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Questionable Efficacy of Drugs to Delay Dementia

pillsAlthough prevention or at least early intervention is normally considered the best method to ward off or lessen the effects of a disorder, the issue becomes murky when the condition is dementia.

Researchers from Italy have examined the evidence in favor of giving people considered to be close to developing dementia the drugs that are most commonly used to treat the condition itself.

They have concluded that these drugs (cholinesterase inhibitors) do not seem to delay the appearance of Alzheimer disease or other forms of dementia.

Three cholinesterase inhibitors – donepezil, rivastigmine and galantamine – are currently approved for use in mild-to-moderate Alzheimer disease.

Some experts are not convinced that they are effective, but other experts and patient support groups have called for the drugs to be given to people with “mild cognitive impairment (MCI)” – the term that is used to describe the condition where people have memory problems that are more severe than those normally seen in others of their age, but otherwise have no symptoms of dementia.

It is believed that people with MCI are at high risk of developing Alzheimer disease.

Dr Raschetti and colleagues at Italy’s National Centre for Epidemiology, Surveillance and Health Promotion in Rome conducted a systematic review of the data from clinical trials that had addressed the use of cholinesterase inhibitors with MCI patients. In none of the six trials that they examined did the use of the drugs significantly reduce the rate of progression from MCI to dementia.

One problem that came to light during their review was that there is no generally accepted precise definition for MCI. There was therefore some variation between the trials in the mental state of the people given the drugs.

Dr Raschetti and his team have called for more clinical trials to be done, but using a single agreed definition of mild cognitive impairment. Until such trials have found a benefit from using cholinesterase inhibitors in this way, there seems to be no justification for doctors to do so in clinical practice.

Source: Public Library of Science

Questionable Efficacy of Drugs to Delay Dementia

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2018). Questionable Efficacy of Drugs to Delay Dementia. Psych Central. Retrieved on February 19, 2019, from
Scientifically Reviewed
Last updated: 8 Aug 2018
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
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