Morley John E, Morris John C, Berg-Weger Marla, Borson Soo, Carpenter Brian D, Del Campo Natalia, Dubois Bruno, Fargo Keith, Fitten L Jaime, Flaherty Joseph H, Ganguli Mary, Grossberg George T, Malmstrom Theodore K, Petersen Ronald D, Rodriguez Carroll, Saykin Andrew J, Scheltens Philip, Tangalos Eric G, Verghese Joe, Wilcock Gordon, Winblad Bengt, Woo Jean, Vellas Bruno
Divisions of Geriatric Medicine and Endocrinology, Saint Louis University School of Medicine, St Louis, MO.
Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, MO.
J Am Med Dir Assoc. 2015 Sep 1;16(9):731-9. doi: 10.1016/j.jamda.2015.06.017.
Cognitive impairment creates significant challenges for patients, their families and friends, and clinicians who provide their health care. Early recognition allows for diagnosis and appropriate treatment, education, psychosocial support, and engagement in shared decision-making regarding life planning, health care, involvement in research, and financial matters. An IAGG-GARN consensus panel examined the importance of early recognition of impaired cognitive health. Their major conclusion was that case-finding by physicians and health professionals is an important step toward enhancing brain health for aging populations throughout the world. This conclusion is in keeping with the position of the United States' Centers for Medicare and Medicaid Services that reimburses for detection of cognitive impairment as part the of Medicare Annual Wellness Visit and with the international call for early detection of cognitive impairment as a patient's right. The panel agreed on the following specific findings: (1) validated screening tests are available that take 3 to 7 minutes to administer; (2) a combination of patient- and informant-based screens is the most appropriate approach for identifying early cognitive impairment; (3) early cognitive impairment may have treatable components; and (4) emerging data support a combination of medical and lifestyle interventions as a potential way to delay or reduce cognitive decline.
认知障碍给患者及其家人、朋友以及提供医疗保健服务的临床医生带来了重大挑战。早期识别有助于进行诊断、采取适当治疗、开展教育、提供心理社会支持，并让患者参与有关生活规划、医疗保健、参与研究和财务事宜的共同决策。一个国际老年病学和老年医学协会-全球老龄化研究网络（IAGG-GARN）共识小组研究了早期识别认知健康受损的重要性。他们的主要结论是，医生和卫生专业人员进行病例筛查是改善全球老年人口脑健康的重要一步。这一结论与美国医疗保险和医疗补助服务中心的立场一致，该中心将认知障碍检测纳入医疗保险年度健康检查的报销范围，也与国际上呼吁将早期检测认知障碍作为患者权利的要求相符。该小组就以下具体发现达成了一致：（1）有经过验证的筛查测试，实施时间为3至7分钟；（2）结合患者自评和他人报告的筛查方法是识别早期认知障碍的最合适方法；（3）早期认知障碍可能有可治疗的因素；（4）新出现的数据支持将医学干预和生活方式干预相结合，作为延缓或减少认知衰退的一种潜在方法。
