Abstract: Background　Dementia is a term describing a group of symptoms of acquired cognitive impairment，whose progression is associated with significantly decreased activities of daily living，learning，work and social abilities，seriously affecting the quality of life. Comprehensive and effective community management of dementia contributes to the delay of dementia progression，and high-quality clinical practice guidelines can provide effective management strategies，so the use of both of them may improve the quality and consistency of community management of dementia. Objective　 To assess the qualities of clinical practice guidelines and consensuses covering community management of dementia，providing a reference for the management of dementia in primary care. Methods　From September 2019 to January 2020，we searched for evidence-based clinical practice guidelines on dementia management and dementia care consensuses published between 2008 and 2020 from literature databases and websites，and screened them based on the inclusion and exclusion criteria. We reviewed the eligible guidelines and consensuses using the AGREE Ⅱ，and assessed the overall agreement among reviewers using the kappa coefficient. Results　A total of 45 guidelines were finally included. The mean values of standardized percentage of these guidelines in terms of six domains of scope and purpose，stakeholder involvement，rigour of development，clarity of presentation，applicability，and editorial independence were （77.2±8.96）%，（46.3±21.16）%，（39.19±20.8）%，（71.70±17.3）%，（26.3±17.35）%，and（40.6±33.73）%，respectively. By comprehensive evaluation，one was A-rated，23 were B-rated，and 21 were C-rated. Inter-rater agreement was good and the kappa coefficient was（0.73±0.16）（P<0.001）. Finally，24 moderate-to-high quality guidelines were selected，and the mean values of their standardized percentage scores in the above-mentioned six domains were （80.20%±7.90）%，（54.50±16.98）%，（48.90±16.03）%，（77.90±7.99）%，（33.20±17.34）%，（53.3±35.63）%，respectively. The average kappa coefficient for inter-rater agreement for rating these 24 guidelines was （0.73±0.16）（P<0.001）. Conclusion　 By use of the AGREE Ⅱ，we singled out evidence-based moderate-to-high quality guidelines/consensuses on the management of people with dementia. Although the methodology needs to be further standardized and strengthened，these overall high-quality guidelines could be used as guidance for the management of dementia in primary care，and as a reference for the development of guidelines on the management of dementia in primary care.

Key words: Dementia, Alzheimer disease, Community management, Guideline, Quality appraisal, AGREE Ⅱ

摘要： 背景　痴呆是一种获得性认知功能障碍，随着病情进展，患者日常生活、学习、工作和社交能力明显减退，严重影响患者生活质量。全面而有效的痴呆社区管理能够延缓痴呆进程，而高质量的临床实践指南能够提供有效的管理策略，从而提高痴呆社区管理的质量和一致性。目的　对国内外包含痴呆社区管理内容的临床实践指南和共识进行评价，以期为基层医疗卫生机构进行痴呆管理提供参考。方法　2019年9月至2020年1月，检索国内外文献数据库及网站，按照纳入和排除标准查找2008—2020年发表的有关痴呆管理的循证临床实践指南、痴呆照护共识等；使用指南研究和评估工具Ⅱ（AGREE Ⅱ）对指南进行质量评价，并通过Kappa值对评价者间总的一致性进行评价。结果　共入选45篇指南，指南范围与目的、参与人员、严谨性、清晰性、应用性与独立性6个领域标准化百分比得分分别为（77.2±8.96）%、（46.3±21.16）%、（39.19±20.8）%、（71.70±17.3）%、（26.3±17.35）%、（40.6±33.73）%，经过全面评价后，A级指南1部，B级指南23部，C级指南21部。评价者间一致性较好，Kappa值为（0.73±0.16）（P<0.01）。最终评选出24部中、高质量指南，指南范围与目的、参与人员、严谨性、清晰性、应用性、独立性6个领域平均得分分别为（80.20%±7.90）%、（54.50±16.98）%、（48.90±16.03）%、（77.90±7.99）%、（33.20±17.34）%和（53.3±35.63）%。筛选出的24部中高质量指南的Kappa值评分均值为（0.70±0.20）（P<0.01）。结论　本研究应用AGREE Ⅱ对入选指南或共识进行质量评价，评选出了中、高质量指南，尽管制定方法学有待进一步规范和加强，但总体质量较高，并遵循了循证原则，能够为基层医疗卫生机构进行痴呆管理提供指导，为我国建立基层医疗卫生机构痴呆管理指南提供参考。

关键词: 痴呆, 阿尔茨海默病, 社区管理, 指南, 质量评价, 临床指南研究与评估系统Ⅱ