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Le médecin généraliste et la maladie d’Alzheimer

The primary care physician and Alzheimer’s disease: a position paper

  • Article Original / Original Article
  • Published:
Les cahiers de l'année gérontologique

Résumé

Le médecin généraliste (MG) occupe une place essentielle dans la prise en charge du sujet âgé souffrant de maladie d’Alzheimer (MA). Le travail suivant, issu d’une revue de la littérature et d’un consensus d’experts, aborde son rôle dans les différentes étapes de la prise en charge de la maladie. Le MG doit assurer une détection des symptômes de démence, dans certaines situations ciblées, pour pouvoir favoriser ensuite le diagnostic précoce de MA. Dans certains cas typiques, le MG pourra poursuivre le bilan étiologique et évoquer le diagnostic de MA, avant d’adresser le patient à une consultation spécialisée, pour confirmation. Le MG doit également être partie prenante du processus d’annonce diagnostique et d’élaboration du plan de suivi. Il doit également participer à la prise en charge pharmacologique et non pharmacologique du patient ainsi qu’à la mise en place des aides. Enfin, il se doit de favoriser l’accès des patients aux essais cliniques concernant les thérapeutiques innovantes et la prévention.

Abstract

The primary care physician has a central role in the management of older adults with Alzheimer’s disease (AD). The proposals in this article stem from a collaborative work of a panel of experts involved in the care of AD patients. The primary care physician’s (PCP) intervention appears essential at all levels: detection of the onset of dementia, diagnostic management, treatment and follow-up and lastly therapeutic research. In primary care practice, the first step is to identify dementia. Then a group of uncomplicated demented old subjects with typical AD symptoms can be identified, in which the PCP could make the diagnosis and then seek specialist confirmation. Disclosure to patient and family should be done by both specialist and PCP. Then the PCP has a key role in pharmacological and nonpharmacological management of the disease, in support services and in follow-up. Finally, the role of the PCP in clinical trials must be integrated in the daily practice.

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Authors and Affiliations

  1. Gérontopôle, service de médecine interne gériatrique, CHU de Toulouse, hôpital Casselardit, 170, avenue de Casselardit, F-31300, Toulouse, France

    H. Villars, F. Nourhashemi & B. Vellas

  2. Département de médecine générale, Faculté de médecine de Toulouse-Rangueil, 133, route de Narbonne, F-31062, Toulouse cedex, France

    S. Bismuth & S. Oustric

  3. Inserm U558, F-31073, Toulouse, France

    F. Nourhashemi & B. Vellas

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  1. H. Villars
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  2. S. Bismuth
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  3. S. Oustric
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  4. F. Nourhashemi
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  5. B. Vellas
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Correspondence to H. Villars.

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Villars, H., Bismuth, S., Oustric, S. et al. Le médecin généraliste et la maladie d’Alzheimer. cah. année gerontol. 2, 2–12 (2010). https://doi.org/10.1007/s12612-010-0044-6

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