Conference paper
DRUGS IN ALZHEIMER’S DISEASE DEMENTIA: AN OVERVIEW OF CURRENT PHARMACOLOGICAL MANAGEMENT AND FUTURE DIRECTIONS
Saigeet Eleti
; Emmanuel College, University of Cambridge, Cambridge, UK
Abstract
Background: Alzheimer’s dementia is one of the most significant health burdens of the modern age in both industrialised and
non-industrialised nations as it is a major cause of morbidity and functional impairment in the elderly. Currently there are no cures
for progressive dementias, including Alzheimer’s disease, and no treatments that would modify their progress. Intervention involves
pharmacological treatment to temporarily relieve the symptoms, including three cholinesterase inhibitors and a noncompetitive
NMDA antagonist, and the efficacy of these is widely debated. While our understanding of the underlying pathology of Alzheimer’s
continues to grow, we have yet to fully elucidate the mechanisms that drive neuronal loss in this condition. Any truly diseasemodifying
treatment must be developed to target these pathological pathways.
Methods: An extensive analysis of the available literature is presented here, including a number of trials, meta-analyses and
reviews, with the aim of assessing current management, establishing best practice and summarising the future of dementia care.
Results: The efficacy of acetylcholinesterase inhibitors remains controversial due to uncertainty over what change is considered
clinically significant. Any derived benefit seems to be independent of dementia severity and donepezil is the most cost-effective for
Alzheimer’s dementia. Memantine potentially influences the underlying pathological processes in Alzheimer’s disease and may be
more effective in moderate to severe Alzheimer’s dementia. The role of combination therapy remains uncertain. Future therapies are
aimed at modulating the disease process by using chemical agents to inhibit amyloid and tau deposition. None have been approved
clinically.
Conclusions: Current pharmacological therapy for Alzheimer’s dementia is very limited and primarily aims at achieving
symptom control. A major limitation is our lack of knowledge of the underlying pathology and it is only by better understanding the
disease process that we can optimize therapeutic agents that modify disease progression.
Keywords
Alzheimer’s dementia; pharmacological treatment; future directions
Hrčak ID:
264917
URI
Publication date:
30.8.2016.
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