REM Sleep Behavior Disorder as a Pathway to Dementia: If, When, How, What, and Why Should Physicians Disclose the Diagnosis and Risk for Dementia.

IF 1.5 Q4 CLINICAL NEUROLOGY

Current Sleep Medicine Reports Pub Date : 2021-01-01 Epub Date: 2021-07-24 DOI:10.1007/s40675-021-00206-1

Roneil G Malkani, Neil S Wenger

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引用次数: 11

Abstract

Purpose of review: People with isolated REM (rapid eye movement) sleep behavior disorder (iRBD) have a high lifetime risk of developing a neurodegenerative disease, including dementia, but disclosure of this risk remains controversial. Herein, we summarize this controversy and provide guidance on disclosure.

Recent findings: Neurodegeneration risk disclosure in iRBD is controversial because of a long latency to disease onset and a lack of preventative strategies. Balancing the relevant ethical principles of beneficence, nonmaleficence, and autonomy is challenging. Although there are few data on disclosure in iRBD, evidence from discussing risk in other diseases with dementia provides some guidance.

Summary: We provide an approach to risk disclosure for patients with iRBD. Patients should be asked if they want to know about future risks. If so, disclosure should be patient centered, focusing on what might happen. Discussion should occur early to give patients time to prepare for the future and consider participating in research.

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快速眼动睡眠行为障碍作为痴呆的途径:如果，何时，如何，什么，以及为什么医生应该披露痴呆的诊断和风险。

综述目的:孤立性REM(快速眼动)睡眠行为障碍(iRBD)患者一生中发展为神经退行性疾病(包括痴呆)的风险很高，但这种风险的披露仍存在争议。在此，我们总结了这一争议，并提供了披露的指导。最近发现:iRBD的神经退行性变风险披露存在争议，因为疾病发病潜伏期长，缺乏预防策略。平衡相关的道德原则，慈善，非恶意，和自治是具有挑战性的。尽管在iRBD中披露的数据很少，但讨论其他痴呆疾病风险的证据提供了一些指导。摘要:我们为iRBD患者提供了一种风险披露的方法。应该询问患者是否想知道未来的风险。如果是这样，披露应该以耐心为中心，关注可能发生的事情。应该尽早进行讨论，让患者有时间为未来做准备，并考虑参与研究。

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

Current Sleep Medicine Reports Medicine-Pulmonary and Respiratory Medicine

CiteScore

2.50

自引率

5.60%

发文量

期刊介绍： Current Sleep Medicine Reports aims to review the most important, recently published articles in the field of sleep medicine. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care and prevention of sleep conditions. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas such as insomnia, narcolepsy, sleep apnea, circadian rhythm disorders, and parasomnias. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also occasionally provided.