Alzheimer's disease

Patients should be seen at least every 6 months to evaluate for functional and cognitive change. Issues such as daily medication use, functional status, comorbid illnesses, new signs and symptoms, carer burden, and need for future respite care or nursing home placement should be discussed. Medication continuation may be discussed if the disease progresses without apparent symptomatic benefit or plateau. Home safety risk assessment should be made at every visit.

Driving status should be reassessed at least every 6 months. The American Academy of Neurology and UK Royal College of Psychiatrists have published guidelines for assessment of driving risk in dementia.[203]Iverson DJ, Gronseth GS, Reger MA, et al. Practice parameter update: evaluation and management of driving risk in dementia: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2010 Apr 20;74(16):1316-24. http://www.neurology.org/content/74/16/1316.long http://www.ncbi.nlm.nih.gov/pubmed/20385882?tool=bestpractice.com [204]Royal College of Psychiatrists. Driving with dementia or mild cognitive impairment: consensus guidelines for clinicians [internet publication]. https://research.ncl.ac.uk/driving-and-dementia/consensusguidelinesforclinicians/Final%20Guideline.pdf Clinicians remain subject to local reporting requirements and associated liability when diagnosing any driver with dementia.