Interventions for Neuropsychiatric Symptoms in Neurocognitive Impairment Due to Alzheimer's Disease: A Review of the Literature.

摘要: Neurocognitive impairment due to Alzheimer's disease (previously termed dementia) (AD) is the most common form of cognitive worldwide. Given anticipated increase in population aged 65 and over, prevalence persons with AD expected exponentially during next 30 years. Noncognitive neuropsychiatric symptoms (NPS) commonly occur are associated adverse outcomes for patients their caregivers. This review summarizes randomized, controlled trials (RCTs) published between 2004 2014 a primary outcome measure change symptom severity NPS AD. Of 388 articles initially identified through literature search, 33 met inclusion criteria. Fifteen these studies had agitation/aggression as targeted symptom. Twenty-eight evaluated pharmacologic treatments, including psychotropics, enhancers, stimulants, nutraceuticals. Nonpharmacologic interventions included bright light, music, exercise, cognitive-stimulation therapies. Among interventions, modest efficacy was reported aripiprazole, citalopram, trazodone, methylphenidate, scheduled analgesics. Significant reduction nearly all nonpharmacologic interventions. Variations methodology such criteria, study setting, measures limit generalizability results. Barriers implementation clinical settings include resource training limitations. Electroconvulsive therapy dronabinol promising emerging treatment strategies. Randomized needed order validate utility electroconvulsive dronabinol, where whom will prove valuable.