24 25 1 30 7 25 1 29 URL (http://www.igakuken.or.jp/research/gakujutsu_syukai/g_syukai130129/pdf/03.pdf) i
ii
Alistair Burns Benoit Lavallart Russell de Burgh Nis Peter Nissen Julie Meerveld Anne Higgins Paul McCrone & iii
1
early detection early diagnosis Burns Burns 46 2
Burns GP GP GP GP Lavallart Lavallart MCI GP GP GP GP 1 3
2 3 4 5 GP MAIA Memory Resource and Research Center 2 1 de Burgh de Burgh 3 1 50 80 3 GP 1 2 GP 3 4
GP de Burgh 2 1 1 GP GP GP Nissen GP Nissen 3 1 GP GP GP GP 1 GP 5
GP GP GP 2 GP 10 1 GP 1 GP GP GP GP Burns GP 1 Nissen 14 7 1 Meerveld 6
Meerveld GP 40 11 1 2012 1 4 Higgins Higgins Meerveld 7
GP McCrone McCrone QOL QOL 8
McCrone Lavallart Lavallart GP 25 25 Burns 3 case finding 9
GP Burns timely diagnosis (early diagnosis) 3 2 advanced care planning MRI 3 1 GP GP GP GP GP GP Higgins GP 3 GP 3 1 10
2 1 GP 1 1 Burns I have dementia. I also have a life. Burns I have dementia. I also have a life. 11
Memory Services National Accreditation Programme: MSNAP MSNAP National Institute for Health and Clinical Excellence NICE 14 A4 Nissen MCI 10 10 1 GP GP 12
GP Meerveld GP GP GP GP GP GP GP Higgins 13
Cultural Olympiad GP Burns GP Meerveld GP GP 1 GP GP MMSE Mini Mental State Examination CT 14
Burns 2 MMSE CT 1 Nissen Burns Burns 1 15
16
3 1 2 1 2 3 de Burgh GP 1 17
advanced care planning 65 1 de Burgh 18
Nissen GP integrated intervention 2 Nissen 1 GP 19
2 GP 1 Meerveld Meerveld 2005 GP GP 20
GP GP 1 Higgins Higgins NHS 1 21
NHS 1 Burns individual budget Burns Higgins GP de Burgh 1 1 1 22
MAIA MAIA Lavallart MAIA MAIA 1 MAIA PRISMA 6 1 GP 2 MAIA 3 23
1 1 1 MAIA 20 2014 McCrone McCrone Higgins 1 Higgins personal budget 24
1 MAIA 2 MAIA 1 Lavallart MAIA Lavallart MAIA 2 1 6 7 1 PRISMA 2 3 25
Higgins Higgins 1 1 2 Meerveld Meerveld GP 26
GP 1 2 1 10 GP GP 3 1 PGB 2 Nissen 27
Burns Higgins NHS NHS 10 50 HoNOS Health of the Nation Outcome Scales 5 de Burgh 1 28
1 1 Lavallart 2 70 2 29
30
BPSD BPSD BPSD BPSD 48 1 31
300 900 Burns BPSD Burns BPSD BPSD behavioral and psychiatric symptoms of dementia 1990 1990 Burns 90 4 1 65 5 2002 FDA 32
2009 Sube Banerjee 18 1800 1600 1800 1600 5 52 1 3 1 Paul Burstow BPSD GP agitated BPSD watchful waiting Burns 33
Burns Lavallart BPSD 1 BPSD BPSD 2 UCC BPSD UCC NPI Neuropsychiatric Inventory UCC 60 2 nurse assistant BPSD 100 BPSD 34
BPSD Nissen BPSD 1 2 36 2 Meerveld 33 35
41 64 10 41 64 BPSD 1 NHS Afifa Qazi GP Burns Qazi GP BPSD GP Qazi 36
Higgins Lavallart BPSD Lavallart 20 2 1 2 2 1 BPSD 80 1 37
