EFNS guidelines for the diagnosis and management of Alzheimer's disease.
OBJECTIVE
In 2008 a task force was set up to develop a revision of the European Federation of the Neurological Societies (EFNS) guideline for the diagnosis and management of Alzheimer's disease (AD) and other disorders associated with dementia, published in early 2007. The aim of this revised international guideline was to present a peer-reviewed evidence-based statement for the guidance of practice for clinical neurologists, geriatricians, psychiatrists, and other specialist physicians responsible for the care of patients with AD. Mild cognitive impairment and non-Alzheimer dementias are not included in this guideline.


METHODS
The task force working group reviewed evidence from original research articles, meta-analysis, and systematic reviews, published before May 2009. The evidence was classified and consensus recommendations graded (A, B, or C) according to the EFNS guidance. Where there was a lack of evidence, but clear consensus, good practice points were provided.


RESULTS
The recommendations for clinical diagnosis, blood tests, neuropsychology, neuroimaging, electroencephalography, cerebrospinal fluid (CSF) analysis, genetic testing, disclosure of diagnosis, treatment of AD, behavioural and psychological symptoms in dementia, legal issues, counselling and support for caregivers were all revised as compared with the previous EFNS guideline.


CONCLUSIONS
A number of new recommendations and good practice points are made, namely in CSF, neuropsychology, neuroimaging and reviewing non-evidence based therapies. The assessment, interpretation, and treatment of symptoms, disability, needs, and caregiver stress during the course of AD require the contribution of many different professionals. These professionals should adhere to these guideline to improve the diagnosis and management of AD.
Hort
J
J
Memory Disorders Clinic, Deartment of Neurology, Charles University in Prague, Second Faculty of Medicine and Motol Hospital, Prague, Czech Republic. jakub.hort@seznam.cz
O'Brien
J T
JT
Gainotti
G
G
Pirttila
T
T
Popescu
B O
BO
Rektorova
I
I
Sorbi
S
S
Scheltens
P
P
D026683:Advisory Committees / Q000592:standards*; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D017028:Caregivers / Q000592:standards; D018153:Czech Republic; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000379:methods / Q000592:standards; D003955:Diagnostic Tests, Routine / Q000379:methods / Q000592:standards; D042241:Early Diagnosis; D006801:Humans; D009480:Neuropharmacology / Q000379:methods / Q000592:standards; D009483:Neuropsychological Tests / Q000592:standards; D018697:Nootropic Agents / Q000627:therapeutic use; D009746:Nursing, Team / Q000592:standards*; D026741:Physical Therapy Modalities / Q000592:standards
D018697:Nootropic Agents