痴呆症的影响：健康差距、人口趋势、护理干预措施和经济成本。
Impact of dementia: Health disparities, population trends, care interventions, and economic costs.
机构信息
University of Southern California, Los Angeles, California, USA.
LEAD Coalition (Leaders Engaged on Alzheimer's Disease), Washington, District of Columbia, USA.
出版信息
J Am Geriatr Soc. 2021 Jul;69(7):1774-1783. doi: 10.1111/jgs.17345.
INTRODUCTION
The dementia experience is not a monolithic phenomenon-and while core elements of dementia are considered universal-people living with dementia experience the disorder differently. Understanding the patterning of Alzheimer's disease and related dementias (ADRD) in the population with regards to incidence, risk factors, impacts on dementia care, and economic costs associated with ADRD can provide clues to target risk and protective factors for all populations as well as addressing health disparities.
METHODS
We discuss information presented at the 2020 National Research Summit on Care, Services, and Supports for Persons with Dementia and Their Caregivers, Theme 1: Impact of Dementia. In this article, we describe select population trends, care interventions, and economic impacts, health disparities and implications for future research from the perspective of our diverse panel comprised of academic stakeholders, and persons living with dementia, and care partners.
RESULTS
Dementia incidence is decreasing yet the advances in population health are uneven. Studies examining the educational, geographic and race/ethnic distribution of ADRD have identified clear disparities. Disparities in health and healthcare may be amplified by significant gaps in the evidence base for pharmacological and non-pharmacological interventions. The economic costs for persons living with dementia and the value of family care partners' time are high, and may persist into future generations.
CONCLUSIONS
Significant research gaps remain. Ensuring that ADRD healthcare services and long-term care services and supports are accessible, affordable, and effective for all segments of our population is essential for health equity. Policy-level interventions are in short supply to redress broad unmet needs and systemic sources of disparities. Whole of society challenges demand research producing whole of society solutions. The urgency, complexity, and scale merit a "whole of government" approach involving collaboration across numerous federal agencies.
简介
痴呆症的体验并不是一个单一的现象——尽管痴呆症的核心元素被认为是普遍存在的，但患有痴呆症的人对这种疾病的体验却各不相同。了解人群中阿尔茨海默病及相关痴呆症（ADRD）的发病模式、风险因素、对痴呆症护理的影响以及与 ADRD 相关的经济成本，可以为所有人群提供目标风险和保护因素的线索，以及解决健康差异问题。
方法
我们讨论了 2020 年全国痴呆症患者及其护理人员护理、服务和支持研究峰会的信息，主题 1：痴呆症的影响。在本文中，我们从由学术利益相关者、痴呆症患者和护理伙伴组成的多元化小组的角度，描述了一些人口趋势、护理干预措施和经济影响、健康差异以及对未来研究的影响。
结果
痴呆症的发病率正在下降，但人口健康的进步并不均衡。研究检查了 ADRD 的教育、地理和种族/民族分布，发现了明显的差异。在药物和非药物干预的证据基础方面存在显著差距，这可能会放大健康和医疗保健方面的差异。痴呆症患者和家庭护理伙伴的时间的经济成本很高，并且可能会持续到未来几代。
结论
仍存在重大的研究差距。确保 ADRD 医疗服务和长期护理服务和支持对我们人口的所有群体都是可及、负担得起和有效的，对于实现健康公平至关重要。政策层面的干预措施很少，无法解决广泛的未满足需求和系统性的差异来源。全社会的挑战需要研究产生全社会的解决方案。这种紧迫性、复杂性和规模需要采取“整个政府”的方法，涉及众多联邦机构的合作。
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