Clinical practice guidelines for dementia in Australia

Kate Laver, Robert G Cumming, Suzanne M Dyer, Meera R Agar, Kaarin J Anstey, Elizabeth Beattie, Henry Brodaty, Tony Broe, Lindy Clemson, Maria Crotty, Margaret Dietz, Brian M Draper, Leon Flicker, Margeret Friel, Louise Mary Heuzenroeder, Susan Koch, Susan Kurrle, Rhonda Nay, C Dimity Pond, Jane Thompson, Yvonne Santalucia, Craig Whitehead and Mark W Yates
Med J Aust 2016; 204 (5): 191-193. || doi: 10.5694/mja15.01339



  • About 9% of Australians aged 65 years and over have a diagnosis of dementia.
  • Clinical practice guidelines aim to enhance research translation by synthesising recent evidence for health and aged care professionals.
  • New clinical practice guidelines and principles of care for people with dementia detail the optimal diagnosis and management in community, residential and hospital settings. The guidelines have been approved by the National Health and Medical Research Council.
  • The guidelines emphasise timely diagnosis; living well with dementia and delaying functional decline; managing symptoms through training staff in how to provide person-centred care and using non-pharmacological approaches in the first instance; and training and supporting families and carers to provide care.


Please login with your free MJA account to view this article in full

  • Kate Laver1
  • Robert G Cumming2
  • Suzanne M Dyer1
  • Meera R Agar3,4
  • Kaarin J Anstey5
  • Elizabeth Beattie6
  • Henry Brodaty4
  • Tony Broe7
  • Lindy Clemson2
  • Maria Crotty1
  • Margaret Dietz8
  • Brian M Draper4
  • Leon Flicker9
  • Margeret Friel1
  • Louise Mary Heuzenroeder1
  • Susan Koch1
  • Susan Kurrle2
  • Rhonda Nay1
  • C Dimity Pond1
  • Jane Thompson1
  • Yvonne Santalucia1
  • Craig Whitehead1
  • Mark W Yates1

  • 1 Flinders University, Adelaide, SA
  • 2 University of Sydney, Sydney, NSW
  • 3 Braeside Hospital, Sydney, NSW
  • 4 UNSW Australia, Sydney, NSW
  • 5 Australian National University, Canberra, ACT
  • 6 Queensland University of Technology, Brisbane, QLD
  • 7 Neuroscience Research Australia, Sydney, NSW
  • 8 Monash Health, Melbourne, VIC
  • 9 University of Western Australia, Perth, WA
  • 10 Department of Correctional Services, Darwin, NT
  • 11 SA Heath, Adelaide, SA
  • 12 Royal District Nursing Service, Melbourne, VIC
  • 13 La Trobe University, Melbourne, VIC
  • 14 University of Newcastle, Newcastle, NSW
  • 15 Alzheimer's Australia, Canberra, ACT
  • 16 Liverpool Hospital, Sydney, NSW
  • 17 Ballarat Health Services, Ballarat, VIC

Competing interests:

No relevant disclosures.

