First practice guidelines for clinical evaluation of Alzheimer’s disease

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)