Chassagne Philippe, Idrissi-Kassimy Fatiha, Rigal Olivier
Service de Médecine Interne Gériatrique, UPCOG, CHU de Rouen, France.
Psychol Neuropsychiatr Vieil. 2008 Mar;6(1):43-8. doi: 10.1684/pnv.2008.0111.
Epidemiological data suggest a strong association between aging, dementia and comorbidity such as cancer, chronic renal failure or undernourishment. These chronic conditions may lead to invasive diagnosis procedures as well as to difficult therapeutic management. When they occur in elderly patients with cognitive disorders or dementia, physicians and caregivers should apply specific care program. For example, if an adjuvant chimiotherapy is discussed for an old demented patient with cancer, informed consent and details about the treatment program should be carefully provide. At the onset of a chronic disease, the assessment of its prognosis as well as its impact on the autonomy or quality of life is particular when the patient is also demented. We discuss the specific characteristics about management of demented elderly patients who require high risk treatment because of severe and lethal diseases.
流行病学数据表明，衰老、痴呆与诸如癌症、慢性肾衰竭或营养不良等合并症之间存在密切关联。这些慢性病可能导致侵入性诊断程序以及复杂的治疗管理。当它们发生在患有认知障碍或痴呆的老年患者中时，医生和护理人员应采用特定的护理方案。例如，如果要为一名患有癌症的老年痴呆患者讨论辅助化疗，应仔细提供知情同意书和治疗方案的详细信息。在慢性病发作时，当患者同时患有痴呆症时，对其预后以及对自主性或生活质量的影响进行评估尤为重要。我们讨论了因严重致命疾病而需要进行高风险治疗的老年痴呆患者管理的具体特征。
