标准与规范
ENGLISH ABSTRACT
脑认知健康管理中国专家共识(2023)
脑认知健康管理中国专家共识制定委员会
《中华健康管理学杂志》编辑委员会
作者及单位信息
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DOI: 10.3760/cma.j.cn115624-20230908-00124
Chinese expert consensus on cognitive health management (2023)
Chinese Expert Consensus Committee on Brain Cognitive Health Management
Chinese Journal of Health Management Editorial Committee
Tang Yi
Zeng Qiang
Authors Info & Affiliations
Chinese Expert Consensus Committee on Brain Cognitive Health Management
Chinese Journal of Health Management Editorial Committee
Tang Yi
Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, 100053, China
Zeng Qiang
Second Medical Center of PLA General Hospital, Beijing 100853, China
·
DOI: 10.3760/cma.j.cn115624-20230908-00124
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摘要

保持脑认知健康是脑健康管理的重要内容,针对适宜人群开展脑认知健康筛查、风险评估及早期干预对认知障碍相关疾病防治有着重要的战略意义。本共识针对脑认知健康管理的适宜人群,通过量表、问卷以及各项临床生物标志物的筛查,评估为认知障碍不同风险的人群,并针对各人群推荐个体化的健康管理方案,开展生活方式干预、危险因素管理及认知数字疗法等,同时建立规范的随访制度,定期评估健康干预的效果,形成连续动态的脑认知健康管理模式。

认知障碍;健康管理;筛查;危险分层;干预;共识
引用本文

脑认知健康管理中国专家共识制定委员会,《中华健康管理学杂志》编辑委员会. 脑认知健康管理中国专家共识(2023)[J]. 中华健康管理学杂志,2023,17(12):881-892.

DOI:10.3760/cma.j.cn115624-20230908-00124

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认知障碍是一类以获得性认知功能损害为核心症状,可导致患者日常生活和工作能力减退、伴或不伴有精神行为异常的综合征 1,依据其严重程度不同,分为主观认知下降(subjective cognitive decline,SCD),轻度认知障碍(mild cognitive impairment,MCI)和痴呆。SCD是指个体主观上认为自己较之前正常状态认知功能(尤其是记忆功能)的下降,但客观的神经心理测评得分达不到诊断MCI的标准 2。MCI是指主观有记忆等认知功能下降的主诉、客观检查有一项或多项认知功能损害超过了与正常年龄和教育相匹配的水平,但未达到痴呆程度,且日常生活能力未受到明显影响 3。研究表明,MCI是介于认知正常和痴呆的中间状态,具有向痴呆转归的较高可能性,每年有10%~15%的MCI患者进展为痴呆 4。痴呆是一种以获得性认知功能障碍为核心,至少有2项认知域障碍,并导致患者日常生活与学习能力明显减退、常伴有精神行为异常的综合征 5 , 6。导致认知障碍的主要疾病包括阿尔茨海默病(Alzheimer′s disease,AD)、血管性认知障碍(vascular cognitive impairment,VCI)、额颞叶变性和路易体痴呆等。
随着人口老龄化趋势日益严峻,我国认知障碍人群增长迅速,给家庭和社会带来沉重负担。截至2020年我国≥60岁人群痴呆患病率约为6.04%(约1 507万) 6,MCI患病率约为15.54%(约3 877万),SCD患病率约为12%~50% 7。2015年我国AD患者总社会经济成本约1.03万亿元 8,占国内生产总值的1.47% 9。大多数认知障碍尤其是神经退行性认知障碍通常隐匿起病、缓慢进展,一旦进展到痴呆阶段,治疗困难。因此,早期开展脑认知健康筛查、评估、干预是认知障碍相关疾病防治的关键。
为进一步规范和推进脑认知健康管理工作,脑认知健康管理中国专家共识制定委员会自2023年2月组织了神经病学、健康管理学、老年病学、心理学、护理学和循证医学等领域的专家,针对脑认知健康的筛查、评估和干预等关键内容进行了充分的证据分析与讨论,最终形成本共识。本共识结合牛津循证医学中心证据等级与推荐等级 10和已发表的专家共识、指南以及高质量的实证研究综合考量后进行推荐 111,对于缺乏循证医学证据的情况,共识的推荐意见基于专家的临床经验和专业知识,由专家委员会经过充分讨论及审查后确定。
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备注信息
A
唐毅,首都医科大学宣武医院神经内科,北京 100053,Email: grodef.pabsohwxiygnat
B
曾强,解放军总医院第二医学中心健康管理研究院,北京 100853,Email: mocdef.6ab21103qz
C
脑认知健康管理中国专家共识制定委员会,《中华健康管理学杂志》编辑委员会. 脑认知健康管理中国专家共识(2023)[J]. 中华健康管理学杂志, 2023, 17(12): 881-892. DOI: 10.3760/cma.j.cn115624-20230908-00124.
D
专家委员会成员均声明无利益冲突
E
国家重点研发计划 (2022YFC3602600)
国家自然科学基金 (82220108009,81970996,82201568)
国家科技创新2030-重大项目 (2021ZD0201801)
中国科协青年托举人才 (2021QNRC001)
北京市医院管理中心创新梦工场经费资助 (202118)
北京市科技新星 (Z211100002121051)
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