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Traité sur la maladie d’Alzheimer pp 63–73Cite as

Place du médecin généraliste dans le diagnostic et le suivi des patients atteints de maladie d’Alzheimer

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Résumé

La prévalence de la maladie d’Alzheimer (MA) en France place cette pathologie au centre des enjeux de notre système de santé dans les années à venir [1]. Le médecin généraliste, par la place particulière qu’il occupe auprès du patient, joue un rôle clé dans la prise en charge du sujet âgé souffrant de MA. En effet, ce type de patient nécessite une prise en charge « globale », « intégrée » et adaptée à des besoins médicopsychosociaux complexes [2]. Le médecin généraliste doit donc pouvoir détecter la maladie pour un diagnostic précoce, mais également organiser le suivi du patient. Rappelons qu’en Europe, 25 % à 60 % des patients souffrant de MA, selon les pays, vivent à domicile comme cela a été mis en évidence dans des suivis de cohortes [3, 4] et que, de ce fait, il est le plus souvent le premier médecin que le couple patient/aidant consulte [5].

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références

  1. INSERM Expertise collective (2007) Maladie d’Alzheimer: enjeux scientifiques, médicaux et sociétaux. Éditions Inserm

    Google Scholar 

  2. Gay B, Le Gloaziou MF, Budowski M, et al. (2003) Abrégé de Médecine générale Masson, Paris

    Google Scholar 

  3. Gillette-Guyonnet S, Nourhashemi F, Andrieu S and the REAL.FR Group (2003) The REAL.FR research program on Alzheimer’s disease and its management: methods and preliminary results. J Nutr Health Aging 7: 91–6

    CAS  PubMed  Google Scholar 

  4. Reynish E, Cortes F, Andrieu S, et al. (2007) The ICTUS Study: A Prospective longitudinal observational study of 1,380 AD patients in Europe. Study design and baseline characteristics of the cohort. Neuroepidemiology 29: 29–38

    Article  CAS  PubMed  Google Scholar 

  5. vanHout HP, Vernooij-Dassen MJ, Stalman WA (2007) Diagnosing dementia with confidence by GPs. Fam Pract 24: 616–21

    Article  PubMed  Google Scholar 

  6. Tsolaki M, Papaliagkas V, Anogianakis G, et al. (2010) European Alzheimer Disease Consortium.Consensus statement on dementia education and training in Europe. J Nutr Health Aging 14(2): 131–35

    Article  CAS  PubMed  Google Scholar 

  7. Turner S, Iliffe S, Downs M, et al. (2004) General practitioners’ knowledge, confidence and attitudes in the diagnosis and management of dementia. Age Ageing 33: 461–7

    Article  PubMed  Google Scholar 

  8. Waldorff FB, Almind G, Mäkelä M, et al. (2003) Implementation of a clinical dementia guideline. A controlled study on the effect of a multifaceted strategy. Scand J Prim Health Care 21: 142–7

    Article  PubMed  Google Scholar 

  9. Wilcock J, Iliffe S, Turner S, et al. (2009) Concordance with clinical practice guidelines for dementia in general practice. Aging Ment Health 13: 155–61

    Article  PubMed  Google Scholar 

  10. Pond D, Brodaty H (2004) Diagnosis and management of dementia in general practice. Aust Fam Physician 33: 789–93

    PubMed  Google Scholar 

  11. Werner P (2006-2007) Family physicians’ recommendations for the treatment of Alzheimer’s disease. Am J Alzheimers Dis Other Demen 21: 403–10

    Article  PubMed  Google Scholar 

  12. England E (2006) Improving the management of dementia. BMJ 332: 681–2

    Article  PubMed  Google Scholar 

  13. Bridges-Webb C, Giles B, Speechly C, et al. (2007) Patients with dementia and their carers. Ann N Y Acad Sei 1114: 130–36

    Article  Google Scholar 

  14. Villars H, Oustric S, Andrieu S, et al. (2010) The primary care physician and Alzheimer’s disease: an international position paper. J Nutr Health Aging 14(2): 110–20

    Article  CAS  PubMed  Google Scholar 

  15. Cantegreil-Kallen I, Lieberherr D, Garcia A, et al (2004) Detection of Alzheimer’s disease in general medicine: preliminary results of a Sentinelles general practitioner’s network survey. Rev Med Interne 25: 548–55

    Article  CAS  PubMed  Google Scholar 

  16. Hinton L, Franz CE, Reddy G, et al. (2007) Practice constraints, behavioral problems, and dementia care: primary care physicians’ perspectives. J Gen Intern Med 22: 1487–92

    Article  PubMed Central  PubMed  Google Scholar 

  17. Renshaw J, Scurfield P, Cloke L, Orrell M (2001) General practitioners’ views on the early diagnosis of dementia. Br J Gen Pract 51: 37–8

