TY - JOUR
KW - Alzheimer Disease/diagnosis/therapy
KW - Clinical Competence
KW - Early Diagnosis
KW - Health Services for the Aged/standards
KW - Humans
KW - Interdisciplinary Communication
KW - Patient Care Management
KW - Patient Care Team
KW - Physician's Role
KW - Primary Health Care/standards
KW - Quality of Health Care
KW - Societies
AU - H. Villars
AU - S. Oustric
AU - S. Andrieu
AU - J. P. Baeyens
AU - R. Bernabei
AU - H. Brodaty
AU - K. Brummel-Smith
AU - C. Celafu
AU - N. Chappell
AU - J. Fitten
AU - G. Frisoni
AU - L. Froelich
AU - O. Guerin
AU - G. Gold
AU - I. Holmerova
AU - S. Iliffe
AU - A. Lukas
AU - R. Melis
AU - J. E. Morley
AU - H. Nies
AU - F. Nourhashemi
AU - J. Petermans
AU - Ribera Casado
AU - L. Rubenstein
AU - A. Salva
AU - C. Sieber
AU - A. Sinclair
AU - R. Schindler
AU - E. Stephan
AU - R . Y. Wong
AU - B. Vellas
A1 - 
AB - This paper aims to define the role of the primary care physician (PCP) in the management of Alzheimer's disease (AD) and to propose a model for a work plan. The proposals in this position paper stem from a collaborative work of experts involved in the care of AD patients. It combines evidence from a literature review and expert's opinions who met in Paris, France, on July 2009 during the International Association of Geriatrics and Gerontology (IAGG) World Congress. The PCP's intervention appears essential at many levels: detection of the onset of dementia, diagnostic management, treatment and follow-up. The key role of the PCP in the management of AD, as care providers and care planners, is consolidated by the family caregiver's confidence in their skills. In primary care practice the first step is to identify dementia. The group proposes a "case finding" strategy, in target situations in which dementia should be detected to allow, secondarily, a diagnosis of AD, in certain cases. We propose that the PCP identifies 'typical' cases. In typical cases, among older subjects, the diagnosis of "probable AD" can be done by the PCP and then confirm by the specialist. While under-diagnosis of AD exists, so does under-disclosure. Disclosure to patient and family should be done by both specialist and PCP. Then, the PCP has a central role in management of the disease with the general objectives to detect, prevent and treat, when possible, the complications of the disease (falls, malnutrition, behavioural and psychological symptoms of dementia). The PCP needs to give basic information to the caregiver on respite care and home support services in order to prevent crisis situations such as unplanned institutionalisation and "emergency" hospital admission. Finally, therapeutic research must be integrated in the daily practice of PCP. It is a matter of patients' right to benefit from access to innovation and clinical research whatever his age or diseases, while of course fully respecting the rules and protective measures that are in force.
BT - The journal of nutrition, health & aging
C5 - General Literature
CP - 2
CY - France
IS - 2
JF - The journal of nutrition, health & aging
N2 - This paper aims to define the role of the primary care physician (PCP) in the management of Alzheimer's disease (AD) and to propose a model for a work plan. The proposals in this position paper stem from a collaborative work of experts involved in the care of AD patients. It combines evidence from a literature review and expert's opinions who met in Paris, France, on July 2009 during the International Association of Geriatrics and Gerontology (IAGG) World Congress. The PCP's intervention appears essential at many levels: detection of the onset of dementia, diagnostic management, treatment and follow-up. The key role of the PCP in the management of AD, as care providers and care planners, is consolidated by the family caregiver's confidence in their skills. In primary care practice the first step is to identify dementia. The group proposes a "case finding" strategy, in target situations in which dementia should be detected to allow, secondarily, a diagnosis of AD, in certain cases. We propose that the PCP identifies 'typical' cases. In typical cases, among older subjects, the diagnosis of "probable AD" can be done by the PCP and then confirm by the specialist. While under-diagnosis of AD exists, so does under-disclosure. Disclosure to patient and family should be done by both specialist and PCP. Then, the PCP has a central role in management of the disease with the general objectives to detect, prevent and treat, when possible, the complications of the disease (falls, malnutrition, behavioural and psychological symptoms of dementia). The PCP needs to give basic information to the caregiver on respite care and home support services in order to prevent crisis situations such as unplanned institutionalisation and "emergency" hospital admission. Finally, therapeutic research must be integrated in the daily practice of PCP. It is a matter of patients' right to benefit from access to innovation and clinical research whatever his age or diseases, while of course fully respecting the rules and protective measures that are in force.
PP - France
PY - 2010
SN - 1760-4788; 1279-7707
SP - 110
EP - 120
EP - 
T1 - The primary care physician and Alzheimer's disease: an international position paper
T2 - The journal of nutrition, health & aging
TI - The primary care physician and Alzheimer's disease: an international position paper
U1 - General Literature
U2 - 20126959
VL - 14
VO - 1760-4788; 1279-7707
Y1 - 2010
ER -