Options for the Management of Dementia in Primary Care

Abstract

Alzheimer's disease is a devastating condition. One in ten of us can expect to develop dementia in retirement. It is more common in women, and carers of sufferers are more often female, either spouses or daughters. The principles of management centre around early diagnosis, based upon an accurate clinical history and investigation to exclude other possible causes or exacerbating factors, and ongoing monitoring, support and advice as the condition progresses. The dementia sufferer interacts with the physical and social environment and her behaviour needs to be considered in this context. Drug therapy plays a part in improving symptoms; there are specific drugs available but their efficacy is still unproven. The carers of sufferers are often under considerable strain and their needs must be considered in planning services. Although Alzheimer's disease is a deteriorating condition, it should not lead to therapeutic nihilism. There is a great deal that can be done to alleviate suffering, both for the patient and the carer, and in providing this the rewards can be great.