Background: Alzheimer's disease (AD) is the most common cause of dementia. Management of AD is dynamic and multidisciplinary, involving pharmacological and non-pharmacological interventions to manage patient’s symptoms, prevent clinical decline and improve quality of life. The aim of this study is to evaluate the standard of patient care provided for the management of AD.

Patients and methods: This was a retrospective clinical audit of patients in Brunei Darussalam, with International Classification of Disease and related health problems, tenth revision (ICD-10) diagnosis of AD between 2019 and 2020.

Results: There were a total of 168 patients (68 males, 100 females). Their mean age was 79.5 years. Only half of the patients (n = 84) were given advice to slow down the progression of disease, and less than half (49.1%) of eligible patients were offered cognitive stimulation therapy. 51.8% (n = 87) were referred to occupational therapist for assessment of activities of daily living. 113 patients (67.3%) were started on cognitive enhancers; of these, 92 were continued on these medications. Donepezil was the most common drug prescribed (n = 78). Only 44.2% (n = 50) of the 113 patients were maximized on their cognitive enhancer dose. 84.1% had documented follow-up evaluation on the effect of cognitive enhancers. 88 (52.4%) patients had behavioral and psychological symptoms of dementia (BPSD), of whom 64 (72.7%) received treatment, with quetiapine (n = 33, 51.6%) being the most prescribed drug.

Conclusions: There are still gaps between guidelines and practice; more effort is needed to improve achieving the standards of care for management of AD in Brunei Darussalam.