TA111 Alzheimer's disease - donepezil, galantamine, rivastigmine (review) and memantine: guidance (amended September 2007)

Text explaining the new TA111 recommendations

Following the outcome of a judicial review in August 2007, NICE has amended and reissued this guidance.  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.