Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-745bb68f8f-f46jp Total loading time: 0 Render date: 2025-02-10T21:21:44.186Z Has data issue: false hasContentIssue false

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
Get access

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aarsland, D., Bronnick, K. & Karlsen, K. (1999). Donepezil for dementia with Lewy Bodies: a case study. International Journal of Geriatric Psychiatry, 14, 69–74.Google Scholar
AD2000 Collaborative Group (2004). Long-term donepezil treatment in 565 patients with Alzheimer's disease (AD2000): randomized double-blind trial. Lancet, 363, 2105–15.
Aisen, P. S., Schafer, K. A., Grundman, M.et al. (2003). Effects of rofecoxib or naproxen vs placebo on Alzheimer disease progression: a randomized controlled trial. Journal of the American Medical Association, 289, 2819–26.Google Scholar
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington, DC: APA.
American Psychiatric Association (1997). Practice Guideline for the treatment of patients with Alzheimer's disease and other dementias of late life. American Journal of Psychiatry, 154 (Suppl.), 1–39.
Anand, R., Messina, J. & Hartman, R. (2000). Dose-response effect of rivastigmine in the treatment of Alzheimer's disease. International Journal of Geriatric Psychopharmacology, 2, 68–72.Google Scholar
Aupperle, P. M., Koumaras, B., Ohen, M., Rabinowicz, A. & Mirski, D. (2004). Long-term effects of rivastigmine treatment on neuropsychiatric and behavioral disturbances in nursing home residents with moderate to severe Alzheimer's disease: results of a 52-week open-label study. Current Medical Research and Opinions, 20, 1605–12.Google Scholar
Ballard, C., O'Brien, J., Barber, B.et al. (2000). Neurocardiovascular instability, hypotensive episodes, and MRI lesions in neurodegenerative dementia. Annals of New York Academy of Sciences, 903, 442–5.Google Scholar
Barber, R., Scheltens, P., Gholkar, A.et al. (1999). White matter lesions on magnetic resonance imaging in dementia with Lewy bodies, Alzheimer's disease, vascular dementia, and normal ageing. Journal of Neurology, Neurosurgery and Psychiatry, 67, 66–72.Google Scholar
Barber, R., Gholkar, A., Scheltens, P., Ballard, C., McKeith, I. G. & O'Brien, J. T. (2000). MRI volumetric correlates of white matter lesions in dementia with Lewy bodies and Alzheimer's disease. International Journal of Geriatric Psychiatry, 15, 911–16.Google Scholar
Baskys, A. & Blaabjerg, M. (2005). Understanding regulation of nerve cell death by mGluRs as a method for development of successful neuroprotective strategies. Journal of the Neurological Sciences, 229–30, 201–9.Google Scholar
Benavente, O., Hart, R., Koudstaal, P., Laupacis, A. & McBride, R. (2000). Oral anticoagulants for preventing stroke in patients with non-valvular atrial fibrillation and no previous history of stroke or transient ischemic attacks. Cochrane Database of Systematic Reviews, 2, CD001927. Oxford: Update Software Ltd.
Bentham, P., Gray, R., Sellwood, E. & Raftery, J. (1999). Effectiveness of rivastigmine in Alzheimer's disease. British Medical Journal, 319, 640–1.Google Scholar
Beversdorf, D. Q., Warner, J. L., Davis, R. A., Sharma, U. K., Nagaraja, H. N. & Scharre, D. W. (2004). Donepezil in the treatment of dementia with Lewy Bodies. American Journal of Geriatric Psychiatry, 12, 542–4.Google Scholar
Bilikiewicz, A., Opala, G., Podemski, R.et al. (2002). An open-label study to evaluate the safety, tolerability and efficacy of rivastigmine in patients with mild to moderate probable Alzheimer's disease in the community setting. Medical Science Monitor, 8, PI9–15.Google Scholar
Birks, J. & Flicker, L. (2003). Selegiline for Alzheimer's disease. Cochrane Database of Systematic Reviews, 1, CD000442.Google Scholar
Birks, J. & Harvey, R. J. (2006). Donepezil for dementia due to Alzheimer's disease. Cochrane Database of Systematic Reviews, 1, CD001190.Google Scholar
Birks, J., Evans, Grimley J., Iakovidou, V. & Tsolaki, M. (2000). Rivastigmine for Alzheimer's disease. Cochrane Database of Systematic Reviews, 4, CD001191.Google Scholar
Birks, J., Grimley, E. V. & Dongen, M. (2002). Ginkgo biloba for cognitive impairment and dementia. Cochrane Database of Systematic Review, 4, CD003120.Google Scholar
Black, S., Román, G. C., Geldmacher, D. S.et al. (2003). Efficacy and tolerability of donepezil in vascular dementia. Positive results of a 24-week, multicenter, international randomized, placebo-controlled clinical trial. Stroke, 34, 2323–32.Google Scholar
Blau, T. H. (1977). Quality of life, social indicators and criteria of change. Professional Psychology: Research and Practice, 8, 464–73.Google Scholar
Boada-Rovira, M., Brodaty, H., Cras, P.et al. (2004). Efficacy and safety of donepezil in patients with Alzheimer's disease: results of a global, multinational, clinical experience study. Drugs and Aging, 21, 43–53.Google Scholar
Bråne, G., Gottfries, C. G. & Winblad, B. (2001). The Gottfries-Brane-Steen scale: validity, reliability and application in anti-dementia drug trials. Dementia and Geriatric Cognitive Disorders, 12, 1–14.Google Scholar
Bucks, R. S., Ashworth, D. L., Wilcock, G. K. & Siegfried, K. (1996). Assessment of activities of daily living in dementia: development of the Bristol activities of daily living scale. Age and Ageing, 25, 113–20.Google Scholar
Bullock, R., Erkinjuntti, T., Lilienfeld, S. & GAL-INT-6 Study Group (2004). Management of patients with Alzheimer's disease plus cerebrovascular disease: 12-month treatment with galantamine. Dementia and Geriatric Cognitive Disorders, 17, 29–34.Google Scholar
Buysse, D. J., Reynolds, C. F. 3rd, Monk, T. H., Berman, S. R. & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213.Google Scholar
Canadian Study of Health and Aging Working Group (1994). Canadian Study of health and aging: study methods and prevalence of dementia. Canadian Medical Association Journal, 150, 899–913.