  • 1. Australian Institute of Health and Welfare. Dementia in Australia. Canberra: AIHW, 2012. (Cat. No. AGE 70.) (accessed Jan 2016).
  • 2. Burns A, Iliffe S. Dementia. BMJ 2009; 338: b75.
  • 3. Grol R, Grimshaw JM. From best evidence to best practice: effective implementation of change in patients care. Lancet 2003; 362: 1225-1230.
  • 4. Grimshaw J, Thomas R, MacLennan G, et al. Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technol Assess 2004; 8: 1-72.
  • 5. National Institute for Health and Care Excellence. Dementia: supporting people with dementia and their carers in health and social care. NICE guidelines [CG42]. London: NICE, 2006. (accessed Jan 2016).
  • 6. ADAPTE Collaboration. The ADAPTE process: resource toolkit for guideline adaptation. ADAPTE, 2009. (accessed Jan 2016).
  • 7. Koch T, Iliffe S, EVIDEM-ED project. Rapid appraisal of barriers to the diagnosis and management of patients with dementia in primary care: a systematic review. BMC Fam Pract 2010; 11: 52.
  • 8. Lin JS, O’Connor E, Rossom RC, et al. Screening for cognitive impairment in older adults: an evidence update for the US Preventive Services Task Force (Evidence Synthesis No. 107). Rockville, MD: Agency for Healthcare Research and Quality, 2013. (accessed Jan 2016).
  • 9. LoGiudice D, Waltrowicz W, Brown K, et al. Do memory clinics improve the quality of life of carers? A randomized pilot trial. Int J Geriatr Psychiatry 1999; 14: 626-632.
  • 10. Dobert N, Pantel J, Frolich L, et al. Diagnostic value of FDG-PET and HMPAO-SPET in patients with mild dementia and mild cognitive impairment: metabolic index and perfusion index. Dement Geriatr Cogn Disord 2005; 20: 63-70.
  • 11. Albert MS, DeKosky ST, Dickson D, et al. The diagnosis of mild cognitive impairment due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7: 270-279.
  • 12. Ward A, Tardiff S, Dye C, Arrighi HM. Rate of conversion from prodromal Alzheimer’s disease to Alzheimer’s dementia: a systematic review of the literature. Dement Geriatr Cogn Disord Extra 2013; 3: 320-332.
  • 13. Clare L, Whitaker R, Woods RT, et al. AwareCare: a pilot randomized controlled trial of an awareness-based staff training intervention to improve quality of life for residents with severe dementia in long-term care settings. Int Psychogeriatr 2013; 25: 128-139.
  • 14. Huizing A, Hamers JP, Gulpers M, Berger M. Short-term effects of an educational intervention on physical restraint use: a cluster randomized trial. BMC Geriatr 2006; 6: 17.
  • 15. Testad I, Ballard C, Bronnick K, Aarsland D. The effect of staff training on agitation and use of restraint in nursing home residents with dementia: a single-blind, randomized controlled trial. J Clin Psychiatry 2010; 71: 80-86.
  • 16. Chenoweth L, King MT, Jeon YH, et al. Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: a cluster-randomised trial. Lancet Neurol 2009; 8: 317-325.
  • 17. Chen X, Kistler C. Oral health care for older adults with serious illness: when and how? J Am Geriatr Soc 2015; 63: 375-378.
  • 18. Centre for Health Economics Monash University, University of South Australia Veterans’ Medicines Advice and Therapeutics Education Services, Department of Health and Ageing Pharmaceutical Policy Branch, Ahmed R. Post market review: Pharmaceutical Benefits Scheme anti-dementia medicines to treat Alzheimer disease. Canberra: Department of Health, 2012. (accessed Jan 2016).
  • 19. Birks J, Craig D. Galantamine for vascular cognitive impairment. Cochrane Database Syst Rev 2006; (1): CD004746.
  • 20. Birks J, McGuinness B, Craig D. Rivastigmine for vascular cognitive impairment. Cochrane Database Syst Rev 2013; (5): CD004744.
  • 21. Malouf R, Birks J. Donepezil for vascular cognitive impairment. Cochrane Database Syst Rev 2004; (1): CD004395.
  • 22. Wang HF, Yu JT, Tang SW, et al. Efficacy and safety of cholinesterase inhibitors and memantine in cognitive impairment in Parkinson’s disease, Parkinson’s disease dementia, and dementia with Lewy bodies: systematic review with meta-analysis and trial sequential analysis. J Neurol Neurosurg Psychiatry 2015; 86: 135-143.
  • 23. Schmidt R, Hofer E, Bouwman FH, et al. EFNS-ENS/EAN Guideline on concomitant use of cholinesterase inhibitors and memantine in moderate to severe Alzheimer’s disease. Eur J Neurol 2015; 22: 889-898.
  • 24. Bond M, Rogers G, Peters J, et al. The effectiveness and cost-effectiveness of donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer’s disease (review of Technology Appraisal No 111): a systematic review and economic model. Health Technol Assess 2012; 16: 1-470.
  • 25. Tricco AC, Soobiah C, Berliner S, et al. Efficacy and safety of cognitive enhancers for patients with mild cognitive impairment: a systematic review and meta-analysis. CMAJ 2013; 185: 1393-1401.
  • 26. Dignity in Care [website]. (accessed Jan 2015).
  • 27. Gitlin LN, Winter L, Dennis MP, et al. Targeting and managing behavioral symptoms in individuals with dementia: a randomized trial of a nonpharmacological intervention. J Am Geriatr Soc 2010; 58: 1465-1474.
  • 28. Tremont G, Davis JD, Bishop DS, Fortinsky RH. Telephone-delivered psychosocial intervention reduces burden in dementia caregivers. Dementia 2008; 7: 503-520.
  • 29. Pieper MJ, van Dalen-Kok AH, Francke AL, et al. Interventions targeting pain or behaviour in dementia: a systematic review. Ageing Res Rev 2013; 12: 1042-1055.
  • 30. Porsteinsson AP, Drye LT, Pollock BG, et al. Effect of citalopram on agitation in Alzheimer disease: the CitAD randomized clinical trial. JAMA 2014; 311: 682-691.
  • 31. Sepehry AA, Lee PE, Hsiung GY, et al. Effect of selective serotonin reuptake inhibitors in Alzheimer’s disease with comorbid depression: a meta-analysis of depression and cognitive outcomes. Drugs Aging 2012; 29: 793-806.
  • 32. Schneider LS, Dagerman KS, Insel P. Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials. JAMA 2005; 294: 1934-1943.
  • 33. Black BS, Johnston D, Rabins PV, et al. Unmet needs of community-residing persons with dementia and their informal caregivers: findings from the maximizing independence at home study. J Am Geriatr Soc 2013; 61: 2087-2095.
  • 34. Olazaran J, Reisberg B, Clare L, et al. Nonpharmacological therapies in Alzheimer’s disease: a systematic review of efficacy. Dement Geriatr Cogn Disord 2010; 30: 161-178.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.