阿尔茨海默病居家筛查专家共识  

Consensus of An International Expert Panel on At-Home Screen for Alzheimer’s Disease

作　　者：徐群[1] JWesson Ashford 陈彪[3] 陈树斌 Jeffrey Cummings 顾柏俊 郭起浩 韩璎[3] 花迎雪 金华 Nagaendran Kandiah 李海雁 刘晓蕾 刘新 卢佩琳[14] 裴中[15] 施晓耕 孙凯 汤彬 Goerge Vradenburg 王惠芳[20] 王军[21] 王晓明[22] 王艳蕊 王艳梅[24] 王玉林 翁文锋 辛美哲[27] 张玉兰[28] 赵禾欣[29] 周显波 王虹峥 Qun XU;JWesson Ashford;PIU CHAN;Shubin CHEN;Jeffrey Cummings;Ben JGu;Qihao GUO;Ying HAN;Yingxue HUA;Hua JIN;Nagaendran Kandiah;Haiyan LI;Xiaolei LIU;Xin LIU;Peilin LU;Zhong PEI;Xiaogeng SHI;Kai SUN;Bin TANG;Goerge Vradenburg;Huifang WAGN;Jun WANG;Xiaoming WANG;Yanrui WANG;Yanmei WANG;Yulin WANG;Wenfeng WENG;Meizhe XIN;Yulan ZHANG;Hexin ZHAO;Xianbo ZHOU;Hongzheng WANG(Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China;Stanford University,Palo Alto,CA,USA;Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Shanghai Anda Hospital,Shanghai 201204,China;University of Nevada,Las Vegas,NV,USA;Florey Institute,University of Melbourne,Melbourne,Australia;The Sixth People’s Hospital of Shanghai,Shanghai 200233,China;Shanghai Xinchang Community Health Service Center,Shanghai 200065;University of California,San Diego,CA,USA;Nanyang Technological University,Singapore;The First People’s Hospital of Dali,Yunan 671013,China;The First Affiliated Hospital of Kunming Medical University,Kunming 650032,China;Affiliated Hospital of Chengdu University,Chengdu 610081,China;Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,Hangzhou 310009,China;The First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,China;Guangdong Provincial Cadre Health Center,Guangzhou 510080,China;Longgang Medical Imaging Institute of Shantou University Medical College,Shantou 515041,Guangdong,China;Shanghai Jian'ai Public Welfare Development Center,Shanghai 201824,China;Davos Alzheimer’s Collaborative,Wayne,PA,USA;Yangzhi Rehabilitation Hospital Affiliated to Tongji University(Shanghai Sunshine Rehabilitation Center),Shanghai 201613,China;Institute of Life Science and Biological Engineering,Beijing Jiaotong University,Beijing 100044;Affiliated Hospital of North Sichuan Medical College,Nanchong 637002,Sichuan,China;Leling Elderly Social Work Service Center in Shijingshan,Beijing 100040,China;Kunming Municipal Hospital of Traditional Chinese Medicine,Kunming 650011,China;Shenzhen Longchen

机构地区：[1]上海交通大学医学院附属仁济医院,上海200127 [2]Stanford University,Palo Alto,CA,美国 [3]首都医科大学宣武医院,北京100053 [4]上海市安达医院,上海201204 [5]University of Nevada,Las Vegas,NV,美国 [6]澳大利亚墨尔本大学Florey研究所,墨尔本,澳大利亚 [7]上海市第六人民医院,200233上海 [8]上海市新场社区卫生服务中心,上海200065 [9]University of California,San Diego,CA,美国 [10]Nanyang Technological University,新加坡 [11]大理市第一人民医院,云南大理671013 [12]昆明医科大学第一附属医院,昆明650032 [13]成都大学附属医院,成都610040 [14]浙江大学医学院附属邵逸夫医院,杭州310009 [15]中山大学附属第一医院,广州510080 [16]广东省干部保健中心,广州510080 [17]汕头大学医学院龙岗影像研究所,广东汕头515041 [18]上海剪爱公益发展中心,上海201824 [19]Davos Alzheimer's Collaborative,Wayne,PA,美国 [20]同济大学附属养志康复医院(上海市阳光康复中心),上海201613 [21]北京交通大学生命科学与生物工程研究院,北京100044 [22]川北医学院附属医院,四川南充637002 [23]北京市石景山区乐龄老年社会工作服务中心,北京100040 [24]昆明市中医医院,昆明650011 [25]深圳龙城医院,深圳518100 [26]广州市白云区新市街社区卫生服务中心,广州510410 [27]中华预防医学会,北京100021 [28]中国人民解放军总医院,北京100039 [29]北京医院,北京100730 [30]华盛顿临床研究学院阿尔茨海默研究中心(美国),阿斯诺来(上海)医药科技有限公司,上海200131 [31]阿尔茨海默病防治协会,北京100027

