The dementias

Mulley, Graham; Jones, Roy

Abstract

Alzheimer's disease (AD) is the commonest cause of dementia in adults whatever their age. In patients over 65, vascular dementia is the second commonest cause of dementia, followed by dementia with Lewy bodies (DLB). There should be a low threshold for considering the diagnosis of dementia in older people, especially people over 80. It is important to exclude potentially reversible causes of dementia. Cognitive assessment is central to diagnosis and management of dementia; a standardised test such as the Mini-Mental State Examination should be used. People with DLB often react badly to neuroleptic drugs. Three acetylcholinesterase inhibitors, donepezil, rivastigmine and galantamine, are available for treating people with mild and moderate AD. A fourth drug, memantine, that acts on N-methyl-D-aspartate glutamatergic receptors has recently become available for people with moderate and severe dementia.

• Journal Article Type: Article
• Publication Date: Sep 1, 2003
• Journal: Clinical Medicine
• Print ISSN: 1470-2118
• Electronic ISSN: 1473-4893
• Publisher: Royal College of Physicians
• Peer Reviewed: Peer Reviewed
• Volume: 3
• Issue: 5
• Pages: 404-408
• DOI: https://doi.org/10.7861/clinmedicine.3-5-404
• Keywords: dementia, Alzheimer's disease
• Public URL: https://uwe-repository.worktribe.com/output/1068059
• Publisher URL: http://dx.doi.org/10.7861/clinmedicine.3-5-404