Caro, J., Getsios, D., Migliaccio-Walle, K., Ishak, J., El-Hadi, W. & the AHEAD Study Group. (2003). Rational choice of cholinesterase inhibitor for the treatment of Alzheimer's disease in Canada: a comparative economic analysis. BioMed Central Geriatrics, 3, 6.Google Scholar
Clare, L., Woods, R. T., Cook, Moniz E. D., Orrell, M. & Spector, A. (2003). Cognitive rehabilitation and cognitive training for early-stage Alzheimer's disease and vascular dementia. Cochrane Database of Systematic Reviews, 4, CD003260.Google Scholar
Corey-Bloom, J., Anand, R. & Veach, J. for the ENA 713 B352 Study Group (1998). A randomized trial evaluating the efficacy and safety of ENA 713 (rivastigmine tartrate), a new acetylcholinesterase inhibitor, in patients with mild to moderately severe Alzheimer's disease. International Journal of Geriatric Psychopharmacology, 1, 55–65.Google Scholar
Coulson, B. S., Fenner, S. G. & Almeida, O. P. (2002). Successful treatment of behavioural problems in dementia using a cholinesterase inhibitor: the ethical questions. Australian and New Zealand Journal of Psychiatry, 36, 259–262.Google Scholar
Craig, M. C., Maki, P. M. & Murphy, D. G. (2005). The Women's Health Initiative Memory Study: findings and implications for treatment. Lancet Neurology, 4, 190–4.Google Scholar
Crystal, H. A., Dickson, D. W., Lizardi, J. E., Davies, P. & Wolfson, L. I. (1990). Antemortem diagnosis of diffuse Lewy body disease. Neurology, 40, 1523–8.Google Scholar
Cummings, J. L., Anand, R., Koumaras, B.et al. (2000). Rivastigmine provides behavioural benefits to Alzheimer's disease patients residing in a nursing home: findings from a 26-week trial. Neurology, 54, A468. [Abstract S79.002]Google Scholar
Cupp, M. J. (1999). Herbal remedies: adverse effects and drug interactions. American Family Physician, 59, 1239–45.Google Scholar
Day, M. (2006). NICE says anti-dementia drugs should be used only for moderate Alzheimer's disease. British Medical Journal, 333, 774.Google Scholar
DeJong, R., Osterlund, O. W. & Roy, G. W. (1989). Measurement of quality-of-life changes in patients with Alzheimer's disease. Clinical Therapeutics, 11, 545–54.Google Scholar
Dennis, M. & Boyle, A. (1998). Management of cognitive impairment of vascular origin. Psychiatric Bulletin: The Journal of Trends in Psychiatric Practice, 22, 287.Google Scholar
DeRenzi, E. & Vignolo, L. (1962). The token test: a sensitive test to detect receptive disturbances in aphasics. Brain, 85, 665–78.Google Scholar
Dietch, J. T., Hewett, L. J. & Jones, S. (1989). Adverse effects of reality orientation. Journal of the American Geriatric Society, 37, 974–6.Google Scholar
Doody, R. S., Geldmacher, D. S., Gordon, B., Perdomo, C. A., Pratt, R. D. & the Donepezil Study Group (2001). Open-label, multicenter, phase 3 extension study of the safety and efficacy of donepezil in patients with Alzheimer disease. Archives of Neurology, 58, 427–33.Google Scholar
Eagger, S., Levy, R. & Sahakian, B. (1991). Tacrine in Alzheimer's disease. The Lancet, 337, 989–92.Google Scholar
Edwards, K. R., Hershey, L., Wray, L.et al. (2004). Efficacy and safety of galantamine in patients with dementia with Lewy bodies: a 12-week interim analysis. Dementia and Geriatric Cognitive Disorders, 17(Suppl. 1), 40–8.Google Scholar
Eisdorfer, C., Cohen, D., Paveza, G. J.et al. (1992). An empirical evaluation of the Global Deterioration Scale for staging Alzheimer's disease. American Journal of Psychiatry, 149, 190–4.Google Scholar
Erkinjuntti, T., Kurz, A., Gauthier, S., Bullock, R., Lilienfeld, S. & Damaraju, C. V. (2002). Efficacy of galantamine in probable vascular dementia and Alzheimer's disease combined with cerebrovascular disease: a randomised trial. Lancet, 359, 1283–90.Google Scholar
Erkinjuntti, T., Kurz, A., Small, G.et al. (2003). An open-label extension trial of galantamine in patients with vascular dementia and mixed dementia. Clinical Therapeutics, 25, 1765–82.Google Scholar
Espeland, M. A., Rapp, S. R., Shumaker, S. A.et al. (2004). Conjugated equine estrogens and global cognitive function in postmenopausal women: Women's Health Initiative Memory Study. Journal of the American Medical Association, 291, 2959–68.Google Scholar
Fahn, S. & Elton, R. L. (1987). The UPDRS Development Committee. Unified Parkinson's Disease Rating Scale. In Recent Developments in Parkinson's Disease, ed. Fahn, S., Marsden, C. D. & Goldstein, M., pp. 153–63, 293–304. New York: Macmillan.
