Guttman R, Altman R D, Nielsen N H
Council on Scientific Affairs, American Medical Association, Chicago, Ill., USA.
Arch Fam Med. 1999 Jul-Aug;8(4):347-53. doi: 10.1001/archfami.8.4.347.
Alzheimer disease (AD) takes a heavy economic, social, physical, and psychological toll on patients, families, and society. Because of the increasing life expectancy in the United States, AD is expected to afflict approximately 14 million people within the next few decades. There is currently no cure, only interventions that can temporarily ameliorate the profound cognitive losses and behavioral manifestations of the disorder. Community services are fragmented and underutilized. Physicians, in their traditional role as gatekeepers, can encourage more families to use supportive services. This article reviews the guidelines on the diagnosis and treatment of AD of the Agency for Health Care Policy and Research, the American Academy of Neurology, the Veterans Health Administration, and the American Psychiatric Association. Although these guidelines contain valuable information, they do not adequately address the role of the family physician and the need for continuity of care. Recommendations regarding AD from the Council on Scientific Affairs, which were adopted as American Medical Association policy in December 1997, are included in this article.
阿尔茨海默病（AD）给患者、家庭和社会带来了沉重的经济、社会、身体和心理负担。由于美国人均寿命不断延长，预计在未来几十年内，AD将折磨约1400万人。目前尚无治愈方法，只有一些干预措施能暂时缓解该疾病严重的认知衰退和行为表现。社区服务零散且未得到充分利用。医生作为传统的把关人，可以鼓励更多家庭使用支持性服务。本文回顾了医疗保健政策与研究机构、美国神经病学学会、退伍军人健康管理局以及美国精神病学协会关于AD诊断和治疗的指南。尽管这些指南包含了有价值的信息，但它们并未充分阐明家庭医生的作用以及持续护理的必要性。本文还纳入了科学事务委员会于1997年12月被采纳为美国医学协会政策的关于AD的建议。
