Diagnosis and treatment of Alzheimer disease and related disorders: Consensus statement of the American Association for Geriatric Psychiatry, the Alzheimer's Association, and the American Geriatrics Society

Gary W. Small, Peter V Rabins, Patricia P. Barry, Neil S. Buckholtz, Steven T. DeKosky, Steven H. Ferris, Sanford I. Finkel, Lisa P. Gwyther, Zaven S. Khachaturian, Barry D. Lebowitz, Thomas D. McRae, John C. Morris, Frances Oakley, Lon S. Schneider, Joel E. Streim, Trey Sunderland, Linda A. Teri, Larry E. Tune

Research output: Contribution to journalArticle

Abstract

Objective. - A consensus conference on the diagnosis and treatment of Alzheimer disease (AD) and related disorders was organized by the American Association for Geriatric Psychiatry, the Alzheimer's Association, and the American Geriatrics Society on January 4 and 5, 1997. The target audience was primary care physicians, and the following questions were addressed: (1) How prevalent is AD and what are its risk factors? What is its impact on society? (2) What are the different forms of dementia and how can they be recognized? (3) What constitutes safe and effective treatment for AD? What are the indications and contraindications for specific treatments? (4) What management strategies are available to the primary care practitioner? (5) What are the available medical specialty and community resources? (6) What are the important policy issues and how can policymakers improve access to care for dementia patients? (7) What are the most promising questions for future research? Participants. - Consensus panel members and expert presenters were drawn from psychiatry, neurology, geriatrics, primary care, psychology, nursing, social work, occupational therapy, epidemiology, and public health and policy. Evidence. - The expert presenters summarized data from the world scientific literature on the questions posed to the panel. Consensus Process. - The panelists listened to the experts' presentations, reviewed their background papers, and then provided responses to the questions based on these materials. The panel chairs prepared the initial drafts of the consensus statement, and these drafts were read by all panelists and edited until consensus was reached. Conclusions. - Alzheimer disease is the most common disorder causing cognitive decline in old age and exacts a substantial cost on society. Although the diagnosis of AD is often missed or delayed, it is primarily one of inclusion, not exclusion, and usually can be made using standardized clinical criteria. Most cases can be diagnosed and managed in primary care settings, yet some patients with atypical presentations, severe impairment, or complex comorbidity benefit from specialist referral. Alzheimer disease is progressive and irreversible, but pharmacologic therapies for cognitive impairment and nonpharmacologic and pharmacologic treatments for the behavioral problems associated with dementia can enhance quality of life. Psychotherapeutic intervention with family members is often indicated, as nearly half of all caregivers become depressed. Health care delivery to these patients is fragmented and inadequate, and changes in disease management models are adding stresses to the system. New approaches are needed to ensure patients' access to essential resources, and future research should aim to improve diagnostic and therapeutic effectiveness.

Original languageEnglish (US)
Pages (from-to)1363-1371
Number of pages9
JournalJournal of the American Medical Association
Volume278
Issue number16
StatePublished - Oct 22 1997
Externally publishedYes

Fingerprint

Consensus
Alzheimer Disease
Dementia
Primary Care Nursing
Primary Health Care
Therapeutics
Literature
Geriatric Psychiatry
Occupational Therapy
Primary Care Physicians
Public Policy
Neurology
Disease Management
Health Policy
Social Work
Caregivers
Comorbidity
Patient Care
Epidemiology
Referral and Consultation

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Diagnosis and treatment of Alzheimer disease and related disorders : Consensus statement of the American Association for Geriatric Psychiatry, the Alzheimer's Association, and the American Geriatrics Society. / Small, Gary W.; Rabins, Peter V; Barry, Patricia P.; Buckholtz, Neil S.; DeKosky, Steven T.; Ferris, Steven H.; Finkel, Sanford I.; Gwyther, Lisa P.; Khachaturian, Zaven S.; Lebowitz, Barry D.; McRae, Thomas D.; Morris, John C.; Oakley, Frances; Schneider, Lon S.; Streim, Joel E.; Sunderland, Trey; Teri, Linda A.; Tune, Larry E.

In: Journal of the American Medical Association, Vol. 278, No. 16, 22.10.1997, p. 1363-1371.

