A similar pattern was seen for women with mixed AD/VaD, although memantine and rivastigmine were the second choice drugs at DC1 (Table 3)

A similar pattern was seen for women with mixed AD/VaD, although memantine and rivastigmine were the second choice drugs at DC1 (Table 3). Follow-up A total of 84 medical records were received from the GPs. Eighteen per cent of the GPs medical records made no reference to the patients dementia or treatment even though dementia drugs were included in the list of medications prescribed. Conclusions The results indicate that the Swedish guidelines for treatment of cognitive symptoms in AD are being followed in primary care. However, documentation of follow-up of drug treatment was sometimes insufficient, which calls for development of guidelines for complete medical records and medication lists. Introduction Dementia drugs provide symptomatic treatment and can affect cognition and global function in Alzheimers disease (AD). [1], [2] This effect is probably best achieved if the treatment is administered early, ideally immediately after cognitive examination and diagnosis. [3] Guidelines issued by the Swedish National Board of Health and Welfare for treatment of dementia state that patients with mild to moderate AD Betamethasone should be offered cholinesterase inhibitors for cognitive symptoms, while patients with moderate to severe AD should be prescribed memantine. The guidelines also declare that treatment must be followed Betamethasone up for dose adjustment and regularly thereafter at least once a year. [4] Within the Stockholm health authority area, cognitive examinations are conducted by general practitioners (GPs) and at dementia clinics. Often, GPs refer patients to dementia clinics for Betamethasone specialist evaluation and then resume responsibility for patient treatment once the clinical examination has been completed. There are currently four dementia drugs available on the Swedish market; three cholinesterase inhibitors (donepezil, rivastigmine, galantamine) and the NMDA receptor antagonist CD247 memantine. [5] The three cholinesterase inhibitors differ Betamethasone in terms of acetylcholinesterase and butyrylcholinesterase inhibition, pharmacokinetics, interactions and adverse reactions. [6], [7] Approximately two out of three patients who are treated with a cholinesterase inhibitor demonstrate a positive response to the treatment. [8] These drugs are usually well-tolerated and the main adverse drug reactions are gastrointestinal disorders. [9], [6] Memantine is a non-competitive NMDA receptor antagonist that can help to mitigate the cognitive symptoms and maintain global function. Betamethasone Again, the effect varies between patients and the drug dose should be adjusted in patient with impaired kidney function. [10] It is largely unknown how the medical treatment of patients diagnosed with dementia is followed up in primary care. Therefore, the aim of this study was to investigate the medical treatment of patients who was examined and diagnosed in two dementia clinics and then referred back to their GPs. Methods Participants A retrospective study was conducted from April to October 2011. All patients (n?=?616) who had been referred to two dementia clinics for a cognitive examination in 2008 were included. Both clinics have their catchment area in north west Stockholm, Sweden. We then selected the patients who were diagnosed with AD or mixed AD/vascular dementia (VaD) and who were prescribed dementia drugs (cholinesterase inhibitors and/or memantine) (n?=?331; 54%). By April 2011, 90 (27%) of the patients registered in 2008 had died. The remaining 241 patients (the study group) received a letter from their dementia clinic informing them of the study and asking their permission to acquire their medical records from their GP. The letter also contained a consent certificate to be signed by the patient or a member of his/her family granting permission to access the patients medical record and returned to the clinic. Figure 1 shows the.