Lavallart GP 12 BPSD 2 1 DBMAS BPSD DBMAS de Burgh DBMAS Dementia Behaviour Management Advisory Service DBMAS 2 1 1 24 1 DBMAS BPSD GP DBMAS GP GP National Dementia Helpline DBMAS DBMAS agitated 38
Geriant Meerveld 1 Geriant Geriant Geriant Geriant 1 1 39
Geriant Buurtzorg Nissen BPSD BPSD 3 1 2 40
3 3 National Prescribing Service de Burgh de Burgh National Prescribing Service GP National Prescribing Service National Prescribing Service 41
5 900 20 34 8,000 5 2,000 900 300 3 1 3 180 20 Burns 500 BPSD 10 42
BPSD BPSD BPSD BPSD Burns BPSD agitated Burns 6 6 5 3 4 Qazi Higgins Burns 1 43
Meerveld Meerveld 44
de Burgh mixed funding model 1 de Burgh GP mixed funding model 1 BPSD Burns de Burgh 4 1 45
3 46
47
4 2 3 1995 Carers Act Higgins Higgins 1995 1999 National Carer Strategy 1 48
2 NHS 1995 49
Carers Recognition Act de Burgh 2010 Carers Recognition Act 6 6 2 5 24 1 1 Lavallart Lavallart GP 50
10 2 1 2 12,000 Nissen Nissen 1 5 7 51
1 2 10 1 McCrone McCrone Nissen Nissen 1 Burns Sheffield Dementia Information Pack 52
Sheffield Dementia Information Pack Burns 3 2 Prime Minister s Challenge on Dementia 4 1 McCrone 1 Nissen 1 1 53
EU Eurocarers 10 1 Higgins 1 Higgins voluntary sector organization 54
2 1 1 NHS UK Crossroads Nissen 2 Meerveld Meerveld 55
Meerveld 1990 1 1 1 1 56
Lavallart 1 2 2 1 2 Nissen Nissen 57
McCrone 3 2 4 Higgins Burns 58
Burns 300 400 2 3 3 de Burgh 2 1 1 70 59
Lavallart 1 60
Espace éthique 61
2 1 Mental Capacity Act Burns 1 Espace éthique Emmanuel Hirsch Lavallart Burns 2005 Mental Capacity Act Burns 2005 2007 2 62
5 1 2 unwise decision 3 4 Mental Health Act 5 301 enduring power of attorney lasting power of attorney lasting power of attorney Court of Protection advanced decisions Office of Public Guardian 4 4 63
2007 Burns Higgins Higgins Nissen Nissen 64
2 1 2 65
Higgins Meerveld Meerveld 2 1 de Burgh de Burgh 2 3 66
advance directive Lavallart Lavallart 1 1 social representation 2 67
3 4 5 www.espace-ethique-alzheimer.org 68
Burns Burns Nissen 69
70
2 1 1 2 2 Nissen Burns 71
Nissen 0.2 1 McCrone 24 20 72
Burns Burns 1 Living well with dementia GP 1 5 17 2 55 50 Nissen 100 130 100 5 Nissen McCrone 5400 73
5 McCrone McCrone 2 1 1 2 2 Burns 1 10 74
1 1 1 QALY McCrone NICE National Institute for Health and Clinical Excellence NICE QALY QALY QOL QOL QOL QOL QOL 1 QALY 75
1 McCrone NICE Meerveld 76
Meerveld 2 GP GP McCrone 1 GP 1 77
7 1 5 Burns Burns McCrone Higgins GP 78
McCrone 1 de Burgh 2 10 10 1 Lavallart Lavallart 79
de Burgh 80
Meerveld European Research Program Lavallart 1 4 2 4 1 81
Higgins 82
Burns Higgins 3 implementation group 1 1 15 de Burgh 2 Lavallart 83
Nissen 3 Nissen 1 2 1 1 1 84