Cheshire Home (Shatin), Hospital Authority, Hong Kong.
School of Health Sciences, Caritas Institute of Higher Education, Hong Kong.
Hong Kong Med J. 2019 Dec;25(6):473-482. doi: 10.12809/hkmj198073. Epub 2019 Dec 4.
Dementia is one of the most costly, disabling diseases associated with ageing, yet it remains underdiagnosed in primary care. In this article, we present the comprehensive approach illustrated with a classical case for diagnosing dementia which can be applied by healthcare professionals in primary care. This diagnostic approach includes history taking and physical examination, cognitive testing, informant interviews, neuropsychological testing, neuroimaging, and the utility of cerebrospinal fluid biomarkers. For the differential diagnosis of cognitive impairment, the differences and similarities among normal ageing, mild cognitive impairment, depression, and delirium are highlighted. As primary care physicians are playing an increasingly prominent role in the caring of elderly patients in an ageing population, their role in the diagnosis of dementia should be strengthened in order to provide a quality care for patients with dementia.
痴呆症是与衰老相关的最昂贵、最致残的疾病之一，但在初级保健中仍未得到充分诊断。在本文中，我们展示了一种全面的诊断方法，并通过一个经典病例进行了说明，该方法可由初级保健中的医疗保健专业人员应用。这种诊断方法包括病史采集和体格检查、认知测试、知情人访谈、神经心理学测试、神经影像学以及脑脊液生物标志物的应用。为了对认知障碍进行鉴别诊断，突出了正常衰老、轻度认知障碍、抑郁和谵妄之间的差异和相似之处。由于初级保健医生在老龄化人口中对老年患者的护理中发挥着越来越重要的作用，他们在痴呆症诊断中的作用应该得到加强，以便为痴呆症患者提供优质的护理。
