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推进痴呆症护理:意大利在世卫组织全球行动计划和欧洲战略框架内的公共卫生应对措施综述

Advancing dementia care: a review of Italy's public health response within the WHO Global Action Plan and European strategies.

作者信息

Ancidoni Antonio, Salemme Simone, Marconi Domitilla, Bellomo Guido, Pani Sara Maria, Locuratolo Nicoletta, Lacorte Eleonora, Lombardo Flavia Lucia, Bacigalupo Ilaria, Fabrizi Elisa, Canevelli Marco, Sciancalepore Francesco, Lorenzini Patrizia, Palazzesi Ilaria, Paggetti Alice, Della Gatta Francesco, Piscopo Paola, Salvi Emanuela, Zambri Francesca, Di Nolfi Annachiara, Palermo Vittorio, Sciattella Paolo, Bini Chiara, Mennini Francesco Saverio, Bianchi Caterina Bianca Neve Aurora, Landoni Fiammetta, Giannini Maria Assunta, Di Fiandra Teresa, Vanacore Nicola

机构信息

National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanita, Rome, Italy.

Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.

出版信息

BMJ Public Health. 2025 Aug 17;3(2):e002250. doi: 10.1136/bmjph-2024-002250. eCollection 2025.

Abstract

INTRODUCTION

Dementia is a growing global public health priority, with the WHO Global Action Plan (GAP) calling for coordinated efforts worldwide. Italy, one of the oldest nations globally, faces a significant challenge with approximately 2 million individuals living with dementia or mild cognitive impairment. In response, the Italian Fund for Alzheimer's and other Dementias (IFAD) was established in 2020 to align national efforts with the WHO GAP's objectives. This study analyses IFAD activities from 2021 to 2023, offering insights into Italy's public health response to dementia and its relevance to global strategies.

METHODS

We conducted a structured, iterative review of all activities coordinated by the Italian Dementia Observatory (OssDem-Istituto Superiore di Sanità (ISS)) within IFAD 2021-2023. Global, regional and national documents on dementia prevention, care and support were retrieved from official websites, institutional repositories and targeted web searches using the keywords 'dementia', 'brain health' and 'ageing'. Two reviewers independently screened and extracted data with a predefined matrix mapped to the seven WHO GAP Action Areas. Human-subject studies cited had independent ethics approval and informed consent; no new data were collected for this review.

RESULTS

IFAD activities led to substantial progress in dementia care services, with memory clinics, residential care facilities and daycare centres mapped, revealing regional disparities in service provision. Modifiable risk factors accounted for 39.5% of dementia cases in Italy, with an estimated 67 000 cases preventable through risk reduction. National guidelines were developed to standardise dementia care pathways, and training programmes addressed gaps in HP and caregiver preparedness, particularly highlighted by the COVID-19 pandemic.

DISCUSSION

Italy's experience provides valuable lessons for countries facing similar demographic challenges. The IFAD extension to 2024-2026 aims to address persistent regional disparities and further implement national guidelines and prevention strategies. By integrating Italy's progress with broader international frameworks, the Italian model can inform global efforts to enhance dementia care, highlighting the importance of scalable, regionally adapted strategies for addressing the growing global burden of dementia.

摘要

引言

痴呆症是全球日益关注的公共卫生重点问题,世界卫生组织全球行动计划(GAP)呼吁全球各国共同协作。意大利作为全球老龄化程度最高的国家之一,约有200万人患有痴呆症或轻度认知障碍,面临着巨大挑战。为此,意大利阿尔茨海默病及其他痴呆症基金(IFAD)于2020年成立,以使国家努力与世界卫生组织全球行动计划的目标保持一致。本研究分析了IFAD在2021年至2023年期间的活动,深入了解意大利对痴呆症的公共卫生应对措施及其与全球战略的相关性。

方法

我们对意大利痴呆症观察站(OssDem - 国家卫生研究院(ISS))在2021 - 2023年IFAD框架内协调的所有活动进行了结构化的迭代审查。从官方网站、机构知识库以及使用关键词“痴呆症”、“脑健康”和“老龄化”进行的针对性网络搜索中,检索了关于痴呆症预防、护理和支持的全球、区域和国家文件。两位审查员使用预先定义的矩阵独立筛选和提取数据,该矩阵对应世界卫生组织全球行动计划的七个行动领域。引用的人体研究均获得了独立的伦理批准和知情同意;本次审查未收集新数据。

结果

IFAD的活动在痴呆症护理服务方面取得了重大进展,绘制了记忆诊所、寄宿护理设施和日托中心的分布图,揭示了服务提供方面的地区差异。在意大利,可改变的风险因素占痴呆症病例的39.5%,估计通过降低风险可预防67000例病例。制定了国家指南以规范痴呆症护理途径,培训计划弥补了卫生保健人员和护理人员准备方面的差距,这在新冠疫情期间尤为突出。

讨论

意大利的经验为面临类似人口挑战的国家提供了宝贵教训。IFAD延长至2024 - 2026年旨在解决持续存在的地区差异,并进一步实施国家指南和预防战略。通过将意大利的进展与更广泛的国际框架相结合,意大利模式可为全球加强痴呆症护理的努力提供参考,突出了可扩展的、因地制宜的战略对于应对日益增长的全球痴呆症负担的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e841/12359490/21bfc91b226a/bmjph-3-2-g001.jpg

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