Деменции позднего возраста: смертность и сроки дожития

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: 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: 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: 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.

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