Initiating treatment with cholinesterase inhibitors
| ECG, electrocardiogram; ICD-10, International classification of diseases, 10th revision. |
| • Establish diagnosis of Alzheimer’s disease using standardised criteria (for example, ICD-10) through interviewing the patient, taking a collateral history, and undertaking a cognitive assessment. The patient should have a full dementia blood screen and neuroimaging, when appropriate, to identify co-morbidities and reversible causes of cognitive impairment |
| • Explain and discuss diagnosis, prognosis, and treatment options with patient and carer |
| • Agree a treatment plan with involvement from a multidisciplinary team. Suggest and encourage the patient and carer to contact the local branch of the Alzheimer’s Society |
| • Establish baseline scores for cognitive function, global functioning, neuropsychiatric symptoms, and activities of daily living using standardised rating scales |
| • Commence cholinesterase inhibitor |
| • Make sure an ECG has been conducted recently to exclude problems with cardiac conduction |
| • Monitor the patient’s progress regularly using clinical skills and standardised rating scales |