多病共存患者认知功能的管理现状

韩悦; 杨振华; 韩庆烽; 肖卫忠

doi:10.16766/j.cnki.issn.1674-4152.003129

多病共存患者认知功能的管理现状

doi: 10.16766/j.cnki.issn.1674-4152.003129

韩悦¹,
杨振华¹,
韩庆烽¹,
肖卫忠^{1, 2, ,}

1.
北京大学第三医院全科医学科，北京 100191
2.
北京大学第三医院神经内科

基金项目:

2021年全科医学教育教学研究课题 B-YXGP20210201-01

详细信息

通讯作者:
肖卫忠，E-mail：weizhongx@sina.com

中图分类号: R749.16 R592
计量
- 文章访问数: 391
- HTML全文浏览量: 219
- PDF下载量: 19
- 被引次数: 0
出版历程
- 收稿日期: 2022-06-14
- 网络出版日期: 2023-09-13

Current status of management of cognitive function in patients with multimorbidity

1.
Department of General Medicine, Peking University Third Hospital, Beijing 100191, China

摘要

摘要: 随着人口老龄化的不断加剧，多病共存的问题日渐严重，而多病共存也成为影响认知功能的重要原因，甚至两者互为相关，若不进行综合管理，很容易形成双向的恶性循环。多病共存与认知功能障碍相互作用的机制尚不明确，可能与加速衰老及其过程中的慢性炎症和氧化应激有关，因此还需要更多基础研究来阐明这些观点。在多病共存的基础上，存在多重用药、潜在不恰当用药、药物与药物之间的相互作用以及药物对认知功能的影响等问题是全科医生必须面对的公共卫生问题，加强对多病共存患者认知功能的筛查、评估，并积极地采取干预措施，包括非药物、药物治疗、精神心理和康复等综合的管理措施，必将避免或减少多病共存患者认知功能障碍的发生、延缓认知功能障碍的进展。遗憾的是目前对多病共存患者认知功能的管理主要沿用以往认知功能障碍的评估和治疗，没有考虑多病共存在其中的影响，因此建立健全多病共存患者认知功能的管理指南亟待解决。随着分级诊疗制度的不断完善，全科医护人员必将担负起多病共存患者认知功能管理的重担，在提高自身能力的同时必须加强对此类患者的初步筛查、评估、干预、再评估、再干预，真正体现全科医生对多病共存的连续性管理。
- 多病共存 /
- 慢性病 /
- 认知功能 /
- 健康管理
Abstract: With the increasing ageing of the population, the problem of multimorbidity is becoming more and more serious, and the multimorbidity has also become a major cause of cognitive impairment. Indeed, the two are interrelated. Without a comprehensive approach, it is easy to create a vicious circle in both directions. The mechanisms of the interaction between multimorbidity and cognitive impairment are unclear, which may be related to accelerated ageing and its chronic inflammation and oxidative stress, so more basic research is needed to clarify these views. Because of multimorbidity, problems such as polypharmacy, potentially inappropriate drug use, drug-drug interactions, and the effects of drugs on cognitive function are public health issues that general practitioners need to address. Cognitive function screening, assessment and active intervention measures in patients with multimorbidity, and comprehensive management including non-drug treatment, drug treatment, psycho-psychology and rehabilitation, will definitely prevent or reduce the occurrence of cognitive dysfunction in patients with multimorbidity. Slowing the progression of cognitive impairment. Unfortunately, the current management of cognitive function in patients with multimorbidity mainly follows the previous assessment and treatment of cognitive dysfunction without considering the impact of multimorbidity. Therefore, there is an urgent need to establish and improve guidelines for the management of the cognitive function in patients with multimorbidity. With the continuous improvement of the hierarchical diagnosis and treatment system, general practitioners will surely shoulder the burden of cognitive function management of patients with multimorbidity. While improving our own capabilities, we need to strengthen the initial screening, assessment, intervention, reassessment, and re-intervention of such patients, which truly reflects the continuous management of multimorbidity by general practitioners.
- Multimorbidity /
- Chronic diseases /
- Cognitive function /
- Health management

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