title: [Updated Dementia guideline: reflections from primary care].
abstract: The updated Dementia guideline of the Dutch Geriatrics Society (NVKG) recommends additional testing (e.g. EEG, cerebrospinal fluid, CT/MRI or SPECT scans) only in cases of persisting significant diagnostic uncertainty. This more parsimonious use of tests appears to contrast with the current trend for specialist memory assessment services to favour full test batteries for all patients, and may be more efficient and less burdensome for patients. However, unlike the benchmark Dementia guideline of the Dutch College of General Practitioners (NHG), the NVKG guideline recommends treatment of Alzheimer's disease patients with cholinesterase inhibitors or memantine. Although meta-analyses yield significant beneficial treatment effects, in our opinion these are not clinically relevant and are mostly short-lived and counterbalanced by the burden of adverse effects. Nevertheless, the NVKG guideline also devotes considerable attention to psychosocial interventions that are valuable for the quality of life of both patients and their carers.
authors: Radboudumc, afd. Eerstelijnsgeneeskunde, Nijmegen.
authors: Marieke
authors: M
authors: Perry
authors: Eric P
authors: EP
authors: Moll van Charante
mesh_terms: D000368:Aged; D002800:Cholinesterase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D003704:Dementia / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D042241:Early Diagnosis; D058005:General Practitioners; D005853:Geriatrics / Q000592:standards; D006801:Humans; D008559:Memantine / Q000009:adverse effects / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000592:standards*; D011788:Quality of Life
chemical_list: D002800:Cholinesterase Inhibitors; D008559:Memantine