摘要
Abstract
Alzheimer's disease and related cognitive disorders are characterized by an insidious onset and long disease course,making early identification a critical strategy for reducing disease burden.The 10th edition of the Guidelines for Preventive Activities in General Practice issued by the Royal Australian College of General Practitioners(RACGP)adopts a strong primary care orientation and emphasizes opportunistic case-finding among high-risk populations,integrating evidence-based principles on screening,selection of cognitive assessment tools,and multidimensional management of modifiable risk factors.Drawing on the 2024 Lancet Commission on Dementia Prevention,Intervention and Care,World Health Organization evidence,and the life-course management framework,this paper systematically interprets the key recommendations of the RACGP guideline from a general practice perspective,with a focus on risk identification,exclusion of reversible causes,stratified use of screening instruments,and longitudinal management.The analysis suggests that commonly used tools such as the MoCA,GPCOG,RUDAS and AD8 demonstrate complementary strengths across different community populations and clinical contexts,supporting their integration into opportunistic screening pathways in primary care.In addition,interventions targeting physical activity,metabolic control,hearing impairment,sleep disorders and medication optimization constitute a feasible life-course prevention package.In the Chinese primary care context,early identification of cognitive impairment remains constrained by insufficient linkage between screening and referral,limited workforce training and resource integration,and low public awareness.This paper proposes embedding cognitive screening into family doctor contract services and chronic disease management programmes,and leveraging integrated care networks to establish a closed-loop pathway encompassing screening,assessment,referral,intervention and follow-up,thereby advancing earlier prevention and strengthening the role of primary care in dementia risk reduction.关键词
阿尔茨海默病/痴呆(失智症)/全科医生/早期识别/认知障碍/初级卫生保健Key words
Alzheimer's disease/Dementia/General practitioners/Early identification/Cognitive impairment/Primary health care分类
医药卫生
