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Date: Wednesday, Sept. 25, 1996 FOR IMMEDIATE RELEASE Contact: AHCPR Public Affairs (301) 594-1364, Howard Holland, Ext. 1374, Salina Prasad, Ext. 1317>
"Many health care professionals, as well as patients, their families and friends, mistakenly view the early symptoms of Alzheimer's disease as inevitable consequences of aging," said HHS Secretary Donna E. Shalala. "I urge all physicians to become familiar with the guidelines findings and recommendations so patients will receive the best care possible.
"I also urge everyone, especially people with aging family members and friends, to become acquainted with the symptoms that may indicate Alzheimer's disease. If you or someone you know has any of these symptoms, you should talk about them with a doctor as soon as possible," Shalala said.
"Early recognition of Alzheimer's disease, or identification of other types of dementias, can prevent costly and inappropriate treatment, and give patients and family members time to address the complex financial, legal and medical issues these conditions present," said Paul T. Costa, Jr., Ph.D., of the Gerontology Research Center at the National Institute on Aging, and co-chair of the panel of public- and private-sector experts responsible for the guideline. "This guideline provides the tools needed to conduct an initial assessment when symptoms are present," Dr. Costa said.
Symptoms like increased difficulty with learning and retaining new information, handling complex tasks, reasoning, and spatial ability and orientation should trigger a clinical assessment. A family history of dementia and/or Down syndrome are possible risk factors that merit special attention.
"Patients who are depressed, taking multiple medications, or abusing alcohol are frequently misdiagnosed or not treated because their symptoms are confused with Alzheimer's disease or other dementias," according to T. Franklin Williams, M.D., FACP, Professor of Medicine Emeritus, University of Rochester Medical Center, Distinguished Physician, Department of Veterans Affairs Medical Center, and guideline panel co-chair. "Depression is the most common psychiatric illness in older persons, and can be difficult to distinguish from dementia."
An initial clinical assessment should combine information on the symptoms' onset, progression, and duration; results of a physical examination; an evaluation of mental and functional status; and reports from family members and/or friends. Clinicians should consider factors such as physical disability, and they should also rule out delirium and depression.
When findings of an initial evaluation do point to Alzheimer's disease or other dementias, the AHCPR-sponsored guideline recommends further clinical evaluation, and stresses the importance of follow-up and continuity of care. Only when the initial assessment is complete is it appropriate to conduct laboratory tests. Follow-up, with assessment of declining mental function, may be the most useful diagnostic procedure for differentiating Alzheimer's disease from normal aging.
AHCPR's clinical practice guideline on Alzheimer's disease is the agency's last guideline and marks a transition in the guideline program. AHCPR's guideline program has been restructured in response to requests from public- and private-sector guideline users seeking the scientific foundation to produce their own high-quality, evidence-based guidelines.
In the future, AHCPR will respond to these requests by providing evidence reports that will include literature reviews, evidence tables, decision analyses, meta-analyses, and other products. As a result, the agency will be able to produce a broader base of scientific information and foster a wider range of tools for the enhancement of clinical practice.
An overview for clinicians and consumers of the Alzheimer's clinical practice guideline, and the consumer publication, Early Alzheimer's Disease: A Guide for Patients and Families, are available free of charge from the AHCPR Publications Clearinghouse. To receive these publications, call toll-free 800-358-9295; or write to Alzheimer's Guideline, AHCPR Publications Clearinghouse, P.O. Box 8547, Silver Spring, Md. 20907-8547. They are also available 24 hours a day, 7 days a week, through AHCPR InstantFax, 301-594-2800.
The overview and consumer guide are also available on the Internet through AHCPR's Home Page. To access and/or download the guideline products, use a Web browser, specifying URL www.ahcpr.gov/guide/, and click on "Clinical Practice Guidelines Online."
Note: HHS press releases are available on the World Wide Web at: www.hhs.gov.