出　　处：《阿尔茨海默病及相关病杂志》2024年第3期176-183,共8页Chinese Journal of Alzheimer's Disease and Related Disorders

摘　　要：老年人痴呆或认知障碍多由一种以上年龄相关的常见脑部疾病所致。阿尔茨海默病(Alzheimer's disease,AD)是其中最常见的神经变性疾病,且是全球前10位死因中唯一无法治愈或缺乏长期对症疗效的疾病,给个人、家庭和全球经济都带来了巨大的负担。早期及时发现和干预是对抗AD的最佳策略。在过去的30年中,许多研究都提出了降低痴呆风险的方法,2020年《柳叶刀》杂志的痴呆预防报告已阐明通过应对风险因素可以预防或延缓超过40%的痴呆。然而,目前全球医疗体系尚未具备早期或及时发现AD的足够能力。最近的一项研究发现,只有不到10%的轻度认知障碍(mild cognitive impairment,MCI)是在初级医疗机构中诊断出来的。近来,抗淀粉样蛋白β(Amyloid beta,Aβ)抗体药物lecanemab和donanemab被批准上市用于早期AD治疗,以及30年的随访研究证明改善风险因素显著减少AD痴呆的发病率并延长了寿命,使得人们对AD早期识别的关注迅速增加。阿尔茨海默病防治协会(China Association for Alzheimer's Disease,CAAD)认识到居家早期和及时发现AD的重要性,并成立了一个由协会成员、临床医生和研究人员组成的全球AD多领域专家团队,就以下目标达成共识:①为个人、家庭、社区、协会和组织提供专家指导意见;②介绍用于认知障碍和痴呆居家筛查的数字工具和可用资源,并为AD高危人群或疑似患者制定下一步应对策略;③讨论现有可用或将来可能的居家筛查适宜AD生物标志物;④为未来的改进和全球应用建立可行性框架。专家组对于当前可用的证据、工具和资源进行综述,并进一步考量其在AD居家筛查中的价值。Dementia/cognitive impairment in elderly persons is often caused by more than one common age-related brain diseases.Alzheimer’s disease(AD)is the most common neurodegenerative disease that leads to or contributes to dementia/cognitive impairment.It is the only one of the 10 top deadliest diseases globally that has no curative nor long lasting effective symptom treatments.AD places tremendous burdens on individuals,their families,and the economies of essentially all societies.Early and timely detection and intervention has been increasingly considered to be the best strategy to combat AD.Over the last 3 decades,numerous studies have suggested approaches to reducing the risk of dementia,and up to 40%of dementia cases could be prevented or delayed by addressing risk factors,which are outlined in the 2020 Lancet report on dementia prevention.However,the current global healthcare system is not equipped sufficiently to detect AD early or in a timely fashion.For example,a recent study found that less than 10%of mild cognitive impairment(MCI)is diagnosed in primary care setting.Recently,with the full approval of the anti-Amyloid beta(Aβ)antibody drug lecanemab and donanemab for early AD and the publications of~20-year follow-up studies establishing that modification of risk factors could markedly reduce AD-dementia incidence and increase life span,there is rapidly growing interest in early AD recognition.The Chinese Association of Alzheimer’s Disease(CAAD)recognizes the importance of early and timely detection of AD in an at-home setting and has assembled a global panel of association professionals,clinicians and researchers who are expert in different areas of AD to reach the consensus reported here with the following goals:1)to provide individuals,family,community,associations and organizations with expert guidance,2)on the digital tools and available resources for the screen of cognitive impairment/dementia at home and describe a work flow for the next steps for those at risk or suspected of AD,3)discuss current

关 键 词：认知评估 阿尔茨海默病 认知障碍 痴呆 居家 筛查 

分 类 号：R749[医药卫生—神经病学与精神病学]