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Preview of Alzheimers

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Understanding NICE guidance
Information for people who use NHS services
Donepezil, galantamine,
rivastigmine and memantine
for Alzheimer's disease
NICE `technology This leaflet is about when donepezil, galantamine, rivastigmine and
appraisal guidance' memantine should be used to treat people with Alzheimer's disease in the
NHS in England and Wales. It does not cover the use of these drugs for
advises on when
patients with other forms of dementia (for example, vascular dementia
and how drugs and or dementia with Lewy bodies). It explains guidance (advice) from NICE
other treatments (the National Institute for Health and Clinical Excellence). It is written for
should be used in people with Alzheimer's disease but it may also be useful for their families,
the NHS. carers or anyone with an interest in the condition.
It does not describe Alzheimer's disease or the treatments in detail ­
your specialist should discuss these with you. Some sources of further
information and support are on page 5.
Following the outcome of a judicial review in August 2007, NICE
amended and reissued the guidance. The new information is given
in the box on page 3.
Information about NICE technology appraisal guidance 111
Issue date: November 2006 (amended September 2007)

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What has NICE said?
These may not be Donepezil, galantamine and rivastigmine are recommended as
options for moderate Alzheimer's disease only, and if:
the only possible
treatments for · treatment is started by a doctor who specialises in the care of
Alzheimer's people with dementia
disease.…read more

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Assessing the severity of Alzheimer's disease
Usually, healthcare professionals should use the MMSE test to assess This leaflet contains
whether a person has moderate Alzheimer's disease. However, the a summary in plain
test is not suitable for some people.
English of the
When using the MMSE test, healthcare professionals should make guidance NICE has
sure that people from different ethnic or cultural backgrounds and
issued to the NHS.
people with disabilities have equal access to treatment.…read more

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Alzheimer's disease
Alzheimer's disease is a type of dementia. It affects the brain and causes
problems with memory, thinking and behaviour. It is a progressive disease,
which means it gets worse over time as more parts of the brain are
The Mini Mental State Examination (MMSE) is a test that is used to
measure how severe a person's Alzheimer's disease is. The lower the
MMSE score, the more severe is the disease.…read more

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More information about Alzheimer's disease
The organisation below can provide more information and support for
people with Alzheimer's disease. Please note that NICE is not responsible
for the quality or accuracy of any information or advice provided by
this organisation.
· The Alzheimer's Society, 0845 300 0336,
NHS Direct online ( may be a good starting point
for finding out more. Your local Patient Advice and Liaison Service (PALS)
may also be able to give you further advice and support.…read more

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National Institute for Health and Clinical Excellence
MidCity Place, 71 High Holborn, London WC1V 6NA; ISBN 1-84629-474-6
N1329 10k 1P Sep 07
© National Institute for Health and Clinical Excellence, 2007. All rights reserved. This material may be freely
reproduced for educational and not-for-profit purposes. No reproduction by or for commercial organisations,
or for commercial purposes, is allowed without the express written permission of the Institute.…read more


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