The recognition, assessment and management of dementing disorders: Conclusions from the Canadian Consensus Conference on Dementia

Objective: i) To develop evidence based consensus statements on which to bu ild clinical practice guidelines for primary care physicians towards the re cognition, assessment and management of dementing disorders; ii) to dissemi nate and evaluate the impact of these statements and guidelines built on th ese statements. Options: Structured approach to assessment, including recom mended laboratory tests, choices for neuroimaging and referral; management of complications (especially behaviour problems and depression) and use of cognitive enhancing agents. Potential outcomes: Consistent and improved cli nical care of persons with dementia; cost containment by more selective use of laboratory investigations, neuroimaging and referrals; appropriate use of cognitive enhancing agents. Evidence: Authors of each background paper w ere entrusted to: perform a literature search, discover additional relevant material including references cited in retrieved articles; consult with ot her experts in the field and then synthesize information. Standard rules of evidence were applied. Based upon this evidence, consensus statements were developed by a group of experts, guided by a steering committee of eight i ndividuals from the areas of Neurology, Geriatric Medicine, Psychiatry, Fam ily Medicine, Preventive Health Care and Health Care Systems. Values: Recom mendations have been developed with particular attention to the context of primary care and are intended to support family physicians in their ongoing assessment and care of patients with dementia, Benefits, harms and costs: Potential for improved clinical care of individuals with dementia, A dissem ination and evaluation strategy will attempt to measure the impact of the r ecommendations. Recommendations: See text. Validation: Four other sets of c onsensus statements and/or guidelines have been published recently. These r ecommendations are generally congruent with our own consensus statements. T he consensus statements have been endorsed by relevant bodies in Canada. Sp onsors: Funding was provided by equal contributions from seven pharmaceutic al companies and by a grant from the Consortium of Canadian Centres for Cli nical Cognitive Research (C5R). Contributions were received from two Canadi an universities (McGill, McMaster), Several societies supported delegates t o the conference.