Banner Alzheimer's Institute, University of Arizona College of Medicine, 901 E. Willetta St, Phoenix, AZ, 85006, USA.
Primary Care Education Consortium, 608 Wateree Key Court, Winnsboro, SC, 29180, USA.
BMC Psychiatry. 2023 Oct 4;23(1):716. doi: 10.1186/s12888-023-05129-5.
Alzheimer's disease (AD) is a progressive neurological disorder and the most common cause of dementia. The clinical continuum of AD ranges from asymptomatic disease to mild cognitive impairment (MCI), followed by AD dementia, categorized as mild, moderate, or severe. Almost one-third of patients suspected of having MCI or mild AD dementia are referred to specialists including psychiatrists. We sought to better understand the role that psychiatrists play in the diagnosis, treatment, and management of patients with all-cause MCI or mild AD dementia.
We conducted an anonymous, online survey among physicians in the United States between February 4, 2021, and March 1, 2021. We surveyed psychiatrists, primary care physicians (PCPs), geriatricians, and neurologists who treat patients with all-cause MCI or mild AD dementia.
A total of 301 physicians participated in the survey, 50 of whom were psychiatrists. Of their patients with all-cause MCI or mild AD dementia, psychiatrists reported personally diagnosing two-thirds (67%). Psychiatrists used various methods to diagnose MCI or mild AD dementia including mental status testing (94%), review of patient medical history (86%), and neurological exams (61%). Upon diagnosis, psychiatrists reported most commonly discussing treatments (86%), management strategies (80%), disease progression (72%), and etiology of MCI or mild AD dementia (72%) with their patients. Most psychiatrists surveyed (82%) reported receiving advanced formal training in MCI and AD dementia care, primarily via residency training (38%), continuing medical education (22%) or fellowship (18%). Additionally, almost all psychiatrists (92%) reported receiving referrals for ongoing management of patients with MCI or mild AD dementia, primarily from PCPs or neurologists. However, only 46% of psychiatrists viewed themselves as the coordinator of care for their patients with MCI or mild AD dementia.
Many psychiatrists indicated that they were well-informed about MCI and AD dementia and have a strong interest in providing care for these patients. They can provide timely and accurate diagnosis of clinical MCI and mild AD dementia and develop optimal treatment plans for patients. Although many psychiatrists consider other physicians to be the care coordinators for patients with MCI and mild AD dementia, psychiatrists can play a key role in diagnosing and managing patients with MCI and mild AD dementia.
阿尔茨海默病（AD）是一种进行性神经退行性疾病，也是痴呆症的最常见病因。AD 的临床连续谱从无症状疾病到轻度认知障碍（MCI），然后是 AD 痴呆症，分为轻度、中度或重度。几乎三分之一被怀疑患有 MCI 或轻度 AD 痴呆症的患者会被转介给包括精神科医生在内的专家。我们试图更好地了解精神科医生在诊断、治疗和管理所有病因的 MCI 或轻度 AD 痴呆症患者方面所扮演的角色。
我们于 2021 年 2 月 4 日至 2021 年 3 月 1 日期间在美国的医生中进行了一项匿名在线调查。我们调查了治疗所有病因的 MCI 或轻度 AD 痴呆症患者的精神科医生、初级保健医生（PCP）、老年病医生和神经科医生。
共有 301 名医生参与了这项调查，其中 50 名为精神科医生。他们的所有病因的 MCI 或轻度 AD 痴呆症患者中，精神科医生报告亲自诊断了三分之二（67%）。精神科医生使用各种方法诊断 MCI 或轻度 AD 痴呆症，包括精神状态测试（94%）、患者病史回顾（86%）和神经系统检查（61%）。在诊断后，精神科医生报告最常与患者讨论治疗（86%）、管理策略（80%）、疾病进展（72%）和 MCI 或轻度 AD 痴呆症的病因（72%）。接受调查的大多数精神科医生（82%）报告说，他们接受了 MCI 和 AD 痴呆症护理方面的高级正规培训，主要通过住院医师培训（38%）、继续医学教育（22%）或奖学金（18%）。此外，几乎所有的精神科医生（92%）都报告说，他们收到了正在接受 MCI 或轻度 AD 痴呆症管理的患者的转介，主要来自 PCP 或神经科医生。然而，只有 46%的精神科医生认为自己是 MCI 或轻度 AD 痴呆症患者护理的协调者。
许多精神科医生表示，他们对 MCI 和 AD 痴呆症有充分的了解，并对为这些患者提供护理有浓厚的兴趣。他们可以为临床 MCI 和轻度 AD 痴呆症患者提供及时、准确的诊断，并为患者制定最佳治疗方案。尽管许多精神科医生认为其他医生是 MCI 和轻度 AD 痴呆症患者的护理协调者，但精神科医生可以在诊断和管理 MCI 和轻度 AD 痴呆症患者方面发挥关键作用。
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