THE PRIMARY CARE PHYSICIAN AND ALZHEIMER'S DISEASE: AN INTERNATIONAL POSITION PAPER
Identifieur interne : 007495 ( Main/Exploration ); précédent : 007494; suivant : 007496THE PRIMARY CARE PHYSICIAN AND ALZHEIMER'S DISEASE: AN INTERNATIONAL POSITION PAPER
Auteurs : H. Villars [France] ; S. Oustric [France] ; S. Andrieu [France] ; J. P. Baeyens [Belgique] ; R. Bernabei [Italie] ; H. Brodaty [Australie] ; K. Brummel-Smith [États-Unis] ; C. Celafu [États-Unis] ; N. Chappell [Canada] ; J. Fitten [États-Unis] ; G. Frisoni [Italie] ; L. Froelich [Allemagne] ; O. Guerin [France] ; G. Gold [Suisse] ; I. Holmerova [République tchèque] ; S. Iliffe [Royaume-Uni] ; A. Lukas ; R. Melis ; J. E. Morley ; H. Nies ; F. Nourhashemi [France] ; J. Petepmans ; J. Ribera Casado ; L. Rubenstein ; A. Salva ; C. Sieber ; A. Sinclair ; R. Schindler ; E. Stephan ; R. Y. Wong ; B. Vellas [France]Source :
- The Journal of nutrition, health & aging [ 1279-7707 ] ; 2010.
Descripteurs français
- Pascal (Inist)
- Wicri :
English descriptors
- KwdEn :
Abstract
This paper aims to define the role of the primary care physician (PCP) in the management of Alzheimer's disease (AD) and to propose a model for a work plan. The proposals in this position paper stem from a collaborative work of experts involved in the care of AD patients. It combines evidence from a literature review and expert's opinions who met in Paris, France, on July 2009 during the International Association of Geriatrics and Gerontology (IAGG) World Congress. The PCP's intervention appears essential at many levels: detection of the onset of dementia, diagnostic management, treatment and follow-up. The key role of the PCP in the management of AD, as care providers and care planners, is consolidated by the family caregiver's confidence in their skills. In primary care practice the first step is to identify dementia. The group proposes a "case finding" strategy, in target situations in which dementia should be detected to allow, secondarily, a diagnosis of AD, in certain cases. We propose that the PCP identifies 'typical' cases. In typical cases, among older subjects, the diagnosis of "probable AD" can be done by the PCP and then confirm by the specialist. While under-diagnosis of AD exists, so does under-disclosure. Disclosure to patient and family should be done by both specialist and PCP. Then, the PCP has a central role in management of the disease with the general objectives to detect, prevent and treat, when possible, the complications of the disease (falls, malnutrition, behavioural and psychological symptoms of dementia). The PCP needs to give basic information to the caregiver on respite care and home support services in order to prevent crisis situations such as unplanned institutionalisation and "emergency" hospital admission. Finally, therapeutic research must be integrated in the daily practice of PCP. It is a matter of patients' right to benefit from access to innovation and clinical research whatever his age or diseases, while of course fully respecting the rules and protective measures that are in force.
