Nourhashémi Fati, Gillette Sophie, Andrieu Sandrine
Hôpitaux de Toulouse (P. B. Vellas), 31300 Toulouse.
Rev Prat. 2005 Nov 15;55(17):1903-11.
Alzheimer's disease (AD) is the main cause of progressive decline during which there is progressive dependence on family members and the health care system. The first step in the treatment is to make a diagnosis and communicate it to patients and families. The many things that should be done for optimal management must be started early. In the majority of patients enhancement of cholinergic function can produce a plateau for a period of time or at least can reduce the speed of decline. Comprehensive and appropriate treatment plans that meet all patients' needs can only be developed as a result of thorough assessment of the patient, the family, and the home environment. The assessment should address the patient's medical condition, including functional status, cognitive status, other medical conditions and non cognitive symptoms of AD. The assessment should also address the caregiver's needs and risks. Physicians should solicit and consider their input in post-diagnostic treatment planning. Comprehensive reassessment should occur every 6 months or more frequently with any sudden decline or be havioral change. The primary care practitioner should provide information and education about current level of disease and should talk with the patient and family to establish treatment goals.
阿尔茨海默病（AD）是导致病情逐渐衰退的主要原因，在此期间患者对家庭成员和医疗保健系统的依赖会不断增加。治疗的第一步是做出诊断并告知患者及其家属。为实现最佳管理而应做的诸多事项必须尽早开展。在大多数患者中，增强胆碱能功能可在一段时间内使病情趋于平稳，或者至少能减缓衰退速度。只有通过对患者、其家庭及家庭环境进行全面评估，才能制定出满足所有患者需求的综合且恰当的治疗方案。评估应涵盖患者的医疗状况，包括功能状态、认知状态、其他医疗状况以及AD的非认知症状。评估还应关注照护者的需求和风险。医生在诊断后的治疗规划中应征求并考虑他们的意见。每6个月或在病情突然衰退或出现行为变化时更频繁地进行全面重新评估。初级保健医生应提供有关当前疾病水平的信息和教育，并应与患者及其家属交谈以确立治疗目标。
