Toward common mechanisms for risk factors in Alzheimer's syndrome.
Toward common mechanisms for risk factors in Alzheimer's syndrome.
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DOI：
10.1016/j.trci.2017.08.009
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发表时间：
2017-11
期刊：
影响因子：
--
通讯作者：
Cedazo-Minguez A
中科院分区：
文献类型：
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作者：
Medina M;Khachaturian ZS;Rossor M;Avila J;Cedazo-Minguez A
降低医疗保健成本的全球战略目标，特别是由于人口老龄化和/或患有各种慢性疾病-残疾的人所需的医疗保健服务市场不断扩大而导致大幅增加的前景，是一个复杂而艰巨的挑战，涉及多个方面。目前的预测预测，由于慢性残疾患病率呈指数级攀升以及需要某种形式的医疗保健的绝对人数增加，对健康的需求将显着增加。因此，全球卫生保健系统迫在眉睫的经济困境要求制定一项战略目标，以促进全球研发工作的大幅扩展，以发现和开发广泛的干预措施，以延迟和/或预防慢性致残疾病的发作。采用这样一个战术目标的理由是基于这样一个前提：即使通过一项高度集中的跨国研究计划将残疾的发生稍微延迟 5 年，慢性残疾状况的成本和患病率也会减少一半。由于最近药物试验中出现了许多失败的历史，本文的中心论文是主张探索采用新颖的机械思想、理论和范式来开发广泛和/或类型的干预措施。尽管我们讨论的主要焦点是生物学治疗方法，但我们认识到非药物干预新兴知识的重要性及其对降低医疗保健成本的潜在影响。尽管我们可能在很长一段时间内找不到治疗或预防痴呆症的药物，但研究已经开始证明非药物干预措施对医疗保健经济学的潜在贡献，包括康复、促进自主性和延迟住院治疗的潜力，从而促进健康老龄化和降低护理成本。
The global strategic goal of reducing health care cost, especially the prospects for massive increases due to expanding markets for health care services demanded by aging populations and/or people with a wide range of chronic disorders-disabilities, is a complex and formidable challenge with many facets. Current projections predict marked increases in the demand for health driven by both the exponential climb in the prevalence of chronic disabilities and the increases in the absolute numbers of people in need of some form of health care. Thus, the looming predicament for the economics of health care systems worldwide mandates the formulation of a strategic goal to foster significant expansion of global R&D efforts to discover and develop wide-ranging interventions to delay and/or prevent the onset of chronic disabling conditions. The rationale for adopting such a tactical objective is based on the premise that the costs and prevalence of chronic disabling conditions will be reduced by half even if a modest delay of 5 years in the onset of disability is obtained by a highly focused multinational research initiative. Because of the recent history of many failures in drug trials, the central thesis of this paper is to argue for the exploration-adoption of novel mechanistic ideas, theories, and paradigms for developing wide range and/or types of interventions. Although the primary focus of our discussion has been on biological approaches to therapy, we recognize the importance of emerging knowledge on nonpharmacological interventions and their potential impact in reducing health care costs. Although we may not find a drug to cure or prevent dementia for a long time, research is starting to demonstrate the potential contributes of nonpharmacological interventions toward the economics of health care in terms of rehabilitation, promoting autonomy, and potential to delay institutionalization, thus promoting healthy aging and reductions in the cost of care.