Severity of cognitive impairment at initial diagnosis of Alzheimer's disease was the strongest predictor of survival

摘要

Given the aging population and the corresponding increase in the incidence of AD, information on the prognosis of AD will help practitioners and unpaid caregivers to better meet the needs of patients with AD.This well designed, prospective study by Larson ef a/ provides estimates of survival after initial diagnosis of AD. Estimated survival rates were longer than those reported by the Canadian Study of Health and Aging (3.2 y for men and 3.4 y for women).This difference may be attributed to the older sample in the Canadian Study of Health and Aging.Length of survival after onset of AD may be quite different from length of survival after initial diagnosis. Identifying the precise onset of AD may be difficult because of the insidious nature of the disease, unpaid caregiver's lack of awareness of changes in cognition and functional abilities, and the patient's ability to compensate for impairments. Although diagnosis at the onset of disease may not alter the natural course of AD, it could provide opportunities to ensure that patients and their unpaid caregivers receive the most appropriate care and support throughout the course of the disease.The importance of accurately diagnosing dementia cannot be overemphasised because different forms of dementia require different types of interventions. Patients with AD primarily need support services, such as help in the home. Unfortunately, reduced healthcare spending in some countries has affected the availability of homemaking services.In addition to recommending effective strategies for managing the symptoms of AD,healthcare professionals should advocate for publicly funded support services required by patients with AD.