Research output: Contribution to journalArticle

Small, GW, Rabins, PV, Barry, PP, Buckholtz, NS, DeKosky, ST, Ferris, SH, Finkel, SI, Gwyther, LP, Khachaturian, ZS, Lebowitz, BD, McRae, TD, Morris, JC, Oakley, F, Schneider, LS, Streim, JE, Sunderland, T, Teri, LA & Tune, LE 1997, 'Diagnosis and treatment of Alzheimer disease and related disorders: Consensus statement of the American Association for Geriatric Psychiatry, the Alzheimer's Association, and the American Geriatrics Society', Journal of the American Medical Association, vol. 278, no. 16, pp. 1363-1371.
Small, Gary W. ; Rabins, Peter V ; Barry, Patricia P. ; Buckholtz, Neil S. ; DeKosky, Steven T. ; Ferris, Steven H. ; Finkel, Sanford I. ; Gwyther, Lisa P. ; Khachaturian, Zaven S. ; Lebowitz, Barry D. ; McRae, Thomas D. ; Morris, John C. ; Oakley, Frances ; Schneider, Lon S. ; Streim, Joel E. ; Sunderland, Trey ; Teri, Linda A. ; Tune, Larry E. / Diagnosis and treatment of Alzheimer disease and related disorders : Consensus statement of the American Association for Geriatric Psychiatry, the Alzheimer's Association, and the American Geriatrics Society. In: Journal of the American Medical Association. 1997 ; Vol. 278, No. 16. pp. 1363-1371.
@article{a8387cd4fc2243618f9f83f75d1f293f,
title = "Diagnosis and treatment of Alzheimer disease and related disorders: Consensus statement of the American Association for Geriatric Psychiatry, the Alzheimer's Association, and the American Geriatrics Society",
abstract = "Objective. - A consensus conference on the diagnosis and treatment of Alzheimer disease (AD) and related disorders was organized by the American Association for Geriatric Psychiatry, the Alzheimer's Association, and the American Geriatrics Society on January 4 and 5, 1997. The target audience was primary care physicians, and the following questions were addressed: (1) How prevalent is AD and what are its risk factors? What is its impact on society? (2) What are the different forms of dementia and how can they be recognized? (3) What constitutes safe and effective treatment for AD? What are the indications and contraindications for specific treatments? (4) What management strategies are available to the primary care practitioner? (5) What are the available medical specialty and community resources? (6) What are the important policy issues and how can policymakers improve access to care for dementia patients? (7) What are the most promising questions for future research? Participants. - Consensus panel members and expert presenters were drawn from psychiatry, neurology, geriatrics, primary care, psychology, nursing, social work, occupational therapy, epidemiology, and public health and policy. Evidence. - The expert presenters summarized data from the world scientific literature on the questions posed to the panel. Consensus Process. - The panelists listened to the experts' presentations, reviewed their background papers, and then provided responses to the questions based on these materials. The panel chairs prepared the initial drafts of the consensus statement, and these drafts were read by all panelists and edited until consensus was reached. Conclusions. - Alzheimer disease is the most common disorder causing cognitive decline in old age and exacts a substantial cost on society. Although the diagnosis of AD is often missed or delayed, it is primarily one of inclusion, not exclusion, and usually can be made using standardized clinical criteria. Most cases can be diagnosed and managed in primary care settings, yet some patients with atypical presentations, severe impairment, or complex comorbidity benefit from specialist referral. Alzheimer disease is progressive and irreversible, but pharmacologic therapies for cognitive impairment and nonpharmacologic and pharmacologic treatments for the behavioral problems associated with dementia can enhance quality of life. Psychotherapeutic intervention with family members is often indicated, as nearly half of all caregivers become depressed. Health care delivery to these patients is fragmented and inadequate, and changes in disease management models are adding stresses to the system. New approaches are needed to ensure patients' access to essential resources, and future research should aim to improve diagnostic and therapeutic effectiveness.",
author = "Small, {Gary W.} and Rabins, {Peter V} and Barry, {Patricia P.} and Buckholtz, {Neil S.} and DeKosky, {Steven T.} and Ferris, {Steven H.} and Finkel, {Sanford I.} and Gwyther, {Lisa P.} and Khachaturian, {Zaven S.} and Lebowitz, {Barry D.} and McRae, {Thomas D.} and Morris, {John C.} and Frances Oakley and Schneider, {Lon S.} and Streim, {Joel E.} and Trey Sunderland and Teri, {Linda A.} and Tune, {Larry E.}",
year = "1997",
month = "10",
day = "22",
language = "English (US)",
volume = "278",
pages = "1363--1371",
journal = "JAMA - Journal of the American Medical Association",
issn = "0098-7484",
publisher = "American Medical Association",
number = "16",

}

TY - JOUR

T1 - Diagnosis and treatment of Alzheimer disease and related disorders

T2 - Consensus statement of the American Association for Geriatric Psychiatry, the Alzheimer's Association, and the American Geriatrics Society

AU - Small, Gary W.

AU - Rabins, Peter V

AU - Barry, Patricia P.

AU - Buckholtz, Neil S.

AU - DeKosky, Steven T.

AU - Ferris, Steven H.

AU - Finkel, Sanford I.

AU - Gwyther, Lisa P.

AU - Khachaturian, Zaven S.

AU - Lebowitz, Barry D.

AU - McRae, Thomas D.

AU - Morris, John C.

