Jessen Frank
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Köln, Köln, Germany.
Fortschr Neurol Psychiatr. 2022 Jul;90(7-08):320-325. doi: 10.1055/a-1808-6459. Epub 2022 May 25.
English In 2019, key players from politics, society, social insurance providers, care and medicine initiated the process of developing the National Dementia Strategy under the leadership of the Federal Ministry of Health, the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth and the German Alzheimer's Association, and in 2020, the strategy was officially adopted. The National Dementia Strategy aims to improve the lives and care of people with dementia in Germany. To this end, four fields of action were defined, covering the areas of social participation, support and advice for people with dementia and their relatives, nursing and medical care, and research. A total of 27 goals with 162 concrete individual measures were formulated. An evaluation of the implementation is to take place in 2026. The breadth of the topics and also of the stakeholders involved are the the strengths of the dementia strategy. Unfortunately, there are no claims for improvement of inpatient geronto-psychiatric, neurological and geriatric care structures nor for adequate funding and integration of outpatient memory clinics into care. In connection with this, there is a conceptual lack of reference to the current medical understanding of dementia as a consequence of specific brain diseases with preclinical and mildly symptomatic courses before the dementia stage as well as to biomarker-based early diagnostics and to future molecular-specific disease-modifying treatments. Furthermore, there is a lack of a package of measures to exploit prevention potentials by reduction of risk factors for dementia at the population levels. Irrespective of this, the National Dementia Strategy is of great importance for patients and their caregivers. It can sustainably improve the living situation of people with dementia in Germany.
2019年,来自政治、社会、社会保险机构、护理和医学领域的关键参与者在联邦卫生部、联邦家庭事务、老年公民、妇女和青年部以及德国阿尔茨海默病协会的领导下,启动了国家痴呆症战略的制定进程,并于2020年正式通过该战略。国家痴呆症战略旨在改善德国痴呆症患者的生活和护理状况。为此,确定了四个行动领域,涵盖社会参与、为痴呆症患者及其亲属提供支持和咨询、护理和医疗以及研究。共制定了27项目标和162项具体的单独措施。将于2026年对实施情况进行评估。该痴呆症战略的优势在于主题的广度以及所涉及的利益相关者的范围。不幸的是,对于住院老年精神科、神经科和老年护理结构的改善,以及门诊记忆诊所的充足资金和融入护理体系,均未提出要求。与此相关的是,在概念上缺乏对痴呆症当前医学理解的参考,即痴呆症是由特定脑部疾病导致的,在痴呆症阶段之前有临床前和轻度症状阶段,以及缺乏基于生物标志物的早期诊断和未来分子特异性疾病修正治疗的参考。此外,还缺乏一套通过在人群层面降低痴呆症风险因素来挖掘预防潜力的措施。尽管如此,国家痴呆症战略对患者及其护理人员非常重要。它可以可持续地改善德国痴呆症患者的生活状况。