Guidelines for the treatment of patients with dementia
Abstract
In this article we suggest guidelines for the diagnostic process with appropriate investigations to be carried out. Part of the guidelines is intended for pharmacotherapeutic treatment and ranges from already established treatment of cognitive decline to treating behavioral and psychological changes. These have a significant impact on the quality of life of patients and their families, in particular, because of often controversial reports on the effectiveness of pharmacological therapy. Current guidelines focus on the role of physicians, although we are aware of the fact that dementia care requires a highly multidisciplinary approach.
Downloads
References
Rakuša M. Granda G. Kogoj A. Mlakar J. Vodušek DB. Mini-mental state examination: standardization and validation for the elderly Slovenian population. Eur J Neurol 2006; 13 141–5.
Maruta C, Guerreiro M, et al. The use of neuropsychological tests across Europe: the need for a consensus in the use of assessment tools for dementia. Eur J Neurol 2011; 18: 279–285.
Hort J, O'Brien JT, et al. EFNS guidelines for the diagnosis and management of Alzheimer's disease. Eur J Neurol 2010; 17: 1236–1248.
McKeith I, Cummings J. Behavioural changes and psychological symptoms in dementia disorders. Lancet Neurol 2005; 4: 735–742.
Ritchie CM. Meta-analisis of randommised trials of the efficiaty and safety of donepezil, galantamine and rivastigmine for the treatment of Alzheimer's disease. Am J Geriatr Psychiatry 2004; 12: 358–69.
Passmore AP, Bayer AJ, Steinhagen-Thiessen. Cognitive, global and functional benefits of donepezil in Alzheimer's disease and vascular dementia: result from large-scale clinical trials. J Neurol Sci 2005; 229–230: 141–146.
Kavirajan H, Schneider LS. Efficacy and adverese effects of cholinesterase inhibitors and memantine in vascular dementia: a meta-analysis of randomised controlled trals. Lancet Neurol 2007; 9 (6): 782–92.
Youn JC, Lee DY, Jhoo JH, Kim KW, Choo IH, Woo JI. Prevalence of Neuropsychiatric symtoms and syndromes in Alzheimer's disease. Arch Gerontol Geriatr 2010; 5: 2011 May-Jun; 52 (3): 258–63.
Swearer J. Behavioral disturbances in dementia. In: Handbook of dementing illnesses. Morris JC (ed). New York: Marcel Dekker Inc., 1994.
Munro CA, Brandt J, Sheppard JM, Steele CD, Samus QM, Steinberg M et al. Cognitive response to pharmacological treatment for depression in Alzheimer disease: secondary outcomes from the depression in Alzheimer's diseasse study (DIADS). Am J Geriatr Psychiatry 2004, 12: 491–8.
Hogan DB, Bailey P, Carswell A, Clarke B, Cohen C, Forbes D et al. Management of mild to moderate Alzheimer's disease and dementia. Alzheimer's & Dementia 2007; 3: 355–84.
Teri L, Logsdon RG, Uomoto J, McCurry SM. Behavioral treatment of depression in dementia patients: a controlled clinical trial. J Gerontol B Psychol Sci Soc Sci 1997; 52: 159–66.
Seignourel PJ, Kunik ME, Snow L, Wilson N, Stanley M. Anxiety in dementia: A critical review. Clin Psychol Rev 2008; 28: 1071–82.
Bliwise DL. Sleep disorders in Alzheimer's disease and other Dementias. Clinical cornestone 2004; 6(suppl 1A): 16–28.
Lyketsos CG, Sheppard JM, Steinberg M, Taschanz JA, Norton MC, Steffens Dc et al. Neuropsychiatric disturbance in Alzheimer's disease clusters into three groups: The Cache County study. Int J Geriatr Psychiatry 2001; 16: 1043–53.
Samaras N, Chevalley T, Samaras D, Gold G. Older Patients in the Emergency Department: A Review. Ann Emerg Med 2010;65 supl 56: 361–269.
De Deyn PP, Katz IR, Brodaty H, Lyons B, Greenspan A, Burns A. Management of agitation, aggression and psychosis associate with dementia: A pooled analysis including three randomized placebo-controlled double-blind trials in nursing home residents treated with risperidone. Clin Neurol Neurosurg 2005; 107: 497–508.
Korošec Jagodič H, Jagodič K, Pregelj P. Obravnava bolnika z delirijem. Zdrav Vestn 2009; 78: 473–80.
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: 1934–194.
Mehhan KM, Wang H, David SR, Nisivoccia JR, Jones B, Beasley SM Jr, et al. Comparison of rapidly acting intramuscular olanzapine, lorazepam and placebo: a double-blind, randomized study in acutely agitated patients with dementia. Neuropsychopharmacology 2002; 26: 494–504.
Jacoby R, Oppenheimer C. Psychiatry in the elderly. Oxford University Press; 2002.
The Author transfers to the Publisher (Zdravniški vestnik/Slovenian Medical Journal) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Zdravniški vestnik/Slovenian Medical Journal) has the right to transfer the rights, acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.