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Dementia Practice Guidelines

There are many practice guidelines for the management of dementia, but all of them approach the problem in the same way. Guideline documents from organizations such as the American Academy of Neurology and the American Geriatrics Society focus treatment on four main areas: drug therapy to help a patient's cognitive abilities, drug therapy to manage behavioral disturbances resulting from dementia, educational programming or information for caregivers, and training for the patient to help improve functional performance.

  1. Helping a Patient's Cognitive Abilities

    • Dementia practice guidelines recommend vitamin E and drugs called cholinesterase inhibitors to help reduce confusion and improve memory, thought and reasoning. Cholinesterase inhibitors help increase the level and duration of certain transmitters in the brain. Some research studies also support the use of seligiline to help a patient's cognitive function. Seligiline helps prevent the breakdown of other kinds of transmitters in the brain. Research has shown that drug treatment of patients who are in the mild to moderate stages of dementia can help improve brain function, and in many cases, keep symptoms of dementia from getting worse.

    Managing Behavioral Disturbances

    • Guidelines also suggest that doctors prescribe antidepressants or antipsychotic drugs to help manage behavioral problems resulting from dementia in patients, such as hostility, paranoia, combativeness, agitation or depression. Most guidelines also discuss the impact that behavioral changes can have on both the patient and family or caregivers, underscoring the importance of appropriate management of these problems.

    Education and Support for Family and Caregivers

    • Research studies presented by the American Academy of Neurology show that caregiver support groups and short-term educational programs make some difference in how caregivers manage the stressful burden of helping a family member or someone in their care with dementia. However, these sorts of programs do not affect the progression of the patient's disease or the ultimate outcome. One particular study showed that intensive educational programming only delayed the time that it took a caregiver to place a patient in a specialized nursing home.

    Training to Improve Performance of Daily Functions

    • Another component of all professional guidelines for treatment of dementia is special training or interventions to help dementia patients improve their ability to function in daily life. Scheduled toileting, for example, can help reduce the risk of incontinence and the embarrassment and feelings of failure it can cause. Skills practices that focus on activities of daily living, along with positive reinforcement, can help improve a patient's ability to perform everyday functions and increase a feeling of independence.

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