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识别中低收入国家阿尔茨海默病及相关痴呆症研究和管理中的差距和障碍:对卫生专业人员和研究人员的调查。

Identifying Gaps and Barriers in Alzheimer's Disease and Related Dementia Research and Management in Low- and Middle-Income Countries: A Survey of Health Professionals and Researchers.

机构信息

Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.

Institute of Public Health, Washington University, St. Louis, MO, USA.

出版信息

J Alzheimers Dis. 2024;101(4):1307-1320. doi: 10.3233/JAD-240650.

Abstract

BACKGROUND

The significant increase in Alzheimer's disease and related dementia prevalence is a global health crisis, acutely impacting low- and lower-middle and upper-middle-income countries (LLMICs/UMICs).

OBJECTIVE

The objective of this study is to identify key barriers and gaps in dementia care and research in LLMICs and UMICs.

METHODS

We conducted an international, cross-sectional survey among clinicians and healthcare professionals (n = 249 in 34 countries) across LLMICs and UMICs, exploring patient demographics, use of clinical diagnosis, dementia evaluation, screening/evaluation tools, and care and treatment.

RESULTS

Significant disparities were found in diagnostic practices, access to assessments, and access to care. On average, clinicians in LLMICs saw more patients, had less time for evaluations, lower use of formal screening and tools, and less access to biomarkers. They were also under-resourced compared to UMICs.

CONCLUSIONS

The findings provide insights for policymakers, healthcare organizations, and researchers to address the complex challenges associated with dementia care in diverse settings. Addressing these challenges requires a multipronged approach involving local, national, and international stakeholders.

摘要

背景

阿尔茨海默病和相关痴呆症患病率的显著增加是一个全球性的健康危机,严重影响了低收入和中低收入国家(LMICs/UMICs)。

目的

本研究旨在确定 LLMICs 和 UMICs 中痴呆症护理和研究的主要障碍和差距。

方法

我们对 LLMICs 和 UMICs 中的临床医生和医疗保健专业人员(n=34 个国家的 249 名)进行了一项国际、横断面调查,探讨了患者人口统计学、临床诊断的使用、痴呆评估、筛查/评估工具以及护理和治疗情况。

结果

在诊断实践、评估机会和护理机会方面存在显著差异。平均而言,LMICs 的临床医生看诊的患者更多,用于评估的时间更少,更不常使用正式的筛查和工具,获得生物标志物的机会也更少。与 UMICs 相比,他们的资源也更少。

结论

这些发现为政策制定者、医疗保健组织和研究人员提供了见解,以解决在不同环境中与痴呆症护理相关的复杂挑战。应对这些挑战需要采取多管齐下的方法,涉及地方、国家和国际利益相关者。

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