Commentary on “The Third Canadian Consensus Conference on the Diagnosis and Treatment of Dementia, 2006.” Clinical guidelines are not enough: System-wide, population-based programs are needed to improve the care of patients with Alzheimer’s disease and related dementias

Abstract

This issue truly represents a timely, expert, wellorganized synopsis of recent developments in the treatment and care of patients with Alzheimer’s disease, particularly from the Canadian perspective, but based on worldwide data. The purpose of this effort is to create a consensus of recommendations on relevant issues based on new knowledge. The consensus process is rigorous and clearly defined, and has a strong base of evidence. The papers and recommendations presented here cover many critical and relevant areas of recent advances in the field. Relevant clinical topics range from early detection to treatment and management of care. Ultimately, 215 recommendations were considered, and 149 recommendations were approved with strong consensus by the Canadian academic community involved in clinical research and care. I will not attempt to comment specifically on these many recommendations that were so carefully and thoughtfully evaluated by my esteemed colleagues, though in general, I certainly agree with them. Rather, my perspective will address the real value of this extensive, expensive, and time-consuming work. It is critically important to note that, quoting Dr. Chertkow in his paper, “Translating, disseminating, and implementing our recommendations received particular emphasis.” An implementation committee was created to address these “knowledge translation” issues, with a specific work plan that included publications, tool kits, and practice aids for distribution to Canadian family practitioners, course material, and “assessment of the impact o f... recommendations on clinical practice and patient outcomes.” Chertkow states,