EFNS guidelines for the diagnosis and management of Alzheimer's disease
EFNS guidelines for the diagnosis and management of Alzheimer's disease
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DOI：
10.1111/j.1468-1331.2010.03040.x
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发表时间：
2010-10-01
影响因子：
5.1
通讯作者：
Scheltens, P.
中科院分区：
文献类型：
--
作者：
Hort, J.;O'Brien, J. T.;Scheltens, P.
背景和目标：2008 年成立了一个工作组，负责制定欧洲神经学会联合会 (EFNS) 指南的修订版，该指南用于诊断和管理阿尔茨海默病 (AD) 和其他痴呆相关疾病，该指南于 2007 年初发布。修订后的国际指南的目的是提出经过同行评审的基于证据的声明，为临床神经学家、老年病学家、精神病学家和其他专家提供实践指导负责治疗 AD 患者的医生。本指南不包括轻度认知障碍和非阿尔茨海默氏痴呆。方法：工作组工作组审查了 2009 年 5 月之前发表的原始研究文章、荟萃分析和系统评价中的证据。根据 EFNS 指南对证据进行了分类并达成共识建议分级（A、B 或 C）。在缺乏证据但有明确共识的地方，提供了良好实践要点。结果：与之前的 EFNS 指南相比，临床诊断、血液检查、神经心理学、神经影像学、脑电图、脑脊液（CSF）分析、基因检测、诊断披露、AD 治疗、痴呆症行为和心理症状、法律问题、对护理人员的咨询和支持等方面的建议均进行了修订。结论：许多新建议和良好实践点取得了进展，即脑脊液、神经心理学、神经影像学和审查非证据疗法。 AD 过程中症状、残疾、需求和护理人员压力的评估、解释和治疗需要许多不同专业人员的贡献。这些专业人员应遵守这些指南，以改善 AD 的诊断和管理。
Background and objectives:In 2008 a task force was set up to develop a revision of the European Federation of the Neurological Societies (EFNS) guideline for the diagnosis and management of Alzheimer's disease (AD) and other disorders associated with dementia, published in early 2007. The aim of this revised international guideline was to present a peer-reviewed evidence-based statement for the guidance of practice for clinical neurologists, geriatricians, psychiatrists, and other specialist physicians responsible for the care of patients with AD. Mild cognitive impairment and non-Alzheimer dementias are not included in this guideline.Methods:The task force working group reviewed evidence from original research articles, meta-analysis, and systematic reviews, published before May 2009. The evidence was classified and consensus recommendations graded (A, B, or C) according to the EFNS guidance. Where there was a lack of evidence, but clear consensus, good practice points were provided.Results:The recommendations for clinical diagnosis, blood tests, neuropsychology, neuroimaging, electroencephalography, cerebrospinal fluid (CSF) analysis, genetic testing, disclosure of diagnosis, treatment of AD, behavioural and psychological symptoms in dementia, legal issues, counselling and support for caregivers were all revised as compared with the previous EFNS guideline.Conclusion:A number of new recommendations and good practice points are made, namely in CSF, neuropsychology, neuroimaging and reviewing non-evidence based therapies. The assessment, interpretation, and treatment of symptoms, disability, needs, and caregiver stress during the course of AD require the contribution of many different professionals. These professionals should adhere to these guideline to improve the diagnosis and management of AD.