Farlow, M., Anand, R., Messina, J., Hartman, R. & Veach, J. (2000). A 52-week study of the efficacy of rivastigmine in patients with mild to moderately severe Alzheimer's disease. European Neurology, 44, 236–41.Google Scholar
Farlow, M., Lilly, M. L. & the ENA 713 B352 Study Group (2005). Rivastigmine: an open-label, observational study of safety and effectiveness in treating patients with Alzheimer's disease for up to 5 years. BioMed Central Geriatrics, 5, 1–7.Google Scholar
Feldman, H., Gauthier, S., Hecker, J.et al. (2001). A 24week, randomized, double-blind study of donepezil in moderate to severe Alzheimer's disease. Neurology, 57, 613–20.Google Scholar
Fergusson, E. & Howard, R. (2000). Donepezil for the treatment of psychosis in dementia with Lewy bodies. International Journal of Geriatric Psychiatry, 15, 280–1.Google Scholar
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975). “Mini-Mental State” – a practical method for grading the cognitive state of patients for the clinician. Psychiatry Research, 12, 189–98.Google Scholar
Forette, F., Anand, R. & Gharabawi, G. (1999). A phase II study in patients with Alzheimer's disease to assess the preliminary efficacy and maximum tolerated dose of rivastigmine (Exelon). European Journal of Neurology, 6, 423–9.Google Scholar
Fröelich, L., Gertz, H.-J., Heun, R.et al. (2004). Donepezil for Alzheimer's disease in clinical practice – the DONALD study. Dementia and Geriatric Cognitive Disorders, 18, 37–43.Google Scholar
Frölich, L., Klinger, T. & Berger, F. M. (2002). Treatment with donepezil in Alzheimer patients with and without cerebrovascular disease. Journal of the Neurological Sciences, 203–4, 137–9.Google Scholar
Galasko, D., Bennett, D., Sano, M.et al. (1997). An inventory to assess activities of daily living for clinical trials in Alzheimer's disease. The Alzheimer's Disease Cooperative Study. Alzheimer Disease and Associated Disorders, 11(Suppl. 2), S33–9.Google Scholar
Geizer, M. & Ancill, R. J. (1998). Combination of risperidone and donepezil in Lewy Body dementia. Canadian Journal of Psychiatry, 43, 421–2.Google Scholar
Gélinas, I., Gauthier, L., McIntyre, M. & Gauthier, S. (1999). Development of a functional measure for persons with Alzheimer's disease: the Disability Assessment for Dementia. American Journal of Occupational Therapy, 53, 471–81.Google Scholar
Giacobini, E., Zhu, X. D., Williams, E. & Sherman, K. A. (1996). The effect of the selective reversible acetylcholinesterase inhibitor E2020 on extracellular acetylcholine and biogenic amine levels in rat cortex. Neuropharmacology, 35, 205–11.Google Scholar
Gottfries, C. G., Blennow, K., Karlsson, I. & Wallin, A. (1994). The neurochemistry of vascular dementia. Dementia, 5, 163–7.Google Scholar
Gottfries, C. G., Bråne, G., Gullberg, B. & Steen, G. (1982). A new scale for dementia syndromes. Archives of Gerontology and Geriatrics, 1, 311–30.Google Scholar
Grace, J., Daniel, S., Stevens, T.et al. (2001). Long-term use of rivastigmine in patients with dementia with Lewy Bodies: an open-label trial. International Psychogeriatrics, 13, 199–205.Google Scholar
Grace, J. B., Walker, M. P. & McKeith, I. G. (2000). A comparison of sleep profiles in patients with dementia with Lewy Bodies and Alzheimer's disease. International Journal of Geriatric Psychiatry, 15, 1028–33.Google Scholar
Graham, A. J., Martin-Ruiz, C. M., Teaktong, T., Ray, M. A. & Court, J. A. (2002). Human brain nicotinic receptors, their distribution and participation in neuropsychiatric disorders. Current Drug Targets – CNS & Neurological Disorders, 1(4), 387–97.Google Scholar
Grandmaison, E. & Simard, M. (2003). Critical review of memory stimulation programs in Alzheimer's disease. Journal of Neuropsychiatry and Clinical Neurosciences, 15, 130–44.Google Scholar
Grossberg, G., Irwin, P., Satlin, A., Mesenbrink, P. & Spiegel, R. (2004). Rivastigmine in Alzheimer's disease. Efficacy over two years. American Journal of Geriatric Psychiatry, 12, 420–31.Google Scholar
Heun, R., Papassotiropoulos, A. & Jennssen, F. (1998). The validity of psychometric instruments for detection of dementia in the elderly general population. International Journal of Geriatric Psychiatry, 13, 368–80.Google Scholar
Hogervorst, E., Williams, J., Budge, M., Riedel, W. & Jolles, J. (2000). The nature of the effect of female gonadal hormone replacement therapy on cognitive function in post-menopausal women: a meta-analysis. Neuroscience, 101, 485–512.Google Scholar
Hogervorst, E., Yaffe, K., Richards, M. & Huppert, F. (2002). Hormone replacement therapy to maintain cognitive function in women with dementia. Cochrane Database of Systemetic Reviews, 3, CD003799.Google Scholar
