A 85-year-old man with advanced Alzheimer's dementia (MMSE 5/30) has been in a care home for 3 years. He is CFS 8, bedbound, and has limited verbal ou...

Question

A 85-year-old man with advanced Alzheimer's dementia (MMSE 5/30) has been in a care home for 3 years. He is CFS 8, bedbound, and has limited verbal output. His daughter asks the GP whether his Donepezil 10 mg should be continued. His Barthel Index is 2/20. According to NICE NG97, what factors should guide the decision to continue or stop Donepezil?

Accepted Answer

The decision should consider whether Donepezil is still providing meaningful benefit (cognitive, behavioural, functional, or global), the views of the patient (as far as ascertainable) and carers, and the effect of withdrawal on the individual - a trial withdrawal with monitoring may be appropriate

Answer

Donepezil must be continued for life once started

Answer

Donepezil should be stopped automatically when MMSE falls below 10

Answer

Donepezil is only for mild to moderate AD and must be stopped in severe disease

Answer

The care home should decide independently

uk-dgm MCQ (SBA): Donepezil Continuation Decision in Severe Dementia