psychiatryПСИХИАТРИЯPsychiatry (Moscow) (Psikhiatriya)1683-83192618-6667FSBSI “The Mental Health Research Centre”; LLC «Publisher «MIA»10.30629/2618-6667-2019-17-2-54-67psychiatry-404Research ArticleНАУЧНЫЕ ОБЗОРЫSCIENTIFIC REVIEWSДеменции позднего возраста: смертность и сроки дожитияDementia of Old Age: Mortality and SurvivalМихайловаН. М.MikhaylovaN. M.

Михайлова Наталия Михайловна, доктор медицинских наук

Nataliya M. Mikhaylova, Dr. of Sci. (Med.),

MikhaylovaNM@yandex.ruФГБНУ «Научный центр психического здоровья»РоссияFSBSI «Mental Health Research Centre»Russian Federation2019311020191725467Copyright © Михайлова Н.М., 20192019Михайлова Н.М.Mikhaylova N.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.journalpsychiatry.com/jour/article/view/404Цель

Цель: обобщить данные исследований о показателях смертности и сроков дожития больных деменцией позднего возраста и представить изменения в представлениях продолжительности и конце жизни больных деменцией в соответствии с результатами современных исследований.

Материал и метод

Материал и метод: для составления обзора литературы по ключевым словам «поздний возраст», «деменция», «смертность» и «дожитие» отобраны и проанализированы статьи в базах MEDLINE/PubMed с 1990 по 2019 г., а также релевантные ссылки в списках литературы анализированных статей.

Результаты и обсуждение

Результаты и обсуждение: по результатам анализа научных публикаций представлены различия показателей смертности и сроков дожития при деменциях позднего возраста в сравнении с их значениями в отсутствие деменции. Показаны отличия показателей смертности и сроков дожития в зависимости от нейродегенеративного и сосудистого генеза деменции. Отмечена тенденция к увеличению продолжительности заболевания при деменциях позднего возраста, прежде всего, нейродегенеративного генеза, в сравнении с прежними представлениями. Среди факторов влияния на значения показателей смертности и дожития наиболее значимыми признаются гендерные и возрастные характеристики больных деменцией, наличие множественной соматической патологии. Современные возможности диагностики деменции на более ранних этапах заболевания рассмотрены в плане изменения представлений об увеличении продолжительности заболевания. Неоднозначно оценивается эффект терапевтического вмешательства, так же как условий жизни больных деменцией и организации ухода за ними.

Заключение

Заключение: представление об ожидаемой продолжительности жизни больных деменцией необходимо для индивидуальной врачебной работы с пациентами и членами их семей, а также для государственного планирования объема медицинской и социальной помощи населению старшего возраста.

The aim of the review

The aim of the review: to generalize the data of the studies on mortality rates and terms of survival of patients with late age dementias, and to present the changes in notions of lifetime and the end of life in patients with late age dementias in accordance with the results of current studies.

Material and methods

Material and methods: for making a review of the literature according to the key words «late age», «dementia», «mortality», and «survival», papers were selected and analyzed from 1990 till 2019 in databases of MEDLINE/PubMed, as well as relevant references in the literature of the analyzed papers.

The results and discussion: according to the results of the analysis of scientific publications, the differences between the mortality rates and the terms of survival were presented in comparison to their values in the case of dementia’s absence. The differences between the mortality rates and the terms of survival, depending on neurodegenerative and vascular genesis of dementia, were shown.

A tendency towards the increase of duration of illness was noticed in dementias of late age, first of all of neurodegenerative type, in comparison to the previous notions. Among the factors of influence on mortality rates and terms of survival, gender and age characteristics of dementia patients, and the presence of multiple medical pathologies, are considered the most significant.

Among the factors of influence on the values of mortality rates and survival, gender and age-related characteristics of patients with dementia, the presence of multiple medical pathologies, are considered the most significant. The current possibilities of dementia diagnostics at the earlieststages of the disease, were considered as to the change of concepts of an increase in the duration of the illness. The effect of therapeutic inter vention is evaluated ambiguously, as well as the living conditions of patients with dementia and the organization of care for them.

Conclusion

Conclusion: the notion of the expected duration of life of the patients with dementia is necessar y for individual medical work with the patients and the members of their families, as well as for state planning of the volume of medical and social assistance to the patients of old age.

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The authors declare that there are no conflicts of interest present.