    CAS  PubMed Central  PubMed  Google Scholar 

  18. HAS Quelle place pour les médicaments anti-alzheimer dans la prise en charge des patients. Août 2007. http://www.has-sante.fr

  19. HAS Diagnostic et prise en charge de la maladie d’Alzheimer et des maladies apparentées. Mars 2008. http://www.has-sante.fr

  20. Hopman-Rock M, Tak EC, Staats PG (2001) Development and validation of the Observation List for early signs of Dementia (OLD). Int J Geriatr Psychiatry 16:406–14

    Article  CAS  PubMed  Google Scholar 

  21. Brown J, Pengas G, Dawson K, et al. (2009) Self administered cognitive screening test (TYM) for detection of Alzheimer’s disease: cross sectional study. BMJ 338: b2030

    Article  PubMed Central  PubMed  Google Scholar 

  22. Belmin J, Pariel-Madjlessi S, Surun P, et al. (2007) The cognitive disorders examination (Codex) is a reliable 3-minute test for detection of dementia in the elderly (validation study on 323 subjects) Presse Med 36: 1183–90

    Article  PubMed  Google Scholar 

  23. Coley N, Ousset PJ, Andrieu S, et al. (2008) Memory complaints to the general practitioner: data from the GuidAge study. J Nutr Health Aging 12: 66S–72S

    Article  CAS  PubMed  Google Scholar 

  24. Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9: 179–86

    Article  CAS  PubMed  Google Scholar 

  25. Thomas JM (2005) Early screen of the Alzheimer’s disease by the general practitioner. Review of the literature Rev Med Brux 26: 279–88

    Google Scholar 

  26. Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12: 189–98

    Article  CAS  PubMed  Google Scholar 

  27. Brodaty H, Low LF, Gibson L, Burns K (2006) What is the best dementia screening instrument for general practitioners to use? Am J Geriatr Psychiatry 14: 391–400

    Article  PubMed  Google Scholar 

  28. Brodaty H, Pond D, Kemp NM, et al. (2002) The GPCOG: a new screening test for dementia designed for general practice. J Am Geriatr Soc 50(3): 530–4

    Article  PubMed  Google Scholar 

  29. Solomon PR, Hirschoff A, Kelly B, et al (1998) A 7 minute neurocognitive screening battery highly sensitive to Alzheimer’s disease. Arch Neurol 55: 349–55

    Article  CAS  PubMed  Google Scholar 

  30. Mendez MF, Ala T, Underwood KL (1992) Development of scoring criteria for the clock drawing task in Alzheimer’s disease. J Am Geriatr Soc 40(11): 1095–9

    CAS  PubMed  Google Scholar 

  31. Dubois B, Touchon J, Portet F, et al. (2002) “The 5 words”: a simple and sensitive test for the diagnosis of Alzheimer’s disease. Presse Med 31: 1696–99

    CAS  PubMed  Google Scholar 

  32. Bhidayasiri R (2007) A typical dementia: when it is not Alzheimer’s disease. J Med Assoc Thai 90: 2222–32

    PubMed  Google Scholar 

  33. Cantegreil-Kallen I, Lieberherr D, Garcia A, et al. (2004) Detection of Alzheimer’s disease in general medicine: preliminary results of a Sentinelles general practitioner’s network survey. Rev Med Interne 25: 548–55

    Article  CAS  PubMed  Google Scholar 

  34. Bamford C, Lamont S, Eccles M, et al. (2004) Disclosing a diagnosis of dementia: a systematic review. Int J Geriatr Psychiatry 19: 151–69

    Article  PubMed  Google Scholar 

  35. HAS Maladie d’Alzheimer et maladies apparentées, suivi médical des aidants naturels. Actualisation fevrier 2010. http://www.has-sante.fr

  36. http://www.has-sante.fr/portail/jcms/c_1108356/medicaments-de-la-maladie-dalzheimer-la-has-revele-les-resultats-de-sa-reevaluation/portail/jcms/c_1108356/medicaments-de-la-maladie-dalzheimer-la-has-revele-les-resultats-de-sa-reevaluation

  37. Hughes A, Coulter F, Gillespie R, et al. (2000) Anticholinesterases in the treatment of Alzheimer’s dementia—the first year’s experience in Argyll & Clyde. Health Bull (Edinb) 58: 20–4

    CAS  Google Scholar 

  38. California Workgroup on guidelines for Alzheimer’s Disease Management. Guidelines for Alzheimer’sdiseasemanagement (2008) http://www.alz.org/californiasouthland/documents/professional_GuidelineFullReport.pdf

  39. Nourhashemi F, Olde Rikkert MG, Burns A et al. (2010) Follow-up for Alzheimer patients: European Alzheimer Disease Consortium position paper. J Nutr Health Aging 14(2): 121–30

