苏格兰脑健康服务模式:苏格兰脑健康服务国家护理路径的理论基础和科学依据

IF 8.5 3区 医学 Q1 CLINICAL NEUROLOGY Jpad-Journal of Prevention of Alzheimers Disease Pub Date : 2021-12-01 DOI:10.14283/jpad.2021.63
C. Ritchie, J. Waymont, C. Pennington, K. Draper, A. Borthwick, N. Fullerton, M. Chantler, M. E. Porteous, S. Danso, A. Green, L. Mcwhirter, G. Muniz Terrera, S. Simpson, G. Thompson, D. Trépel, T. Quinn, A. Kilgour
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引用次数: 9

摘要

为了解决神经退行性疾病(如阿尔茨海默病)对社会、经济、健康和社会护理的影响,我们必须果断地从被动的临床实践转向主动的临床实践,并在全社会开展以证据为基础的脑健康教育。大多数疾病进程至少可以部分预防、减缓或逆转。长期以来,我们忽视了对神经退行性疾病过程的干预,这主要是由于一种误解,即他们的主要症状-认知能力下降-是一个正常的,与年龄相关的过程,但也由于缺乏多学科合作。我们现在了解到,神经退行性疾病有可改变的危险因素,成功地控制常见的合并症(如糖尿病和高血压)可以减少神经退行性疾病的发病率,并且疾病过程开始(而且,关键是,可以被发现、减少、延迟、预防或治疗)比以前认识到的要早几十年。苏格兰政府与苏格兰阿尔茨海默病协会合作建立的苏格兰脑健康组织提出了影响深远的公共卫生和临床实践办法,以减少神经退行性疾病的发病率。专注于苏格兰脑健康的临床服务,我们提出了苏格兰脑健康服务模式。据我们所知,苏格兰脑健康模式建立在个性化风险分析、有针对性的风险降低和预防、疾病早期检测、公平获取和利用综合数据协助临床决策的基础上,标志着全国范围内全面改革临床、社会和政治方法来预防、评估和治疗神经退行性疾病的第一个例子。
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The Scottish Brain Health Service Model: Rationale and Scientific Basis for a National Care Pathway of Brain Health Services in Scotland
In order to address the oft-cited societal, economic, and health and social care impacts of neurodegenerative diseases, such as Alzheimer’s disease, we must move decisively from reactive to proactive clinical practice and to embed evidence-based brain health education throughout society. Most disease processes can be at least partially prevented, slowed, or reversed. We have long neglected to intervene in neurodegenerative disease processes, largely due to a misconception that their predominant symptom — cognitive decline — is a normal, age-related process, but also due to a lack of multi-disciplinary collaboration. We now understand that there are modifiable risk factors for neurodegenerative diseases, that successful management of common comorbidities (such as diabetes and hypertension) can reduce the incidence of neurodegenerative disease, and that disease processes begin (and, crucially, can be detected, reduced, and delayed, prevented, or treated) decades earlier in life than had previously been appreciated. Brain Health Scotland, established by Scottish Government and working in partnership with Alzheimer Scotland, propose far-reaching public health and clinical practice approaches to reduce neurodegenerative disease incidence. Focusing here on Brain Health Scotland’s clinical offerings, we present the Scottish Model for Brain Health Services. To our knowledge, the Scottish Model for Brain Health, built on foundations of personalised risk profiling, targeted risk reduction and prevention, early disease detection, equity of access, and harnessing comprehensive data to assist in clinical decision-making, marks the first example of a nationwide approach to overhauling clinical, societal, and political approaches to the prevention, assessment, and treatment of neurodegenerative disease.
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来源期刊
自引率
7.80%
发文量
85
期刊介绍: The JPAD « Journal of Prevention of Alzheimer’Disease » will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including : neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes. JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.
期刊最新文献
Burden of Illness in People with Alzheimer's Disease: A Systematic Review of Epidemiology, Comorbidities and Mortality. Are Population-Level Approaches to Dementia Risk Reduction Under-Researched? A Rapid Review of the Dementia Prevention Literature. Expectancy Does Not Predict 18-month Treatment Outcomes with Cognitive Training in Mild Cognitive Impairment. Lifestyle and Socioeconomic Transition and Health Consequences of Alzheimer's Disease and Other Dementias in Global, from 1990 to 2019. Data-Driven Thresholding Statistically Biases ATN Profiling across Cohort Datasets.
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