Fereshtehnejad Seyed-Mohammad, Lökk Johan
Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, ON M5T 2S8, Canada.
Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada.
Healthcare (Basel). 2025 Jul 31;13(15):1873. doi: 10.3390/healthcare13151873.
: Neurodegenerative proteinopathies, such as Alzheimer's disease (AD), Parkinson's disease (PD), and dementia with Lewy bodies (DLB), are increasingly prevalent worldwide mainly due to population aging. These conditions are marked by complex etiologies, overlapping pathologies, and progressive clinical decline, with significant consequences for patients, caregivers, and healthcare systems. This review aims to synthesize evidence on the healthcare complexities of major neurodegenerative proteinopathies to highlight current knowledge gaps, and to inform future care models, policies, and research directions. : We conducted a comprehensive literature search in PubMed/MEDLINE using combinations of MeSH terms and keywords related to neurodegenerative diseases, proteinopathies, diagnosis, sex, management, treatment, caregiver burden, and healthcare delivery. Studies were included if they addressed the clinical, pathophysiological, economic, or care-related complexities of aging-related neurodegenerative proteinopathies. : Key themes identified include the following: (1) multifactorial and unclear etiologies with frequent co-pathologies; (2) long prodromal phases with emerging biomarkers; (3) lack of effective disease-modifying therapies; (4) progressive nature requiring ongoing and individualized care; (5) high caregiver burden; (6) escalating healthcare and societal costs; and (7) the critical role of multidisciplinary and multi-domain care models involving specialists, primary care, and allied health professionals. : The complexity and cost of neurodegenerative proteinopathies highlight the urgent need for prevention-focused strategies, innovative care models, early interventions, and integrated policies that support patients and caregivers. Prevention through the early identification of risk factors and prodromal signs is critical. Investing in research to develop effective disease-modifying therapies and improve early detection will be essential to reducing the long-term burden of these disorders.
神经退行性蛋白病,如阿尔茨海默病(AD)、帕金森病(PD)和路易体痴呆(DLB),在全球范围内日益普遍,主要原因是人口老龄化。这些疾病的特点是病因复杂、病理重叠以及临床症状进行性恶化,对患者、护理人员和医疗系统都产生了重大影响。本综述旨在综合主要神经退行性蛋白病在医疗方面的复杂性证据,以突出当前的知识空白,并为未来的护理模式、政策和研究方向提供参考。我们在PubMed/MEDLINE中进行了全面的文献检索,使用了与神经退行性疾病、蛋白病、诊断、性别、管理、治疗、护理人员负担和医疗服务相关的医学主题词(MeSH)和关键词组合。如果研究涉及与衰老相关的神经退行性蛋白病的临床、病理生理、经济或护理相关复杂性,则纳入研究。确定的关键主题包括:(1)病因多因素且不明,常伴有共病;(2)前驱期长,有新兴生物标志物;(3)缺乏有效的疾病修饰疗法;(4)病情进展需要持续的个性化护理;(5)护理人员负担重;(6)医疗和社会成本不断上升;(7)多学科和多领域护理模式的关键作用,涉及专科医生、初级保健医生和专职医疗人员。神经退行性蛋白病的复杂性和成本凸显了迫切需要以预防为重点的策略、创新的护理模式、早期干预以及支持患者和护理人员的综合政策。通过早期识别风险因素和前驱症状进行预防至关重要。投资开展研究以开发有效的疾病修饰疗法并改善早期检测,对于减轻这些疾病的长期负担至关重要。