Korecky Karina, Schicktanz Silke
Department of Medical Ethics and History of Medicine, University Medical Center Göttingen, Göttingen, Germany.
Med Health Care Philos. 2025 Sep;28(3):473-485. doi: 10.1007/s11019-025-10272-9. Epub 2025 May 26.
In recent years, medical research has sparked hope that up to a third of dementia cases could be prevented. This optimism is driven by a shift in the understanding of dementia and, in particular, Alzheimer's Disease (AD)-from being a rapid-onset brain disease in later life to a condition strongly linked to lifestyle factors, progressing slowly and gradually through asymptomatic, pre-symptomatic, and symptomatic stages with varying degrees of severity. Accompanying this evolving perception, the use of mobile healthcare applications (mHealth apps) based on dementia prevention research has been on the rise. Health policymakers and companies increasingly advocate for these apps. However, concerns remain about the medical quality of such mHealth apps for dementia prevention. Bioethical research has highlighted significant challenges associated with their use. This paper critically examines dementia prevention strategies through the lenses of mHealth technologies. Exploring four mHealth apps for dementia prevention as case studies, we identify and analyze unsolved ethical issues related to primary, secondary, and tertiary prevention. Hereby we offer a new perspective on familiar ethical dilemmas in dementia prevention, and emphasize the need to examine potentially intensified challenges in the context of digital health in the future in more depth.
近年来，医学研究燃起了希望，即高达三分之一的痴呆症病例有望得到预防。这种乐观情绪源于对痴呆症，尤其是阿尔茨海默病（AD）认识的转变——从一种在晚年迅速发病的脑部疾病，转变为一种与生活方式因素密切相关的疾病，它会在无症状、症状前和有症状阶段缓慢且逐渐地发展，且严重程度各不相同。随着这种认知的不断演变，基于痴呆症预防研究的移动医疗应用程序（mHealth应用程序）的使用一直在增加。卫生政策制定者和公司越来越多地倡导使用这些应用程序。然而，对于此类用于预防痴呆症的mHealth应用程序的医疗质量，人们仍存在担忧。生物伦理研究突出了与它们的使用相关的重大挑战。本文通过mHealth技术的视角批判性地审视痴呆症预防策略。通过将四款用于预防痴呆症的mHealth应用程序作为案例研究进行探索，我们识别并分析了与一级、二级和三级预防相关的未解决的伦理问题。借此，我们为痴呆症预防中常见的伦理困境提供了一个新视角，并强调未来有必要在数字健康背景下更深入地审视潜在加剧的挑战。
