Document Detail


Practice parameter: management of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology.
MedLine Citation:
PMID:  11342679     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To define and investigate key issues in the management of dementia and to make literature-based treatment recommendations. METHODS: The authors searched the literature for four clinical questions: 1) Does pharmacotherapy for cognitive symptoms improve outcomes in patients with dementia? 2) Does pharmacotherapy for noncognitive symptoms improve outcomes in patients with dementia? 3) Do educational interventions improve outcomes in patients and/or caregivers? 4) Do other nonpharmacologic interventions improve outcomes in patients and/or caregivers? RESULTS: Cholinesterase inhibitors benefit patients with AD (Standard), although the average benefit appears small; vitamin E likely delays the time to clinical worsening (Guideline); selegiline, other antioxidants, anti-inflammatories, and estrogen require further study. Antipsychotics are effective for agitation or psychosis in patients with dementia where environmental manipulation fails (Standard), and antidepressants are effective in depressed patients with dementia (Guideline). Educational programs should be offered to family caregivers to improve caregiver satisfaction and to delay the time to nursing home placement (Guideline). Staff of long-term care facilities should also be educated about AD to minimize the unnecessary use of antipsychotic medications (Guideline). Behavior modification, scheduled toileting, and prompted voiding reduce urinary incontinence (Standard). Functional independence can be increased by graded assistance, skills practice, and positive reinforcement (Guideline).
Authors:
R S Doody; J C Stevens; C Beck; R M Dubinsky; J A Kaye; L Gwyther; R C Mohs; L J Thal; P J Whitehouse; S T DeKosky; J L Cummings
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Publication Detail:
Type:  Guideline; Journal Article; Practice Guideline    
Journal Detail:
Title:  Neurology     Volume:  56     ISSN:  0028-3878     ISO Abbreviation:  Neurology     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-05-08     Completed Date:  2001-06-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1154-66     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurology, Baylor College of Medicine, Houston, TX, USA.
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MeSH Terms
Descriptor/Qualifier:
Dementia / therapy*
Humans
Comments/Corrections
Comment In:
Evid Based Nurs. 2002 Jan;5(1):20   [PMID:  11915798 ]
Neurology. 2001 May 8;56(9):1131-2   [PMID:  11342676 ]
ACP J Club. 2001 Nov-Dec;135(3):94

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