Clinical practice guideline also presents recommendations for specialist care and primary care of patients with Alzheimer disease, dementia
By Elana Gotkine HealthDay Reporter
MONDAY, Jan. 6, 2025 (HealthDay News) — In a clinical practice guideline issued by the Alzheimer’s Association and published online Dec. 23 in Alzheimer’s & Dementia, recommendations are presented for the diagnostic evaluation of patients with Alzheimer disease (AD) or AD and related dementias (ADRD). The guideline is applicable to both specialist care and primary care of patients with AD/ADRD.
Alireza Atri, M.D., Ph.D., from Banner Sun Health Research Institute and Banner Alzheimer’s Institute in Sun City, Arizona, and colleagues developed an evidence-based guideline to empower clinicians to implement a structured approach for assessing patients with symptoms that may represent clinical AD/ADRD. A total of 7,374 publications were reviewed, and of these, 133 met the inclusion criteria. Recommendations were developed in a patient-centered evaluation process.
The authors recommend that clinicians initiate a multitiered evaluation focused on the problem presented by a patient with self- or partner-reported cognitive, behavioral, or functional changes. Clinicians should use patient-centered communication to establish shared goals for the evaluation process and assess the patient’s capacity to engage in the goal-setting process. A structured but personalized diagnostic evaluation of cognitive or behavioral symptoms is recommended using hierarchical tiers of assessments and tests tailored to the patient. During history taking, clinicians should obtain reliable information on changes in cognition, activities of daily living, mood and other neuropsychiatric symptoms, and sensory and motor function, as well as individualized risk factors for cognitive decline. Laboratory tests should also be multitiered and individualized to the patient’s medical risks and profile.
“This first U.S. interdisciplinary national evaluation guideline, designed for broad clinical settings, provides a comprehensive foundation summarizing a high-quality and personalized process within which specific tests are slotted and can be updated as the field evolves,” Atri said in a statement.
Several authors disclosed ties to the pharmaceutical industry.
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