早发性痴呆 (YOD) 和晚发性痴呆 (LOD) 患者在临床需求和疾病轨迹方面的显着差异使得痴呆姑息治疗独一无二。关于YOD和LOD之间姑息治疗需求差异的研究有限，并且在YOD中引入姑息治疗的最佳时间点仍然存在争议。我们进行了系统回顾，总结了有关 YOD 姑息治疗的关键问题，并强调了这一相关领域未满足的需求。按照系统回顾和荟萃分析的首选报告项目 (PRISMA) 指南，我们在 PubMed 数据库中检索了 2017 年发表的所有研究2000 年 1 月和 2022 年 7 月报告了 YOD 中的姑息治疗。在已识别的 32 条记录中，有 8 篇文章符合纳入条件。提取的前 3 个主题围绕 (1) YOD 和 LOD 之间的临床差异，(2) 终末期 YOD 的症状和死亡原因，以及 (3) 早期高级护理计划 (ACP) 的重要性。 YOD 诊断经常被延迟，YOD 患者的躯体合并症较少，但神经精神症状较多，生存时间较长，且病程恶性程度较高。当症状在较年轻时出现时，YOD 患者及其家人面临着独特的心理社会挑战。终末期 YOD 与 LOD 没有什么不同，后者患者患有广泛的身体和心理症状，需要姑息治疗。鉴于影响认知和决策能力的疾病进展更快，尽早开始 ACP 讨论对于 YOD 至关重要；然而，YOD 中的 ACP 完成率仍然很低。鉴于 YOD 中复杂的护理需求和更快的疾病轨迹，YOD 中的姑息治疗应从诊断时开始考虑，并将其纳入常规痴呆症护理中。版权所有 © 2024。由爱思唯尔公司出版

The distinctive differences in clinical needs and disease trajectory between persons with young-onset (YOD) and late-onset dementia (LOD) make dementia palliative care unique. Limited studies have reported on the differences in palliative care needs between YOD and LOD, and the optimal time point to introduce palliative care in YOD remains controversial. We performed a systematic review to summarize key issues surrounding palliative care in YOD and highlight unmet needs in this pertinent area.Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched the PubMed database for all studies published between January 2000 and July 2022 that reported on palliative care in YOD.Of 32 records identified, 8 articles were eligible for inclusion. The top 3 themes extracted centered around (1) clinical differences between YOD and LOD, (2) symptoms and causes of death in end-stage YOD, and (3) the importance of early advanced care planning (ACP). YOD diagnosis is often delayed and persons with YOD have fewer somatic comorbidities but more neuropsychiatric symptoms, longer survival times, and a more malignant disease course. Persons with YOD and their families face unique psychosocial challenges when symptoms start at a younger age. End-stage YOD is not dissimilar to LOD where patients suffer from a broad spectrum of physical and psychological symptoms requiring palliation. Early initiation of ACP discussion is crucial in YOD given the more rapid progression of disease affecting cognition and decision-making capacity; however, rates of ACP completion in YOD remain low.Given the complex care needs and more rapid disease trajectory in YOD, palliative care in YOD should be considered from the time of diagnosis, and to be incorporated into routine dementia care.Copyright © 2024. Published by Elsevier Inc.