专家对DS-AD临床器械、实践和分期的看法:来自一项国际调查的结果

IF 11.1 1区 医学 Q1 CLINICAL NEUROLOGY
Hampus Hillerstrom, Amit Das, Matthew P. Janicki, Natalia S. Rozas, Stephanie L. Santoro
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引用次数: 0

摘要

唐氏综合征相关阿尔茨海默病(DS-AD)的诊断和分期受到缺乏标准化标准、使临床决策、试验参与和获得先进治疗复杂化等因素的阻碍。本研究旨在探讨这些问题的看法。方法一项针对42名DS-AD专业临床医生和研究人员的国际调查收集了关于仪器、症状分期、临床实践和研究重点的观点。结果:受访者指出,唐氏综合征和DS-AD痴呆患者轻度认知障碍的关键领域包括记忆、执行功能、人格、社会行为、注意力、情绪和语言。在评估的10种评估工具中,基于线人的访谈被认为对严重智力残疾(ID)的个体至关重要,而直接评估被认为对轻度至中度智力残疾的个体有用。常见的诊断混杂因素如甲状腺功能减退和睡眠障碍被确定。行为评估提供了一个有价值的功能;然而,未来的工作应该将行为评估与生物标志物结合起来,并制定标准化的分期框架,以提高DS-AD的诊断可靠性、护理计划和治疗策略。个性、社会行为、语言、情绪/情感、记忆、执行功能和注意力被认为是唐氏综合征轻度认知障碍(MCI-DS)和唐氏综合征相关阿尔茨海默病(DS-AD)的关键障碍领域。10个突出的信息提供者和直接评估工具适用于DS和轻度至中度智力残疾(ID)个体,用于识别MCI-DS和DS- ad;然而,对于重度/深度ID个体,适用性的保证程度较低。在标准化清单中协调推荐的工具被确定为促进临床和研究背景一致性的策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Specialists’ perceptions of clinical instruments, practices, and staging of DS-AD: Results from an international survey

Specialists’ perceptions of clinical instruments, practices, and staging of DS-AD: Results from an international survey

Specialists’ perceptions of clinical instruments, practices, and staging of DS-AD: Results from an international survey

Specialists’ perceptions of clinical instruments, practices, and staging of DS-AD: Results from an international survey

Specialists’ perceptions of clinical instruments, practices, and staging of DS-AD: Results from an international survey

INTRODUCTION

Diagnosing and staging Down syndrome–associated Alzheimer's disease (DS-AD) is hindered by the lack of standardized criteria, complicating clinical decision making, trial participation, and access to advanced therapies. This study aimed to explore perceptions of these issues.

METHOD

An international survey of 42 clinicians and researchers specializing in DS-AD gathered perspectives on instruments, symptomatic staging, clinical practices, and research priorities.

RESULTS

Respondents noted that key domains of impairment in mild cognitive impairment in Down syndrome and DS-AD dementia included memory, executive functioning, personality, social behavior, attention, mood, and language. Among the 10 assessment tools evaluated, informant-based interviews were noted as critical for individuals with severe intellectual disability (ID), while direct assessments were noted as useful for those with mild to moderate ID. Common diagnostic confounders like hypothyroidism and sleep disorders were identified.

DISCUSSION

Behavioral assessments provide a valuable function; however, future efforts should integrate behavioral assessments with biomarkers and develop standardized staging frameworks to improve diagnostic reliability, care planning, and treatment strategies for DS-AD.

Highlights

  • Personality, social behavior, language, mood/affect, memory, executive functioning, and attention are recognized as key domains of impairment in both mild cognitive impairment in Down syndrome (MCI-DS) and Down syndrome–associated Alzheimer's disease (DS-AD).
  • Ten prominent informant and direct assessment tools were noted as appropriate for individuals with DS and mild to moderate intellectual disability (ID) for identifying both MCI-DS and DS-AD; however, for individuals with severe/profound ID, there was less assurance of applicability.
  • Harmonizing recommended tools in a standardized list was identified as a strategy to promote consistency across clinical and research contexts.
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来源期刊
Alzheimer's & Dementia
Alzheimer's & Dementia 医学-临床神经学
CiteScore
14.50
自引率
5.00%
发文量
299
审稿时长
3 months
期刊介绍: Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.
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