Current therapeutic strategies in Alzheimer's dementia

Current treatment options in Alzheimer's dementia (AD) follow two strategic decision lines, first to slow down the rate of disease progression to preserve quality of life and individual independence, second to relieve cognitive impairment, as well as behavioral symptoms associated with dementia. The physicians armamentarium of nootropics has recently been extended. In mild to moderate dementia therapeutical efficacy of cholinesterase inhibitors has been demonstrated in large multicenter trials and these drugs are currently recommended for AD patients. As AD progresses behavioral and psychological symptoms of dementia (BPSD) become increasingly prominent and require therapeutic interventions. Non-tricyclic antidepressants, atypical neuroleptics and substances as carbamazepine and buspirone are useful for the treatment of BPSD and may even be superior to commonly used benzodiazepines and classical antipsychotics, in addition, non-pharmacological approaches such as psychotherapy and psychosocial support can also essentially contribute to the treatment of AD. It is the physician who decides from the repertoire of therapeutic options to create an individual treatment concept that optimally addresses patients and caregivers problems and needs.