Holm, A. C. (2004). Alleviation of multiple abnormalities by galantamine treatment in two patients with dementia with Lewy bodies. American Journal of Alzheimer's Disease and Other Dementias, 19, 215–18.Google Scholar
Homma, A., Takeda, M., Imai, Y.et al. (2000). Clinical efficacy and safety of donepezil on cognitive and global function in patients with Alzheimer's disease. A 24week, multicenter, double-blind, placebo-controlled study in Japan. E2020 Study Group. Dementia and Geriatric Cognitive Disorders, 11, 299–313.Google Scholar
Hughes, C. P., Berg, L., Danziger, W. L., Cohen, L. A. & Martin, R. L. (1982). A new clinical scale for the staging of dementia. British Journal of Psychiatry, 140, 566–72.Google Scholar
Jann, M. W. (2000). Rivastigmine, a new-generation cholinesterase inhibitor for the treatment of Alzheimer's disease. Pharmacotherapy, 20, 1–13.Google Scholar
Jellinger, K. A. (2002). Vascular-ischemic dementia: an update. Journal of Neuronal Transmission, 62 (Suppl.), 1–23.Google Scholar
Jia, J. P., Jia, J. M., Zhou, W. D.et al. (2004). Differential acetylcholine and choline concentrations in the cerebrospinal fluid of patients with Alzheimer's disease and vascular dementia. Chinese Medical Journal (England), 117, 1161–4.Google Scholar
Janssen Research Foundation (1999a). Data on file, Study Report No. GAL-INT-3. Titusville, NJ.
Janssen Research Foundation (1999b). Data on file, Study Report No. GAL-INT-7. Titusville, NJ.
Johns, M. W. (1993). Sleepiness, snoring, and obstructive sleep apnea. The Epworth Sleepiness Scale. Chest, 103, 30–6.Google Scholar
Kanowski, S., Herrmann, W. M., Stephan, K., Wierich, W. & Horr, R. (1996). Proof of efficacy of the ginkgo biloba special extract EGb 761 in outpatients suffering from mild to moderate primary degenerative dementia of the Alzheimer type or multi-infarct dementia. Pharmacopsychiatry, 29, 47–56.Google Scholar
Kaplan, E., Goodglass, H. & Weintraub, S. (1978). Boston Naming Test. Philadelphia, PA: Lea and Febiger.
Kaufer, D. (2004). A case study in the treatment of dementia with Lewy bodies. Acta Psychiatrica Scandinavica, 110: 73–6.Google Scholar
Kaufer, D. I., Catt, K. E., Lopez, O. L. & DeKosky, S. T. (1998). Dementia with Lewy bodies; Response of delirium-like features to donepezil. Neurology, 51, 1512.Google Scholar
Khotianov, N., Singh, R. & Singh, S. (2002). Lewy Body dementia: case report and discussion. Journal of the American Board of Family Practice, 15, 50–4.Google Scholar
Kmietowicz, Z. (2005). NICE proposes to withdraw Alzheimer's drugs from NHS. British Medical Journal, 330, 495.Google Scholar
Knopman, D. S., Knapp, M. J., Gracon, S. I. & Davis, C. S.. (1994). The Clinician Interview Based Impression (CIBI): a clinician's global change rating scale in Alzheimer's disease. Neurology, 44, 2315–21.Google Scholar
Krall, W. J., Sramek, J. J. & Cutler, N. R. (1999). Cholinesterase inhibitors: a therapeutic strategy for Alzheimer disease. Annals of Pharmacotherapy, 33, 441–50.Google Scholar
Kumar, V., Anand, R., Messina, J., Hartman, R. & Veach, J. (2000). An efficacy and safety analysis of Exelon in Alzheimer's disease patients with concurrent vascular risk factors. European Journal of Neurology, 7, 159–69.Google Scholar
Kurz, A., Erkinjuntti, T., Small, G., Lilienfeld, S. & Damaraju, C. V. (2003). Long-term safety and cognitive effects of galantamine in the treatment of probable vascular dementia or Alzheimer's disease with cerebrovascular disease. European Journal of Neurology, 10, 633–40.Google Scholar
Lai, C. K., Chi, I. & Kayser-Jones, J. (2004). A randomized controlled trial of a specific reminiscence approach to promote the well-being of nursing home residents with dementia, International Psychogeriatrics, 16, 33–49.Google Scholar
Lanctôt, K. L. & Herrmann, N. (2000). Donepezil for behavioural disorders associated with Lewy Bodies: a case series. International Journal of Geriatric Psychiatry, 15, 338–45.Google Scholar
Langlais, P. J., Thal, L. J., Hansen, L., Galasko, D., Alford, M. & Masliah, E. (1993). Neurotransmitters in basal ganglia and cortex of Alzheimer's disease with and without Lewy bodies. Neurology, 43, 1927–34.Google Scholar
Lawton, M. P. & Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179–86.Google Scholar
Bars, P. L., Katz, M. M., Berman, N., Itil, T. M., Freedman, A. M. & Schatzberg, A. F. (1997). A placebo-controlled, double-blind, randomized trial of an extract of ginkgo biloba for dementia. North American EGb Study Group. Journal of the American Medical Association 278, 1327–32.Google Scholar
