A Delphi Approach to Define Lucid Episodes in People Living With Dementia.

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Alzheimer Disease & Associated Disorders Pub Date : 2024-04-01 Epub Date: 2024-05-17 DOI:10.1097/WAD.0000000000000621

Lauren R Bangerter, Joan M Griffin, Kyungmin Kim, Dawn M Finnie, Maria I Lapid, Joseph E Gaugler, Virginia S Biggar, Theresa Frangiosa

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引用次数: 0

Abstract

Purpose: Lucid episodes (LEs: unexpected episodes of spontaneous, meaningful, and relevant communication or behavior) in Alzheimer disease and related dementias are a new area of scientific inquiry that lacks clinical consensus and require more conceptual attention.

Methods: We aimed to measure consensus from an expert group on: (1) potential medical or clinical explanations for LEs; (2) necessary medical and clinical context to LEs; and (3) interpretation of LEs.

Patients: We convened 13 experts from different disciplines (neurology, psychiatry, psychology, pharmacy, palliative care, hospice, nursing, social work, primary care, geriatrics, and professional home caregivers) to identify elements of LEs.

Results: Experts provided a range of opinions on medical and clinical explanations and questions to understand LEs. Consensus on LEs when presented with clinical vignettes was not reached. Panelists highlighted key medical and contextual factors needed to make a definitive judgement about LEs.

Conclusion: There is variability in how LEs are interpreted by clinical experts, which complicates the identification of LEs in Alzheimer disease and related dementias.

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用德尔菲法定义痴呆症患者的 "清醒发作"。

目的：阿尔茨海默病和相关痴呆症的 "朦胧发作"（LEs：自发的、有意义的、相关的交流或行为的意外发作）是科学研究的一个新领域，但缺乏临床共识，需要在概念上给予更多关注：我们旨在衡量专家组在以下方面的共识：（1）LEs 的潜在医学或临床解释；（2）LEs 的必要医学和临床背景；以及（3）LEs 的解释：我们召集了来自不同学科（神经病学、精神病学、心理学、药学、姑息治疗、临终关怀、护理、社会工作、初级保健、老年病学和专业家庭护理人员）的 13 位专家，以确定 LEs 的要素：结果：专家们就医学和临床解释以及理解LEs的问题提出了各种意见。在展示临床案例时，专家们未能就低风险因素达成共识。专家组成员强调了对 LE 做出明确判断所需的关键医学和背景因素：结论：临床专家对LE的解释存在差异，这使得阿尔茨海默病和相关痴呆症中LE的识别变得复杂。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer Disease & Associated Disorders 医学-病理学

CiteScore

3.10

自引率

4.80%

发文量

期刊介绍： Alzheimer Disease & Associated Disorders is a peer-reviewed, multidisciplinary journal directed to an audience of clinicians and researchers, with primary emphasis on Alzheimer disease and associated disorders. The journal publishes original articles emphasizing research in humans including epidemiologic studies, clinical trials and experimental studies, studies of diagnosis and biomarkers, as well as research on the health of persons with dementia and their caregivers. The scientific portion of the journal is augmented by reviews of the current literature, concepts, conjectures, and hypotheses in dementia, brief reports, and letters to the editor.