Alzheimer's disease patients and their caregivers: Medical care issues for the primary care physician

Alzheimer's disease (AD) is a common problem with complex challenges in assessment and management for the primary care physician. We present a practical, six-step strategy for physicians to use in AD care, summarized by the acronym ACROSS: assessment of AD, communication of the diagnosis, referral to appropriate community resources, ongoing evaluation, providing solutions to patient and caregiver problems, and maintaining sensitivity to family caregiver issues. The family caregiver of the patient with AD provides the physician with essential diagnostic information and implements physician recommendations for AD care. Advice and support from the physician are essential for the family caregiver to withstand the relentless strain of caring for a loved one with a progressive dementia. We provide practical suggestions for management of common patient and caregiver problems across the stages of AD.