Treatment of Dementia: Recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology

There is currently no cure for neurodegenerative or vascular dementias, but some pharmacological and non-pharmacological interventions may contribute to alleviate symptoms, slow disease progression and improve quality of life. Current treatment approaches are based on etiology, symptom profile and stage of dementia. This manuscript presents recommendations on pharmacological and non-pharmacological treatments of dementia due to Alzheimer's disease, vascular cognitive impairment, frontotemporal dementia, Parkinson's disease dementia, and dementia with Lewy bodies.

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References

McKeith I, Boeve B, Dickson D, Halliday G, Taylor J, Weintraub D . Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology. 2017; 89(1):88-100. PMC: 5496518. DOI: 10.1212/WNL.0000000000004058. View

Dichgans M, Markus H, Salloway S, Verkkoniemi A, Moline M, Wang Q . Donepezil in patients with subcortical vascular cognitive impairment: a randomised double-blind trial in CADASIL. Lancet Neurol. 2008; 7(4):310-8. DOI: 10.1016/S1474-4422(08)70046-2. View

Rascovsky K, Hodges J, Knopman D, Mendez M, Kramer J, Neuhaus J . Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain. 2011; 134(Pt 9):2456-77. PMC: 3170532. DOI: 10.1093/brain/awr179. View

Zhu X, Yu Y, Wang H, Jiang T, Cao L, Wang C . Physiotherapy intervention in Alzheimer's disease: systematic review and meta-analysis. J Alzheimers Dis. 2014; 44(1):163-74. DOI: 10.3233/JAD-141377. View

Frederiksen K, Cooper C, Frisoni G, Frolich L, Georges J, Kramberger M . A European Academy of Neurology guideline on medical management issues in dementia. Eur J Neurol. 2020; 27(10):1805-1820. PMC: 7540303. DOI: 10.1111/ene.14412. View

Velayudhan L, Ffytche D, Ballard C, Aarsland D . New Therapeutic Strategies for Lewy Body Dementias. Curr Neurol Neurosci Rep. 2017; 17(9):68. DOI: 10.1007/s11910-017-0778-2. View

do Vale F, Correa Neto Y, Bertolucci P, Machado J, da Silva D, Allam N . Treatment of Alzheimer's disease in Brazil: II. Behavioral and psychological symptoms of dementia. Dement Neuropsychol. 2017; 5(3):189-197. PMC: 5619478. DOI: 10.1590/S1980-57642011DN05030006. View

Engelhardt E, Brucki S, Cavalcanti J, Forlenza O, Laks J, Vale F . [Treatment of Alzheimer's disease: recommendations and suggestions of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology]. Arq Neuropsiquiatr. 2006; 63(4):1104-12. DOI: 10.1590/s0004-282x2005000600035. View

Auchus A, Brashear H, Salloway S, Korczyn A, De Deyn P, Gassmann-Mayer C . Galantamine treatment of vascular dementia: a randomized trial. Neurology. 2007; 69(5):448-58. DOI: 10.1212/01.wnl.0000266625.31615.f6. View

10.

Narasimhalu K, Effendy S, Sim C, Lee J, Chen I, Hia S . A randomized controlled trial of rivastigmine in patients with cognitive impairment no dementia because of cerebrovascular disease. Acta Neurol Scand. 2009; 121(4):217-24. DOI: 10.1111/j.1600-0404.2009.01263.x. View

11.

Davies S, Burhan A, Kim D, Gerretsen P, Graff-Guerrero A, Woo V . Sequential drug treatment algorithm for agitation and aggression in Alzheimer's and mixed dementia. J Psychopharmacol. 2018; 32(5):509-523. PMC: 5944080. DOI: 10.1177/0269881117744996. View

12.

Broadstock M, Ballard C, Corbett A . Latest treatment options for Alzheimer's disease, Parkinson's disease dementia and dementia with Lewy bodies. Expert Opin Pharmacother. 2014; 15(13):1797-810. DOI: 10.1517/14656566.2014.936848. View

13.

Louzada L, Machado F, Quintas J, Ribeiro G, Silva M, Mendonca-Silva D . The efficacy and safety of zolpidem and zopiclone to treat insomnia in Alzheimer's disease: a randomized, triple-blind, placebo-controlled trial. Neuropsychopharmacology. 2021; 47(2):570-579. PMC: 8674235. DOI: 10.1038/s41386-021-01191-3. View

14.

Wilcock G, Mobius H, Stoffler A . A double-blind, placebo-controlled multicentre study of memantine in mild to moderate vascular dementia (MMM500). Int Clin Psychopharmacol. 2002; 17(6):297-305. DOI: 10.1097/00004850-200211000-00005. View

15.

Xu H, Garcia-Ptacek S, Jonsson L, Wimo A, Nordstrom P, Eriksdotter M . Long-term Effects of Cholinesterase Inhibitors on Cognitive Decline and Mortality. Neurology. 2021; 96(17):e2220-e2230. PMC: 8166426. DOI: 10.1212/WNL.0000000000011832. View

16.

Rolinski M, Fox C, Maidment I, McShane R . Cholinesterase inhibitors for dementia with Lewy bodies, Parkinson's disease dementia and cognitive impairment in Parkinson's disease. Cochrane Database Syst Rev. 2012; (3):CD006504. PMC: 8985413. DOI: 10.1002/14651858.CD006504.pub2. View

17.

Beber B, Brandao L, Chaves M . A warning to the Brazilian Speech-Language Pathology and Audiology community about the importance of scientific and clinical activities in primary progressive aphasia. Codas. 2015; 27(5):505-8. DOI: 10.1590/2317-1782/20152015081. View

18.

Carrion C, Folkvord F, Anastasiadou D, Aymerich M . Cognitive Therapy for Dementia Patients: A Systematic Review. Dement Geriatr Cogn Disord. 2018; 46(1-2):1-26. DOI: 10.1159/000490851. View

19.

Meng Q, Lin M, Tzeng I . Relationship Between Exercise and Alzheimer's Disease: A Narrative Literature Review. Front Neurosci. 2020; 14:131. PMC: 7113559. DOI: 10.3389/fnins.2020.00131. View

20.

Kales H, Lyketsos C, Miller E, Ballard C . Management of behavioral and psychological symptoms in people with Alzheimer's disease: an international Delphi consensus. Int Psychogeriatr. 2018; 31(1):83-90. DOI: 10.1017/S1041610218000534. View