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*Only for medical professionals to read for reference.
Early diagnosis and early treatment, win at the starting line! Expert profile Professor Wang Huali, Peking University Institute of Mental Health (Sixth Hospital), Deputy Director, Beijing Key Laboratory of Translational Medicine for Diagnosis and Treatment of Dementia, Executive Director, World Dementia Council (WDC) Executive Director, International Alzheimer's Disease Association (ADI) Executive Director Executive Director of the Pacific Rim Society of Psychiatry (PRCP) Executive Vice Chairman of the Alzheimer's Disease Branch (ADC) of the Chinese Geriatrics Association Vice President of the Psychiatric and Mental Health Branch of the Chinese Society of Geriatrics Vice President of the Chinese Society of Gerontology and Geriatrics The vice chairman of the professional committee founded the first AD doctor-patient family sorority in 2000, created China's characteristic dementia care and counseling technology, proposed the whole process management concept of cognitive impairment, served as a WHO global dementia monitoring consultant, participated in the preparation of WHO global dementia research key reports, dementia Alzheimer’s disease (AD) is one of the most feared diseases in the heart of many elderly people, such as the Cognitive Deterioration Risk Prevention and Control Guidelines, because being entangled in the "Alzheimer's disease" in the general population means normal A series of functions such as life, social interaction, memory, etc.
, will gradually disappear from the patient
.
AD is the most common type of dementia, with insidious onset and diverse clinical manifestations.
At present, the public's understanding of AD is still insufficient
.
Every September is World Alzheimer's Month, and this year's theme is "Know Dementia, Know Alzheimer's"
.
The "medical community" specially invited Professor Wang Huali, director of the Memory Center of Peking University Sixth Hospital, to share her insights on hot issues related to AD diagnosis and treatment
.
(Professor Wang Huali interview video) Breaking the constraints is the key to improving the status quo of early diagnosis of AD in China.
Realizing early detection and early treatment, and moving the prevention and treatment as far as possible, will play a key role in defeating any disease
.
Therefore, during World Alzheimer's Disease Month, the Alzheimer's Disease Branch of the Chinese Geriatric Healthcare Association (ADC) also launched a series of related activities to promote the importance of early diagnosis and early treatment of AD from multiple aspects and multiple dimensions
.
As the vice chairman of ADC, Professor Wang Huali said, “We have translated the theme of this year’s World Alzheimer’s Disease Month in Chinese into'knowing the enemy, knowing the past, early diagnosis and early wisdom', and we hope that more people will understand the disease of AD.
Let more patients get early diagnosis and treatment
.
"After all, from the perspective of clinical status, the current status of early diagnosis and treatment of AD in China is still not ideal
.
Professor Wang Huali analyzed the reasons for this situation.
First, many people do not have enough understanding of the early symptoms of AD.
They believe that memory loss is common when the elderly are getting older, and cannot distinguish between normal physiological aging and pathological forgetting caused by AD.
It will lead to delays in the timing of treatment
.
"A survey conducted by us from 2012 to 2013 showed that for patients diagnosed with cognitive impairment through the memory clinic, the average interval between when their family members noticed the relevant symptoms and when the patient came to the hospital for treatment was more than 2 years, and the family members noticed The symptoms are often not early manifestations.
If it is an earlier symptom, it may take longer
.
"Figure 1.
10 early warning symptoms of dementia and common misunderstandings about AD, and may also include diagnosis AD stigmatizes patients and families
.
Professor Wang Huali pointed out that although many family members have long noticed the suspected early symptoms of AD, they are afraid that the patient will be diagnosed with dementia or cognitive impairment.
Therefore, they dare not bring the patient to the doctor.
Opportunity for early diagnosis and treatment
.
The lack of accurate diagnostic methods and the irregular and imperfect use of existing cognitive function assessment tools are another major reason that restricts the early diagnosis of AD
.
Professor Wang Huali said, “Many clinicians feel that using scales and other assessment tools to diagnose AD is too cumbersome.
