Guidelines for the treatment of Alzheimer's disease from the Italian Association of Psychogeriatrics.
A committee of experts from the Italian Association of Psychogeriatrics compiled the following report, which was then approved by a Steering Committee (comprising 20 specialists in neurology, psychiatry or geriatrics) from the Association and by two Alzheimer associations representing patients and families: the Italian Association for Alzheimer's Disease and the Italian Federation for Alzheimer's Disease. The report is based on a comprehensive review of the scientific literature on the treatment of Alzheimer's disease, discusses methodological aspects of dementia management, and details the limitations of current therapies. These guidelines are, in general, consistent with the principles of evidence-based medicine; however, for some controversial or poorly investigated issues, the guidelines integrate scientific evidence with experience and opinions from experts working in the clinical setting. In particular, the clinical experience of experts has been used to define recommendations for starting and interrupting pharmacotherapy, and to critically review evidence about the efficacy of non-pharmacological interventions. The principal pharmacotherapeutic interventions covered in the guidelines are acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine, and tacrine) and memantine. The main non-pharmacological interventions reviewed are memory training, reality orientation therapy, and combined non-pharmacological interventions. Other issues covered are opportunities for Alzheimer's disease prevention, various modalities of care, and the treatment of comorbidities.
Caltagirone
Carlo
C
Fondazione IRCCS, Santa Lucia, Università Tor Vergata, Rome, Italy. c.caltagirone@hsantalucia.it
Bianchetti
Angelo
A
Di Luca
Monica
M
Mecocci
Patrizia
P
Padovani
Alessandro
A
Pirfo
Elvezio
E
Scapicchio
Pierluigi
P
Senin
Umberto
U
Trabucchi
Marco
M
Musicco
Massimo
M
D000368:Aged; D000544:Alzheimer Disease / Q000150:complications / Q000188:drug therapy* / Q000191:economics / Q000523:psychology; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003866:Depressive Disorder / Q000188:drug therapy / Q000209:etiology; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use; D006801:Humans; D007558:Italy; D008559:Memantine / Q000627:therapeutic use; D011613:Psychotherapy
D002800:Cholinesterase Inhibitors; D018691:Excitatory Amino Acid Antagonists; D008559:Memantine