[Management of Alzheimer disease].
Management of Alzheimer disease is based on drug and nondrug treatments. Specific drug treatment includes acetylcholinesterase inhibitors and memantine. They show moderate efficacy superior to that of placebo for global condition, cognitive disorders, need for care, and behavioral problems, but do not prevent further decline. These treatments remain underused. The efficacy of psychotropic drugs (antidepressants, neuroleptics, and antipsychotic agents) in treating behavioral problems is not well documented. Nondrug activities and interventions have not been sufficiently evaluated scientifically. These involve interventions against the consequences of the disease (loss of autonomy, malnutrition) and helping patients' family caregivers. Among these activities, the best evaluated and most interesting are: educational programs for caregivers, occupational therapy at home, and interventions at home by nurses specially trained as case managers.
Belmin
Joël
J
Service de gériatrie et consultation mémoire, Hôpital Charles Foix et Université Paris VI, Ivry-sur-Seine (94). joel.belmin@cfx.aphp.fr
Péquignot
Renaud
R
Konrat
Cécile
C
Pariel-Madjlessi
Sylvie
S
D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000188:drug therapy / Q000451:nursing / Q000628:therapy*; D000818:Animals; D014150:Antipsychotic Agents / Q000627:therapeutic use; D017028:Caregivers / Q000193:education; D019090:Case Management; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D004195:Disease Models, Animal; D000077265:Donepezil; D015259:Dopamine Agents / Q000627:therapeutic use; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use; D005500:Follow-Up Studies; D005544:Forecasting; D006266:Health Education; D006801:Humans; D007189:Indans / Q000627:therapeutic use; D008559:Memantine / Q000627:therapeutic use; D001523:Mental Disorders / Q000188:drug therapy; D015201:Meta-Analysis as Topic; D018697:Nootropic Agents / Q000627:therapeutic use; D009788:Occupational Therapy; D010880:Piperidines / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011619:Psychotropic Drugs / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors
D014150:Antipsychotic Agents; D002800:Cholinesterase Inhibitors; D015259:Dopamine Agents; D018691:Excitatory Amino Acid Antagonists; D007189:Indans; D018697:Nootropic Agents; D010880:Piperidines; D011619:Psychotropic Drugs; D000077265:Donepezil; D008559:Memantine