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阿尔茨海默病及其他痴呆症中的远程医疗:我们目前的状况如何?

Telemedicine in Alzheimer's disease and other dementias: Where we are?

作者信息

Angelopoulou Efthalia, Papageorgiou Sokratis G

机构信息

1st Department of Neurology, Eginition University Hospital, National and Kapodistrian University of Athens, Athens, Greece.

出版信息

J Alzheimers Dis. 2025 Jan;103(1):3-18. doi: 10.1177/13872877241298295. Epub 2024 Dec 5.

Abstract

The prevalence and global health burden of dementia including Alzheimer's disease (AD) is rising, while patients living in remote and underserved areas face significant challenges in reaching specialized care. Telemedicine offers a valuable solution in bridging this widening gap, by providing equal and timely access to tertiary-specialized centers. Accumulating evidence highlights that most parts of the remote neuropsychological and neurological evaluation are feasible, with patients, healthcare professionals and caregivers being generally satisfied with this means of care. Herein, we provide an updated overview of the available evidence on the use of telemedicine for patients with cognitive disorders, focusing on the different applications and settings, the remote, video-based neurological and neuropsychological assessment, current recommendations, non-pharmacological interventions, as well as legal and ethical considerations. Based on the literature review and our three-year experience in the "Specialized Outpatient Clinic of Memory, Dementia and Parkinson's disease through the National Telemedicine Network" in the Aiginition University Hospital of Athens, we propose a brief guide for assessing patients with cognitive impairment via telemedicine and suggest future research directions for the more effective and appropriate use of telemedicine in dementia assessment and care.

摘要

包括阿尔茨海默病(AD)在内的痴呆症的患病率和全球健康负担正在上升,而生活在偏远和医疗服务不足地区的患者在获得专科护理方面面临重大挑战。远程医疗通过提供平等、及时地接入三级专科中心,为弥合这一日益扩大的差距提供了一个有价值的解决方案。越来越多的证据表明,远程神经心理学和神经学评估的大部分内容是可行的,患者、医护人员和护理人员对这种护理方式总体上感到满意。在此,我们提供了关于远程医疗用于认知障碍患者的现有证据的最新概述,重点关注不同的应用和场景、基于视频的远程神经学和神经心理学评估、当前建议、非药物干预以及法律和伦理考量。基于文献综述以及我们在雅典阿吉尼翁大学医院通过国家远程医疗网络设立的“记忆、痴呆症和帕金森病专科门诊”三年的经验,我们提出了一份通过远程医疗评估认知障碍患者的简要指南,并建议了未来在痴呆症评估和护理中更有效、适当地使用远程医疗的研究方向。

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