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预防痴呆症——一项针对三级内科门诊患者的横断面研究

Preventing Dementia-A Cross-Sectional Study of Outpatients in a Tertiary Internal Medicine Department.

作者信息

Sandu Ioana-Alexandra, Ștefăniu Ramona, Alexa-Stratulat Teodora, Ilie Adina-Carmen, Albișteanu Sabinne-Marie, Turcu Ana-Maria, Sandu Călina-Anda, Alexa Anisia-Iuliana, Pîslaru Anca-Iuliana, Grigoraș Gabriela, Ștefănescu Cristinel, Alexa Ioana-Dana

机构信息

Department of Medical Specialties II, University of Medicine and Pharmacy "Grigore T Popa", 700115 Iasi, Romania.

Geriatrics and Internal Medicine Department, "C. I. Parhon" Hospital, 700503 Iasi, Romania.

出版信息

J Pers Med. 2023 Nov 22;13(12):1630. doi: 10.3390/jpm13121630.

Abstract

Dementia is a significant health problem worldwide, being the seventh leading cause of death (2,382,000 deaths worldwide in 2016). Recent data suggest there are several modifiable risk factors that, if addressed, can decrease dementia risk. Several national dementia screening programs exist; however, limited-income countries do not have the means to implement such measures. We performed a prospective cross-sectional study in an outpatient department to identify individuals at risk for dementia. Patients with no known cognitive dysfunction seeking a medical consult were screened for dementia risk by means of the cardiovascular risk factors, ageing, and dementia (CAIDE) and modified CAIDE tests. Additionally, we collected demographic and clinical data and assessed each participant for depression, mental state, and ability to perform daily activities. Of the 169 patients enrolled, 63.3% were identified as being in the intermediate-risk or high-risk group, scoring more than seven points on the mCAIDE test. Over 40% of the elderly individuals in the study were assessed as "somewhat depressed" or "depressed" on the geriatric depression scale. Almost 10% of the study population was diagnosed de novo with cognitive dysfunction. In conclusion, using a simple questionnaire such as the mCAIDE in a predefined high-risk population is easy and does not represent a major financial burden. At-risk individuals can subsequently benefit from personalized interventions that are more likely to be successful. Limited-resource countries can implement such screening tools in outpatient clinics.

摘要

痴呆症是全球一个重大的健康问题,是第七大死因(2016年全球有238.2万人死亡)。最近的数据表明,有几个可改变的风险因素,若加以应对,可降低痴呆症风险。目前存在多个国家痴呆症筛查项目;然而,低收入国家没有能力实施此类措施。我们在一个门诊部进行了一项前瞻性横断面研究,以确定有痴呆症风险的个体。通过心血管危险因素、衰老和痴呆症(CAIDE)及改良CAIDE测试,对无已知认知功能障碍且寻求医疗咨询的患者进行痴呆症风险筛查。此外,我们收集了人口统计学和临床数据,并评估了每位参与者的抑郁情况、精神状态和日常生活活动能力。在纳入的169名患者中,63.3%被确定为处于中度风险或高风险组,在改良CAIDE测试中得分超过7分。在老年抑郁量表上,该研究中超过40%的老年人被评估为“有点抑郁”或“抑郁”。近10%的研究人群被新诊断为认知功能障碍。总之,在预先定义的高风险人群中使用如改良CAIDE这样简单的问卷很容易,且不会带来重大经济负担。有风险的个体随后可从更有可能成功的个性化干预中受益。资源有限的国家可以在门诊诊所实施此类筛查工具。

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