Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, UK.
Center for Observational and Real-World Evidence, Merck & Co., Inc., Kenilworth, NJ, USA.
J Alzheimers Dis. 2018;62(1):457-466. doi: 10.3233/JAD-170864.
To ensure that patients with dementia and their caregivers receive appropriate treatment and support, early diagnosis is essential but remains challenging. Real-world data from a multi-national, cross-sectional survey of physicians and their patients were analyzed to quantify the diagnostic pathway for dementia, including a focus on severity of patients' cognitive impairment (CI) at the time of symptom onset, referral and subsequent diagnosis. Data were collected for 7,620 patients with CI. Most patients saw a healthcare professional within 1 year of first symptoms and received a diagnosis within 3-7 months of initial consultation. However, only 20% of patients received a diagnosis before their disease progressed beyond the prodromal stage and 23.5% already had moderate CI at diagnosis. These findings show that the goal of identifying and diagnosing CI at the earliest stages of disease is, for many patients, not achieved. Efforts toward public awareness and proactive, earlier detection and intervention, must be maintained-indeed where possible invigorated.
为确保痴呆症患者及其照护者得到适当的治疗和支持，早期诊断至关重要，但仍具有挑战性。对来自多个国家的医生及其患者的横断面调查的真实世界数据进行了分析，以量化痴呆症的诊断途径，包括关注患者症状发作时认知障碍（CI）的严重程度、就诊时的转诊情况以及随后的诊断。共收集了 7620 名 CI 患者的数据。大多数患者在出现首发症状后 1 年内看了医疗保健专业人员，并在初次就诊后 3-7 个月内得到了诊断。然而，只有 20%的患者在疾病进展到前驱期之前得到了诊断，23.5%的患者在诊断时已经有中度 CI。这些发现表明，对于许多患者来说，在疾病的最早阶段识别和诊断 CI 的目标并未实现。必须继续努力提高公众意识，并积极主动地更早地发现和干预疾病——实际上在可能的情况下，还需加强这些努力。
