对认知功能减退和痴呆的老年人自杀意念及行为评估的考量
Considerations for the assessment of suicidal ideation and behavior in older adults with cognitive decline and dementia.
作者信息
Alphs Larry, Brashear H Robert, Chappell Phillip, Conwell Yeates, Dubrava Sarah, Khin Ni A, Kozauer Nicholas, Hartley Dean M, Miller David S, Schindler Rachel J, Siemers Eric R, Stewart Michelle, Yaffe Kristine
机构信息
Janssen Scientific Affairs, LLC, Titusville, NJ, USA.
Janssen Alzheimer Immunotherapy & Research & Development, LLC, South San Francisco, CA, USA.
出版信息
Alzheimers Dement (N Y). 2016 Feb 23;2(1):48-59. doi: 10.1016/j.trci.2016.02.001. eCollection 2016 Jan.
INTRODUCTION
Better understanding of suicide risk and its management in older adults with cognitive impairment and/or dementia remain significant unmet public health needs. Urgency to address them derives from concern that CNS treatments for dementia may impact suicide risk. Regulatory guidances requiring assessment of emergent suicidal ideation and behavior (SI/SB) at every clinical trial visit emphasize the need for understanding their prevalence.
METHODS
The literature regarding SI/SB in older persons with cognitive impairment or dementia was reviewed by an Alzheimer's Association Taskforce with emphasis on epidemiology, classification, assessment, and regulatory requirements.
RESULTS
Gaps in our knowledge were identified, challenges discussed and recommendations for future work provided.
DISCUSSION
Currently available SI/SB data from geriatric persons with dementia do not provide adequate understanding of its epidemiology, identification, assessment, or management. The growing public health burden of this population requires greater attention from clinicians and researchers on tactics and assessment tools to meet these needs.
引言
更好地了解认知障碍和/或痴呆症老年患者的自杀风险及其管理，仍然是重大的未满足的公共卫生需求。解决这些问题的紧迫性源于对痴呆症中枢神经系统治疗可能影响自杀风险的担忧。监管指南要求在每次临床试验访视时评估紧急自杀意念和行为（SI/SB），这强调了了解其患病率的必要性。
方法
阿尔茨海默病协会特别工作组对有关认知障碍或痴呆症老年人SI/SB的文献进行了综述，重点关注流行病学、分类、评估和监管要求。
结果
确定了我们知识上的差距，讨论了挑战，并提供了未来工作的建议。
讨论
目前来自痴呆症老年患者的SI/SB数据未能充分了解其流行病学、识别、评估或管理。这一人群日益增加的公共卫生负担需要临床医生和研究人员更加关注满足这些需求的策略和评估工具。
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