痴呆症护理研究和心理社会因素
Sharon Cohen1, Sarah Cotton2, Juan Fortea3
1Toronto Memory Program, Toronto, ON, Canada.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 25, 2025
概括
早期诊断阿尔茨海默病 (AD) 对于有效治疗至关重要. 这项研究揭示了诊断途径的挑战,包括症状意识和生物标志物使用,影响轻度认知障碍和痴呆症的及时干预.
科学领域:
- 神经学 神经学
- 老年病的医生 老年病的医生
- 公共卫生 公共卫生
背景情况:
- 阿尔茨海默病 (AD) 的疾病修饰治疗方法的出现强调了早期诊断轻度认知障碍 (MCI) 和因AD而导致的痴呆症的必要性.
- 这项研究调查了全球临床护理途径,以确定改善早期和准确诊断的领域.
研究的目的:
- 探索目前的全球临床护理途径,用于诊断轻度认知障碍 (MCI) 和阿尔茨海默病 (AD) 导致的痴呆症.
- 确定在早期和准确诊断AD和MCI方面需要改进的关键领域.
主要方法:
- 在8个国家 (加拿大,法国,德国,意大利,西班牙,英国,日本,美国) 从2022年12月到2024年3月对医生及其患者进行了横截面调查.
- 医生报告了患者的诊断途径,迷你精神状态检查 (MMSE) 评分,以及因AD而患有MCI或痴呆症的患者的治疗方法.
- 收集了患者报告的咨询延迟原因,并对数据进行了描述性分析,按MMSE得分分组.
主要成果:
- 来自829名医生和5654名患者的数据显示,从症状发作到第一次咨询的中位延迟时间为20.7周,其中75.1%的患者延迟寻求医疗护理.
- 患者经常将记忆问题归因于正常衰老 (72.3%). 对于大多数患者来说,初级保健医生是第一个接触点.
- 诊断工具主要包括认知评估 (91.8%) 和家庭反 (89.3%),而AD特定生物标志物测试不常见 (11.8%). 缺乏治疗疗效是治疗变化的关键驱动因素 (48.9%).
结论:
- 这项研究强调了对早期阿尔茨海默病症状和不一致的转诊实践的严重缺乏认识.
- 不经常使用AD特异性生物标志物阻碍了准确和及时的诊断.
- 解决这些诊断挑战对于早期干预至关重要,需要改进治疗选择,因为缺乏疗效导致的治疗变化表明了这一点.
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