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60岁以上患者认知功能衰退的早期检测筛查:老年护理研究。

Early Detection Screening of Cognitive Decline in Patients Over 60 Years: ELDERCARE Study.

作者信息

Putignano Salvatore, Forgione Luigi, Fusco Mariano, Giacummo Attilio, Magli Elisa, Marino Saverio, Marzano Raffaele, Putignano Daria, Santamaria Francesco, Spatarella Micaela, Santagada Vincenzo

机构信息

Associazione Geriatri Extraospedalieri a favore di Anziani Svantaggiati (A.G.E.A.S.), Naples, Italy.

Ordine dei Farmacisti della Provincia di Napoli, Naples, Italy.

出版信息

J Alzheimers Dis. 2024;98(1):145-150. doi: 10.3233/JAD-231295.

Abstract

BACKGROUND

Dementia is the fourth leading cause of death in people >  65 years old in western countries.

OBJECTIVE

This cross-sectional assisted survey aimed to evaluate a multidisciplinary team approach of specialists of the Associazione Geriatri Extraospedalieri a favore di Anziani Svantaggiati and pharmacists to facilitate progress in the early identification and management of cognitive decline in patients >  60 years.

METHODS

A multidisciplinary team conducted this cross-sectional assisted survey. Patients (>60 years) with independent and/or assisted walking, subjective memory impairment, mild cognitive impairment or mild Alzheimer's disease (AD) who regularly attended pharmacies underwent the survey. An internal medical examination, a cardiovascular visit, and a short neuropsychological evaluation were conducted for each patient. Demographic, anamnestic, and clinical data were collected anonymously.

RESULTS

279 eligible patients underwent the screening phase. 44% were overweight, 23% obese and 29% hypertensive. 62% of cases showed alterations of supra-aortic trunk with different percentages of stenosis. The neuropsychological evaluation highlighted that 67% of cases were normal according to age and education level, while 18% were in a state condition of cognitive frailty. Mild/moderate cognitive decline, or probably AD, was identified in 14% of cases.

CONCLUSIONS

A multidisciplinary collaboration between pharmacists and specialist medical doctors is essential in early identification of prodromal symptoms of cognitive impairment and AD. The Prompt detection of the condition in this group of patients allowed the specialists to recommend in-depth diagnostic tests and follow-up procedures to slow the course of the disease. This would give time to carry out adequate caregiver training.

摘要

背景

在西方国家,痴呆是65岁以上人群的第四大死因。

目的

这项横断面辅助调查旨在评估老年医学专家协会(Associazione Geriatri Extraospedalieri a favore di Anziani Svantaggiati)的专家和药剂师采用的多学科团队方法,以促进60岁以上患者认知功能下降的早期识别和管理。

方法

一个多学科团队开展了这项横断面辅助调查。对经常光顾药店的、能够独立行走和/或需要辅助行走、有主观记忆障碍、轻度认知障碍或轻度阿尔茨海默病(AD)的60岁以上患者进行调查。对每位患者进行内科检查、心血管检查和简短的神经心理学评估。人口统计学、既往史和临床数据均匿名收集。

结果

279名符合条件的患者进入筛查阶段。44%超重,23%肥胖,29%患有高血压。62%的病例显示主动脉弓上干有改变,狭窄百分比各不相同。神经心理学评估显示,67%的病例根据年龄和教育水平属于正常,而18%处于认知脆弱状态。14%的病例被确定为轻度/中度认知功能下降或可能患有AD。

结论

药剂师和专科医生之间的多学科合作对于早期识别认知障碍和AD的前驱症状至关重要。在这组患者中及时发现病情,使专家能够推荐深入的诊断测试和后续程序,以减缓疾病进程。这将有时间开展充分的护理人员培训。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5bd/11191486/4a5bcf936eff/jad-98-jad231295-g001.jpg

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