a Institute for Health and Aging , University of California in San Francisco , CA , USA.
Aging Ment Health. 2014;18(3):269-75. doi: 10.1080/13607863.2013.837149. Epub 2013 Nov 1.
The increasing number of older adults with dementia is a large and growing public health problem. Alzheimer's disease, the prevailing form of dementia, is projected to quadruple worldwide. To date, the care and social integration of individuals with dementia is complicated by limited collaborations between biomedicine and other disciplines. The objective of this paper is therefore to reflect on the orientation of biomedicine with regard to the science of dementia, and to articulate a path for moving forward.
The authors drew upon, and expanded, the insights of an interdisciplinary, international workshop entitled 'Bioethics and the Science of Aging: The Case of Dementia' held in October 2012 at the University of California in Berkeley.
The care of individuals with dementia compels solid interdisciplinary collaborations. There are several issues affecting the care of individuals with dementia: (1) an evolving definition of dementia; (2) the ambiguous benefits of the diagnosis of dementia; (3) ethical conflicts concerning consent processes and clinical trials; and (4) a limited understanding of the perspective of the person with dementia.
We argue that it is time for a renewed dialogue between biomedicine and other disciplines -- particularly public health, the social sciences, the medical humanities and bioethics. This interdisciplinary dialogue would facilitate a process of self-reflection within biomedicine. This dialogue will also provide the foundation for equitable public health interventions and will further prioritize the values and preferences of individuals with dementia, as well as their care and social integration.
痴呆症老年患者人数不断增加,是一个重大且日益严重的公共卫生问题。阿尔茨海默病是痴呆症的主要形式,预计在全球范围内将增加三倍。迄今为止,由于生物医学与其他学科之间的合作有限,痴呆症患者的护理和社会融合变得复杂。因此,本文旨在反思生物医学对痴呆症科学的定位,并为前进指明道路。
作者借鉴并扩展了 2012 年 10 月在加利福尼亚大学伯克利分校举行的题为“生物伦理学与衰老科学:痴呆症案例”的跨学科国际研讨会的见解。
痴呆症患者的护理需要坚实的跨学科合作。有几个问题影响着痴呆症患者的护理:(1)痴呆症定义的不断演变;(2)痴呆症诊断的模糊益处;(3)与同意过程和临床试验有关的伦理冲突;(4)对痴呆症患者观点的理解有限。
我们认为,现在是生物医学与其他学科——特别是公共卫生、社会科学、医学人文和生物伦理学——之间重新开展对话的时候了。这种跨学科对话将促进生物医学内部的自我反思过程。这种对话还将为公平的公共卫生干预措施奠定基础,并进一步优先考虑痴呆症患者的价值观和偏好,以及他们的护理和社会融合。