First Clinical Guidelines for Alzheimer Disease Evaluation Developed

JULY 23, 2018
Cecilia Pessoa Gingerich
A working group brought together by the Alzheimer’s Association has developed a list of 20 recommendations for clinicians including physicians and nurse practitioners regarding symptoms of Alzheimer’s disease and Related Dementias (ADRD).

“Too often cognitive and behavioral symptoms due to Alzheimer’s disease and other dementias are unrecognized, or they are attributed to something else,” James Hendrix, PhD, Alzheimer’s Association Director of Global Science Initiatives and staff representative to the workgroup, said in a statement. “This causes harmful and costly delays in getting the correct diagnosis and providing appropriate care for persons with the disease.”

The guidelines encompass broad areas of care including enhancing efforts to recognize and effectively evaluate symptoms and communicate to patients and caregivers with compassion.

“These new guidelines will provide an important new tool for medical professionals to more accurately diagnose Alzheimer and other dementias. As a result, people will get the right care and appropriate treatments; families will get the right support and be able to plan for the future,” said Hendrix.

The guidelines recommend that middle-aged or older adults who self-identify or whose care partner or clinician identify cognitive, behavioral, or functional changes should be evaluated in a timely fashion. They emphasize that concerns should not be dismissed as “normal aging” without an assessment.

Additionally, the recommendations state that evaluations of possible Alzheimer disease or other dementias should almost always involve a care partner—a family member or confidant—in addition to the patient and clinician.

Last year, the Alzheimer’s Association convened a Diagnostic Evaluation Clinical Practice Guideline workgroup (AADx-CPG workgroup) of experts from various disciplines to develop the recommendations.

The group’s recommendations were presented at the Alzheimer’s Association International Conference (AAIC) 2018 by Alireza Atri, MD, PhD, Co-chair of the AADx-CPG workgroup, and Director of the Banner Sun Health Research Institute, Sun City, AZ, and Lecturer in Neurology at the Center for Brain/Mind Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston.

“Our goal is to provide evidence-based and practical recommendations for the clinical evaluation process of cognitive behavioral syndromes, Alzheimer disease and related dementias that are relevant to a broad spectrum of US health care providers,” Atri said. “Until now, we have not had highly specific and multispecialty US national guidelines that can inform the diagnostic process across all care settings.”

The AADx-CGP workgroup document continues to be developed with input from leaders in the field and the Alzheimer’s Association reports a goal publication date in late 2018.

“Next steps include reaching out to physician groups and medical societies to encourage primary care doctors, dementia experts, and nurse practitioners to adopt these new best clinical practice guidelines,” Hendrix said.

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