2017年AAN轻度认知功能障碍实践指南解读

Interpretation of the 2017 AAN Practice Guideline for Mild Cognitive Impairment

2017年美国神经病学学会(AAN)在Neurology杂志上对轻度认知功能障碍(MCI)实践指南进行了更新,新指南重点介绍了MCI的评估和管理,提出临床医生应评估MCI患者可治疗的危险因素、认知功能障碍、精神行为症状,并动态监测MCI患者认知功能的变化;药物不良反应、睡眠障碍和抑郁症等危险因素是可逆的,建议患者停用损害认知功能的药物,且对可逆危险因素进行防治是治疗MCI的第一步。虽然目前没有高质量证据支持MCI的药物治疗,但2次/周的定期运动锻炼作为整体治疗的一部分对MCI患者是有益的,并建议对MCI患者尝试进行认知功能训练。

The American Academy of Neurology(AAN)published the updated practice guideline on mild cognitive impairment(MCI)in Neurology in 2017.The new guideline detailedly introduces the assessment and management of MCI.It is suggested that clinicians should evaluate modifiable risk factors,functional impairment,behavioral/neuropsychiatric symptoms and dynamically monitor cognitive status of patients with MCI.Moreover,as controlling and treating modifiable risk factors,such as side effects of medications,sleep disturbance and depression,should be the first step in managing MCI,clinicians are suggested to wean patients from medications contributing to cognitive impairment.Furthermore,although there is no high-quality evidence in support of pharmacologic treatment for MCI,they can recommend MCI patients doing regular exercise twice a week,which might be beneficial for MCI as part of the overall treatment.The guideline also suggests that cognitive interventions might be recommended for MCI patients.