If there are tools or not, there is no method; and the practicality of biomarker detection in clinical practice is still relatively limited.
Hospitals do not yet have the conditions for positron emission computed tomography (PET) testing, and the testing costs are relatively high.
The overall patient acceptance of cerebrospinal fluid testing is low.
These aspects need to be improved
.
"To achieve early diagnosis of AD, The joint effort of the whole society is required.
Professor Wang Huali called that the whole society should pay attention to and recognize AD.
In addition to actively paying attention to and supporting related work during the Alzheimer’s month in September, relevant domestic associations and organizations also need to continue their efforts.
, Provide accessible methods and information in "the closest and most convenient place to the common people"
.
On August 31, 2020, the General Office of the National Health Commission issued the “Working Plan for Exploring Special Services for the Prevention and Treatment of Alzheimer’s Disease”, emphasizing that through popular science and education, the public’s awareness of dementia prevention and control knowledge in pilot areas will be increased to 80% by 2022, and will be established.
Improve the Alzheimer’s prevention and treatment service network, establish and improve a preventive intervention model that combines patient self-management, family management, community management, and hospital management, so that the cognitive function screening rate of the elderly over 65 years old can reach 80%
.
In the implementation of the plan, the establishment of a memory clinic and other measures need to mobilize the power of the whole society to be truly realized
.
Professor Wang Huali said that the Psychiatry and Mental Health Branch of the Chinese Society of Geriatrics has completed training for more than 70 memory clinics in geriatric psychiatrics across the country.
These clinics also carried out a lot of publicity work during Alzheimer’s month.
The memory clinic got rid of the situation of not knowing what to do in the past and can really bring benefits to the people.
I am also very happy to see these results
.
"
Figure 2.
It is of great significance to promote the community's cognition screening of the elderly.
A three-pronged approach to assist AD treatment in many ways.
When it comes to early treatment of AD, Professor Wang Huali believes that treatment must be done at any stage of the disease.
"Three-pronged approach", namely: use targeted drugs to treat AD patients' brain lesions, use non-drug means to intervene AD patients with mental and psychological problems, and at the same time fully intervene patients' families
.
Among them, early treatment with drugs for the cause of the disease is an ideal treatment mode to reduce β-amyloid (Aβ) deposition or pathological tau protein phosphorylation.
However, if these drugs are not yet available or have not been successfully developed, use existing drugs to treat patients Active symptomatic treatment is also advisable
.
In the asymptomatic/symptomatic stage of AD, non-drug methods such as cognitive training and psychological counseling/treatment should be encouraged to intervene in patients’ mental and psychological behavior problems and reduce related adverse consequences.
Experts agree that these methods may be effective against drugs.
The treatment has an auxiliary effect and can also delay the effect of depression on AD
.
As the main caregivers of AD patients, the role of patients’ family members in the course of AD cannot be ignored.
The strong support of family members in the early stage of the disease can allow AD patients to maintain confidence in treatment and improve treatment compliance.
Doctors, patients and family members can form Together, the early intervention of AD is more scientific and standardized
.
Professor Wang Huali said that in order to better serve patients and their families at the same time, Peking University Sixth Hospital also opened a special "psychological treatment for the elderly" clinic this year, providing another way to help patients in addition to the memory clinic, allowing patients and their families Accept the facts of illness earlier and plan better for the future
.
Figure 3.
The support of family members is a great help for the treatment of AD patients.
At the end of the interview, Professor Wang Huali said to AD patients and clinicians as follows: Every Alzheimer’s month, we will carry out a lot of publicity and science work, and Taking advantage of the progress of AD diagnosis and treatment at home and abroad in the past year, especially the successful approval of new treatment drugs in foreign countries, I hope that more people can build the confidence to fight AD, not to be afraid of disease, but to scientifically and positively recognize cognitive impairment.
Only in this way can we bring more opportunities for early diagnosis and early scientific help for patients
.
I believe that with more scientific knowledge, the elderly will have a happier life in their later years
.