Affiliations:
- Allemagne, Australie, Belgique, Canada, France, Italie, Royaume-Uni, République tchèque, Suisse, États-Unis
- Angleterre, Bohême centrale, Grand Londres, Midi-Pyrénées, Occitanie (région administrative)
- Londres, Prague, Toulouse
- University College de Londres
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">THE PRIMARY CARE PHYSICIAN AND ALZHEIMER'S DISEASE: AN INTERNATIONAL POSITION PAPER</title><author><name sortKey="Villars, H" sort="Villars, H" uniqKey="Villars H" first="H." last="Villars">H. Villars</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Gérontopôle, Alzheimer's Disease Research and Clinical Center, Toulouse University Hospital</s1><s3>FRA</s3><sZ>1 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Toulouse University Hospital</wicri:noRegion><wicri:noRegion>Gérontopôle, Alzheimer's Disease Research and Clinical Center, Toulouse University Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Oustric, S" sort="Oustric, S" uniqKey="Oustric S" first="S." last="Oustric">S. Oustric</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of family medicine, Toulouse University Hospital</s1><s3>FRA</s3><sZ>2 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Toulouse University Hospital</wicri:noRegion><wicri:noRegion>Department of family medicine, Toulouse University Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Andrieu, S" sort="Andrieu, S" uniqKey="Andrieu S" first="S." last="Andrieu">S. Andrieu</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Inserm U558</s1><s2>31073 Toulouse</s2><s3>FRA</s3><sZ>3 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Occitanie (région administrative)</region><region type="old region" nuts="2">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Baeyens, J P" sort="Baeyens, J P" uniqKey="Baeyens J" first="J. P." last="Baeyens">J. P. 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Celafu</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Section of Geriatrics, Dept of Medicine, LSUHSC, New Orleans, La. at LSU Health Sciences Center</s1><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Section of Geriatrics, Dept of Medicine, LSUHSC, New Orleans, La. at LSU Health Sciences Center</wicri:noRegion></affiliation></author><author><name sortKey="Chappell, N" sort="Chappell, N" uniqKey="Chappell N" first="N." last="Chappell">N. Chappell</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Center on Aging, University of Victoria; PO Box 1700, STN CSC Victoria</s1><s2>BC V8W 2Y2</s2><s3>CAN</s3><sZ>9 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>BC V8W 2Y2</wicri:noRegion></affiliation></author><author><name sortKey="Fitten, J" sort="Fitten, J" uniqKey="Fitten J" first="J." last="Fitten">J. Fitten</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>DVAMC 116A-9 16111 Plummer street</s1><s2>SEPULVEDA CA 91343</s2><s3>USA</s3><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>DVAMC 116A-9 16111 Plummer street</wicri:noRegion></affiliation></author><author><name sortKey="Frisoni, G" sort="Frisoni, G" uniqKey="Frisoni G" first="G." last="Frisoni">G. Frisoni</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>IRCCS San Giovanni di Rio, FBF, Via Pilastroni 4</s1><s2>25125 Brescia</s2><s3>ITA</s3><sZ>11 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>25125 Brescia</wicri:noRegion></affiliation></author><author><name sortKey="Froelich, L" sort="Froelich, L" uniqKey="Froelich L" first="L." last="Froelich">L. Froelich</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Central Institute for Mental Health J5</s1><s2>68072 Mannheim</s2><s3>DEU</s3><sZ>12 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>68072 Mannheim</wicri:noRegion><wicri:noRegion>Central Institute for Mental Health J5</wicri:noRegion><wicri:noRegion>Central Institute for Mental Health J5</wicri:noRegion></affiliation></author><author><name sortKey="Guerin, O" sort="Guerin, O" uniqKey="Guerin O" first="O." last="Guerin">O. Guerin</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>University of Nice Sophia Antipolis. Gerontology 430 Avenue Pessicart</s1><s2>0600 Nice</s2><s3>FRA</s3><sZ>13 aut.</sZ><sZ>21 aut.