This is a new guideline from NICE on the management of dementia. Most of this is not new, but there were a couple of things I wasn’t fully aware of. I’ll list the things that were new to me, then do a bit of a summary.
- Cognitive testing. NICE lists a few recommended tests we should use. None of them are MMSE or GPCOG 🙁
- Anticholinergic burden. If your patients are on drugs that affect this, especially if they are on several, then it may have a significant impact on their memory.
- If a patient is eligible for memantine as add on therapy, it can be started by the GP without discussion with a specialist.
How should we assess patients in primary care?
Take a history and examination and do some blood and urine tests. Interestingly NICE gives no advice on what bloods to do, nor on what urine tests to do. There is apparently no evidence. They are for ruling out other causes though.