Alzheimers Disease - Modern Medicine

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Update on neuropsychiatric symptoms of dementia: evaluation and management

With black box warnings on antipsychotics and doubts persisting about the efficacy and safety of other medications used off label, nonpharmacologic interventions in neuropsychiatric symptoms of dementia increase in importance. Behavioral management, cognitive stimulation therapy, and caregiver and health care staff education show the most promise.

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Update on neuropsychiatric symptoms of dementia: antipsychotic use

Antipsychotic medications have a modest effect on the neuropsychiatric symptoms of dementia, but product labels warn of the excess risk of death and morbidity associated with their use in older patients. As such, these agents should not be the first choice for the treatment of behavioral and psychotic symptoms of dementia. Nevertheless, a trial of these agents may be indicated in instances in which the severity of symptoms is extreme, or symptoms do not respond to nonpharmacologic methods or other medications.

Elderly female patient presents with onset of resistant hypertension (CME)

Elderly female patient presents with onset of resistant hypertension

Update on neuropsychiatric symptoms of dementia: evaluation and management

Key points in differential diagnosis of dementia

Degenerative dementia subtypes have more overlapping signs and symptoms than defining ones, but being able to distinguish among them is important because each has unique prognostic and treatment considerations. Key elements of the history, physical exam, and diagnostic tests can help reveal an accurate diagnosis.

Non-pharmacologic treatment of insomnia in persons with dementia

Insomnia affects up to 35% of community-dwelling adults with dementia. Although non-pharmacologic treatments can be safe and effective alternatives to the sedative-hypnotic medications commonly prescribed, practical approaches such as light therapy, exercise, and sleep-hygiene modification are often underused in clinical practice to treat insomnia in patients with dementia.