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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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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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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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...]

Cochrane review finds no good quality evidence for common medicines used to treat sleep problems in Alzheimer’s Disease

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People with dementia caused by Alzheimer’s Disease (ADD) (which is estimated to be around three quarters of people with dementia) often suffer from sleep disturbances.  These symptoms cause distress to the person with dementia and to their carers, increase the likelihood of admission to a care home, and are also very difficult for care home [read the full story...]

Dealing with a diagnosis of dementia: putting a systematic review into context

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Last July I wrote a blog (Helping patients and carers deal with a diagnosis of dementia: one size doesn’t fit all) about a systematic review of qualitative evidence (Bunn, 2012) relating to patients and carers experiences of reaching and adapting to a diagnosis of dementia.  That blog was heavily influenced by personal experience of my [read the full story...]

New Cochrane review says that vitamin E should not be used to treat dementia

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It was relatively recently that every Tom, Dick and Harry in the scientific community was popping vitamin E supplements in the hope that this antioxidant would help protect them from the damaging effects of free radicals. Us elves get our vitamin E from the vegetables, fruits and whole grains that make up our naturally healthy diet. Many single [read the full story...]

Cholinesterase inhibitors are an effective treatment for patients with Parkinson’s disease with dementia

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People with Alzheimer’s disease experience a loss of nerve cells that use a chemical called acetylcholine as a chemical messenger. Dementia symptoms become more severe as more nerve cells are lost. Cholinesterase inhibitors are a group of drugs (including donepezil, rivastigmine and galantamine) that prevent the enzyme acetylcholinesterase from breaking down acetylcholine in the brain. [read the full story...]

When is it appropriate to prescribe antipsychotics to treat the behavioural and psychological symptoms of dementia?

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This topic has been well publicised in recent years and for good reason. We know that there is a huge disparity between the number of people with dementia who are prescribed antipsychotics (180,000 in England each year) and the number who may derive some benefit from the treatment (36,000). We also know that dangerous side [read the full story...]

No evidence for the use of aspirin, steroids or NSAIDs for the treatment of Alzheimer’s disease

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Alzheimer’s disease affects 1-2% of people aged 65-70 and approximately 20% of those over 80 years. As our population ages, the condition is on the increase and it’s estimated that 2030, an estimated 7.7 million Americans aged 65 and older will have Alzheimer’s disease. We do not yet know exactly how and why Alzheimer’s disease [read the full story...]