Poon Ngar Yee, Ooi Chun How, How Choon How, Yoon Peng Soon
Department of Psychological Medicine, Changi General Hospital, Singapore.
Department of Geriatric Medicine, Changi General Hospital, Singapore.
Singapore Med J. 2018 Jun;59(6):295-299. doi: 10.11622/smedj.2018070.
With the increasing life expectancy and ageing population in Singapore, we are likely to see more patients with dementia seeking help from their primary care clinicians. Acetylcholinesterase inhibitors and N-Methyl-D-aspartate receptor antagonists for dementia management can be costly given their modest efficacy, and it is important to discuss the risks and benefits with patients before a shared decision is made. Non-pharmacological management such as regular structured routine, good sleep hygiene, reminiscence and other activities are also useful in improving the well-being of dementia patients. Caregivers and family members can be advised on what to watch out for to keep patients safe at home and outdoors, as dementia patients have poor safety awareness. The primary care clinician can manage depression, if present, and refer the patient to memory clinics or appropriate specialist clinics for further assessment when indicated.
随着新加坡人均寿命的延长和人口老龄化,我们可能会看到更多痴呆症患者向基层医疗临床医生寻求帮助。用于痴呆症治疗的乙酰胆碱酯酶抑制剂和N-甲基-D-天冬氨酸受体拮抗剂,鉴于其疗效有限,费用可能较高,因此在做出共同决策之前,与患者讨论风险和益处很重要。非药物管理,如定期结构化日常活动、良好的睡眠卫生习惯、回忆及其他活动,对改善痴呆症患者的健康状况也很有用。鉴于痴呆症患者安全意识较差,可就居家和户外保障患者安全的注意事项向护理人员和家庭成员提供建议。基层医疗临床医生可处理患者出现的抑郁症状,并在有指征时将患者转介至记忆诊所或合适的专科诊所进行进一步评估。