 Delirium 在老年人
Sharon K Inouye1, Rudi G J Westendorp2, Jane S Saczynski3
1Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA.
Lancet (London, England)
|September 3, 2013
概括
痴呆症是老年人常见且严重的急性认知障碍,需要正式诊断. 非药物预防是最有效的,因为药物治疗缺乏证据.
科学领域:
- 老年病的医生 老年病的医生
- 神经学 神经学
- 公共卫生 公共卫生
背景情况:
- 妄想是一种频繁,严重,往往致命的急性疾病,影响65岁及以上的个体的注意力和认知能力.
- 尽管存在巨大的成本和死亡率,但它仍未得到充分的认可.
- 诊断依赖于正式的认知评估和急性症状发病史.
研究的目的:
- 审查当前对老年人痴呆症的理解.
- 突出有效的预防和治疗策略.
- 强调妄想在理解大脑病理生理学和患者安全方面的作用.
主要方法:
- 审查现有的关于痴呆症诊断,预防和治疗的文献.
- 对痴呆症对大脑健康和患者安全的影响的分析.
- 讨论与妄想有关的公共卫生优先事项.
主要成果:
- 多组分,非药物方法是预防妄想的最有效策略.
- 没有令人信服的证据支持药物预防或治疗的有效性.
- 建议减少药物用于镇静和止痛,以及非药物方法.
结论:
- 妄想作为大脑脆弱性的标志物和潜在的认知损伤机制.
- 解决妄想症对于改善患者安全和推动全系统过程改进至关重要.
- 公共卫生工作的重点应该是改进编码,补偿,研究资金以及对临床医生和公众的教育.
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