Topic: Dementia Subject: Medicine An 85 year old white male is brought to you for the first time by his son. The father has recently seen a neurologist who performed a workup for dementia and diagnosed moderate Alzheimers disease. Which one of the following is true regarding the use of a cholinesterase inhibitor in this patient?
A. It is too late to initiate cholinesterase therapy
B. Agitation is often intensified by these agents
C. Memory is likely to improve significantly
D. Nursing-home placement may be delayed a year or longer
Correct Answer : D.
Medications for dementia should be prescribed with caution, and the patient watched closely for side effects. Currently available cholinesterase inhibitors are at least as effective for vascular dementia as they are for Alzheimers dementia, although they are not approved for this use by the FDA. These agents include donepezil, rivastigmine, and galantamine, and they are often helpful in Alzheimers disease patients with agitation. Anticholinesterase therapy is considered the standard of care for Alzheimers disease, and therapy can begin at any stage in the disease process, although early therapy is the most beneficial. While the medication will not restore memory, it does prevent the rapid loss of more memory. Long-term studies on effectiveness are still in progress, but most evidence at present indicates that nursing-home placement can be delayed by a year and possibly longer.