Knowledge of Alzheimer's disease (AD), timely recognition and good management should be the norm in all health and social care settings. This paper seeks to focus on developments in diagnosis and treatment.
Key research papers and policy documents published in the last few years are reviewed, with an emphasis on those most relevant to Wales.
The number of people with AD is predicted to steadily increase over the next 40 years. Recent policy developments have recognised the importance of better identification and management of dementia and have proposed memory clinics as the core of new services for early diagnosis and identification. Newer biomarkers of AD enable diagnosis to be made more reliably and at a stage before the patient is demented (prodromal AD). Latest guidance from the National Institute for Health and Clinical Excellence (NICE) now recommends that the use of anticholinesterase inhibitor drugs or memantine is considered in all patients with AD. There is active research into newer treatment approaches, notably the role of cognitive rehabilitation in early dementia and the use of potentially disease‐modifying drugs such as anti‐amyloid antibodies. Unfortunately, current research funding is inadequate and only a small minority of people with AD become involved with research.
The paper shows that, given the growing importance of AD, there is an urgent need to boost recruitment of people with dementia into research trials. There is also a need to address ethical considerations of diagnosing prodromal AD – this is important for both the person undergoing assessment and for society as a whole.
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