Dawaa Reference

Clinical reference

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.