Levesque, L. E., Brophy, J. M. & Zhang, B. (2005). The risk for myocardial infarction with cyclooxygenase-2 inhibitors: a population study of elderly adults. Annals of Internal Medicine, 142, 481–9.Google Scholar
Levy, R., Eagger, S., Griffiths, M.et al. (1994). Lewy bodies and response to tacrine in Alzheimer's disease. Lancet, 343, 176.Google Scholar
Loy, C. & Schneider, L. (2006). Galantamine for Alzheimer's disease and mild cognitive impairment. Cochrane Database of Systematic Reviews, 1. Oxford: Update Software Ltd.Google Scholar
Lyketsos, C. G., Reichman, W. E., Kershaw, P. & Zhu, Y. (2004). Long-term outcomes of galantamine in patients with Alzheimer's disease. American Journal of Geriatric Psychiatry, 12, 473–82.Google Scholar
Maclean, L. E., Collins, C. C. & Byrne, E. J. (2001). Dementia with Lewy Bodies treated with rivastigmine: effects on cognition, neuropsychiatric symptoms, and sleep. International Psychogeriatrics, 13, 277–88.Google Scholar
Malouf, R. & Birks, J. (2004). Donepezil for vascular cognitive impairment. Cochrane Database of Systematic Reviews, 1, CD004395. Oxford: Update Software Ltd.Google Scholar
Matthews, H. P., Korbey, J., Wilkinson, D. G. & Rowden, J. (2000). Donepezil in Alzheimer's disease: eighteen month results from Southampton Memory Clinic. International Journal of Geriatric Psychiatry, 15, 713–20.Google Scholar
McGeer, P. L., Schulzer, M., & McGeer, E. G. (1996). Arthritis and anti-inflammatory agents as possible protective factors for Alzheimer's disease: a review of 17 epidemiologic studies. Neurology, 47, 425–32.Google Scholar
McKeith, I. G. (2000). Clinical Lewy body syndromes. Annals of New York Academy of Sciences, 920, 1–8.Google Scholar
McKeith, I. G., Perry, R. H., Fairbairn, A. F., Jabeen, S. & Perry, E. K. (1992). Operational criteria for senile dementia of Lewy body type (SDLT). Psychological Medicine, 22, 911–22.Google Scholar
McKeith, I. G., Galasko, D., Kosaka, K.et al. (1996). Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology, 47, 1113–24.Google Scholar
McKeith, I., Del Ser, T., Spano, P.et al. (2000a). Efficacy of rivastigmine in dementia with Lewy bodies: a randomised, double-blind, placebo-controlled international study. Lancet, 356, 2031–6.Google Scholar
McKeith, I. G., Grace, J. B., Walker, Z.et al. (2000b). Rivastigmine in the treatment of dementia with Lewy bodies: Preliminary findings from an open trial. International Journal of Geriatric Psychiatry, 15, 387–92.Google Scholar
McKeith, I. G., Wesnes, K. A., Perry, E. & Ferrara, R. (2004). Hallucinations predict attentional improvements with rivastigmine in dementia with Lewy Bodies. Dementia and Geriatric Cognitive Disorders, 18, 94–100.Google Scholar
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. & Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939–44.Google Scholar
McShane, R., Sastre, Areosa A. & Minakaran, N. (2006). Memantine for dementia. Cochrane Database of Systematic Reviews, 2, CD003154. Oxford: Update Software Ltd.Google Scholar
Miller, E. R. III, Pastor-Barriuso, R., Dalal, D., Riemersma, R. A., Appel, L. J. & Guallar, E. (2005). Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Annals of Internal Medicine, 142, 37–46.Google Scholar
Minett, T. S. C., Thomas, A., Wilkinson, L. M.et al. (2003). What happens when donepezil is suddenly withdrawn? An open label trial in dementia with Lewy bodies and Parkinson's disease with dementia. International Journal of Geriatric Psychiatry, 18, 988–93.Google Scholar
Mohs, R. C., Doody, R. S., Morris, J. C.et al. (2001). A 1-year, placebo-controlled preservation of function survival study of donepezil in AD patients. Neurology, 57, 481–8.Google Scholar
Mohs, R. C., Knopman, D., Petersen, R. C.et al. (1997). Development of cognitive instruments for use in clinical trials of antidementia drugs: additions to the Alzheimer's Disease Assessment Scale that broaden its scope. The Alzheimer's Disease Cooperative Study. Alzheimer Disease and Associated Disorders, 11 (Suppl. 2), S13–21.Google Scholar
Nelson, A., Fogel, B. S. & Faust, D. (1986). Bedside cognitive screening instruments, a critical assessment. Journal of Nervous Mental Disease, 174, 73–83.Google Scholar
Nicholl, C. G., Lynch, S., Kelly, C. A.et al. (1995). The Cognitive Drug Research computerized assessment system in the evaluation of early dementia – is speed of the essence?International Journal of Geriatric Psychiatry, 10, 199–206.Google Scholar
Nordberg, A. & Svensson, A.-L. (1998). Cholinesterase inhibitors in the treatment of Alzheimer's disease: a Comparison of tolerability and pharmacology. Drug Experience, 19, 465–80.Google Scholar
