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Guidelines and Care Management Issues for People with Alzheimer’s Disease and Other Dementias

  • Review Article
  • Published:
Disease Management & Health Outcomes

Abstract

Most people with Alzheimer’s disease and other dementias do not receive ongoing, intentional medical management for these conditions, and effective coordination of medical and non-medical care is rare. Many published guidelines and consensus statements provide recommendations for identification, diagnosis and ongoing management of key issues, including cognitive decline, behavioral and psychiatric symptoms, depression, safety, family caregiver support and use of community services. These recommendations provide a strong basis for the development of disease management approaches that could improve medical outcomes and quality of life for people with these conditions and their families. In the US, a demonstration project (Chronic Care Networks for Alzheimer’s Disease) is testing an innovative model of coordinated medical and non-medical care that incorporates many of the recommendations.

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Notes

  1. In the US, tacrine, a cholinesterase inhibitor, was approved for the treatment of Alzheimer’s disease in 1993. As of early 2002, three other cholinesterase inhibitors have also been approved for the treatment of Alzheimer’s disease: donepezil, rivastigmine and galantamine.

  2. The telephone interviews were conducted by Roper Starch Worldwide, Inc., with funding from Janssen Pharmaceutica and Ortho-McNeil Pharmaceuticals. Some of the family members (222) were identified through a random digit dialing system that includes all telephone households in the US, both listed and unlisted. An additional 154 family members were selected from a national mail panel of more than 500 000 households that is screened periodically for various diseases. The physician sample was drawn from an AMA directory that lists all physicians (both members and non-members) in the US and their specialty and included only physicians with at least 10% of their patients aged 65 years or over and some patients with a diagnosis of Alzheimer’s disease

  3. At least one study found lower rates of coexisting medical conditions[58] perhaps in part because of sample factors.

  4. Available data indicate that 20 to 25% of people with Alzheimer’s disease and other dementias live alone.[71] US census data for 2000 show that among people aged 85 years and older, 59% of women live alone. Alzheimer’s disease and other dementias are most common in this age group, and it is likely that many very old people with Alzheimer’s disease, other dementias and other coexisting medical conditions are living alone.

  5. Three additional documents provide background information or a summary for particular guidelines and are helpful in understanding the guidelines.[116–118]

  6. Four additional documents provide background information or a summary for particular guidelines and are helpful in understanding the guidelines.[116,117,119,120]

  7. The six CCN/AD sites are in Denver (Colorado), Minneapolis/St Paul (Minnesota), Philadelphia (Pennsylvania), San Francisco (California), Troy/Albany (New York), and the upstate New York service area of the US Department of Veterans Affairs.

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  1. Alzheimer’s Association, 1319 F St, N. W. Suite 710, Washington, DC, 20004, United States

    Katie Maslow

  2. National Chronic Care Consortium, Minneapolis, Minnesota, USA

    John Selstad

  3. Madlyn and Leonard Abramson Center for Jewish Life, Philadelphia, Pennsylvania, USA

    Susan J. Denman MD (Director)

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Maslow, K., Selstad, J. & Denman, S.J. Guidelines and Care Management Issues for People with Alzheimer’s Disease and Other Dementias. Dis-Manage-Health-Outcomes 10, 693–706 (2002). https://doi.org/10.2165/00115677-200210110-00003

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  • DOI: https://doi.org/10.2165/00115677-200210110-00003

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