Der Internist · 2014
[Therapy for patients with dementia. Treatment strategies in the elderly].
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Jessen F
Аннотация
BACKGROUND: The number of patients with dementia is increasing. There is often uncertainty about adequate treatment.
OBJECTIVES: In this paper, current treatment recommendations for dementia are summarized.
MATERIAL AND METHODS: The basis of the article is the S3 guideline on dementia from the Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN) and Deutschen Gesellschaft für Neurologie (DGN). In addition, newer therapeutic approaches and recent publications have been taken into consideration.
RESULTS: Before the initiation of treatment, a meaningful differential diagnosis is required to identify potentially reversible causes of dementia syndrome and to determine the correct treatment for specific dementia types. For Alzheimer's disease, acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmin) and memantine are efficacious and provide patient-related benefit. For other dementia types, there is evidence for efficacy of these drugs in some cases. Neuropsychiatric symptoms should first be managed by individual counseling and caregivers education and support. If this is not sufficiently effective, individual psychopharmacological drugs are available for specific conditions.
DISCUSSION: Dementia can not be cured, but current treatment can achieve relief of disease burden and improve quality of life for patients and caregivers.
OBJECTIVES: In this paper, current treatment recommendations for dementia are summarized.
MATERIAL AND METHODS: The basis of the article is the S3 guideline on dementia from the Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN) and Deutschen Gesellschaft für Neurologie (DGN). In addition, newer therapeutic approaches and recent publications have been taken into consideration.
RESULTS: Before the initiation of treatment, a meaningful differential diagnosis is required to identify potentially reversible causes of dementia syndrome and to determine the correct treatment for specific dementia types. For Alzheimer's disease, acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmin) and memantine are efficacious and provide patient-related benefit. For other dementia types, there is evidence for efficacy of these drugs in some cases. Neuropsychiatric symptoms should first be managed by individual counseling and caregivers education and support. If this is not sufficiently effective, individual psychopharmacological drugs are available for specific conditions.
DISCUSSION: Dementia can not be cured, but current treatment can achieve relief of disease burden and improve quality of life for patients and caregivers.