Symptomatic treatment of dementias

Abstract

The advances in the diagnosis of the new types of dementia such as dementia with Lewy bodies, or the range of frontotemporal dementias, as well as the appearance of the cholinesterase inhibitors as a potentially effective treatment for the cognitive impairment in Alzheimer’s disease, have implied a substantial change in the diagnostic and therapeutical approach to dementias. Until the appearance of those treatments leading to the prevention or stabilisation of neurodegenerative disorders, the management of the patient with a dementia is at present definited by two main aspects: a) the realization of a correct differential diagnosis of the demential syndrome, and b) the establishment of the most suitable pharmacological symptomatic treatment to each patient, combining it with non-pharmacological measures. The neuropharmacological treatment for the cognoscitive impairment must be completed thoughout the whole evolutive process of the disease with the suitable pharmacological treatment of the psychological and behavioural disorders of dementia, which define the patients’ and their caretakers’ quality of life to a great extent. In this article we go through the neuropharmacological treatment of the cognitive impairment, mainly the use of cholinesterase inhibitors, and the psychopharmacological treatment of the psychological and behavioural symptoms of the main types of the dementia: Alzheimer’s disease, vascular dementia, dementia with lewy bodies and frontotemporal dementias.