</sZ><sZ>31 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>0600 Nice</wicri:noRegion><wicri:noRegion>University of Nice Sophia Antipolis. Gerontology 430 Avenue Pessicart</wicri:noRegion><wicri:noRegion>University of Nice Sophia Antipolis. Gerontology 430 Avenue Pessicart</wicri:noRegion></affiliation></author><author><name sortKey="Gold, G" sort="Gold, G" uniqKey="Gold G" first="G." last="Gold">G. Gold</name><affiliation wicri:level="1"><inist:fA14 i1="14"><s1>Service de Médecine Interne de Rehabilitation Hôpital des Trois chênes, Dpt de Réhabilitation et Gériatrie 3, Chemin du Pont Bochet</s1><s2>1226 Thonex Geneva</s2><s3>CHE</s3><sZ>14 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>1226 Thonex Geneva</wicri:noRegion></affiliation></author><author><name sortKey="Holmerova, I" sort="Holmerova, I" uniqKey="Holmerova I" first="I." last="Holmerova">I. Holmerova</name><affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Center of Gerontology Simunkova 1600</s1><s2>18200 Praha</s2><s3>CZE</s3><sZ>15 aut.</sZ></inist:fA14><country>République tchèque</country><placeName><settlement type="city">Prague</settlement><region type="région" nuts="2">Bohême centrale</region></placeName></affiliation></author><author><name sortKey="Iliffe, S" sort="Iliffe, S" uniqKey="Iliffe S" first="S." last="Iliffe">S. Iliffe</name><affiliation wicri:level="4"><inist:fA14 i1="16"><s1>Dept. of Primary Care & Population Sciences, University College London, Hampstead Campus, Rowland Hill St</s1><s2>London NW3 2PF</s2><s3>GBR</s3><sZ>16 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>London NW3 2PF</wicri:noRegion><orgName type="university">University College de Londres</orgName><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Lukas, A" sort="Lukas, A" uniqKey="Lukas A" first="A." last="Lukas">A. Lukas</name></author><author><name sortKey="Melis, R" sort="Melis, R" uniqKey="Melis R" first="R." last="Melis">R. Melis</name></author><author><name sortKey="Morley, J E" sort="Morley, J E" uniqKey="Morley J" first="J. E." last="Morley">J. E. Morley</name></author><author><name sortKey="Nies, H" sort="Nies, H" uniqKey="Nies H" first="H." last="Nies">H. Nies</name></author><author><name sortKey="Nourhashemi, F" sort="Nourhashemi, F" uniqKey="Nourhashemi F" first="F." last="Nourhashemi">F. Nourhashemi</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>University of Nice Sophia Antipolis. Gerontology 430 Avenue Pessicart</s1><s2>0600 Nice</s2><s3>FRA</s3><sZ>13 aut.</sZ><sZ>21 aut.</sZ><sZ>31 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>0600 Nice</wicri:noRegion><wicri:noRegion>University of Nice Sophia Antipolis. Gerontology 430 Avenue Pessicart</wicri:noRegion><wicri:noRegion>University of Nice Sophia Antipolis. Gerontology 430 Avenue Pessicart</wicri:noRegion></affiliation></author><author><name sortKey="Petepmans, J" sort="Petepmans, J" uniqKey="Petepmans J" first="J." last="Petepmans">J. Petepmans</name></author><author><name sortKey="Ribera Casado, J" sort="Ribera Casado, J" uniqKey="Ribera Casado J" first="J." last="Ribera Casado">J. Ribera Casado</name></author><author><name sortKey="Rubenstein, L" sort="Rubenstein, L" uniqKey="Rubenstein L" first="L." last="Rubenstein">L. Rubenstein</name></author><author><name sortKey="Salva, A" sort="Salva, A" uniqKey="Salva A" first="A." last="Salva">A. Salva</name></author><author><name sortKey="Sieber, C" sort="Sieber, C" uniqKey="Sieber C" first="C." last="Sieber">C. Sieber</name></author><author><name sortKey="Sinclair, A" sort="Sinclair, A" uniqKey="Sinclair A" first="A." last="Sinclair">A. Sinclair</name></author><author><name sortKey="Schindler, R" sort="Schindler, R" uniqKey="Schindler R" first="R." last="Schindler">R. Schindler</name></author><author><name sortKey="Stephan, E" sort="Stephan, E" uniqKey="Stephan E" first="E." last="Stephan">E. Stephan</name></author><author><name sortKey="Wong, R Y" sort="Wong, R Y" uniqKey="Wong R" first="R. Y." last="Wong">R. Y. Wong</name></author><author><name sortKey="Vellas, B" sort="Vellas, B" uniqKey="Vellas B" first="B." last="Vellas">B. Vellas</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>University of Nice Sophia Antipolis. Gerontology 430 Avenue Pessicart</s1><s2>0600 Nice</s2><s3>FRA</s3><sZ>13 aut.</sZ><sZ>21 aut.</sZ><sZ>31 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>0600 Nice</wicri:noRegion><wicri:noRegion>University of Nice Sophia Antipolis. Gerontology 430 Avenue Pessicart</wicri:noRegion><wicri:noRegion>University of Nice Sophia Antipolis. 