Dementia in older people: an update
Dementia in older people: an update
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DOI：
10.1111/imj.12572
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发表时间：
2014-11-01
影响因子：
2.1
通讯作者：
Watson, R.
中科院分区：
文献类型：
--
作者：
LoGiudice, D.;Watson, R.
痴呆症是老年人的一种常见病症，其特征是多种认知缺陷，导致功能水平下降。对于老年人来说，多种病理因素都会导致这种情况，除了血管变化之外，还包括阿尔茨海默病、路易体痴呆症中常见的变化。抑郁、谵妄和服用多种药物等共病因素可能导致认知能力下降。新型生物标志物和神经影像技术可能在不久的将来有助于提高诊断的准确性。迄今为止，药物治疗基本上不成功，只能缓解症状。痴呆症的及时诊断可以促进有关个人和财务规划的重要讨论，并向痴呆症患者及其护理人员提供教育和支持。痴呆症患者通常会经历痴呆症的行为和心理症状，这可能会给家人和护理人员带来很大的困扰。临床指南指出非药物方法是一线措施，包括关注疼痛、营养和环境。痴呆症被认为是澳大利亚的国家健康优先事项，需要进一步紧急考虑将风险因素作为预防措施以延迟痴呆症的发生。
Dementia is a common condition of the elderly characterised by multiple cognitive deficits resulting in a decline from previous level of function. In the older person, multiple pathologies contribute, including changes commonly seen in Alzheimer disease, dementia with Lewy bodies in addition to vascular changes. Comorbid factors, such as depression, delirium and polypharmacy can contribute to cognitive decline. Novel biomarkers and neuroimaging techniques may assist in the near future to improve accuracy of diagnosis. To date, pharmacological therapies have been largely unsuccessful and provide symptomatic relief only. The timely diagnosis of dementia can facilitate important discussions regarding personal and financial planning and introduce education and supports to the person with dementia and their carers. The person with dementia commonly experiences behavioural and psychological symptoms of dementia that may cause much distress, including to families and carers. Clinical guidelines indicate non-pharmacological approaches as first line measures, including attention to pain, nutrition and the environment. Dementia is recognised as a National Health Priority in Australia, and efforts to target risk factors as preventative measures to delay onset of dementia require further urgent consideration.