Medication in advanced dementia: how can we judge what is appropriate?

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Caroline Struthers appraises a recent US cross-sectional study of the use of medications of “questionable benefit” in nursing home residents with advanced dementia. She concludes that all medications are of questionable value if they have side effects which might have a negative impact on quality of life or are likely to cause harm.

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Cognitive and exercise interventions for older adults with and without cognitive impairment

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Jake Crawshaw reports on a recent systematic review of cognitive and exercise interventions for older people with and without cognitive impairment.

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Meta-review presents the risks of all-cause and suicide mortality in mental disorders

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This recent and well-conducted meta-review concludes that the impact on mortality and suicide of mental disorders is substantial, and probably poorly appreciated as a public health problem. Raphael Underwood’s blog summarises the data for all-cause and suicide mortality in mental disorders.

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Alternatives to medication for agitation in dementia

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Andrés Fonseca summarises the findings of a recent systematic review of the clinical effectiveness and cost-effectiveness of sensory, psychological and behavioural interventions for managing agitation in dementia.

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Statins have no beneficial effect on cognition in dementia, but can cause serious side-effects

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This updated Cochrane review on statins for the treatment of dementia contains worrying adverse effects data, but Caroline Struthers has to do a significant amount of digging to root it all out.

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What should we prescribe for neuropsychiatric symptoms in Alzheimer’s disease?

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Psychiatrist Andrés Fonseca considers how his clinical practice should change, after reading a systematic review and meta-analysis of drug treatment for neuropsychiatric symptoms in Alzheimer’s disease

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Dementia through the eyes of a carer: What would you want for your relative?

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Josephine Neale summarises a recent review of qualitative evidence that finds carers’ views are mixed and lie on a spectrum of acceptance of their relative as actively dying with dementia.

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Which (if any) drugs should we use for agitated or aggressive behaviour in dementia?

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This is a dilemma I frequently face when I am called out to see someone with dementia on the ward or living in a nursing home. On the one hand I am thinking that anything I use can potentially have serious side-effects and will probably lead to increased health risks and increased mortality. On the [read the full story...]