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Villars</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Gérontopôle, Alzheimer's Disease Research and Clinical Center, Toulouse University Hospital</s1><s3>FRA</s3><sZ>1 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Toulouse University Hospital</wicri:noRegion><wicri:noRegion>Gérontopôle, Alzheimer's Disease Research and Clinical Center, Toulouse University Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Oustric, S" sort="Oustric, S" uniqKey="Oustric S" first="S." last="Oustric">S. Oustric</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of family medicine, Toulouse University Hospital</s1><s3>FRA</s3><sZ>2 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Toulouse University Hospital</wicri:noRegion><wicri:noRegion>Department of family medicine, Toulouse University Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Andrieu, S" sort="Andrieu, S" uniqKey="Andrieu S" first="S." last="Andrieu">S. Andrieu</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Inserm U558</s1><s2>31073 Toulouse</s2><s3>FRA</s3><sZ>3 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>31073 Toulouse</wicri:noRegion><placeName><settlement type="city">Toulouse</settlement><region type="region" nuts="2">Occitanie (région administrative)</region><region type="old region" nuts="2">Midi-Pyrénées</region></placeName></affiliation></author><author><name sortKey="Baeyens, J P" sort="Baeyens, J P" uniqKey="Baeyens J" first="J. P." last="Baeyens">J. P. Baeyens</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Generaal Jungbluthlaan 11</s1><s2>8400 Oostende</s2><s3>BEL</s3><sZ>4 aut.</sZ></inist:fA14><country>Belgique</country><wicri:noRegion>Generaal Jungbluthlaan 11</wicri:noRegion></affiliation></author><author><name sortKey="Bernabei, R" sort="Bernabei, R" uniqKey="Bernabei R" first="R." last="Bernabei">R. Bernabei</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Instituto de medecine Interna e Geriatria Universita Cattalica del Sacre Cuore Largo A Gemelli 8</s1><s2>00168 ROME</s2><s3>ITA</s3><sZ>5 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Instituto de medecine Interna e Geriatria Universita Cattalica del Sacre Cuore Largo A Gemelli 8</wicri:noRegion></affiliation></author><author><name sortKey="Brodaty, H" sort="Brodaty, H" uniqKey="Brodaty H" first="H." last="Brodaty">H. Brodaty</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>University Of New South Wales; Dementia Collaborative Research Center; 45 Beach Street</s1><s2>Coogee NSW 2034</s2><s3>AUS</s3><sZ>6 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>University Of New South Wales; Dementia Collaborative Research Center; 45 Beach Street</wicri:noRegion></affiliation></author><author><name sortKey="Brummel Smith, K" sort="Brummel Smith, K" uniqKey="Brummel Smith K" first="K." last="Brummel-Smith">K. Brummel-Smith</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Department of Geriatrics Florida State University College of Medicine 1115 West Call St, Suite 3140</s1><s2>Tallahassee, FL 32306-4300</s2><s3>USA</s3><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Tallahassee, FL 32306-4300</wicri:noRegion></affiliation></author><author><name sortKey="Celafu, C" sort="Celafu, C" uniqKey="Celafu C" first="C." last="Celafu">C. Celafu</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Section of Geriatrics, Dept of Medicine, LSUHSC, New Orleans, La. at LSU Health Sciences Center</s1><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Section of Geriatrics, Dept of Medicine, LSUHSC, New Orleans, La. at LSU Health Sciences Center</wicri:noRegion></affiliation></author><author><name sortKey="Chappell, N" sort="Chappell, N" uniqKey="Chappell N" first="N." last="Chappell">N. Chappell</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Center on Aging, University of Victoria; PO Box 1700, STN CSC Victoria</s1><s2>BC V8W 2Y2</s2><s3>CAN</s3><sZ>9 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>BC V8W 2Y2</wicri:noRegion></affiliation></author><author><name sortKey="Fitten, J" sort="Fitten, J" uniqKey="Fitten J" first="J." last="Fitten">J. Fitten</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>DVAMC 116A-9 16111 Plummer street</s1><s2>SEPULVEDA CA 91343</s2><s3>USA</s3><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>DVAMC 116A-9 16111 Plummer street</wicri:noRegion></affiliation></author><author><name sortKey="Frisoni, G" sort="Frisoni, G" uniqKey="Frisoni G" first="G." last="Frisoni">G. Frisoni</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>IRCCS