Montefiore-Einstein Center for the Aging Brain: Preliminary Data
Montefiore-Einstein Center for the Aging Brain: Preliminary Data
复制标题
DOI：
10.1111/jgs.14473
复制
发表时间：
2016-11-01
影响因子：
6.3
通讯作者：
Zwerling, Jessica
中科院分区：
文献类型：
--
作者：
Verghese, Joe;Malik, Rubina;Zwerling, Jessica
鉴于痴呆症护理管理的多面性，跨学科的综合临床方法是必要的。我们描述了我们在蒙特菲奥里-爱因斯坦老年脑中心(CAB)进行基于门诊的痴呆症护理的一年经验，该中心由老年病学家、神经学家和神经心理学家组成的多专业团队参与，并得到老年精神病学家、理疗师和社会服务的支持。CAB的目标是最大限度地提高痴呆症的结果，包括定期监测患者的健康和认知情况，对患者、他们的家人和照顾者进行教育和支持；酌情启动药物和非药物治疗，以及便利获得临床试验。CAB遵循咨询模式，转诊到该中心的患者将接受老年、神经心理学和神经病学专家的全面三步评估和管理计划，并与患者、护理人员和初级保健医生共享。在我们第一年因认知障碍而就诊的366名患者中，71%是平均年龄74岁的女性。患者自我确认的种族包括高加索人(26%)、非裔美国人(25%)、西班牙裔(18%)和多种族(5%)。CAB常见的最终诊断包括轻度认知障碍综合征(31%)、阿尔茨海默病(20%)、混合性痴呆(11%)、血管性痴呆(9%)、额颞痴呆(4%)和路易体痴呆(4%)。我们一年的进展报告表明，跨学科临床痴呆症护理模式在门诊环境中是可行的，并得到患者、照顾者和转诊医生的高度接受。
Given the multifaceted nature of dementia care management, an interdisciplinary comprehensive clinical approach is necessary. We describe our one-year experience with outpatient based dementia care at the Montefiore-Einstein Center for the Aging Brain (CAB) involving an multispecialty team of geriatricians, neurologists, and neuropsychologists, supported by geriatric psychiatrists, physiatrists, and social services. The goals of the CAB is to maximize dementia outcomes, including regular monitoring of patient's health and cognition, education and support to patients, their families and caregivers; initiation of pharmacological and non-pharmacological treatments as appropriate, and the facilitation of access to clinical trials. The CAB follows a consultative model where patients referred to the center receive a comprehensive three step evaluation and management plan from Geriatric, Neuropsychology and Neurology specialists that is shared with patient, caregivers and primary care physicians. Of the 366 patients seen for cognitive complaints in our first year, 71% were women with a mean age of 74 years. Self-identified ethnicity of patients included Caucasian (26%), African-American (25%), Hispanic (18%) and multiracial (5%). Common final diagnoses assigned at the CAB included mild cognitive impairment syndromes (31%), Alzheimer's disease (20%), mixed dementia (11%), vascular dementia (9%), Frontotemporal dementia (4%) and dementia with Lewy bodies (4%). Our one-year progress report indicates that an interdisciplinary clinical dementia care model is feasible in the outpatient setting as well as highly accepted by patients, caregivers and referring physicians.