Stancu Patrick, Hentsch Lisa, Seeck Margitta, Zekry Dina, Graf Christophe, Fleury Vanessa, Assal Frédéric
Division of Neurology, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland.
Division of Palliative Medicine, Department of Rehabilitation, and Geriatrics, Geneva University Hospitals, Geneva, Switzerland.
Neurodegener Dis. 2025;25(1):14-20. doi: 10.1159/000540972. Epub 2024 Oct 4.
Over the past few decades, advances in the neurology of aging have been considerable and have led to a better understanding of the science of age-related neurological disorders. Likewise, it changed the perception of classical neurology practice, research, and the way of looking at age-related conditions. Neurological disorders are the most frequent cause of major disability in the elderly and account for almost half of the incapacitation occurring beyond age 65 and more than 90% of serious dependency. However, a number of neurological changes occur also in the absence of a specific disease, making the assessment and management of neurological complaints and findings a specific expertise.
Maximizing success in clinical care of the elderly requires expertise in geriatric neurology, which includes an understanding of current research regarding aging and age-related neurological dysfunctions, and the ability to work with other geriatric healthcare providers. Although current therapies for neurodegenerative diseases mainly offer symptomatic relief without slowing progression, the landscape is evolving. Biomarkers of pathology and neuroimaging have continued to develop, with a significant impact on diagnosis and treatment. These advances have not only helped to improve our knowledge of disease pathophysiology but also disease stages, guiding symptomatic monitoring, and possible therapeutic options at a pre-symptomatic stage.
Neurological disorders are a leading cause of major disability and dependency in the elderly, underscoring the need for expertise in geriatric neurology for effective clinical care of this population. Although current therapies for neurodegenerative diseases primarily provide symptomatic relief without slowing disease progression, advancements in biomarkers and neuroimaging are significantly evolving. These advancements enhance our understanding of disease pathophysiology and stages, guiding symptomatic monitoring and potential therapeutic options at a pre-symptomatic stage. As knowledge about age-associated conditions is steadily rising and geriatric medicine gains further recognition, this article argues for a new focus on the role of neurologists in geriatric medicine, emphasizing the importance of integrating current research and collaborative care approaches in the management of elderly patients.
在过去几十年中,衰老神经学取得了显著进展,使人们对与年龄相关的神经障碍科学有了更好的理解。同样,它改变了对经典神经学实践、研究以及看待与年龄相关病症方式的认知。神经障碍是老年人严重残疾的最常见原因,几乎占65岁以上人群失能情况的一半,以及严重依赖情况的90%以上。然而,在没有特定疾病的情况下也会发生一些神经变化,这使得对神经症状和发现的评估与管理成为一项特殊的专业技能。
在老年人临床护理中取得最大成功需要老年神经学方面的专业知识,这包括对当前有关衰老和与年龄相关神经功能障碍研究的理解,以及与其他老年医疗保健提供者合作的能力。尽管目前针对神经退行性疾病的疗法主要只能缓解症状而无法减缓疾病进展,但情况正在不断演变。病理学和神经影像学的生物标志物持续发展,对诊断和治疗产生了重大影响。这些进展不仅有助于提高我们对疾病病理生理学的认识,还能帮助了解疾病阶段,指导症状监测以及在症状前阶段的可能治疗选择。
神经障碍是老年人严重残疾和依赖的主要原因,这凸显了老年神经学专业知识对于有效护理这一人群的必要性。尽管目前针对神经退行性疾病的疗法主要提供症状缓解而不减缓疾病进展,但生物标志物和神经影像学方面的进展正在显著发展。这些进展增强了我们对疾病病理生理学和阶段的理解,指导症状监测以及症状前阶段的潜在治疗选择。随着对与年龄相关病症的认识不断提高以及老年医学获得进一步认可,本文主张重新关注神经科医生在老年医学中的作用,强调在老年患者管理中整合当前研究和协作护理方法的重要性。