A Risk-Benefit Assessment of Dementia Medications: Systematic Review of the Evidence

Abstract

ChEIs produce small, short-lived improvements in cognitive function in mild to moderate dementia, which may not translate into clinically meaningful effects. Marginal benefits are seen with severe disease, long-term treatment, and advanced age. Cholinergic side effects, including weight loss, debility, and syncope, are clinically significant and could be especially detrimental in the frail elderly population, in which the risks of treatment outweigh the benefits. Memantine monotherapy may have minimal benefits in moderate to severe dementia, balanced by minimal adverse effects.

Abdominal Epilepsy Associated With Alzheimer's Disease

“…3 Seizures in individuals with AD, especially nonconvulsive seizures, may be difficult to distinguish from dementia-related fluctuations in attention and cognition. Moreover, in individuals with AD treated with cholinesterase inhibitors, 10 some gastrointestinal symptoms caused by abdominal epilepsy might be wrongly attributed to adverse effects of these drugs. Thus, geriatricians should maintain a high degree of suspicion for any symptoms resulting from seizure activity in AD and amnestic mild cognitive impairment, including paroxysmal gastrointestinal symptoms due to abdominal epilepsy.…”

Neurodegenerative Case Study

“…He was also referred to a Speech, Language, and Learning Center which will assist in helping the patient develop coping skills during his gradual loss of cognitive and physical faculties [2]. Currently, there is no known cure for Lewy Body Dementia [3].…”

Management of Alzheimers Disease: Role of Existing Therapies, Traditional Medicines and New Treatment Targets

“…Recently, a systematic review assessing the riskbenefits of dementia medications concluded that ACHEI gave moderate improvement in cognitive, functional, and global benefits to patients with mild to moderate AD, however, the clinical significance of these effects are unclear [30] . Also, long-term efficacy of ACHEI is an issue as their efficacy wanes with duration of treatment.…”

“…Also, long-term efficacy of ACHEI is an issue as their efficacy wanes with duration of treatment. Side effects with ACHEI include weight loss, debility and syncope, which could be detrimental in elderly patients [30] .…”