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AAGP Releases Principles of Care for Patients with Dementia Due to Alzheimer's Disease

Skip breadcrumb navigation Care model aims to improve quality of life for Alzheimer's patients and their caregivers

BETHESDA, MD (July 5, 2006) – The American Association for Geriatric Psychiatry (AAGP) released today its position statement on principles of care for patients with dementia due to Alzheimer's disease (AD). With more than 4.5 million Americans suffering from AD, the most common form of dementia, and with this number expected to triple in the next 40-50 years, AAGP saw a critical need to provide a minimal set of care principles for medical professionals to follow when treating patients with AD.

"We are clearly in a period where we should all be thinking of Alzheimer's as a condition we can treat, even though we do not have a cure yet," said Constantine Lyketsos, M.D., M.H.S., professor at Johns Hopkins School of Medicine and chair of the AAGP task force that prepared the position statement.

AAGP recognized that existing scientific evidence, coupled with clinical experience and common sense, provided sufficient information to create the principles of care. The care model consists of a series of therapeutic interventions that are pharmacologic and non-pharmacologic and aims to:
  • delay disease progression
  • delay functional decline
  • improve quality of life
  • support dignity
  • control symptoms
  • provide comfort at all stages of AD
The model provides physicians and clinicians guidance about the key elements of these care principles and why this care should be made available to AD patients and their caregivers. The position statement encompasses clinical care for AD patients in typical clinical settings such as primary care, specialist care, and long-term care, including assisted living environments.

"The members of the AAGP task force were focused on providing sound and practical treatment advice for clinicians given the best evidence available. Alzheimer's patients and their families deserve the best care possible," said AAGP President Christopher Colenda, MD, MPH, dean of the Texas A&M Health Science Center College of Medicine and a co-author of the position statement.

The principles of dementia care are organized around the following key areas of therapy:

Disease therapies for AD, targeted specifically at aspects of the current pathophysiological understanding of the disease – This section addresses several factors that have been identified as accelerators of AD progression, including: amyloid deposition; post-menopausal loss of estrogen in women; inflammatory response; oxidative free radicals; brain vascular disease; high cholesterol; and glutamate excitoxicity.

Symptomatic therapies for cognitive symptoms – This section discusses cholinesterase inhibitors, the class of drugs with the strongest evidence supporting their efficacy in treating the cognitive symptoms of mild to moderate AD.

Symptomatic therapies for other neuropsychiatric symptoms – This section addresses the non-cognitive neuropsychiatric symptoms associated with dementia such as agitation, aggression, delusions, etc. and the non-pharmacologic interventions and pharmacologic therapies to manage them.

Interventions targeted at, and the provision of, supportive care to patients – This section provides a minimal checklist of issues to be addressed with patients, which include: safety matters; day-to-day living structure; general medical health monitoring; and advanced care planning.

Interventions targeted at, and the provision of, supportive care to caregivers – This section provides a minimal checklist of issues to be addressed with caregivers, which include: educating caregivers; teaching problem solving skills; accessing resources; long-range planning; emotional support; and respite.

SOURCE: American Association for Geriatric Psychiatry
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