The management of dementia worldwide: A review on policy practices, clinical guidelines, end-of-life care, and challenge along with aging population

抄録

Dementia, with a high incidence rate, fast-developing syndrome and large disease burden, raises challenges to global health and social systems. In this review, in order to elaborate current management and diagnosis statements of dementia, and provide further reference to improve dementia service system, we stated policies, clinical guidelines and management experiences concerning dementia across the world. According to the existing dementia management policies and plans, most countries focus on the following aspects: timely detection of dementia, improvement of service quality, person-centered and integrated dementia services at all stages, dementia awareness and friendliness, and scientific research of dementia. Detection of dementia requires knowledge of medical history and cognitive examination, while dementia diagnosis requires more professional medical examination results. Regarding different types of dementia, multiple international standards are used in practice. The overall goals of dementia treatments include postponing the process of cognitive decline and reducing pain caused by cognitive decline, behavioral and psychological symptoms of dementia (BPSD). Treatments include pharmacotherapy interventions and non-pharmacotherapy interventions. In the end-of-life, palliative care is required to improve the quality of life of people with dementia, and maintain their functions. Challenges exist in reducing the disease burden of dementia in the situation of aging population. There are policy bottlenecks and shortcomings to overcome providing medical care services for people with dementia. We would like to suggest strengthening continuous integrated dementia services, improving community services and management support, encouraging policy and financial support for nursing workers, and better support in the end-of-life.