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Review: pharmacological and non-pharmacological interventions improve outcomes in patients with dementia and for their caregivers

Data sources
Studies were identified by searching Medline, EMBASE/Excerpta Medica, CINAHL, Current Contents, Psychological Abstracts, PsycINFO, and the Cochrane databases with terms that include Alzheimer's disease (AD), vascular or multi-infarct dementia, dementia with associated parkinsonian disorder, progressive supranuclear palsy, frontotemporal dementia, and senile dementia. Additional terms used were question specific. Bibliographies of relevant papers were also reviewed.

Study selection
Studies were selected if they were randomised controlled trials published in any language or other types of studies published in English with > 20 participants.

Data extraction
Data were extracted on study quality, participant characteristics, interventions, outcome measures, and results.

Main results
380 articles met the selection criteria. Several studies comparing cholinesterase inhibitors (eg, tacrine, donepezil, tartrate, and galantamine) with placebo showed that these drugs were more effective than placebo for improving cognitive outcomes in a subgroup of patients with mild-to-moderate AD. Studies of cholinergic precursors (eg, lecithin) and muscarinic agonists (eg, xanomeline) for the treatment of AD . . . [Full text of this article]

A Mark Clarfield, MD

Soroka Hospital Centre and Ben Gurion University of the Negev Beersheva, Israel