Orgogozo, J. M., Rigaud, A. S., Stoffler, A., Mobius, H. J. & Forette, F. (2002). Efficacy and safety of memantine in patients with mild to moderate vascular dementia: a randomized, placebo-controlled trial (MMM 300). Stroke, 33, 1834–9.Google Scholar
Partridge, J. G., Apparsundaram, S., Gerhardt, G. A., Ronesi, J. & Lovinger, D. M. (2002). Nicotinic acetylcholine receptors interact with dopamine in induction of striatal long-term depression. Journal of Neurosciences, 22, 2541–9.Google Scholar
Perry, E., Walker, M., Grace, J. & Perry, R. (1999). Acetylcholine in mind: a neurotransmitter correlate of consciousness?Trends in Neurosciences, 22, 273–80.Google Scholar
Perry, E. K., Kerwin, J., Perry, R. H., Blessed, G. & Fairbairn, A. F. (1990b). Visual hallucinations and the cholinergic system in dementia (letter). Journal of Neurology, Neurosurgery, and Psychiatry, 53, 88.Google Scholar
Perry, E. K., Marshall, E., Perry, R. H.et al. (1990a). Cholinergic and dopaminergic activities in senile dementia of Lewy body type. Alzheimer's Disease and Associated Disorders, 4, 87–95.Google Scholar
Perry, E. K., Irving, D., Kerwin, J. M.et al. (1993). Cholinergic transmitter and neuotrophic activities in Lewy body dementia: similarity to Parkinson's and distinction from Alzheimer's disease. Alzheimer's Disease and Associated Disorders, 7, 69–79.Google Scholar
Pimlott, S. L., Piggott, M., Owens, J.et al. (2004). Nicotinic acetylcholine receptor distribution in Alzheimer's disease, dementia with Lewy Bodies, Parkinson's disease, and vascular dementia: in vitro study using 5[125I]-A-85380. Neuropsychopharmacology, 29, 108–16.Google Scholar
Pirtillä, T., Wilcock, G., Truyen, L. & Damaraju, C. V. (2004). Long-term efficacy and safety of galantamine in patients with mild-to-moderate Alzheimer's disease: multicenter trial. European Journal of Neurology, 11, 734–41.Google Scholar
Rabins, P. V. (2006). Guideline Watch: Practice Guideline for the Treatment of Patients With Alzheimer's Disease and Other Dementias of Late Life. Washington, DC: American Psychiatric Association.
Rahkonen, T., Eloniemi-Sulkava, U., Rissanen, S., Vatanen, A., Viramo, P. & Sulkava, R. (2003). Dementia with Lewy bodies according to the consensus criteria in a general population aged 75 or older. Journal of Neurology and Neurosurgery Psychiatry, 74, 720–4.Google Scholar
Raskind, M. A., Peskind, E. R., Truyen, L., Kershaw, P. & Damaraju, C. V. (2004). The cognitive benefits of galantamine are sustained for at least 36 months. Archives of Neurology, 61, 252–6.Google Scholar
Raskind, M. A., Peskind, E. R., Wessel, T., Yuan, W. & The Galantamine USA-1 Study Group (2000). Galantamine in AD: a 6-month randomized, placebo-controlled trial with a 6-month extension. The Galantamine USA-1 Study Group. Neurology, 54, 2261–8.Google Scholar
Reisberg, B., Ferris, S. H., Leon, M. J. & Crook, T. (1982). The Global Deterioration Scale for assessment of primary degenerative dementia. American Journal of Psychiatry, 139, 1136–9.Google Scholar
Reisberg, B., Doody, R., Stöffler, A., Schmitt, F., Ferris, S. & Möbius, H. J. for the Memantine Study Group (2003). Memantine in moderate-to severe Alzheimer's disease. New England Journal of Medicine, 348, 1333–41.Google Scholar
Relkin, N. R., Reichman, W. E., Orazem, J. & McRae, T. (2003). A large, community-based, open-label trial of donepezil in the treatment of Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 16, 15–24.Google Scholar
Ritchie, C. W., Ames, D., Clayton, T. & Lai, R. (2004). Metaanalysis of randomized trials of the efficacy and safety of donepezil, galantamine, and rivastigmine for the treatment of Alzheimer disease. American Journal of Geriatric Psychiatry, 12, 358–69.Google Scholar
Rockwood, K., Mintzer, J., Truyen, L., Wessel, T. & Wilkinson, D. (2001). Effects of a flexible galantamine dose in Alzheimer's disease: a randomized, controlled trial. Journal of Neurology, Neurosurgery, and Psychiatry, 71, 589–95.Google Scholar
Rogers, S. L. & Friedhoff, L. T. (1998). Long-term efficacy and safety of donepezil in the treatment of Alzheimer's disease: an interim analysis of the results of a US multicentre open label extension study. European Neuropsychopharmacology, 8, 67–75.Google Scholar
Rogers, J., Kirby, L. C., Hempelman, S. R.et al. (1993). Clinical trial of indomethacin in Alzheimer's disease. Neurology, 43, 1609–11.Google Scholar
Rogers, S. L. & Friedhoff, L. T. (1996). The efficacy and safety of donepezil in patients with Alzheimer's disease: results of a US multicentre, randomized, double-blind, placebo-controlled trial. The Donepezil Study Group. Dementia, 7, 293–303.Google Scholar
Rogers, S. L., Doody, R. S., Mohs, R. C., Friedhoff, L. T. & the Donepezil Study Group (1998a). Donepezil improves cognition and global function in Alzheimer disease. A 15-week, double-blind, placebo-controlled study. Archives of Internal Medicine, 158, 1021–31.Google Scholar
