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优化衰老大脑:预防痴呆症的 BEAD 研究中的伦理学问题。

Optimizing the Aging Brain: The BEAD Study on the Ethics of Dementia Prevention.

机构信息

Alessandro Blasimme, ETH Zurich, Zurich, Switzerland,

出版信息

J Frailty Aging. 2023;12(2):111-116. doi: 10.14283/jfa.2023.6.

Abstract

Dementia has lately undergone a profound reconceptualization. Long conceived of as an unpreventable process of mental deterioration, current evidence shows that it can be prevented in at least one in three cases intervening on a specified set of factors. Issues of justice and equity loom large on the implementation of dementia prevention, from a global health perspective. Our project thus embraces emerging evidence about dementia risk factors and their uneven distribution nationally and globally by specifically focusing on the situated aspects of dementia prevention. The aim of the BEAD study (Optimizing the Aging Brain? Situating Ethical Aspects in Dementia Prevention) is to dissect the ethical and clinical assumptions of this novel understanding of dementia, and to analyze how such new discourse on dementia prevention plays out in three countries: Canada, Germany and Switzerland. This study adopts a multi-perspective, comparative, qualitative approach, combining stakeholder interviews with different kinds of focused ethnographies, elaborating on conceptual, ethical, and social aspects of what we would like to call the "new dementia". By situating the paradigmatic shifts in Alzheimer's and dementia research within current aging cultures and contemporary social policies, we aim to initiate a debate about the often implicit unresolved social, ethical, and political implications and preconditions of the medical understanding and handling of cognitive disorders.

摘要

近年来,痴呆症经历了深刻的概念重构。长期以来,人们认为痴呆症是一种不可预防的精神衰退过程,但现有证据表明,至少可以在三分之一的病例中通过干预一系列特定因素来预防痴呆症。从全球卫生的角度来看,在实施痴呆症预防措施方面,公平和公正问题显得尤为突出。我们的项目因此接受了关于痴呆症风险因素及其在国家和全球范围内分布不均的新证据,特别是通过专门关注痴呆症预防的具体方面。BEAD 研究(优化衰老大脑?在痴呆症预防中定位伦理方面)的目的是剖析这种对痴呆症新认识的伦理和临床假设,并分析这种关于痴呆症预防的新论述在加拿大、德国和瑞士这三个国家的具体表现。本研究采用多视角、比较、定性的方法,将利益攸关方访谈与不同类型的重点民族志相结合,深入阐述了我们所谓的“新痴呆症”的概念、伦理和社会方面。通过将阿尔茨海默病和痴呆症研究中的范式转变置于当前的老龄化文化和当代社会政策中,我们旨在引发一场关于医学理解和处理认知障碍所隐含的未解决的社会、伦理和政治影响和前提的辩论。

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