Dementia Prevention and Treatment

Dementia Prevention and Treatment

2024-03-04 | David B. Reuben, MD; Sarah Kremen, MD; Donovan T. Maust, MD, MS
The article "Dementia Prevention and Treatment" by Reuben, Kremen, and Maust provides a comprehensive review of current strategies for preventing and treating dementia. Dementia affects 10% of those 65 years or older and 35% of those 90 years or older, with Alzheimer's disease (AD) being the most common cause. While no randomized clinical trials have conclusively proven that interventions can prevent dementia, addressing modifiable risk factors may have other health benefits. Treatment options for AD include cholinesterase inhibitors, memantine, and amyloid immunomodulators, which can modestly slow cognitive and functional decline in mild cognitive impairment or mild dementia due to AD. Behavioral and psychological symptoms of dementia are best managed with nonpharmacologic approaches, including identifying and mitigating underlying causes and tailored behavioral interventions. Psychotropic medications have minimal evidence of efficacy and are associated with increased mortality and cognitive decline. Emerging prevention and treatment strategies, such as multifactorial interventions and new drug developments, hold promise for improving dementia care in the future. The authors emphasize the importance of continued research to reduce the global burden of dementia.The article "Dementia Prevention and Treatment" by Reuben, Kremen, and Maust provides a comprehensive review of current strategies for preventing and treating dementia. Dementia affects 10% of those 65 years or older and 35% of those 90 years or older, with Alzheimer's disease (AD) being the most common cause. While no randomized clinical trials have conclusively proven that interventions can prevent dementia, addressing modifiable risk factors may have other health benefits. Treatment options for AD include cholinesterase inhibitors, memantine, and amyloid immunomodulators, which can modestly slow cognitive and functional decline in mild cognitive impairment or mild dementia due to AD. Behavioral and psychological symptoms of dementia are best managed with nonpharmacologic approaches, including identifying and mitigating underlying causes and tailored behavioral interventions. Psychotropic medications have minimal evidence of efficacy and are associated with increased mortality and cognitive decline. Emerging prevention and treatment strategies, such as multifactorial interventions and new drug developments, hold promise for improving dementia care in the future. The authors emphasize the importance of continued research to reduce the global burden of dementia.
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