Pharmacologic Interventions to Prevent Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer-Type Dementia

  title={Pharmacologic Interventions to Prevent Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer-Type Dementia},
  author={Howard A Fink and Eric Jutkowitz and John Riley McCarten and Laura Sue Hemmy and Mary E Butler and Heather Davila and Edward R. Ratner and Collin Calvert and Terry R. Barclay and Michelle Brasure and Victoria A. Nelson and Robert Kane},
  journal={Annals of Internal Medicine},
Dementia is a clinical syndrome in which an acquired cognitive deficit interferes with a person's independence in daily activities (1). It adversely affects patient quality of life, burdens caregivers, increases institutionalization, and is costly to families and society (2). Alzheimer disease is the most common cause of dementia, although differentiation between when Alzheimer disease is present in isolation and when it is combined with another cause of dementia may not be possible in clinical… 

Mild Cognitive Impairment in Clinical Practice: A Review Article

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Effect of Statin Therapy on Cognitive Decline and Incident Dementia in Older Adults.

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  • Y. Maki
  • Medicine, Psychology
    Journal of primary health care
  • 2021
It is necessary to increase patients’ health literacy, which requires medical professionals to provide them with appropriate evidence-based information, and it is important to provide psychological support to people who have been diagnosed.

Lifestyle Modifications and Nutritional Interventions in Aging-Associated Cognitive Decline and Alzheimer’s Disease

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The treatment of AD remains a challenge, with a special focus on behavioral symptoms, and interventions that could delay or prevent dementia onset in some subjects are focused on minimizing modifiable risk factors and maximizing protective factors.

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Different conceptions of MCI are reviewed, the diagnosis and prognostication ofMCI, and presently available management approaches for this condition are reviewed.

Practical recommendations for timely, accurate diagnosis of symptomatic Alzheimer’s disease (MCI and dementia) in primary care: a review and synthesis

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Mild cognitive impairment as a diagnostic entity

  • R. Petersen
  • Psychology, Medicine
    Journal of internal medicine
  • 2004
It is suggested that the diagnosis of mild cognitive impairment can be made in a fashion similar to the clinical diagnoses of dementia and AD, and an algorithm is presented to assist the clinician in identifying subjects and subclassifying them into the various types of MCI.

Treatment of cardiovascular risk factors to prevent cognitive decline and dementia: a systematic review

The evidence of a preventive treatment effect aimed at vascular risk factors on cognitive decline and dementia in later life is scarce and mostly based on secondary outcome parameters.

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Preliminary evidence suggests that good-quality RCTs evaluating the effects of any intervention for MCI should include trials of psychological group interventions and piribedil, and there was no replicated evidence that any intervention was effective.

Vitamin E and donepezil for the treatment of mild cognitive impairment.

Vitamin E had no benefit in patients with mild cognitive impairment and donepezil therapy was associated with a lower rate of progression to Alzheimer's disease during the first 12 months of treatment, a finding supported by the secondary outcome measures.

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The current research on the list of putative risk or protective factors is largely inadequate to confidently assess their association with AD or cognitive decline, and further research that addresses the limitations of existing studies is needed to be able to make recommendations on interventions.

Effect of raloxifene on prevention of dementia and cognitive impairment in older women: the Multiple Outcomes of Raloxifene Evaluation (MORE) randomized trial.

Raloxifene at a dose of 120 mg/day, but not 60 mg/days, resulted in reduced risk of cognitive impairment in postmenopausal women.

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Judicious treatment of hypertension, taking into account goals of care and individual characteristics (eg, age and comorbidities), seems justified to safeguard vascular health and, as a consequence, brain health.

Metformin in Amnestic Mild Cognitive Impairment: Results of a Pilot Randomized Placebo Controlled Clinical Trial.

A larger trial seems warranted to evaluate the efficacy and cognitive safety of metformin in prodromal AD, and changes in total recall of the Selective Reminding Test and the score of the Alzheimer's Disease Assessment Scale-cognitive subscale were not significant.