Chapman Daniel P, Williams Sheree Marshall, Strine Tara W, Anda Robert F, Moore Margaret J
Division of Adult and Community Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mail Stop K-67, Atlanta, GA 30341, USA.
Prev Chronic Dis. 2006 Apr;3(2):A34. Epub 2006 Mar 15.
With the aging of the U.S. population, a better understanding of the presentation and impact of dementia is essential to the future of public health. Dementia refers not to a single disorder but to a number of syndromes characterized by diverse behavioral, cognitive, and emotional impairments. Because dementia is costly in terms of both personal suffering and economic loss, an understanding of its prevalence, risk factors, and potential interventions is emerging as an increasingly important facet of public health and health care delivery. Recent advances in the understanding of its presentation, course, and relevant interventions have taken place.
We identified articles for review primarily by conducting a Medline search using the subject headings dementia, mild cognitive impairment, Alzheimer's disease, vascular dementia, frontotemporal dementia, and Lewy body dementia. Other relevant studies were elicited through a Medline search using the subject headings mental disorders and stigma.
Dementia represents a diverse category of syndromes characterized by deficits in memory, cognitive function, and behavior. Symptoms associated with dementia appear to be distributed along a continuum, with even subsyndromal presentations affecting the health of older adults and meriting intervention. To promote cognitive functioning and independence among older adults, public health interventions need to facilitate both early detection and treatment of dementia. The availability of adult day care and respite services is important in maintaining the health and quality of life of individuals caring for older adults with dementia. Recent advances in the treatment of dementia may slow the course of cognitive decline, thereby enhancing the quality of life of older individuals as well as decreasing costs associated with institutional care.
Despite the growing availability of pharmacologic and psychosocial interventions that are potentially helpful to people with dementia and their caregivers, the majority of older adults with dementia do not receive appropriate treatment. With the aging of the U.S. population, efforts to foster recognition of dementia and its treatments and to destigmatize them are emerging as an increasingly important facet of public health intervention.
随着美国人口老龄化，更好地了解痴呆症的表现和影响对公共卫生的未来至关重要。痴呆症并非指单一疾病，而是指一系列以多种行为、认知和情感障碍为特征的综合征。由于痴呆症在个人痛苦和经济损失方面代价高昂，了解其患病率、风险因素和潜在干预措施正成为公共卫生和医疗保健服务中日益重要的一个方面。目前在痴呆症的表现、病程及相关干预措施的认识上已有新进展。
我们主要通过使用主题词痴呆症、轻度认知障碍、阿尔茨海默病、血管性痴呆、额颞叶痴呆和路易体痴呆进行Medline检索来确定供审查的文章。通过使用主题词精神障碍和污名化进行Medline检索引出其他相关研究。
痴呆症是一类多样的综合征，其特征为记忆、认知功能和行为缺陷。与痴呆症相关的症状似乎呈连续分布，即使是亚综合征表现也会影响老年人的健康并值得干预。为促进老年人的认知功能和独立性，公共卫生干预措施需要推动痴呆症的早期发现和治疗。成人日托和临时护理服务的可获得性对于维持照顾痴呆症老年人的个人的健康和生活质量很重要。痴呆症治疗方面最近的进展可能会减缓认知衰退的进程，从而提高老年人的生活质量，并降低与机构护理相关的成本。
尽管越来越多的药物和心理社会干预措施可能对痴呆症患者及其护理人员有帮助，但大多数患有痴呆症的老年人并未得到适当治疗。随着美国人口老龄化，努力促进对痴呆症及其治疗方法的认识并消除对它们的污名化正成为公共卫生干预中日益重要的一个方面。
