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抗痴呆药物:在晚期阶段有什么证据?
Daniel Ferreira1,2, Noémi Nogueira2, Joana Guimarães1,2
1Departamento de Neurociências e Saúde Mental, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
Porto biomedical journal
|May 1, 2024
概括
对于晚期痴呆症,抗痴呆药物提供了小的认知益处. 继续或停止这些治疗的决定应该是个性化的,考虑到成本和护理人员的负担.
科学领域:
- 老年学是指老年学的学科.
- 神经学 神经学
- 公共卫生 公共卫生
背景情况:
- 痴呆症是一个重大的公共卫生挑战,患病率不断上升,成本高昂,以及护理人员的压力.
- 目前的抗痴呆药物提供症状缓解,而不是疾病修饰.
- 在晚期痴呆症阶段处方这些药物在全球范围内进行辩论.
研究的目的:
- 审查关于晚期阿尔茨海默病 (AD) 和混合痴呆症中抗痴呆药物的证据.
- 评估认知,功能和不良事件的结果.
- 探索与健康相关的成本和护理人员负担.
主要方法:
- 35项研究的系统审查.
- 分析有关认知和功能结果的数据.
- 对不良事件,成本和护理人员负担的评估.
主要成果:
- 大多数研究都集中在阿尔茨海默病上,并且是异质的,显示了轻微的认知/功能改善.
- 有证据表明,引入/维持药物可能有好处,但临床意义尚不清楚.
- 费用和护理人员负担似乎有利于继续治疗,尽管效果有所减少.
结论:
- 个人决策对于在晚期痴呆症中启动或取消抗痴呆药物至关重要.
- 需要对标准化设计进行进一步的研究.
- 益处的临床意义需要仔细考虑.
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