*This article is only used to provide scientific information to medical and health professionals, and does not represent the platform's views
Early diagnosis and early treatment, win at the starting line! Expert profile Professor Wang Huali, Peking University Institute of Mental Health (Sixth Hospital), Deputy Director, Beijing Key Laboratory of Translational Medicine for Diagnosis and Treatment of Dementia, Executive Director, World Dementia Council (WDC) Executive Director, International Alzheimer's Disease Association (ADI) Executive Director Executive Director of the Pacific Rim Society of Psychiatry (PRCP) Executive Vice Chairman of the Alzheimer's Disease Branch (ADC) of the Chinese Geriatrics Association Vice President of the Psychiatric and Mental Health Branch of the Chinese Society of Geriatrics Vice President of the Chinese Society of Gerontology and Geriatrics The vice chairman of the professional committee founded the first AD doctor-patient family sorority in 2000, created China's characteristic dementia care and counseling technology, proposed the whole process management concept of cognitive impairment, served as a WHO global dementia monitoring consultant, participated in the preparation of WHO global dementia research key reports, dementia Alzheimer’s disease (AD) is one of the most feared diseases in the heart of many elderly people, such as the Cognitive Deterioration Risk Prevention and Control Guidelines, because being entangled in the "Alzheimer's disease" in the general population means normal A series of functions such as life, social interaction, memory, etc.
, will gradually disappear from the patient
.
AD is the most common type of dementia, with insidious onset and diverse clinical manifestations.
At present, the public's understanding of AD is still insufficient
.
Every September is World Alzheimer's Month, and this year's theme is "Know Dementia, Know Alzheimer's"
.
The "medical community" specially invited Professor Wang Huali, director of the Memory Center of Peking University Sixth Hospital, to share her insights on hot issues related to AD diagnosis and treatment
.
(Professor Wang Huali interview video) Breaking the constraints is the key to improving the status quo of early diagnosis of AD in China.
Realizing early detection and early treatment, and moving the prevention and treatment as far as possible, will play a key role in defeating any disease
.
Therefore, during World Alzheimer's Disease Month, the Alzheimer's Disease Branch of the Chinese Geriatric Healthcare Association (ADC) also launched a series of related activities to promote the importance of early diagnosis and early treatment of AD from multiple aspects and multiple dimensions
.
As the vice chairman of ADC, Professor Wang Huali said, “We have translated the theme of this year’s World Alzheimer’s Disease Month in Chinese into'knowing the enemy, knowing the past, early diagnosis and early wisdom', and we hope that more people will understand the disease of AD.
Let more patients get early diagnosis and treatment
.
"After all, from the perspective of clinical status, the current status of early diagnosis and treatment of AD in China is still not ideal
.
Professor Wang Huali analyzed the reasons for this situation.
First, many people do not have enough understanding of the early symptoms of AD.
They believe that memory loss is common when the elderly are getting older, and cannot distinguish between normal physiological aging and pathological forgetting caused by AD.
It will lead to delays in the timing of treatment
.
"A survey conducted by us from 2012 to 2013 showed that for patients diagnosed with cognitive impairment through the memory clinic, the average interval between when their family members noticed the relevant symptoms and when the patient came to the hospital for treatment was more than 2 years, and the family members noticed The symptoms are often not early manifestations.
If it is an earlier symptom, it may take longer
.
"Figure 1.
10 early warning symptoms of dementia and common misunderstandings about AD, and may also include diagnosis AD stigmatizes patients and families
.
Professor Wang Huali pointed out that although many family members have long noticed the suspected early symptoms of AD, they are afraid that the patient will be diagnosed with dementia or cognitive impairment.
Therefore, they dare not bring the patient to the doctor.
Opportunity for early diagnosis and treatment
.
The lack of accurate diagnostic methods and the irregular and imperfect use of existing cognitive function assessment tools are another major reason that restricts the early diagnosis of AD
.
Professor Wang Huali said, “Many clinicians feel that using scales and other assessment tools to diagnose AD is too cumbersome.
If there are tools or not, there is no method; and the practicality of biomarker detection in clinical practice is still relatively limited.
