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超越诊断:通过系统综述探索痴呆症患者的剩余自主性

Beyond Diagnosis: Exploring Residual Autonomy in Dementia Through a Systematic Review.

作者信息

Anselmo Anna, Corallo Francesco, Pagano Maria, Cardile Davide, Marra Angela, Maresca Giuseppa, De Luca Rosaria, Alagna Antonella, Quartarone Angelo, Calabrò Rocco Salvatore, Cappadona Irene

机构信息

IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy.

出版信息

Medicina (Kaunas). 2025 May 14;61(5):895. doi: 10.3390/medicina61050895.

Abstract

: The connection between cognitive decline and autonomy represents a complex and multifactorial area of research. Cognitive decline manifests as a progressive impairment of higher mental functions and is typical of neurodegenerative conditions such as dementia. Autonomy, on the other hand, is defined as an individual's ability to independently manage activities of daily living and make informed decisions. The objective of this study was to investigate whether certain daily living skills can persist despite the advancement of dementia, and what factors contribute to their preservation in maintaining autonomy. : A literature review was conducted using the databases PubMed, Web of Science, Scopus, Cochrane Library, Embase, and PsycInfo. Out of an initial pool of 12,113 studies, only 19 met the inclusion criteria and were selected for analysis. The findings indicate that, in non-institutionalized settings, some daily living abilities may remain preserved despite cognitive deterioration. In contrast, within institutionalized environments, a significant correlation emerged between cognitive decline and the progressive loss of personal autonomy. : This study highlights the importance of assessing residual abilities in individuals with dementia. Recognizing and supporting these remaining skills can play a crucial role in enhancing quality of life, delaying institutionalization, and promoting autonomy even in the presence of advanced cognitive decline.

摘要

认知能力下降与自主性之间的联系是一个复杂且多因素的研究领域。认知能力下降表现为高级心理功能的渐进性损害,是痴呆等神经退行性疾病的典型特征。另一方面,自主性被定义为个体独立管理日常生活活动并做出明智决策的能力。本研究的目的是调查尽管痴呆病情进展,某些日常生活技能是否仍能持续存在,以及哪些因素有助于在维持自主性方面保留这些技能。:使用PubMed、科学网、Scopus、Cochrane图书馆、Embase和PsycInfo数据库进行了文献综述。在最初的12113项研究中,只有19项符合纳入标准并被选作分析。研究结果表明,在非机构化环境中,尽管认知能力恶化,一些日常生活能力可能仍得以保留。相比之下,在机构化环境中,认知能力下降与个人自主性的逐渐丧失之间存在显著相关性。:本研究强调了评估痴呆患者残余能力的重要性。认识并支持这些剩余技能对于提高生活质量、延缓机构化以及即使在存在严重认知能力下降的情况下促进自主性都能发挥关键作用。

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