Rogers, S. L., Farlow, M. R., Doody, R. S., Mohs, R., Friedhoff, L. T. & the Donepezil Study Group (1998b). A 24-week, double-blind, placebo-controlled trial of donepezil in patients with Alzheimer. Neurology, 50, 136–45.Google Scholar
Rogers, S. L., Doody, R. S., Pratt, R. D. & Ieni, J. R. (2000). Long-term efficacy and safety of donepezil in the treatment of Alzheimer's disease: final analysis of a US multicentre open-label study. European Neuropsychopharmacology, 10, 195–203.Google Scholar
Rojas-Fernandez, C. H. (2001). Successful use of donepezil for the treatment of dementia with Lewy Bodies. Annals of Pharmacotherapy, 35, 202–5.Google Scholar
Román, G. C., Tatemichi, T. K., Erkinjuntti, T.et al. (1993). Vascular dementia: Diagnostic criteria for research studies. Report of the NINCDS-AIREN International Workshop. Neurology, 43, 250–60.Google Scholar
Rosen, W. G., Mohs, R. C. & Davis, K. L. (1984). A new rating scale for Alzheimer's disease. American Journal of Psychiatry, 141, 1356–64.Google Scholar
Rosen, W. G., Terry, R. D., Fuld, P. A., Katzman, R. & Peck, A. (1980). Pathological verification of ischemic score in differentiation of dementias. Annals of Neurology, 7, 486–8.Google Scholar
Rösler, M., Anand, R., Cicin-Sain, A.et al. (1999). Efficacy and safety of rivastigmine in patients with Alzheimer's disease: international randomised controlled trial. British Medical Journal, 318, 633–8.Google Scholar
Rossouw, J. E., Anderson, G. L., Prentice, R. L.et al. (2002). Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. Journal of the American Medical Association, 288, 321–33.Google Scholar
Rüther, E., Glaser, A., Bleich, S., Degner, D. & Wiltfang, J. (2000). A prospective PMS study to validate the sensitivity for change of the D-Scale in advanced stages of dementia using the NMDA-antagonist memantine. Pharmacopsychiatry, 33, 103–8.Google Scholar
Samuel, W., Caligiuri, M., Galasko, D.et al. (2000). Better cognitive and psychopathologic response to donepezil in patients prospectively diagnosed as dementia with Lewy Bodies: a preliminary study. International Journal of Geriatric Psychiatry, 15, 794–802.Google Scholar
Sano, M., Ernesto, C., Thomas, R. G.et al. (1997). A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's Disease Cooperative Study. New England Journal of Medicine, 336, 1216–22.Google Scholar
Saxton, J., McGonigle-Gibson, K., Swihart, A., Miller, M. & Boller, F. (1990). Assessment of the severely impaired patient: description and validation of a new neuropsychological test battery. Psychological Assessment: Journal of Consulting and Clinical Psychology, 2, 298–303.Google Scholar
Scharf, S., Mander, A., Ugoni, A., Vajda, F. & Christophidis, N. (1999). A double-blind, placebo-controlled trial of diclofenac/misoprostol in Alzheimer's disease. Neurology, 53, 197–201.Google Scholar
Schneider, L. S., Olin, J. T., Doody, R. S.et al. (1997). Validity and reliability of the Alzheimer's Disease Cooperative Study – clinical global impression of change. Alzheimer's Disease and Associated Disorders, 11 (Suppl. 2), S22–32.Google Scholar
Shea, C., MacKnight, C. & Rockwood, K. (1998). Donepezil for treatment of Dementia with Lewy Bodies: a case series of nine patients. International Psychogeriatrics, 10, 229–38.Google Scholar
Shumaker, S. A., Legault, C., Kuller, L.et al. (2004). Conjugated equine estrogens and incidence of probable dementia and mild cognitive impairment in postmenopausal women: Women's Health Initiative Memory Study. Journal of the American Medical Association, 291, 2947–58.Google Scholar
Simard, M. (1998). The MMSE: strengths and weaknesses of a clinical instrument. The Canadian Alzheimer Disease Review, 2, 10–12.Google Scholar
Simard, M. & Reekum, R. (1999). Memory assessment in studies of cognition-enhancing drugs for Alzheimer's disease. Drugs and Aging, 14, 197–230.Google Scholar
Simard, M., Reekum, R. & Cohen, T. (2000). Review of cognitive and behavioral symptoms in dementia with Lewy Bodies. Journal of Neuropsychiatry and Clinical Neurosciences, 12, 425–50.Google Scholar
Simpson, P. M., Surmon, D. J., Wesnes, K. A.et al. (1991). The cognitive drug research computerized assessment system for demented patients: a validation study. International Journal of Geriatric Psychiatry, 6, 95–102.Google Scholar
Skjerve, A. & Nygaard, H. A. (2000). Improvement in sundowning in dementia with Lewy Bodies after treatment with donepezil. International Journal of Geriatric Psychiatry, 15, 1147–51.Google Scholar