San Giovanni di Rio, FBF, Via Pilastroni 4</s1><s2>25125 Brescia</s2><s3>ITA</s3><sZ>11 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>25125 Brescia</wicri:noRegion></affiliation></author><author><name sortKey="Froelich, L" sort="Froelich, L" uniqKey="Froelich L" first="L." last="Froelich">L. Froelich</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Central Institute for Mental Health J5</s1><s2>68072 Mannheim</s2><s3>DEU</s3><sZ>12 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>68072 Mannheim</wicri:noRegion><wicri:noRegion>Central Institute for Mental Health J5</wicri:noRegion><wicri:noRegion>Central Institute for Mental Health J5</wicri:noRegion></affiliation></author><author><name sortKey="Guerin, O" sort="Guerin, O" uniqKey="Guerin O" first="O." last="Guerin">O. Guerin</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>University of Nice Sophia Antipolis. Gerontology 430 Avenue Pessicart</s1><s2>0600 Nice</s2><s3>FRA</s3><sZ>13 aut.</sZ><sZ>21 aut.</sZ><sZ>31 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>0600 Nice</wicri:noRegion><wicri:noRegion>University of Nice Sophia Antipolis. Gerontology 430 Avenue Pessicart</wicri:noRegion><wicri:noRegion>University of Nice Sophia Antipolis. Gerontology 430 Avenue Pessicart</wicri:noRegion></affiliation></author><author><name sortKey="Gold, G" sort="Gold, G" uniqKey="Gold G" first="G." last="Gold">G. Gold</name><affiliation wicri:level="1"><inist:fA14 i1="14"><s1>Service de Médecine Interne de Rehabilitation Hôpital des Trois chênes, Dpt de Réhabilitation et Gériatrie 3, Chemin du Pont Bochet</s1><s2>1226 Thonex Geneva</s2><s3>CHE</s3><sZ>14 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>1226 Thonex Geneva</wicri:noRegion></affiliation></author><author><name sortKey="Holmerova, I" sort="Holmerova, I" uniqKey="Holmerova I" first="I." last="Holmerova">I. Holmerova</name><affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Center of Gerontology Simunkova 1600</s1><s2>18200 Praha</s2><s3>CZE</s3><sZ>15 aut.</sZ></inist:fA14><country>République tchèque</country><placeName><settlement type="city">Prague</settlement><region type="région" nuts="2">Bohême centrale</region></placeName></affiliation></author><author><name sortKey="Iliffe, S" sort="Iliffe, S" uniqKey="Iliffe S" first="S." last="Iliffe">S. Iliffe</name><affiliation wicri:level="4"><inist:fA14 i1="16"><s1>Dept. of Primary Care & Population Sciences, University College London, Hampstead Campus, Rowland Hill St</s1><s2>London NW3 2PF</s2><s3>GBR</s3><sZ>16 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>London NW3 2PF</wicri:noRegion><orgName type="university">University College de Londres</orgName><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Lukas, A" sort="Lukas, A" uniqKey="Lukas A" first="A." last="Lukas">A. Lukas</name></author><author><name sortKey="Melis, R" sort="Melis, R" uniqKey="Melis R" first="R." last="Melis">R. Melis</name></author><author><name sortKey="Morley, J E" sort="Morley, J E" uniqKey="Morley J" first="J. E." last="Morley">J. E. Morley</name></author><author><name sortKey="Nies, H" sort="Nies, H" uniqKey="Nies H" first="H." last="Nies">H. Nies</name></author><author><name sortKey="Nourhashemi, F" sort="Nourhashemi, F" uniqKey="Nourhashemi F" first="F." last="Nourhashemi">F. Nourhashemi</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>University of Nice Sophia Antipolis. Gerontology 430 Avenue Pessicart</s1><s2>0600 Nice</s2><s3>FRA</s3><sZ>13 aut.</sZ><sZ>21 aut.</sZ><sZ>31 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>0600 Nice</wicri:noRegion><wicri:noRegion>University of Nice Sophia Antipolis. Gerontology 430 Avenue Pessicart</wicri:noRegion><wicri:noRegion>University of Nice Sophia Antipolis. Gerontology 430 Avenue Pessicart</wicri:noRegion></affiliation></author><author><name sortKey="Petepmans, J" sort="Petepmans, J" uniqKey="Petepmans J" first="J." last="Petepmans">J. Petepmans</name></author><author><name sortKey="Ribera Casado, J" sort="Ribera Casado, J" uniqKey="Ribera Casado J" first="J." last="Ribera Casado">J. Ribera Casado</name></author><author><name sortKey="Rubenstein, L" sort="Rubenstein, L" uniqKey="Rubenstein L" first="L." last="Rubenstein">L. Rubenstein</name></author><author><name sortKey="Salva, A" sort="Salva, A" uniqKey="Salva A" first="A." last="Salva">A. Salva</name></author><author><name sortKey="Sieber, C" sort="Sieber, C" uniqKey="Sieber