Box 1: General approach to the management of
patients with severe Alzheimer disease
• Patients should be monitored closely by health
professionals at least every 4 months, or at least every
3 months if pharmacotherapy is used (grade C
recommendation, level 3 evidence)
• Monitoring should involve assessment of the patientís
cognition, function, behaviour, and medical and
nutritional status, as well as the caregiver’s safety and
health (grade B recommendation, level 3 evidence)
• The goals of management are to improve the quality of
life for patients and caregivers, maintain optimal
function and provide maximum comfort (grade B
recommendation, level 3 evidence)
• Medical management includes treating intercurrent
medical conditions (e.g., infections, parkinsonian
symptoms, seizures, pressure ulcers), ameliorating pain,
improving nutritional status and optimizing sensory
function (grade B, level 3 evidence)