Dawaa Reference

chronic

Alzheimer's Disease

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Alzheimer Disease - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK499922/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class PD01.00 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (8)

  • Memory loss is the most common first symptom of Alzheimer disease [memory loss]
  • In early-onset disease diagnosed before 60, roughly a quarter first present with impaired judgment and visuospatial difficulty rather than memory loss
  • Trouble managing finances, shopping, meal preparation, or housekeeping reflects declining instrumental daily function
  • Caregivers often describe a gradual shift in memory, thinking, behavior, or daily function
  • One atypical variant brings progressive visual difficulty with problems in object and space perception, calculation, and reading, while memory stays relatively intact early on
  • Another variant starts with worsening language difficulty while memory is preserved early on
  • A less common variant shows impaired planning and executive function out of proportion to memory loss [memory loss]
  • In advanced disease the patient can stop talking and stop responding to being spoken to, eventually becoming bed-bound

Signs — what you find (3)

  • The neurological exam is usually normal apart from loss of smell [loss of smell]
  • Unlike Alzheimer disease, loss of smell is not typically seen in vascular cognitive impairment or depression [loss of smell]
  • Advanced disease can bring focal findings such as apraxia, aphasia, frontal release signs, and primitive reflexes [slurred speech]

Tests (12)

  • Bedside screening with the MMSE, or preferably the MOCA, is part of the standard cognitive workup
  • The MOCA outperforms the MMSE for picking up mild cognitive impairment
  • The Mini-Cog, combining a clock-drawing task with three-item recall, is another primary-care screening test
  • Mini-Cog scores are not meaningfully skewed by a patient's education level
  • Basic bloodwork such as CBC, metabolic panel, TSH, and B12 is drawn to exclude other reversible causes, not because it shows AD-specific changes
  • A brain CT can show cerebral atrophy and third-ventricle widening, but these findings are nonspecific
  • MRI can show entorhinal cortex atrophy followed by medial temporal or hippocampal atrophy
  • Volumetric MRI can show hippocampal shrinkage, a characteristic feature linked to memory decline
  • EEG is usually normal in AD and is not a useful diagnostic tool, though it may show generalized slowing
  • FDG-PET can reveal metabolic impairment in the hippocampi in early or preclinical disease
  • CSF testing shows a drop in amyloid-beta 42 alongside a rise in phosphorylated and total tau
  • Genetic testing is not part of routine workup but is considered for families with rare early-onset disease

If not this — what else fits (10)

  • Depression-related pseudodementia needs to be excluded
  • Dementia with Lewy bodies is a key differential; watch for fluctuating cognition, visual hallucinations, and parkinsonism
  • Vascular dementia belongs on the differential list
  • Frontotemporal dementia mimics AD but visuospatial skills tend to stay intact, a useful discriminator
  • Dialysis dementia, a neurologic complication of chronic dialysis treatment, is another consideration
  • Vitamin B12 deficiency is a reversible cause that should be ruled out
  • Thyroid dysfunction can mimic cognitive decline and needs excluding
  • Polypharmacy is weighed as a possible contributing or mimicking factor
  • Alcohol or drug misuse is considered among the mimicking causes
  • Normal age-related memory change is distinguished from true dementia

SourceStatPearls "Alzheimer Disease" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

The most common cause of dementia, with insidious memory loss and progressive cognitive decline; a GP recognises the pattern, arranges basic work-up to exclude reversible causes, and refers to neurology/psychiatry for formal diagnosis and initiation of a cholinesterase inhibitor or memantine, continuing prescriptions once established. - Refer, with advice

Paediatric dose

Adult-only condition - paediatric section not applicable

Dose source

No dose - referral pathway, no medicine given in primary care

Why

The most common cause of dementia, with insidious memory loss and progressive cognitive decline; a GP recognises the pattern, arranges basic work-up to exclude reversible causes, and refers to neurology/psychiatry for formal diagnosis and initiation of a cholinesterase inhibitor or memantine, continuing prescriptions once established.

Cautions
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - Rapid (weeks to months) cognitive decline is atypical for Alzheimer's and needs urgent work-up for another cause. Refer also for new focal neurological signs, or depression that mimics or coexists with dementia.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.