Evidence base: Alzheimer's disease

A summary of the clinical trials, guidelines, key texts and online resources to help in the management of Alzheimer's disease

Scan of a normal brain (left) and AD patient (right). Blue/black areas show reduced brain activity (Photograph: SPL)
Scan of a normal brain (left) and AD patient (right). Blue/black areas show reduced brain activity (Photograph: SPL)

Clinical trials

The many clinical trials of ChEIs and memantine in AD are summarised in Cochrane reviews:

Technology appraisal

However, guidance from NICE ultimately determines availability of these medications to NHS patients:

  • NICE. Donepezil, galantamine, rivastigmine (review) and memantine for the treatment of Alzheimer's disease. Includes a review of NICE technology appraisal guidance 19. TA111. London, NICE, 2006. www.nice.org.uk/guidance/TA111

New NICE guidance extending the use of ChEIs and memantine is expected to be issued in March 2011.

Guidelines

  • NICE/Social Care Institute for Excellence. Dementia: supporting people with dementia and their carers in health and social care. NICE CG42. London, NICE, 2006. www.nice.org.uk/CG42
  • Scottish Intercollegiate Guidelines Network. Management of patients with dementia. Edinburgh, SIGN, 2006.
  • Waldemar G, Dubois B, Emre M, et al. Recommendations for the diagnosis and management of Alzheimer's disease and other disorders associated with dementia: EFNS guideline. Eur J Neurol 2007;14:e1-26.
  • DoH. Living well with dementia: National Dementia Strategy. London, DoH, 2009.
  • DoH/Alzheimer's Society. Understanding dementia. A resource pack for GPs and patients. London, Alzheimer's Society, 2009.

Key texts

  • Larner AJ. Alzheimer's disease. In: Cappa SF, Abutalebi J, Demonet JF, et al (eds.). Cognitive neurology: a clinical textbook. Oxford, Oxford University Press, 2008: 199-227.

Online

This is a list of fact sheets covering a wide range of dementia-related topics, including genetics and dementia, drug treatment for AD, and understanding and respecting the person with dementia. Fact sheets can be downloaded free as PDFs.

This page provides e-learning resources freely available to all users. It includes a tour of the brain and how to deal with unusual behaviour.

This page details how to obtain power of attorney, an issue which is important to someone with dementia and their families.

 

Contributed by Dr Andrew Larner, consultant neurologist at the Walton Centre for Neurology and Neurosurgery, Liverpool, and Kathleen Storton, a dementia support worker at the Alzheimer's Society

 

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