CONSENSUS STATEMENT FROM A GROUP OF FRENCH EXPERTS ON ALZHEIMERS-DISEASE DIAGNOSIS AND PHARMACOLOGICAL TREATMENT

A group of French expert met on the 7(th) and 8(th) of February 1998 i n order to establish a consensus attitude for Alzheimer's disease diag nosis and treatment. Members were drawn from primary care, geriatrics, neurology and psychiatry They used the consensus statement of the Ame rican Association for Geriatrics, the Alzheimer's Association and the American Geriatrics Society published in JAMA, in October 1997 as a so urce of data for further consideration. Alzheimer's disease is the mos t commun etiology of dementia. Main clinical features are cognitive im pairment and psyche-behavioral disorders. Diagnosis must be one of inc lusion and not exclusion. It is based on interviews of informants and family members and office-based clinical assessment. After a physical examination, cognitive function must be evaluated using the Mini-Menta l State Examination. A laboratory evaluation should include a complete blood cell count, blood chemistry and determination of thyroid-stimul ating hormone, in addition, noncontrast computed tomography head scans are adequate in most cases. Available pharmacologic treatments are no t curative but are given to improve quality of life and enhance cognit ion and behavior. Two cholinesterases inhibitors, tacrine and donepezi l, are the only agents officially anthorized for treatment of the cogn itive impairment in Alzheimer's disease. Mood and behaviour disorders also have to be treated by both pharmacologic and nonpharmacologic str ategies. Only pharmacologic treatments wilt be detailed here. The cons ensus statments established by this group of experts will be reevaluat ed each year, considering the new available data on Alzheimer's diseas e.