AU - Oakley, Frances

AU - Schneider, Lon S.

AU - Streim, Joel E.

AU - Sunderland, Trey

AU - Teri, Linda A.

AU - Tune, Larry E.

PY - 1997/10/22

Y1 - 1997/10/22

N2 - Objective. - A consensus conference on the diagnosis and treatment of Alzheimer disease (AD) and related disorders was organized by the American Association for Geriatric Psychiatry, the Alzheimer's Association, and the American Geriatrics Society on January 4 and 5, 1997. The target audience was primary care physicians, and the following questions were addressed: (1) How prevalent is AD and what are its risk factors? What is its impact on society? (2) What are the different forms of dementia and how can they be recognized? (3) What constitutes safe and effective treatment for AD? What are the indications and contraindications for specific treatments? (4) What management strategies are available to the primary care practitioner? (5) What are the available medical specialty and community resources? (6) What are the important policy issues and how can policymakers improve access to care for dementia patients? (7) What are the most promising questions for future research? Participants. - Consensus panel members and expert presenters were drawn from psychiatry, neurology, geriatrics, primary care, psychology, nursing, social work, occupational therapy, epidemiology, and public health and policy. Evidence. - The expert presenters summarized data from the world scientific literature on the questions posed to the panel. Consensus Process. - The panelists listened to the experts' presentations, reviewed their background papers, and then provided responses to the questions based on these materials. The panel chairs prepared the initial drafts of the consensus statement, and these drafts were read by all panelists and edited until consensus was reached. Conclusions. - Alzheimer disease is the most common disorder causing cognitive decline in old age and exacts a substantial cost on society. Although the diagnosis of AD is often missed or delayed, it is primarily one of inclusion, not exclusion, and usually can be made using standardized clinical criteria. Most cases can be diagnosed and managed in primary care settings, yet some patients with atypical presentations, severe impairment, or complex comorbidity benefit from specialist referral. Alzheimer disease is progressive and irreversible, but pharmacologic therapies for cognitive impairment and nonpharmacologic and pharmacologic treatments for the behavioral problems associated with dementia can enhance quality of life. Psychotherapeutic intervention with family members is often indicated, as nearly half of all caregivers become depressed. Health care delivery to these patients is fragmented and inadequate, and changes in disease management models are adding stresses to the system. New approaches are needed to ensure patients' access to essential resources, and future research should aim to improve diagnostic and therapeutic effectiveness.

AB - Objective. - A consensus conference on the diagnosis and treatment of Alzheimer disease (AD) and related disorders was organized by the American Association for Geriatric Psychiatry, the Alzheimer's Association, and the American Geriatrics Society on January 4 and 5, 1997. The target audience was primary care physicians, and the following questions were addressed: (1) How prevalent is AD and what are its risk factors? What is its impact on society? (2) What are the different forms of dementia and how can they be recognized? (3) What constitutes safe and effective treatment for AD? What are the indications and contraindications for specific treatments? (4) What management strategies are available to the primary care practitioner? (5) What are the available medical specialty and community resources? (6) What are the important policy issues and how can policymakers improve access to care for dementia patients? (7) What are the most promising questions for future research? Participants. - Consensus panel members and expert presenters were drawn from psychiatry, neurology, geriatrics, primary care, psychology, nursing, social work, occupational therapy, epidemiology, and public health and policy. Evidence. - The expert presenters summarized data from the world scientific literature on the questions posed to the panel. Consensus Process. - The panelists listened to the experts' presentations, reviewed their background papers, and then provided responses to the questions based on these materials. The panel chairs prepared the initial drafts of the consensus statement, and these drafts were read by all panelists and edited until consensus was reached. Conclusions. - Alzheimer disease is the most common disorder causing cognitive decline in old age and exacts a substantial cost on society. Although the diagnosis of AD is often missed or delayed, it is primarily one of inclusion, not exclusion, and usually can be made using standardized clinical criteria. Most cases can be diagnosed and managed in primary care settings, yet some patients with atypical presentations, severe impairment, or complex comorbidity benefit from specialist referral. Alzheimer disease is progressive and irreversible, but pharmacologic therapies for cognitive impairment and nonpharmacologic and pharmacologic treatments for the behavioral problems associated with dementia can enhance quality of life. Psychotherapeutic intervention with family members is often indicated, as nearly half of all caregivers become depressed. Health care delivery to these patients is fragmented and inadequate, and changes in disease management models are adding stresses to the system. New approaches are needed to ensure patients' access to essential resources, and future research should aim to improve diagnostic and therapeutic effectiveness.

UR - http://www.scopus.com/inward/record.url?scp=0030801772&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030801772&partnerID=8YFLogxK

M3 - Article

C2 - 9343469

AN - SCOPUS:0030801772

VL - 278

SP - 1363

EP - 1371

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0098-7484

IS - 16

ER -