Background and objectiveThere are about 65000 people suffering from dementia in Norway. Dementia in Alzheimer's disease (AD) is the most common variant. There are three cholinesterase inhibitors available in Norway that may have a positive effect on cognition, such as memory, attention and language, and on the patient s ability to perform activities of daily living (ADL).
This project is about dementia and AD in general and about treatment with cholinesterase inhibitors. I want to investigate where the medical doctors find information about how to diagnose dementia, drug treatment and prescription of cholinesterase inhibitors and who are prescribing these drugs.
MethodIn answering these questions the Norwegian Centre of Dementia Research has been a valuable source. I have also read books and articles found by searching in the Cochrane and Medline databases. The pharmaceutical industry has also given me information. Another source of information has been the Norwegian Electronic Handbook and the Norwegian doctor's association.
Main resultsThe cholinesterase inhibitors available in Norway are donepezil (Aricept) from Pfizer, rivastigmine (Exelon) from Novartis and galantamine (Reminyl) from Janssen-Cilag. Donepezil has a market share higher than 80 %, while the others have less than 10 % each. In Norway the GP's are meant to diagnose people with uncomplicated dementia. They also prescribe about 80 % of the cholinesterase inhibitors. GP's can receive information from different sources.
ConclusionsTreatment with anti-dementia drugs must be individualised and the doctor has to do a close follow-up based on collaboration with the caregivers. The most common and troublesome side effects are nausea and vomiting. It is important to give information and practical support to the patient and his family.
I am looking forward to continue this work with a survey where I am asking Norwegian GP's about how they are diagnosing dementia and treating patients with dementia, with focus on AD.