Pharmacological treatment of dementia and mild cognitive impairment due to Alzheimerʼs disease

Abstract

To give an overview of recent developments in pharmacological treatment options of cognitive as well as behavioural and psychological symptoms of dementia (BPSD) associated with Alzheimer's disease (AD) dementia and mild cognitive impairment due to AD (MCI-AD). Knowledge about the efficacy and limitations of the antidementive drugs memantine and cholinesterase inhibitors (ChEIs) in different stages of AD is further expanding. The prediction of treatment response to ChEI and assessment of treatment outcome in the individual patient remain unsolved issues. Commonly prescribed antidepressants have recently failed to be beneficial in depressed AD dementia patients. Clinical trials on new disease-modifying drugs have been disappointing so far. There is an urgent need for more effective treatment options for cognitive symptoms and BPSD in AD dementia and MCI-AD and for disease-modifying drugs to stop the underlying neurodegenerative process. Recently published new research criteria for the diagnosis of AD enlarge the window for the detection of the disease to early, predementia stages and include biomarkers related to the underlying cerebral AD pathology. In future studies, these criteria will hopefully facilitate the identification of effective drugs in early AD stages.