C" first="C." last="Sieber">C. Sieber</name></author><author><name sortKey="Sinclair, A" sort="Sinclair, A" uniqKey="Sinclair A" first="A." last="Sinclair">A. Sinclair</name></author><author><name sortKey="Schindler, R" sort="Schindler, R" uniqKey="Schindler R" first="R." last="Schindler">R. Schindler</name></author><author><name sortKey="Stephan, E" sort="Stephan, E" uniqKey="Stephan E" first="E." last="Stephan">E. Stephan</name></author><author><name sortKey="Wong, R Y" sort="Wong, R Y" uniqKey="Wong R" first="R. Y." last="Wong">R. Y. Wong</name></author><author><name sortKey="Vellas, B" sort="Vellas, B" uniqKey="Vellas B" first="B." last="Vellas">B. Vellas</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>University of Nice Sophia Antipolis. Gerontology 430 Avenue Pessicart</s1><s2>0600 Nice</s2><s3>FRA</s3><sZ>13 aut.</sZ><sZ>21 aut.</sZ><sZ>31 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>0600 Nice</wicri:noRegion><wicri:noRegion>University of Nice Sophia Antipolis. Gerontology 430 Avenue Pessicart</wicri:noRegion><wicri:noRegion>University of Nice Sophia Antipolis. Gerontology 430 Avenue Pessicart</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">The Journal of nutrition, health & aging</title><title level="j" type="abbreviated">J. nutr. health aging</title><idno type="ISSN">1279-7707</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">The Journal of nutrition, health & aging</title><title level="j" type="abbreviated">J. nutr. health aging</title><idno type="ISSN">1279-7707</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Alzheimer disease</term><term>Clinical trial</term><term>Diagnosis</term><term>Health staff</term><term>Metabolic diseases</term><term>Paper</term><term>Physician</term><term>Position</term><term>Primary health care</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Démence d'Alzheimer</term><term>Soin santé primaire</term><term>Médecin</term><term>Personnel sanitaire</term><term>Position</term><term>Papier</term><term>Diagnostic</term><term>Essai clinique</term><term>Maladie métabolique</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Médecin</term><term>Papier</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">This paper aims to define the role of the primary care physician (PCP) in the management of Alzheimer's disease (AD) and to propose a model for a work plan. The proposals in this position paper stem from a collaborative work of experts involved in the care of AD patients. It combines evidence from a literature review and expert's opinions who met in Paris, France, on July 2009 during the International Association of Geriatrics and Gerontology (IAGG) World Congress. The PCP's intervention appears essential at many levels: detection of the onset of dementia, diagnostic management, treatment and follow-up. The key role of the PCP in the management of AD, as care providers and care planners, is consolidated by the family caregiver's confidence in their skills. In primary care practice the first step is to identify dementia. The group proposes a "case finding" strategy, in target situations in which dementia should be detected to allow, secondarily, a diagnosis of AD, in certain cases. We propose that the PCP identifies 'typical' cases. In typical cases, among older subjects, the diagnosis of "probable AD" can be done by the PCP and then confirm by the specialist. While under-diagnosis of AD exists, so does under-disclosure. Disclosure to patient and family should be done by both specialist and PCP. Then, the PCP has a central role in management of the disease with the general objectives to detect, prevent and treat, when possible, the complications of the disease (falls, malnutrition, behavioural and psychological symptoms of dementia). The PCP needs to give basic information to the caregiver on respite care and home support services in order to prevent crisis situations such as unplanned institutionalisation and "emergency" hospital admission. Finally, therapeutic research must be integrated in the daily practice of PCP. It is a matter of patients' right to benefit from access to innovation and clinical research whatever his age or diseases, while of course fully respecting the rules and protective measures that are in force.