Treatment of memory diseases – Related resources

Cochrane reviews

• Hormone replacement therapy appears not to be effective in maintaining cognitive function in women with Alzheimer´s disease . CDP-choline (cytidine 5'-diphosphocholine) appears to have a positive effect on memory and behaviour, at least in the short to medium term, in the treatment of chronic cerebral disorders in the elderly .
• Cognitive stimulation may benefit cognition in people with mild to moderate dementia over any medication effects .
• Folic acid, with or without vitamin B12, may not exert any beneficial effect on cognitive function or mood of unselected healthy or cognitively impaired older people .
• Melatonin is probably not effective in managing the cognitive and non-cognitive sequelae of dementia .
• Nimodipine 90 mg/day may be of some benefit in patients with features of dementia due to Alzheimer's, cerebrovascular or a mixed disease .
• Massage and touch seem to be beneficial for people with dementia but the evidence is insufficient for general conclusions .
• There is insufficient evidence of the effectiveness of physical activity programs on older persons with dementia .
• Piracetam may have some effect in the treatment of dementia or cognitive impairment but the evidence is inconclusive .
• Evidence on the efficacy of respite care for people with dementia or for their caregivers is insufficient .
• There is no evidence on the effectiveness of snoezelen (multi-sensory stimulation) for dementia . Trazodone is probably not effective as a treatment for behavioural and psychological manifestations of dementia.
• Valproate seems to have no effect in treating agitation among demented patients but seems to increase adverse effects. However, the evidence is insufficient .
• There is no evidence to support the use of thioridazine in dementia, and its use seems to expose patients to excess side effects .
• Exercise programs may have an impact in improving ability to perform activities of daily living and probably in improving cognition in people with dementia .
• Psychological treatments based on a psychological model may benefit people with dementia by reducing depressive symptoms .
• Melatonin is probably not beneficial but trazodone may improve sleep in sleep problems associated with Alzheimer's disease. There is no evidence available of other drugs used for sleep problems .
• Efficacy of cholinesterase inhibitors (ChI’s) on cognitive function and activities of daily living in people with rarer dementias is probably unclear. ChI’s may be associated with more gastrointestinal side effects compared with placebo .

Other evidence summaries

• Various behavioural treatments may have some effect for behavioural disorders in dementia . Olanzapine appears to be effective for psychological and behavioural symptoms in patients with dementia, but it appears to increase sedation and gait disturbances .

Clinical guidelines

• Management of patients with dementia. Scottish Intercollegiate Guidelines Network (SIGN). Guideline No. 86

Literature

Clinical practice reviews

• Ballard C, Gauthier S, Corbett A et al. Alzheimer's disease. Lancet 2011;377(9770):1019-31.

Other literature

• Dowling GA, Burr RL, Van Someren EJ, Hubbard EM, Luxenberg JS, Mastick J, Cooper BA. Melatonin and bright-light treatment for rest-activity disruption in institutionalized patients with Alzheimer's disease. J Am Geriatr Soc 2008 Feb;56(2):239-46.