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Alzheimer's Disease ProgramAbout Alzheimer's Disease
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Home >
Alzheimer's Disease >
Alzheimer's Disease: Clinical Best Practices
Alzheimer's Disease: Clinical Best Practices
Purpose and scope of this document
AD affects over 5 million Americans today - 340,000 of those individuals are Texans. It is the
sixth-leading cause of death in the U.S. and has an economic burden of $226 billion annually.
Texas ranks fourth in the number of AD cases and second in the number of AD deaths. A new
person develops AD every 67 seconds, and current projections indicate that this rate will increase
to one new case every 33 seconds by 2050. In 2014, there were an estimated 15.7 million unpaid
caregivers in the U.S., most of whom were family members. In Texas, 1.3 million unpaid
caregivers provided care to the 340,000 individuals with AD in 2014. This equates to 1.5 billion
hours of unpaid care at a cost of $18.5 billion per year. Alzheimer’s exacts an enormous toll on
individuals, families, the healthcare system, and American businesses. It is a serious problem
affecting many aspects of our society. Until AD can be prevented or cured, the impact of this
disease will only continue to intensify.
Currently there is no treatment available to slow or stop deterioration of brain cells in
Alzheimer’s disease. Five drugs are currently approved that temporarily slow worsening symptoms for on average, six to 12 months, and for about half of the individuals who take them.
Despite current lack of disease-modifying therapies, studies consistently show that active
medical management of Alzheimer’s disease can significantly improve quality of life through all
disease stages for individuals and their caregivers. Active management includes appropriate use
of available treatment options, effective integration of coexisting conditions into the treatment
plan, and use of supportive services such as counseling, activity and support groups, and adult
day center programs.
Most older adults—including those with AD —receive their medical care from Primary Care
Practitioners (PCPs) (Callahan et al., 2006), who may lack the information and other resources
needed to treat this growing and demanding population (Reuben, Roth, Kamberg, & Wenger,
2003). These guidelines were developed specifically for health care professionals in diagnosing
and treating individuals with AD, as appropriate medical management and treatment of this
disease is imperative. These guidelines were developed to promote best practices for
recognizing, diagnosing, and providing treatment to individuals with Alzheimer’s disease or a
related dementia. These guidelines are broad enough in scope that they can be used by primary
healthcare professionals, including physicians, nurse practitioners, physician assistants, social
workers, nurses, and other professionals providing primary care to patients with Alzheimer’s and
their families. Recommendations for management of associated neuropsychiatric symptoms and
coexisting medical conditions often seen in persons with Alzheimer’s disease are included in
these guidelines. Patients with Alzheimer’s disease often need concomitant medication for
treatment of diverse central nervous system disorders associated with progressive brain
dysfunction (Cacabelos). Suggestions for easily administered and scored appraisal tools are
incorporated when possible, as well as diagnostic and treatment pearls.
These guidelines also present best practices on the diagnosis and treatment of mild cognitive
impairment (MCI), which can affect memory and other cognitive areas, but much less severe
than Alzheimer’s or other dementias. Information on the relationship between MCI and
Alzheimer’s disease is also presented.
These guidelines were developed and peer-reviewed by a group of Alzheimer’s disease experts
working to meet the Disease Management objectives of the 2010-2015 Texas State Plan on
Alzheimer’s Disease. These groups include the Texas Council on Alzheimer’s Disease and
Related Disorders, the Alzheimer’s Disease Program at the Texas Department of State Health
Services, and many dedicated volunteers of the Texas Alzheimer’s Disease Partnership.
Ultimately, it is our hope that these guidelines will help improve the quality of life of those
individuals living with this disease, and those who provide care to them.
Click Here to download Clinical Best Practices for the Early Detection, Diagnosis, and
Pharmaceutical and Non-Pharmaceutical Treatment of Persons with Alzheimer’s Disease
Last updated August 26, 2015
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