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Belgique</li><li>Canada</li><li>France</li><li>Italie</li><li>Royaume-Uni</li><li>République tchèque</li><li>Suisse</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Bohême centrale</li><li>Grand Londres</li><li>Midi-Pyrénées</li><li>Occitanie (région administrative)</li></region><settlement><li>Londres</li><li>Prague</li><li>Toulouse</li></settlement><orgName><li>University College de Londres</li></orgName></list><tree><noCountry><name sortKey="Lukas, A" sort="Lukas, A" uniqKey="Lukas A" first="A." last="Lukas">A. Lukas</name><name sortKey="Melis, R" sort="Melis, R" uniqKey="Melis R" first="R." last="Melis">R. Melis</name><name sortKey="Morley, J E" sort="Morley, J E" uniqKey="Morley J" first="J. E." last="Morley">J. E. Morley</name><name sortKey="Nies, H" sort="Nies, H" uniqKey="Nies H" first="H." last="Nies">H. Nies</name><name sortKey="Petepmans, J" sort="Petepmans, J" uniqKey="Petepmans J" first="J." last="Petepmans">J. Petepmans</name><name sortKey="Ribera Casado, J" sort="Ribera Casado, J" uniqKey="Ribera Casado J" first="J." last="Ribera Casado">J. Ribera Casado</name><name sortKey="Rubenstein, L" sort="Rubenstein, L" uniqKey="Rubenstein L" first="L." last="Rubenstein">L. Rubenstein</name><name sortKey="Salva, A" sort="Salva, A" uniqKey="Salva A" first="A." last="Salva">A. Salva</name><name sortKey="Schindler, R" sort="Schindler, R" uniqKey="Schindler R" first="R." last="Schindler">R. Schindler</name><name sortKey="Sieber, C" sort="Sieber, C" uniqKey="Sieber C" first="C." last="Sieber">C. Sieber</name><name sortKey="Sinclair, A" sort="Sinclair, A" uniqKey="Sinclair A" first="A." last="Sinclair">A. Sinclair</name><name sortKey="Stephan, E" sort="Stephan, E" uniqKey="Stephan E" first="E." last="Stephan">E. Stephan</name><name sortKey="Wong, R Y" sort="Wong, R Y" uniqKey="Wong R" first="R. Y." last="Wong">R. Y. Wong</name></noCountry><country name="France"><noRegion><name sortKey="Villars, H" sort="Villars, H" uniqKey="Villars H" first="H." last="Villars">H. Villars</name></noRegion><name sortKey="Andrieu, S" sort="Andrieu, S" uniqKey="Andrieu S" first="S." last="Andrieu">S. Andrieu</name><name sortKey="Guerin, O" sort="Guerin, O" uniqKey="Guerin O" first="O." last="Guerin">O. Guerin</name><name sortKey="Nourhashemi, F" sort="Nourhashemi, F" uniqKey="Nourhashemi F" first="F." last="Nourhashemi">F. Nourhashemi</name><name sortKey="Oustric, S" sort="Oustric, S" uniqKey="Oustric S" first="S." last="Oustric">S. Oustric</name><name sortKey="Vellas, B" sort="Vellas, B" uniqKey="Vellas B" first="B." last="Vellas">B. Vellas</name></country><country name="Belgique"><noRegion><name sortKey="Baeyens, J P" sort="Baeyens, J P" uniqKey="Baeyens J" first="J. P." last="Baeyens">J. P. Baeyens</name></noRegion></country><country name="Italie"><noRegion><name sortKey="Bernabei, R" sort="Bernabei, R" uniqKey="Bernabei R" first="R." last="Bernabei">R. Bernabei</name></noRegion><name sortKey="Frisoni, G" sort="Frisoni, G" uniqKey="Frisoni G" first="G." last="Frisoni">G. Frisoni</name></country><country name="Australie"><noRegion><name sortKey="Brodaty, H" sort="Brodaty, H" uniqKey="Brodaty H" first="H." last="Brodaty">H. Brodaty</name></noRegion></country><country name="États-Unis"><noRegion><name sortKey="Brummel Smith, K" sort="Brummel Smith, K" uniqKey="Brummel Smith K" first="K." last="Brummel-Smith">K. Brummel-Smith</name></noRegion><name sortKey="Celafu, C" sort="Celafu, C" uniqKey="Celafu C" first="C." last="Celafu">C. Celafu</name><name sortKey="Fitten, J" sort="Fitten, J" uniqKey="Fitten J" first="J." last="Fitten">J. Fitten</name></country><country name="Canada"><noRegion><name sortKey="Chappell, N" sort="Chappell, N" uniqKey="Chappell N" first="N." last="Chappell">N. Chappell</name></noRegion></country><country name="Allemagne"><noRegion><name sortKey="Froelich, L" sort="Froelich, L" uniqKey="Froelich L" first="L." last="Froelich">L. Froelich</name></noRegion></country><country name="Suisse"><noRegion><name sortKey="Gold, G" sort="Gold, G" uniqKey="Gold G" first="G." last="Gold">G. Gold</name></noRegion></country><country name="République tchèque"><region name="Bohême centrale"><name sortKey="Holmerova, I" sort="Holmerova, I" uniqKey="Holmerova I" first="I." last="Holmerova">I. Holmerova</name></region></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Iliffe, S" sort="Iliffe, S" uniqKey="Iliffe S" first="S." last="Iliffe">S. Iliffe</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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