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11 - Dementia: pharmacological and non-pharmacological treatments and guideline review

from Part III - Specific treatments

Published online by Cambridge University Press:  12 May 2010

By
Martine Simard  and
Elizabeth L. Sampson
Edited by
Peter Tyrer  and
Kenneth R. Silk
Martine Simard
Affiliation:
Laval University Quebec City, QC Canada
Elizabeth L. Sampson
Affiliation:
Department of Mental Health Sciences Royal Free and University College Medical School London UK
Peter Tyrer
Affiliation:
Imperial College of Science, Technology and Medicine, London
Kenneth R. Silk
Affiliation:
University of Michigan, Ann Arbor
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Summary

Editor's note

This is a valuable chapter and a highly topical one, which overlaps with Chapter 10. Here we have clear evidence for the value of acetylcholinesterase (AChE) inhibitors and, to a lesser extent, memantine, in all common forms of dementia, and there is also some evidence that these benefits are long-lasting. Because these studies are well-integrated and follow similar methodologies, the systematic reviews are highly informative and suggest that these drugs are effective across the range of severity of dementia, and although there are few differences between individual compounds, it is valuable to have the detailed results available for direct comparison. The current argument over who should qualify for treatment is a highly contentious one, with many arguing that all early diagnosed cases should be treated. However, in the UK, the official NICE guidelines argue that this is not cost-effective. While we realize that the chapter is long, we think that this is an exciting and fast-moving area of enquiry. No doubt much will flow from this rich seam of new therapeutic endeavour, and hopefully we may soon arrive at treatments that can significantly change the difficult path that these patients and their families follow.

Introduction

The prevalence estimates of the Canadian Study of Health and Aging (CSHA) suggested that 8% of all Canadians aged 65 and over meet the criteria for dementia. The corresponding figures for Alzheimer's disease (AD) were 5.1% overall (Canadian Study of Health and Aging Working Group, 1994).

Type
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Information
Cambridge Textbook of Effective Treatments in Psychiatry , pp. 217 - 243
Publisher: Cambridge University Press
Print publication year: 2008

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