Abstract
The treatment of cognitive impairment is multidisciplinary and begins with an intervention on risk factors. Non-pharmacological treatment includes measures such as cognitive stimulation and aerobic exercise. In regard to diet, the Mediterranean diet has demonstrated cognitive improvement and only the medical nutrition product souvenaid has managed to show isolated benefits in episodic memory in initial cognitive impairment due to Alzheimer's disease. Among the pharmacological interventions on symptoms, current evidence only supports the use of acetylcholinesterase inhibitors (ACEI) such as donepezil, rivastigmine, and galantamine as well as memantine, a non-competitive NMDA antagonist of glutamate receptors, in mild to moderately-advanced Alzheimer's dementia. ACEI have also shown cognitive benefits in Lewy body dementia, but not in frontotemporal dementia. The treatment of dementia-phase behavioral symptoms improves the quality of life of patients and family members and includes addressing psychosis, agitation, depression, apathy, or sleep disorders.
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