Memory assessment services at a specialized clinic or by community mental health teams should be the single point of referral for all British patients with a possible diagnosis of dementia, according to a new guideline published Nov. 22 by the clinical effectiveness agency for England and Wales.
The guideline from the National Institute for Health and Clinical Effectiveness (NICE) and the Social Care Institute for Excellence also calls for magnetic resonance imaging or computerized tomography to be used to determine subtype diagnoses and exclude other cerebral conditions that could be causing a suspected case of dementia.
Health care and social care providers need to coordinate and integrate care for dementia patients, including jointly agreeing to written policies and procedures, under the NICE guideline.
Dementia patients who develop noncognitive behavioral issues should be assessed to determine the cause of the behavior, including undetected pain, depression, and drug side effects, the guideline says.
The guideline also makes final a NICE drug assessment published earlier this year that restricts use of the acetylcholinesterase inhibitors donepezil, galantamine, and rivastigmine only for those Alzheimer's disease patients who are diagnosed as suffering from moderately severe dementia. Patient groups objected to that decision, but their appeal was rejected in October.