- Section 1 Ageing population and policy
- Section 2 Key concepts in care of older adults
- Section 3 Principles and organization of care
- Section 4 Age-related biological changes, altered physiology, and vulnerability to diseases and chronic conditions
- Section 5 Geriatric syndromes in clinical practice
- Section 6 Nutrition and metabolism
- Section 7 Mobility disorders: prevention, impact, and compensation
- Section 8 Infections in older adults: epidemiology, pathophysiology, diagnosis, and management
- Section 9 Cancer: epidemiology, pathophysiology, diagnosis, and management
- Section 10 Vascular diseases: epidemiology, pathophysiology, diagnosis, and management
- Section 11 Neurological disorders: epidemiology, pathophysiology, diagnosis, and management
- Section 12 Cognitive decline and dementia in older adults: epidemiology, pathophysiology, diagnosis, and management
- Chapter 121 Normal cognition and ageing: structure, function, and cognitive reserve
- Chapter 122 Epidemiology of Alzheimer’s disease: a relevant challenge for long-term follow-up of a population-based cohort
- Chapter 123 Cognitive impairment—risk factors and prevention
- Chapter 124 Neuropsychological evaluation of cognition
- Chapter 125 Mild cognitive impairment
- Chapter 126 The diagnosis of Alzheimer’s disease: assessment and criteria
- Chapter 127 Assessment and diagnosis of the non-Alzheimer dementias
- Chapter 128 Pharmacological interventions in mild cognitive impairment and dementia
- Chapter 129 Non-pharmacologic behavioural activity interventions to prevent dementia
- Chapter 130 Management of comorbidities in dementia patients
- Chapter 131 Evidence-based management of behavioural and psychological symptoms of dementia
- Chapter 132 Caregivers in dementia: role and empowerment
- Chapter 133 A new model of care for patients with dementia: the Japanese initiative for dementia care
- Section 13 Mental health of older adults
- Section 14 Management of common medical conditions: epidemiology, pathophysiology, diagnosis, and management
- Section 15 Palliative medicine and end-of-life care
- Section 16 Healthy ageing
(p. 997) Pharmacological interventions in mild cognitive impairment and dementia
- Chapter:
- (p. 997) Pharmacological interventions in mild cognitive impairment and dementia
- Author(s):
Jacques Hugon
and Claire Paquet
- DOI:
- 10.1093/med/9780198701590.003.0128
Alzheimer’s disease (AD) and other dementias are a major public health concern in many countries because of population ageing. The aetiologic causes of most of the dementias are unknown and recent pharmacological interventions are based on hypotheses such as the ‘amyloid cascade hypothesis’ for AD. Drugs can be divided between symptomatic treatments and disease-modifying drugs. So far regulatory authorities have only approved choline esterase inhibitors (ChEIs) and memantine in AD. It is postulated that the brain lesions in this disease occur 10–15 years before the first clinical signs. New clinical trials are now also including patients with mild cognitive impairment, a stage which often precedes dementia. Primary and secondary outcomes incorporate neuropsychological evaluations but also biomarker assessments such as positon emission tomography (PET) imaging and cerebrospinal fluid (CSF) measurements. This chapter focuses on current available therapies and recent or ongoing clinical trials in mild cognitive impairment and dementias.
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- Section 1 Ageing population and policy
- Section 2 Key concepts in care of older adults
- Section 3 Principles and organization of care
- Section 4 Age-related biological changes, altered physiology, and vulnerability to diseases and chronic conditions
- Section 5 Geriatric syndromes in clinical practice
- Section 6 Nutrition and metabolism
- Section 7 Mobility disorders: prevention, impact, and compensation
- Section 8 Infections in older adults: epidemiology, pathophysiology, diagnosis, and management
- Section 9 Cancer: epidemiology, pathophysiology, diagnosis, and management
- Section 10 Vascular diseases: epidemiology, pathophysiology, diagnosis, and management
- Section 11 Neurological disorders: epidemiology, pathophysiology, diagnosis, and management
- Section 12 Cognitive decline and dementia in older adults: epidemiology, pathophysiology, diagnosis, and management
- Chapter 121 Normal cognition and ageing: structure, function, and cognitive reserve
- Chapter 122 Epidemiology of Alzheimer’s disease: a relevant challenge for long-term follow-up of a population-based cohort
- Chapter 123 Cognitive impairment—risk factors and prevention
- Chapter 124 Neuropsychological evaluation of cognition
- Chapter 125 Mild cognitive impairment
- Chapter 126 The diagnosis of Alzheimer’s disease: assessment and criteria
- Chapter 127 Assessment and diagnosis of the non-Alzheimer dementias
- Chapter 128 Pharmacological interventions in mild cognitive impairment and dementia
- Chapter 129 Non-pharmacologic behavioural activity interventions to prevent dementia
- Chapter 130 Management of comorbidities in dementia patients
- Chapter 131 Evidence-based management of behavioural and psychological symptoms of dementia
- Chapter 132 Caregivers in dementia: role and empowerment
- Chapter 133 A new model of care for patients with dementia: the Japanese initiative for dementia care
- Section 13 Mental health of older adults
- Section 14 Management of common medical conditions: epidemiology, pathophysiology, diagnosis, and management
- Section 15 Palliative medicine and end-of-life care
- Section 16 Healthy ageing