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Titolo:
Practice parameter: Management of dementia (an evidence-based review) - Report of the Quality Standards Subcommittee of the American Academy of Neurology
Autore:
Doody, RS; Stevens, JC; Beck, C; Dubinsky, RM; Kaye, JA; Gwyther, L; Mohs, RC; Thal, LJ; Whitehouse, PJ; DeKosky, ST; Cummings, JL;
Indirizzi:
Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA Baylor Coll Med Houston TX USA 77030 , Dept Neurol, Houston, TX 77030 USA Lutheran Med Off, Ft Wayne, IN USA Lutheran Med Off Ft Wayne IN USALutheran Med Off, Ft Wayne, IN USA Univ Arkansas Med Sci, Coll Med, Dept Geriatr, Little Rock, AR 72205 USA Univ Arkansas Med Sci Little Rock AR USA 72205 Little Rock, AR 72205 USA Univ Kansas, Med Ctr, Dept Neurol, Kansas City, KS 66103 USA Univ Kansas Kansas City KS USA 66103 pt Neurol, Kansas City, KS 66103 USA Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97201 USA Oregon Hlth Sci Univ Portland OR USA 97201 Neurol, Portland, OR 97201 USA Vet Affairs Med Ctr, Portland, OR USA Vet Affairs Med Ctr Portland OR USA et Affairs Med Ctr, Portland, OR USA Duke Univ, Durham, NC 27706 USA Duke Univ Durham NC USA 27706Duke Univ, Durham, NC 27706 USA Mt Sinai Sch Med, Bronx, NY USA Mt Sinai Sch Med Bronx NY USAMt Sinai Sch Med, Bronx, NY USA VA Med Ctr, Bronx, NY USA VA Med Ctr Bronx NY USAVA Med Ctr, Bronx, NY USA Univ Calif San Diego, Dept Neurosci, San Diego, CA 92103 USA Univ Calif San Diego San Diego CA USA 92103 osci, San Diego, CA 92103 USA Case Western Reserve Univ, Dept Neurol, Cleveland, OH 44106 USA Case Western Reserve Univ Cleveland OH USA 44106 Cleveland, OH 44106 USA Univ Hosp Cleveland, Cleveland, OH 44106 USA Univ Hosp Cleveland Cleveland OH USA 44106 eland, Cleveland, OH 44106 USA Univ Pittsburgh, Dept Neurol, Pittsburgh, PA 15260 USA Univ Pittsburgh Pittsburgh PA USA 15260 Neurol, Pittsburgh, PA 15260 USA Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA 15260 USA Univ Pittsburgh Pittsburgh PA USA 15260 sychiat, Pittsburgh, PA 15260 USA Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA Univ Calif Los Angeles Los Angeles CA USA 90024 Los Angeles, CA 90024 USA Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA Univ Calif Los Angeles Los Angeles CA USA 90024 Los Angeles, CA 90024 USA
Titolo Testata:
NEUROLOGY
fascicolo: 9, volume: 56, anno: 2001,
pagine: 1154 - 1166
SICI:
0028-3878(20010508)56:9<1154:PPMOD(>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
PLACEBO-CONTROLLED TRIAL; RANDOMIZED CONTROLLED TRIAL; NURSING-HOME RESIDENTS; ALZHEIMERS-DISEASE PATIENTS; ACETYL-L-CARNITINE; CONTROLLED-RELEASE PHYSOSTIGMINE; PRIMARY DEGENERATIVE DEMENTIA; INTERNATIONAL DOUBLE-BLIND; SUPPORT GROUP PROGRAM; SPECIAL CARE UNITS;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
175
Recensione:
Indirizzi per estratti:
Indirizzo: Doody, RS Amer Acad Neurol, Qual Stand Subcomm, 1080 Montreal Ave, St Paul, MN 55116USA Amer Acad Neurol 1080 Montreal Ave St Paul MN USA 55116 55116USA
Citazione:
R.S. Doody et al., "Practice parameter: Management of dementia (an evidence-based review) - Report of the Quality Standards Subcommittee of the American Academy of Neurology", NEUROLOGY, 56(9), 2001, pp. 1154-1166

Abstract

Objective: To define and investigate key issues in the management of dementia and to make literature-based treatment recommendations. Methods: The authors searched the literature for four clinical questions: 1) Does pharmacotherapy for cognitive symptoms improve outcomes in patients with dementia? 2) Does pharmacotherapy for noncognitive symptoms improve outcomes in patients with dementia? 3) Do educational interventions improve outcomes in patients and/or caregivers? 4) Do other nonpharmacologic interventions improve outcomes in patients and/or caregivers? Results: Cholinesterase inhibitors benefit patients with AD (Standard!, although the average benefit appears small; vitamin E likely delays the time to clinical worsening (Guideline!; selegiline, other antioxidants, anti-inflammatories, and estrogen require further study. Antipsychotics are effective for agitation or psychosis in patients with dementia where environmental manipulation fails (Standard), and antidepressants are effective in depressed patients with dementia (Guideline). Educational programs should be offered to family caregivers to improve caregiver satisfaction and to delay the time to nursing home placement (Guideline). Staff of long-term care facilities should also be educated about AD to minimize the unnecessary use of antipsychotic medications (Guideline). Behavior modification, scheduled toileting, and prompted voiding reduce urinary incontinence (Standard). Functional independence can be increased by graded assistance, skills practice, and positive reinforcement (Guideline).

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Documento generato il 29/09/20 alle ore 20:26:29