Hospitals do not yet have the conditions for positron emission computed tomography (PET) testing, and the testing costs are relatively high.
The overall patient acceptance of cerebrospinal fluid testing is low.
These aspects need to be improved
.
"To achieve early diagnosis of AD, The joint effort of the whole society is required.
Professor Wang Huali called that the whole society should pay attention to and recognize AD.
In addition to actively paying attention to and supporting related work during the Alzheimer’s month in September, relevant domestic associations and organizations also need to continue their efforts.
, Provide accessible methods and information in "the closest and most convenient place to the common people"
.
On August 31, 2020, the General Office of the National Health Commission issued the “Working Plan for Exploring Special Services for the Prevention and Treatment of Alzheimer’s Disease”, emphasizing that through popular science and education, the public’s awareness of dementia prevention and control knowledge in pilot areas will be increased to 80% by 2022, and will be established.
Improve the Alzheimer’s prevention and treatment service network, establish and improve a preventive intervention model that combines patient self-management, family management, community management, and hospital management, so that the cognitive function screening rate of the elderly over 65 years old can reach 80%
.
In the implementation of the plan, the establishment of a memory clinic and other measures need to mobilize the power of the whole society to be truly realized
.
Professor Wang Huali said that the Psychiatry and Mental Health Branch of the Chinese Society of Geriatrics has completed training for more than 70 memory clinics in geriatric psychiatrics across the country.
These clinics also carried out a lot of publicity work during Alzheimer’s month.
The memory clinic got rid of the situation of not knowing what to do in the past and can really bring benefits to the people.
I am also very happy to see these results
.
"
Figure 2.
It is of great significance to promote the community's cognition screening of the elderly.
A three-pronged approach to assist AD treatment in many ways.
When it comes to early treatment of AD, Professor Wang Huali believes that treatment must be done at any stage of the disease.
"Three-pronged approach", namely: use targeted drugs to treat AD patients' brain lesions, use non-drug means to intervene AD patients with mental and psychological problems, and at the same time fully intervene patients' families
.
Among them, early treatment with drugs for the cause of the disease is an ideal treatment mode to reduce β-amyloid (Aβ) deposition or pathological tau protein phosphorylation.
However, if these drugs are not yet available or have not been successfully developed, use existing drugs to treat patients Active symptomatic treatment is also advisable
.
In the asymptomatic/symptomatic stage of AD, non-drug methods such as cognitive training and psychological counseling/treatment should be encouraged to intervene in patients’ mental and psychological behavior problems and reduce related adverse consequences.
Experts agree that these methods may be effective against drugs.
The treatment has an auxiliary effect and can also delay the effect of depression on AD
.
As the main caregivers of AD patients, the role of patients’ family members in the course of AD cannot be ignored.
The strong support of family members in the early stage of the disease can allow AD patients to maintain confidence in treatment and improve treatment compliance.
Doctors, patients and family members can form Together, the early intervention of AD is more scientific and standardized
.
Professor Wang Huali said that in order to better serve patients and their families at the same time, Peking University Sixth Hospital also opened a special "psychological treatment for the elderly" clinic this year, providing another way to help patients in addition to the memory clinic, allowing patients and their families Accept the facts of illness earlier and plan better for the future
.
Figure 3.
The support of family members is a great help for the treatment of AD patients.
At the end of the interview, Professor Wang Huali said to AD patients and clinicians as follows: Every Alzheimer’s month, we will carry out a lot of publicity and science work, and Taking advantage of the progress of AD diagnosis and treatment at home and abroad in the past year, especially the successful approval of new treatment drugs in foreign countries, I hope that more people can build the confidence to fight AD, not to be afraid of disease, but to scientifically and positively recognize cognitive impairment.
Only in this way can we bring more opportunities for early diagnosis and early scientific help for patients
.
I believe that with more scientific knowledge, the elderly will have a happier life in their later years
.
*This article is only used to provide scientific information to medical and health professionals, and does not represent the platform's views