    Article  CAS  PubMed  Google Scholar 

  40. Nourhashemi F, Gillette-Guyonnet S, Andrieu S, et al. (2008) A randomised trial of the impact of a specific care plan in 1120 Alzheimer’s patients (PLASA Study) over a two-year period: design and baseline data. J Nutr Health Aging 12: 263–71

    Article  CAS  PubMed  Google Scholar 

  41. Cummings JL, Mega M, Gray K, et al. (1994) The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 44: 2308–14

    Article  CAS  PubMed  Google Scholar 

  42. Katz S, Ford AB, Moskowitz RW, et al. (1963) Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA 185: 914–19

    Article  CAS  PubMed  Google Scholar 

  43. Vellas BJ, Wayne SJ, Romero L, et al. (1997) One-leg balance is an important predictor of injurious falls in older persons. J Am Geriatr Soc 45: 735–38

    CAS  PubMed  Google Scholar 

  44. Vellas B, Guigoz Y, Garry PJ, et al. (1999) The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition 15: 116–22

    Article  CAS  PubMed  Google Scholar 

  45. Zarit SH, Reever KE, Bach-Peterson J (1980) Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist 20: 649–55

    Article  CAS  PubMed  Google Scholar 

  46. Fitten LJ (2006) Management of behavioral and psychiatric symptoms in dementia. J Nutr Health Aging 10: 409

    CAS  PubMed  Google Scholar 

  47. HAS Prise en charge de la MA et syndromes apparentés: interventions médicamenteuses et non médicamenteurses. Mars 2008. http://www.has-sante.fr

  48. Gillette Guyonnet S, Abellan Van Kan G, Andrieu S, et al. (2007) IANA task force on nutrition and cognitive decline with aging. J Nutr Health Aging 11: 132–52

    CAS  PubMed  Google Scholar 

  49. Guerin O, Soto ME, Brocker P, et al. (2005) Nutritional status assessment during Alzheimer’s disease: results after one year (the REAL French Study Group). J Nutr Health Aging 9: 81–4

    CAS  PubMed  Google Scholar 

  50. Gillioz AS, Villars H, Voisin T, et al. (2009) Spared and impaired abilities in community-dwelling patients entering the severe stage of Alzheimer’s disease. Dement Geriatr Cogn Disord 28(5): 427–32

    Article  PubMed  Google Scholar 

  51. Lyketsos CG, Colenda CC, Beck C, et al. (2006) Position statement of the American Association for Geriatric Psychiatry regarding principles of care for patients with dementia resulting from Alzheimer disease. Am J Geriatr Psychiatry 14: 561–72

    Article  PubMed  Google Scholar 

  52. Petersen RC, Stevens JC, Ganguli M, et al. (2001) Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 56: 1133–42

    Article  CAS  PubMed  Google Scholar 

  53. Yaffe MJ, Orzeck P, Barylak L (2008) Family physicians’ perspectives on care of dementia patients and family caregivers Can Fam Physician 54: 1008–15

    PubMed Central  PubMed  Google Scholar 

  54. Reynish E, Cortes F, Andrieu S, et al. (2007) The ICTUS Study: A Prospective longitudinal observational study of 1,380 AD patients in Europe. Study design and baseline characteristics of the cohort. Neuroepidemiology 29: 29–38

    Article  CAS  PubMed  Google Scholar 

  55. Andrieu, S, Balardy L, Gillette-Guyonnet S, et al. (2003) Burden experienced by informal caregivers assisting Alzheimer’s patients in the REAL.FR study. Rev Med Interne 4(3): 351s–359s

    Article  Google Scholar 

  56. Lachs MS, Pillemer K (2004) Elder abuse. Lancet 364: 1263–72

    Google Scholar 

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Authors and Affiliations

  1. Gérontopôle Service de médecine interne gériatrique, CHU Toulouse Hôpital Casselardit, 70, avenue de Casselardit, 31300, Toulouse, France

    H. Villars & B. Vellas

  2. Service de médecine générale, Faculté de médecine de Toulouse Rangueil, 133, route de Narbonne, 31062, Toulouse cedex, France

    M. E. Rouge-Bugat, J. Subra, S. Bismuth & S. Oustric

  3. Inserm U558, 31073, Toulouse, France

    S. Oustric & B. Vellas

Authors
  1. H. Villars
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  2. M. E. Rouge-Bugat
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  3. J. Subra
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  4. S. Bismuth
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  5. S. Oustric
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  6. B. Vellas
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Correspondence to H. Villars .

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Villars, H., Rouge-Bugat, M.E., Subra, J., Bismuth, S., Oustric, S., Vellas, B. (2013). Place du médecin généraliste dans le diagnostic et le suivi des patients atteints de maladie d’Alzheimer. In: Traité sur la maladie d’Alzheimer. Springer, Paris. https://doi.org/10.1007/978-2-8178-0443-9_4

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  • DOI: https://doi.org/10.1007/978-2-8178-0443-9_4

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-8178-0442-2

  • Online ISBN: 978-2-8178-0443-9

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