Dementia
Dementia: Supporting people with dementia and their carers in health and social care
Summary
Summary of guidance This guideline makes specific recommendations on Alzheimer's disease, dementia with Lewy bodies (DLB), frontotemporal dementia, vascular dementia and mixed dementias, as well as recommendations that apply to all types of dementia. Dementia in Parkinson's disease shares a number ...
Amendment of technology appraisal 111
Following the outcome of a judicial review in August 2007, NICE has amended and reissued the technology appraisal guidance on donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer's disease. The amended guidance clarifies the steps healthcare professionals should take when assessing whether Alzheimer's disease is of moderate severity and highlights that clinicians should be mindful of the need to secure equality of access to treatment.
The amendments include new text that specifically addresses assessments using the Mini Mental State Examination (MMSE) for patients:
- where the MMSE is not, or is not by itself, a clinically appropriate tool for assessing the severity of that patient's dementia because of the patient's learning or other disabilities (for example, sensory impairments) or linguistic or other communication difficulties
or
- where it is not possible to apply the MMSE in a language in which the patient is sufficiently fluent for it to be an appropriate tool for assessing the severity of dementia, or there are similarly exceptional reasons why use of the MMSE, or use of the MMSE by itself, would be an inappropriate tool for assessing the severity of dementia in that individual patient's case.
Update
On 1 May 2008 the Court of Appeal ruled in favour of Eisai's appeal against the original High Court's decision, finding that NICE did breach principles of procedural fairness by providing a 'read only' version of the economic model. It is important to stress that we have not been asked to amend or withdraw the current guidance on the use of these drugs to treat Alzheimer's disease: the drugs continue to be recommended only for people at the moderate stage of the disease. In accordance with the Court of Appeal's ruling, NICE will provide Eisai with an executable version of the economic model for them to comment on. We will then consider those comments and take whatever steps are appropriate.
Guidance documents
Implementing this guidance
Other information
Expected review date: November 2011
About this guidance
Clinical guidelines CG42
Issued: November 2006
How this guidance was produced