Skip to main content
SpringerLink
Log in

Treating dementia with pharmacological options requires careful consideration of the potential benefits and risks

  • Disease Management
  • Published:
Drugs & Therapy Perspectives Aims and scope Submit manuscript

Abstract

Dementia is a progressive disorder characterized by changes in behaviour, executive function, language, memory, personality and reasoning. Current therapeutic options [acetylcholinesterase (AChE) inhibitors and memantine] are unable to slow or reverse disease progression, and the cognitive function and behavioural, functional and global benefits they provide are small. Moreover, AChE inhibitors are associated with significant adverse events, including weight loss and syncope, which could be detrimental in the elderly.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Buckley JS, Salpeter SR. A risk-benefit assessment of dementia medications: systematic review of the evidence. Drugs Aging. 2015;32(6):453–67.

    Article  PubMed  CAS  Google Scholar 

  2. Dementia: supporting people with dementia and their carers in health and social care: NICE clinical guideline 42. London: National Institute for Health and Care Excellence; 2015.

  3. Qaseem A, Snow V, Cross JT Jr, et al. Current pharmacologic treatment of dementia: a clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med. 2008;148(5):370–8.

    Article  PubMed  Google Scholar 

  4. Prince M, Bryce R, Albanese E, et al. The global prevalence of dementia: a systematic review and metaanalysis. Alzheimers Dement. 2013;9(1):63–75 e2.

  5. Russ TC, Morling JR. Cholinesterase inhibitors for mild cognitive impairment. Cochrane Database Syst Rev. 2012;9:CD009132.

  6. Heilpflanzen-Welt. Ginkgo biloba leaf extract (Gingko folium): German Commission E monographs (phytotherapy). http://www.heilpflanzen-welt.de/1994-07-Ginkgo-Biloba-Leaf-Extract-Ginkgo-folium. Accessed 5 Nov 2015.

  7. Flicker L, Grimley Evans J. Piracetam for dementia or cognitive impairment. Cochrane Database Syst Rev. 2004;(1):CD001011.

  8. Tricco AC, Soobiah C, Berliner S, et al. Efficacy and safety of cognitive enhancers for patients with mild cognitive impairment: a systematic review and meta-analysis. CMAJ. 2013;185(16):1393–401.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Cooper C, Li R, Lyketsos C, et al. Treatment for mild cognitive impairment: systematic review. Br J Psychiatry. 2013;203(3):255–64.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Tariot PN, Cummings JL, Katz IR, et al. A randomized, double-blind, placebo-controlled study of the efficacy and safety of donepezil in patients with Alzheimer’s disease in the nursing home setting. J Am Geriatr Soc. 2001;49(12):1590–9.

    Article  PubMed  CAS  Google Scholar 

  11. Birks J. Cholinesterase inhibitors for Alzheimer’s disease. Cochrane Database Syst Rev. 2006;(1):CD005593.

  12. Rolinski M, Fox C, Maidment I, et al. 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.

  13. Lanctot KL, Herrmann N, Yau KK, et al. Efficacy and safety of cholinesterase inhibitors in Alzheimer’s disease: a meta-analysis. CMAJ. 2003;169(6):557–64.

    PubMed  PubMed Central  Google Scholar 

  14. Kavirajan H, Schneider LS. Efficacy and adverse effects of cholinesterase inhibitors and memantine in vascular dementia: a meta-analysis of randomised controlled trials. Lancet Neurol. 2007;6(9):782–92.

    Article  PubMed  CAS  Google Scholar 

  15. McShane R, Areosa Sastre A, Minakaran N. Memantine for dementia. Cochrane Database Syst Rev. 2006;(2):CD003154.

  16. Schneider LS, Dagerman KS, Higgins JP, et al. Lack of evidence for the efficacy of memantine in mild Alzheimer disease. Arch Neurol. 2011;68(8):991–9.

    Article  PubMed  Google Scholar 

  17. Donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer’s disease. NICE technology appraisal guideline 217. London: National Institute for Health and Care Excellence; 2011.

  18. Wang HF, Yu JT, Tang SW, et al. Efficacy and safety of cholinesterase inhibitors and memantine in cognitive impairment in Parkinson’s disease, Parkinson’s disease dementia, and dementia with Lewy bodies: systematic review with meta-analysis and trial sequential analysis. J Neurol Neurosurg Psychiatry. 2015;86(2):135–43.

    Article  PubMed  Google Scholar 

  19. Pariente A, Sanctussy DJ, Miremont-Salame G, et al. Factors associated with serious adverse reactions to cholinesterase inhibitors: a study of spontaneous reporting. CNS Drugs. 2010;24(1):55–63.

    Article  PubMed  CAS  Google Scholar 

  20. Mimica N, Presecki P. Side effects of approved antidementives. Psychiatr Danub. 2009;21(1):108–13.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

    Consortia

    Adis Medical Writers

    Ethics declarations

    The article was adapted from Drugs & Aging 2015;32(6):453–67 [1] by salaried employees of Adis/Springer and was not supported by any external funding.

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Adis Medical Writers. Treating dementia with pharmacological options requires careful consideration of the potential benefits and risks. Drugs Ther Perspect 32, 60–64 (2016). https://doi.org/10.1007/s40267-015-0260-7

    Download citation

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s40267-015-0260-7

    Keywords

    Search

    Navigation