The city has piloted brain health screening and management in multiple districts. More than 30% of the elderly aged 65 and over have been screened for dementia risk in five pilot districts including Haidian and Xicheng.

After the brain health examination, how to manage the brain health of the elderly?

Who guides caregivers of people with moderate to severe cognitive impairment?

The reporter came to Xueyuan Road Community Health Service Center to find out.

  memory test

  Don't let stigma delay treatment

  "Have you lost your keys recently? Have you seen someone you know but can't name them? Have you ever been unable to find your way home? Don't ignore these situations, they may be an early sign of dementia. !"

  This is the test homepage of the Beijing Brain Health Checkup.

As a pilot area, 30% of people aged 65 and over in Haidian District received the screening last year.

In fact, as early as 2018, the district launched an emotional memory assessment at six community health service centers including Xueyuan Road before the city-wide pilot.

  Last year, 1,600 of the 5,000 people aged 65 and over in the Xueyuan Road Community Health Service Centre took part in the screening.

According to the plan, the proportion of elderly people participating in screening this year will increase to 80% from 30% last year.

  "The screening work is not as easy as imagined." Tao Shuli, deputy chief physician of the Department of Psychiatry of Xueyuan Road Community Health Service Center, who has been working on the emotional memory management of the elderly in his jurisdiction for more than three years, said that many elderly people are concerned about brain health. Some people are resistant to screening and are reluctant to accept the evaluation. "Some people are afraid of finding out problems and will be discriminated against by society and their peers. Some people are 'a taboo and avoid doctors', and they are worried that if they are really sick, they will cause trouble to their family members." Some elderly people Because of the "stigma" of not doing screening, the disease was delayed.

  Auntie Sun, who lives in Erlizhuang Community, is 82 years old this year. With the encouragement of the family doctor, the elderly received a brain health screening.

During the initial screening and evaluation, a question called "Drawing a Clock Experiment" made her usually shrewd and capable suddenly get stuck, "The question asked me to draw the hands of 10:10 on a blank clock, and my mind suddenly went blank at that time. ."

  Because of her poor answers, Aunt Sun got the results of the initial screening test of "cognitive decline", which made her fall into deep anxiety and worry - "Am I 'stupid'?" Her family took her specially I went to a psychiatrist to receive anti-anxiety medication.

  The community has been closely following Aunt Sun's situation and introduced her to Tao Shuli's clinic.

Tao Shuli carefully inquired about the old man's condition, and persuaded her to go home to adjust her mood and do another evaluation.

Sure enough, when Aunt Sun relaxed and took the assessment again, the assessment results were normal.

  Tao Shuli said that Alzheimer's disease is a neurodegenerative disease that seriously affects the health and quality of life of the elderly.

Early detection and early intervention can effectively delay the progression of the disease, lastingly maintain the basic living ability of patients, and maintain a good quality of life.

This is the significance of promoting brain health screening in the city.

  In her years of practical work, she found that it often happens that the elderly give up screening, diagnosis, treatment or emotional problems because of "stigma", "In fact, aging is an unavoidable biological natural The process is not an unseemly thing. Because of fear of facing the disease, emotional problems or delays in diagnosis and treatment are not worth the loss.”

  intervention training

  Buying time with fading memories

  Doing math problems, jigsaw puzzles, boccia... In a large conference room of Xueyuan Road Community Health Service Center, social workers are leading the elderly to carry out brain-handling activities.

This is a cognitive training specially designed for the elderly with mild cognitive impairment.

  According to reports, according to the brain health screening of the elderly conducted by Xueyuan Road community in the past two years, more than ten percent of the elderly have positive results in the initial screening.

"These older adults are at high risk for possible cognitive impairment and cannot be screened for."

  Xueyuan Road Community Health Service Center has specially opened outpatient clinics for the elderly with moderate to severe cognitive impairment. It has also received strong support from the Memory Center of Peking University Sixth Hospital and Beijing Muyou Social Work Development Center, inviting the most authoritative experts to the community. , to conduct a second detailed screening for the elderly who were initially screened positive.

Each elderly person undergoes a comprehensive neuropsychological test for about 3 hours to confirm the diagnosis.

Wang Huali, chief physician of the Department of Psychiatry of the Sixth Hospital of Peking University and director of the Memory Disorders Diagnosis and Research Center, and her team often come to the community health service center for consultation.

  Experts will propose specific treatment plans for diagnosed patients.

Community health service centers will provide cognitive training services for patients with mild cognitive impairment.

  "Mild cognitive impairment is between the normal benign forgetfulness in the aging process and Alzheimer's. It is manifested as a progressive decline in memory or other cognitive functions, but does not affect the ability of daily living." Experts say, actively identify and timely , Early intervention plays an important role in delaying the transformation of mild cognitive impairment to moderate to severe cognitive impairment. "Intervention training is to buy time for 'fading memory'."

  spiritual support

  Setting up a "warm classroom" for caregivers

  In the consultation room of the outpatient clinic for moderate and severe cognitive impairment, it is often not the patients themselves who come to "see a doctor", but their family members and children who take care of them.

Some people compare Alzheimer's to a "stealer".

It steals the memories and "souls" of relatives and lovers little by little, leaving only a strange body.

  To this end, the Department of Psychiatry of Xueyuan Road Community Health Center has specially designed nursing knowledge training for the caregivers of the elderly with moderate and severe cognitive impairment.

The content includes how to establish effective communication with sick relatives, how to carry out daily life care, etc.

"One of the main purposes of the class is to help them solve difficult problems in the care process." Tao Shuli said.

  "My dad is in his 90s. He usually hides his wallet. If he can't find it, he keeps asking me for it. Sometimes he says I stole it." Ms. Zhang is in her 60s, and she also suffers from dementia. She has few chronic diseases, and the situation of her old father makes her tired to deal with it.

In the training course on "Coping with Behavior Problems", the doctor gave "symptomatic" guidance to Ms. Zhang's situation.

"You can't be angry, you have to think along his lines." The doctor reassured Ms. Zhang that the old man's things were not stolen by others, but stolen by disease.

In the face of demented relatives, it is necessary to empathize with them and communicate more.

  In this special "training class", doctors and social workers will also ask the family members of the elderly with dementia to write a caregiver's diary and share it with "classmates" in the class.

The process of sharing is itself an outlet for dispelling negative emotions.

"This is a kind of 'peer support', so that everyone is no longer lonely, and warms each other's tired journey with common experiences." Sun Leqi, reporter of this newspaper