ITEMS IN AFP WITH KEYWORD:
Rather than focusing on medications to achieve a small temporary difference in cognition, patients and families might be better served if we focused more on nonpharmacologic treatments, and on more important issues, such as advance directives, driving, living arrangements, caregiver support, and home safety.
Find out which patients benefit from cholinesterase inhibitors, memantine, or vitamin E, and which nonpharmacologic therapies have the best evidence of effectiveness.
Apr 1, 2017 Issue
Alzheimer Disease: Monotherapy vs. Combination Therapy [FPIN's Help Desk Answers]
Combination treatment with memantine and donepezil results in a small improvement in cognitive function that is of uncertain clinical significance in patients with moderate to severe Alzheimer disease, but no improvement in patients with mild to moderate disease.
Feb 1, 2017 Issue
The Effect of Statins on Dementia and Cognitive Decline [Cochrane for Clinicians]
Statins given in later life to patients at risk of vascular disease do not prevent dementia or cognitive decline compared with placebo. Adverse effects are similar between groups.
Dec 1, 2016 Issue
Mini-Mental State Examination for the Detection of Dementia in Older Patients [Cochrane for Clinicians]
When scores are adjusted based on a patient's education level, the MMSE may be useful to rule out a diagnosis of dementia in clinically unevaluated patients 65 years and older (sensitivity = 97%; specificity = 70%). Scores of less than 24 may also be useful to rule in dementia in patients 65 years and older (sensitivity = 85%; specificity = 90%).
Find out which nonpharmacologic treatments are most effective, when antipsychotic therapy is indicated, which medications are appropriate in patients with comorbid conditions, and when antipsychotic therapy should be discontinued.
Aug 1, 2016 Issue
Exercise to Improve Functioning in Patients with Dementia [FPIN's Help Desk Answers]
Exercise programs lasting at least two months moderately increase the ability of patients with dementia to perform ADLs.
Jul 15, 2015 Issue
Screening for Cognitive Impairment in Older Adults [Putting Prevention into Practice]
N.D. is a 72-year-old white man who presents for a preventive visit. He smokes, and his medical history is significant for essential hypertension, which is stable and well controlled with medication. N.D.'s close friend was recently diagnosed with dementia, and N.D. is concerned that he may receive ...
Mar 15, 2015 Issue
Screening for Cognitive Impairment in Older Adults: Recommendation Statement [U.S. Preventive Services Task Force]
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for cognitive impairment.
Benzodiazepine exposure over the preceding five years seems to be associated with an increased likelihood of an Alzheimer disease diagnosis. A dose-response gradient also seems to exist.