Rabheru Kiran
Vancouver General, UBC and Riverview Hospitals, Vancouver, BC, Canada.
Can J Neurol Sci. 2007 Mar;34 Suppl 1:S62-6. doi: 10.1017/s031716710000559x.
This new section to the guidelines was added due to the recognition that clinical milestones are useful indices of the progression of dementia in patients with Alzheimer's disease and could help in the development of stage-specific targeted therapy. This review specifically looks at clinical milestones that could be used in clinical trials, such as global function, function, behaviour, caregiver burden, and quality of life milestones. It also addresses the possible use of biological and surrogate markers for use as milestones--which may eventually replace clinical milestones. It concludes that current definitions of dementia must be broadened beyond cognition alone to include some of the domains listed.
之所以在指南中新增这一部分内容,是因为认识到临床里程碑是阿尔茨海默病患者痴呆进展的有用指标,有助于制定针对特定阶段的靶向治疗。本综述特别关注可用于临床试验的临床里程碑,如整体功能、功能、行为、照料者负担和生活质量里程碑。它还探讨了将生物标志物和替代标志物用作里程碑的可能性——这些标志物最终可能会取代临床里程碑。结论是,目前痴呆的定义必须从仅关注认知扩展到纳入所列的一些领域。