The first practice guidelines
for clinical evaluation of Alzheimer’s disease and other dementias has been
released by the Alzheimer’s Association. The guideline addresses care of
patients in both primary care and specialty care settings.
At their core, the guidelines
recommend that all middle-aged or older individuals who self-report or whose
care partner or clinician report cognitive, behavioral or functional changes
should undergo a timely multi-tiered evaluation. Not just the patient and the
doctor but, almost always, a care partner e.g., family member or confidant
should always be involved.
Most importantly, concerns
should not be dismissed as “normal aging” without a proper assessment. Not
doing so delays the correct diagnosis and consequently, timely and appropriate
care for persons with the disease.
The guidelines also emphasize
on obtaining a history from the patient and also from someone who knows the
patient well to:
· Establish the presence and
characteristics of any substantial changes, to categorize the cognitive
behavioral syndrome.
· Investigate possible causes
and contributing factors to arrive at a diagnosis/diagnoses.
· Appropriately educate,
communicate findings and diagnosis, and ensure ongoing management, care and
support
A broader category of
“Cognitive Behavioral Syndromes” is described in the guidelines indicating that
neurodegenerative conditions such as Alzheimer's disease and related dementias
lead to both behavioral and cognitive symptoms of dementia. As a result, these
conditions can produce changes in mood, anxiety, sleep, and personality
together with interpersonal, work and social relationships, which become
apparent earlier than the typical memory and thinking symptoms of Alzheimer’s
disease.
The guidelines were previewed
on July 22 at the Alzheimer's Association International Conference (AAIC) 2018,
which concludes today in Chicago.
(Source: Alzheimer’s
Association)
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