Abstract:
:Psychosis is common in patients with Alzheimer's disease (AD) and contributes substantially to patient morbidity and caregiver distress. Antipsychotic medications are used to treat psychosis and other psychiatric or behavioral symptoms in AD, although optimal treatment guidelines have been elusive. Choosing the most advantageous medication for an individual patient is challenging. This article provides an overview of clinical management principles and medication treatment strategies for patients with AD and psychosis. Effects of individual medications are also described. Medications in the conventional neuroleptic, atypical antipsychotic, cholinesterase inhibitor, and serotonergic classes have been shown to ameliorate psychosis and behavioral symptoms in patients with AD, although the evidence is not conclusive for many medications. Side effects vary substantially across medication classes and modestly among individual patients. Improvement in agitation, aggression, or other behaviors with antipsychotic medication treatment may not depend on distinct antipsychotic effects. In contrast, there is preliminary evidence that delusions and hallucinations may respond to treatment with medications outside the antipsychotic class. Many important clinical questions warrant further research study. In particular, studies to compare how individual symptoms respond to different medications, and to examine how to best manage overlapping symptoms or incomplete treatment response are needed.
journal_name
Dement Geriatr Cogn Disordjournal_title
Dementia and geriatric cognitive disordersauthors
Sultzer DLdoi
10.1159/000074279keywords:
subject
Has Abstractpub_date
2004-01-01 00:00:00pages
78-90issue
1-2eissn
1420-8008issn
1421-9824pii
74279journal_volume
17pub_type
杂志文章,评审abstract::The gene for apolipoprotein E (APOE) is polymorphic, and its variant APOE4 is a major risk factor for the development of Alzheimer-type dementia (AD). Another risk factor for AD appears to be negative cobalamin balance, which is very common in elderly people. Cobalamin and folate are interdependent and essential compo...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 临床试验,杂志文章
doi:10.1159/000017127
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:The apolipoprotein E (APOE) e4 genetic polymorphism is a major risk factor for Alzheimer' s disease, hence the possible prevention of its detrimental effects on cognition is of high relevance. METHODS:We used linear regression models to assess associations of APOE e4 with cognitive performance in a populati...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000440697
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND/AIMS:Dementia cafés are becoming widespread as a new approach to dementia care, but their operational procedures and significance have not been adequately studied. METHODS:On-the-job training (OJT) for professionals planning to operate a dementia café in the future was conducted in a pioneering dementia caf...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000492174
更新日期:2018-01-01 00:00:00
abstract::In 21 patients suffering from Binswanger's disease (BD) and in 53 patients suffering from Alzheimer's disease, we measured cerebrospinal fluid (CSF) concentrations of somatostatin-like immunoreactivity (SLI), high molecular weight form somatostatin (HMV-SST), somatostatin-25/28 (SST-25/28), somatostatin-14 (SST-14), D...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000106598
更新日期:1997-01-01 00:00:00
abstract:AIMS:The aim of this study was to identify physical and mental health and lifestyle predictors of transition from normal cognition to mild cognitive disorder (MCD). METHODS:A total of 2,082 individuals, aged 60-64 years, were assessed at 2 time-points 4 years apart for mild cognitive impairment (MCI) and other MCDs. ...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000229025
更新日期:2009-01-01 00:00:00
abstract::Apolipoprotein E (APOE) is the major genetic risk factor for late-onset Alzheimer's disease (AD) and has also been implicated in cardiovascular disease, cognitive decline and cognitive changes in healthy ageing. The aim of this paper is to systematically review and critically assess the association between the APOE ge...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章,评审
doi:10.1159/000109150
更新日期:2007-01-01 00:00:00
abstract::To evaluate whether magnetic resonance imaging (MRI) of white matter changes in Alzheimer's disease either under- or overestimates the findings on neuropathology. Postmortem MRI and neuropathological examination were performed on 6 brains from elderly individuals with a postmortem diagnosis of AD. Using a specially de...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000057698
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND/AIMS:Because poor lung function may be a risk factor for cognitive decline, we aimed to test the association of respiratory function with cognitive function and dementia later in life, as well as potential effect modification by APOE epsilon4 carrier status. METHODS:In a prospective population-based cohort ...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000255600
更新日期:2009-01-01 00:00:00
abstract::Alzheimer's disease (AD) is generally understood as primarily affecting cognition while sparing motor function, at least until the later stages of the disease. Studies reported over the past 10 years, however, have documented a prevalence of falls in AD patients significantly higher than in age-matched normal elders; ...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章,评审
doi:10.1159/000105126
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:The assessment of executive function (EF) and activities of daily living (ADL) are important elements in the diagnosis of Alzheimer's disease. METHODS:Following a comprehensive search in three databases, a random-effects meta-analysis was used to investigate the association between ADL ability and seventeen...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章,meta分析
doi:10.1159/000338233
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVES:(1) To investigate the prevalence and characteristics of agitation in patients with Alzheimer's disease (AD) and other forms of dementia; (2) to explore the association between agitation and other clinical variables, including disease severity, functional impairment and other neuropsychiatric symptoms, and (...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000074080
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND/AIMS:Although some patients with primary progressive aphasia (PPA) exhibit novel or improved skills after the onset of dementia, these changes have yet to be quantified. Therefore, this study systematically explored and identified the emergence of positive behaviours after dementia onset. METHODS:This study...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000478852
更新日期:2017-01-01 00:00:00
abstract::The apolipoprotein E (APOE) gene epsilon 4 allele is known to be associated with late-onset familial and sporadic Alzheimer's disease (AD). We assessed the possible relationship between APOE genotypes and morphological or functional changes in AD brains by x-ray computed tomography (CT), magnetic resonance imaging (MR...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000017029
