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痴呆症 IT 筛查系统 (DITS):通过家庭医生和痴呆症专家合作,利用当地社会资源进行痴呆症早期诊断的实际应用。

Dementia IT screening system (DITS): Practical use of local social resources for early diagnosis of dementia with collaboration between family physicians and dementia specialists.

机构信息

Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Tsu, Japan.

Dementia Center, Mie University Hospital, Tsu, Japan.

出版信息

Geriatr Gerontol Int. 2018 Apr;18(4):599-606. doi: 10.1111/ggi.13221. Epub 2018 Jan 2.

DOI:10.1111/ggi.13221
PMID:29292567
Abstract

AIM

To build a dementia screening system in the community to facilitate collaboration among patients/caregiver(s), family clinic physicians and memory clinic specialists.

METHODS

We placed a Dementia Network Promoter (DNP) in four cities in Mie prefecture, Japan. Based on requests from patients/caregiver(s), family clinic physicians ordered dementia screening from the DNP. The DNP carried out screenings at the clinic using an IT device (iPad), and sent the results to a dementia specialist at the Mie University Hospital Dementia Center. The dementia specialist assessed the results of the screening tests, and made a treatment recommendation for a follow-up consultation with a memory clinic or continuing observation by the family clinic. The DNP reported the recommendation of the dementia specialist to the family clinic physician, who provided this information to the patients/caregiver(s). We investigated the characteristics of the patients referred for consultation with the memory clinic.

RESULTS

A total of 158 patients participated in the screening. The majority of patients were in vulnerable living situations characterized by minimal social and family support. The mean score on the Mini-Mental State Examination was 24.1 ± 5.2. Of patients screened, 62% were referred for consultation at the memory clinic, and 57% of those referred completed a consultation at the memory clinic. Patients referred to the memory clinic showed significantly worse cognitive function and ability to complete activities of daily living.

CONCLUSIONS

A dementia screening system might facilitate early consultation and intervention for patients with dementia, and build a more effective network to connect families and memory clinics. Geriatr Gerontol Int 2018; 18: 599-606.

摘要

目的

建立社区痴呆症筛查系统,促进患者/照顾者、家庭诊所医生和记忆诊所专家之间的合作。

方法

我们在日本三重县的四个城市安置了一名痴呆症网络推动者(DNP)。根据患者/照顾者、家庭诊所医生的要求,DNP 从 DNP 处订购痴呆症筛查。DNP 在诊所使用 IT 设备(iPad)进行筛查,并将结果发送到三重大学医院痴呆症中心的痴呆症专家处。痴呆症专家评估筛查测试的结果,并为与记忆诊所的后续咨询或家庭诊所的持续观察做出治疗建议。DNP 将痴呆症专家的建议报告给家庭诊所医生,家庭诊所医生将该信息提供给患者/照顾者。我们调查了转诊至记忆诊所的患者的特征。

结果

共有 158 名患者参加了筛查。大多数患者处于社会和家庭支持最少的脆弱生活状况。简易精神状态检查的平均得分为 24.1±5.2。在接受筛查的患者中,62%被转诊至记忆诊所,其中 57%的转诊患者完成了记忆诊所的咨询。转诊至记忆诊所的患者认知功能和日常生活活动能力明显较差。

结论

痴呆症筛查系统可能有助于为痴呆症患者提供早期咨询和干预,并建立一个更有效的网络,将家庭和记忆诊所联系起来。老年医学与老年病学国际 2018;18:599-606。

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