Solomon, P. R., Adams, F., Silver, A., Zimmer, J. & DeVeaux, R. (2002). Gingko for memory enhancement: a randomized controlled trial. Journal of the American Medical Association, 290, 2015–22.Google Scholar
Spector, A., Orrell, M., Davies, S. & Woods, R. T. (2000). Reminiscence therapy for dementia. Cochrane Database of Systematic Reviews, 2, CD001120. Oxford: Update Software.Google Scholar
Spiegel, R., Brunner, C., Ermini-Funfschilling, D.et al. (1991). A new behavioral assessment scale for geriatric out- and in-patients: the NOSGER (Nurses' Observation Scale for Geriatric Patients). Journal of the American Geriatric Society, 39, 339–47.Google Scholar
Stern, R. G., Mohs, R. C., Davidson, M.et al. (1994). A longitudinal study of Alzheimer's disease: measurement, rate, and predictors of cognitive deterioration. American Journal of Psychiatry, 151, 390–6.Google Scholar
Stewart, W. F., Kawas, C., Corrada, M. & Metter, E. J. (1997). Risk of Alzheimer's disease and duration of NSAID use. Neurology, 48, 626–32.Google Scholar
Szekely, C. A., Thorne, J. E., Zandi, P. P.et al. (2004). Nonsteroidal anti-inflammatory drugs for the prevention of Alzheimer's disease: a systematic review. Neuroepidemiology, 23, 159–69.Google Scholar
Tabet, N. & Feldman, H. (2003). Indomethacin for the treatment of Alzheimer's disease patients. Cochrane Database of Systematic Reviews, 2, CD003673. Oxford: Updated Software Ltd.
Tabet, N., Birks, J. & Grimley, E. J. (2000). Vitamin E for Alzheimer's disease. Cochrane Database of Systematic Reviews, 4, CD002854. Oxford: Update Software Ltd.
Tariot, P. N., Cummings, J. L., Katz, I. R.et al. (2001). A randomized, double-blind, placebo-controlled study of the efficacy and safety of donepezil in patients with Alzheimer's disease in the nursing home setting. Journal of the American Geriatrics Society, 49, 1590–9.Google Scholar
Tariot, P. N., Solomon, P. R., Morris, J. C.et al. (2000). A 5-month, randomized, placebo-controlled trial of galantamine in AD. Neurology, 54, 2269–76.Google Scholar
Tariot, P. N., Farlow, M. R., Grossberg, G. T.et al. (2004). Memantine treatment in patients with moderate to severe Alzheimer's disease already receiving donepezil. A randomized controlled trial. Journal of the American Medical Association, 291, 317–24.Google Scholar
Teng, E. L. & Chui, H. C. (1987). The Modified Mini-Mental State (3MS) examination. Journal of Clinical Psychiatry, 48, 314–18.Google Scholar
Tiraboschi, P., Hansen, L. A., Alford, M.et al. (2002). Early and widespread cholinergic losses differentiate dementia with Lewy bodies from Alzheimer's disease. Archives of General Psychiatry, 59, 946–51.Google Scholar
Wesnes, K. A., McKeith, I. G., Ferrara, R.et al. (2002). Effects of rivastigmine on cognitive function in dementia with Lewy Bodies: a randomised placebo-controlled international study using the cognitive drug research computerised assessment system. Dementia and Geriatric Cognitive Disorders, 13, 183–92.Google Scholar
Wilcock, G. K., Birks, J., Whitehead, A. & Evans, S. J. (2002). The effect of selegiline in the treatment of people with Alzheimer's disease: a meta-analysis of published trials. International Journal of Geriatric Psychiatry, 17, 175–83.Google Scholar
Wilcock, G. K., Lilienfeld, S. & Gaens, E. on behalf of the Galantamine International-1 Study Group. (2000). Efficacy and safety of galantamine in patients with mild to moderate Alzheimer's disease: multicentre randomized controlled trial. British Medical Journal, 321, 1–7.Google Scholar
Wilkinson, D. & Murray, J. in collaboration with the Galantamine Research Group (2001). Galantamine: a randomized, double-blind, dose comparison in patients with Alzheimer's disease. International Journal of Geriatric Psychiatry, 16, 852–7.Google Scholar
Wilkinson, D., Doody, R., Helme, R.et al. (2003). Donepezil in vascular dementia. A randomized, placebo-controlled study. Neurology, 61, 479–86.Google Scholar
Winblad, B. & Poritis, N. (1999). Memantine in severe dementia: results of the 9M-Best study (Benefit and Efficacy in Severely Demented patients during treatment with memantine). International Journal of Geriatric Psychiatry, 14, 135–46.Google Scholar
Winblad, B., Engedal, K., Soininen, H.et al. (2001). A 1-year, randomized, placebo-controlled study of donepezil in patients with mild to moderate AD. Neurology, 57, 489–95.Google Scholar
Woods, B., Spector, A., Jones, C., Orrell, M. & Davies, S. (2005). Reminiscence therapy for dementia. Cochrane Database for Systematic Reviews, 2, CD001120. Oxford: Update Software.Google Scholar
Yanagihara, T. (2002). Vascular dementia in Japan. Annals of New York Academy of Sciences, 977, 24–8.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×