EFNS-ENS Guidelines on the diagnosis and management of disorders associated with dementia.
OBJECTIVE
The last version of the EFNS dementia guidelines is from 2007. In 2010, the revised guidelines for Alzheimer's disease (AD) were published. The current guidelines involve the revision of the dementia syndromes outside of AD, notably vascular cognitive impairment, frontotemporal lobar degeneration, dementia with Lewy bodies, corticobasal syndrome, progressive supranuclear palsy, Parkinson's disease dementia, Huntington's disease, prion diseases, normal-pressure hydrocephalus, limbic encephalitis and other toxic and metabolic disorders. The aim is 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 dementing disorders. It represents a statement of minimum desirable standards for practice guidance.


METHODS
The task force working group reviewed evidence from original research articles, meta-analyses and systematic reviews, published by June 2011. The evidence was classified (I, II, III, IV) 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.


CONCLUSIONS
New recommendations and good practice points are made for clinical diagnosis, blood tests, neuropsychology, neuroimaging, electroencephalography, cerebrospinal fluid (CSF) analysis, genetic testing, disclosure of diagnosis, treatment of behavioural and psychological symptoms in dementia, legal issues, counselling and support for caregivers. All recommendations were revised as compared with the previous EFNS guidelines. The specialist neurologist together with primary care physicians play an important role in the assessment, interpretation and treatment of symptoms, disability and needs of dementia patients.
Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy. sorbi@unifi.it
S
S
Sorbi
J
J
Hort
T
T
Erkinjuntti
T
T
Fladby
G
G
Gainotti
H
H
Gurvit
B
B
Nacmias
F
F
Pasquier
B O
BO
Popescu
I
I
Rektorova
D
D
Religa
R
R
Rusina
M
M
Rossor
R
R
Schmidt
E
E
Stefanova
J D
JD
Warren
P
P
Scheltens
D000544:Alzheimer Disease / Q000175:diagnosis / Q000628:therapy; D003704:Dementia / Q000175:diagnosis / Q000628:therapy; D015140:Dementia, Vascular / Q000175:diagnosis / Q000628:therapy; D057174:Frontotemporal Lobar Degeneration / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D006816:Huntington Disease / Q000175:diagnosis / Q000628:therapy; D006850:Hydrocephalus, Normal Pressure / Q000175:diagnosis / Q000628:therapy; D020961:Lewy Body Disease / Q000175:diagnosis / Q000628:therapy; D020363:Limbic Encephalitis / Q000175:diagnosis / Q000628:therapy; D010300:Parkinson Disease / Q000175:diagnosis / Q000628:therapy; D057178:Primary Progressive Nonfluent Aphasia / Q000175:diagnosis / Q000628:therapy; D017096:Prion Diseases / Q000175:diagnosis / Q000628:therapy; D013494:Supranuclear Palsy, Progressive / Q000175:diagnosis / Q000628:therapy