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真实世界中轻度认知障碍患者的管理:一项意大利调查。

Real-life management of patients with mild cognitive impairment: an Italian survey.

机构信息

Neurology Clinic, Department of Medicine and Aging Sciences, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy.

Neurology Clinic, Department of Neuroscience and Padova Neuroscience Center (PNC), University of Padova, Padua, Italy.

出版信息

Neurol Sci. 2024 Sep;45(9):4279-4289. doi: 10.1007/s10072-024-07478-9. Epub 2024 Mar 25.

Abstract

BACKGROUND

Mild cognitive impairment (MCI) is a syndrome with heterogeneous underlying causes and different rates of disease progression, whose clinical heterogeneity leads to a wide variation in diagnostic and therapeutic approaches in clinical practice. The lack of uniform practical recommendations on diagnostic workup and treatment for MCI patients hinders optimal management of these patients, worsening their prognosis. Standardized guidelines for the investigation and follow-up of MCI are therefore urgently required.

AIM

Aim of our study was to assess the diagnostic and therapeutic approach to MCI patients in the setting of Italian Memory Clinics.

METHODS

A survey was delivered to a sample of Italian neurologists through two different phases: a first exploratory phase recording general information about the usual clinical management of patients with MCI, and a subsequent operative phase assessing the practical diagnostic and therapeutic decisions taken in a real life setting to manage subjects with MCI.

RESULTS

A total of 121 neurologists participated to the first phase of the survey and 203 patients were enrolled in the second phase. Information gathered in the first phase of the survey highlighted a non-uniform use of diagnostic criteria and procedures for MCI, as well as a very heterogeneous therapeutic strategy among Italian neurologists. In the second phase, recorded data on diagnostic and therapeutic approach confirmed the large variability observed in the first phase of the survey.

CONCLUSIONS

The results of our study reflect a suboptimal management of MCI patients in Italy and highlight the need of standardized diagnostic and therapeutic approaches for this condition.

摘要

背景

轻度认知障碍(MCI)是一种综合征,其潜在病因具有异质性,疾病进展速度也不同,其临床异质性导致临床实践中诊断和治疗方法存在广泛差异。由于缺乏针对 MCI 患者的诊断评估和治疗的统一实用建议,因此无法对这些患者进行最佳管理,从而导致其预后恶化。因此,迫切需要制定针对 MCI 的调查和随访的标准化指南。

目的

我们的研究旨在评估意大利记忆诊所中 MCI 患者的诊断和治疗方法。

方法

通过两个不同阶段向意大利神经科医生样本发送了一项调查:第一阶段为探索性阶段,记录了关于 MCI 患者常规临床管理的一般信息;第二阶段为操作性阶段,评估了在实际情况下管理 MCI 患者时所做出的实际诊断和治疗决策。

结果

共有 121 名神经科医生参加了调查的第一阶段,有 203 名患者参加了第二阶段。第一阶段调查中收集的信息突出了 MCI 的诊断标准和程序使用不统一,以及意大利神经科医生之间非常异质的治疗策略。在第二阶段,记录的诊断和治疗方法数据证实了在调查的第一阶段观察到的巨大差异。

结论

我们的研究结果反映了意大利 MCI 患者管理的不理想情况,并强调了针对这种疾病需要标准化的诊断和治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea33/11306749/17d393f240ca/10072_2024_7478_Fig1_HTML.jpg

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