更新日期:1998-03-01 00:00:00
abstract::Heart rate variability is used to assess cardiovascular autonomic function. The cholinesterase inhibitor donepezil potentially affects parasympathetic activity. Twenty participants with Alzheimer's disease or dementia with Lewy bodies were treated with donepezil in a pilot study. Power spectral analysis was used to an...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 临床试验,杂志文章
doi:10.1159/000068781
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVES:To estimate life expectancy of psychogeriatric patients having participated in a reactivation program. To identify prognostic characteristics - on admission - for survival after discharge. DESIGN:A prospective, clinical-empirical observational study. SETTING:A Dutch psychiatric-skilled nursing home. PARTI...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 临床试验,杂志文章
doi:10.1159/000077731
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Lifestyle and vascular factors have been linked to dementia and Alzheimer's disease (AD), but the role of dietary fats in the development of dementia is less clear. METHODS:Participants were derived from random, population-based samples initially studied in midlife (1972, 1977, 1982, or 1987). Fat intake fr...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000093478
更新日期:2006-01-01 00:00:00
abstract::We compared the intact alpha7 nicotinic acetylcholine receptor (alpha7nAChR) protein levels in the peripheral blood leukocytes in 15 Alzheimer's disease (AD) patients and 13 normal elderly control subjects. Demographic data and Mini-Mental State Examination (MMSE) scores were obtained. Western blot analysis for alpha7...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000082661
更新日期:2005-01-01 00:00:00
abstract:AIM:To determine the applicability and psychometric properties of the Italian version of the Disability Assessment of Dementia scale (DAD-I) in a community-residing population with early-stage Alzheimer's disease (AD). METHODS:The DAD-I was administered to the primary caregivers of 159 patients (mean age +/- SD 77.1 +...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000113415
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND/AIMS:The aims of this study were to determine baseline factors related to the progression of subjective memory impairment (SMI) in elderly subjects and to develop a new modeling scale to predict progression. METHODS:Elderly subjects with SMI were recruited from the nationwide Clinical Research Centers for D...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000430807
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND/AIMS:To explore the presenting and early symptoms of dementia with Lewy bodies (DLB). METHOD:Patients with mild dementia fulfilling diagnostic criteria for DLB (n = 61) and Alzheimer's disease (AD) (n = 109) were recruited from outpatient dementia clinics in western Norway. At diagnosis, caregivers were ask...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000333072
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:White matter injury is an important factor for cognitive impairment in memory clinic patients. We determined the added value of diffusion tensor imaging (DTI) of strategic white matter tracts in explaining variance in cognition in memory clinic patients with vascular brain injury. METHODS:We included 159 pa...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000485376
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND/AIMS:We evaluated the differential patterns of brain atrophy in early- and late-onset Alzheimer's disease (AD) by measuring regional z-scores of voxel-based morphometry and assessed the availability of the method for clinical use. METHODS:The first 50 patients with probable AD were compared to 83 age-matche...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000151241
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:In a previous study, low-frequency (0.5 Hz) cranial electrostimulation (CES) neither improved the rest-activity rhythm nor reduced the level of salivary cortisol in patients with probable Alzheimer's disease (AD). To investigate whether the frequency of CES was responsible for these negative findings, we set ...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000095108
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Studies of associations between serum lipids and Alzheimer's disease (AD) or other dementias in the elderly show conflicting results, perhaps due to misclassification of the various dementias. METHODS:For 358 nursing home residents, serum lipids were studied at admission and diagnoses established at autopsy...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000189268
更新日期:2009-01-01 00:00:00
abstract::Findings in patients with dementia of the Alzheimer type (AD patients) concerning the enactment effect, i.e. reaching a better memory performance after encoding actions by performing them in contrast to encoding them by reading, are ambiguous. In order to get more insight into memory deterioration in patients sufferin...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000089135
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND/AIMS:Elderly patients with dementia have a higher risk of falls and fractures as compared to cognitively intact elderly subjects. To investigate whether psychological distress of the caregiver might predispose older persons with Alzheimer disease (AD) to falls and fractures, we performed a prospective cohort...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000288774
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND/AIMS:Verbal fluency patterns can assist in differential diagnosis during neuropsychological assessment and identify individuals at risk for developing Alzheimer's disease (AD). While evidence suggests that subjects with AD perform worse on category fluency than letter fluency tasks, the pattern in mild cogni...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000355558
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the decline in specific neuropsychological functions in nondemented Parkinson's disease (PD) patients with a history of visual hallucinations (VH). METHODS:Twenty PD patients with VH, 20 PD patients without VH and 18 normal controls were followed up over a 1-year period and assessed for cognitive...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000100850
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND/AIMS:This study aimed to investigate the possible association of regional cerebral perfusion and sleep loss in Alzheimer's disease (AD). METHODS:55 AD patients were characterized as having (SL) or not having (NSL) nocturnal sleep loss based on standard AD scales assessing sleep over the previous 4 weeks. (9...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000203889
更新日期:2009-01-01 00:00:00
abstract::The membrane-bound glycoprotein, amyloid precursor protein (APP), plays a central role in Alzheimer's disease (AD). The present paper investigates the neuritogenic-neurotoxic properties of this protein and relates them to possible aetiopathological mechanisms in AD. Marked differences in neuritic differentiation were ...
journal_title:Dementia and geriatric cognitive disorders
pub_type: 杂志文章
doi:10.1159/000051234
更新日期:2001-01-01 00:00:00