The first practice guidelines for the clinical evaluation of cognitive impairment due to Alzheimer’s disease and related dementias (ADRD) were released earlier this year by the American Alzheimer’s Association workgroup.
According to the authors of the guidelines, they envision a world where a cure for AD has been discovered.
Despite more than two decades of advances in diagnostic criteria and technology, too often cognitive and behavioural symptoms due to AD and other dementias are unrecognised or are attributed to something else, said Dr James Hendrix, a member of the workgroup.
“This causes harmful and costly delays in getting the correct diagnosis and providing appropriate care for persons with the disease. These new guidelines will provide an important tool for medical professionals to more accurately diagnose AD and other dementias. As a result, people will get the right care and appropriate treatments and families will get the right support and be able to plan for the future,” he added.
A timely and accurate diagnosis of ADRD increases patient autonomy at earlier stages when they are most able to participate in treatment, life and care decisions allows for early intervention to maximise care and support opportunities, and available treatment outcomes and may also reduce healthcare costs.
The guidelines comprise 20 recommendations, which range from enhancing efforts to recognise and more effectively evaluate symptoms to compassionately communicating with and supporting affected individuals and their caregivers.
At their core, the recommendations include guidance that:
- All middle-aged or older individuals who self-report or whose care partner or clinician report cognitive, behavioural or functional changes should undergo a timely evaluation
- Concerns should not be dismissed as ‘normal ageing’ without a proper assessment
- Evaluation should involve not only the patient and clinician but, almost always, also involve a care partner (eg family member or confidant).
The recommendations furthermore describe a multi-tiered approach to the selection of assessments and tests that are tailored to the individual patient:
- Establish the presence and characteristics of any substantial changes, to categorise the cognitive behavioural 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.