Practice parameter

Management of dementia (an evidence-based review): Report of the quality standards subcommittee of the American Academy of Neurology

R. S. Doody, J. C. Stevens, C. Beck, R. M. Dubinsky, Jeffrey Kaye, L. Gwyther, R. C. Mohs, L. J. Thal, P. J. Whitehouse, S. T. DeKosky, J. L. Cummings

Research output: Contribution to journalArticle

712 Citations (Scopus)

Abstract

Objective: To define and investigate key issues in the management of dementia and to make literature-based treatment recommendations. Methods: The authors searched the literature for four clinical questions: 1) Does pharmacotherapy for cognitive symptoms improve outcomes in patients with dementia? 2) Does pharmacotherapy for noncognitive symptoms improve outcomes in patients with dementia? 3) Do educational interventions improve outcomes in patients and/or caregivers? 4) Do other nonpharmacologic interventions improve outcomes in patients and/or caregivers? Results: Cholinesterase inhibitors benefit patients with AD (Standard), although the average benefit appears small; vitamin E likely delays the time to clinical worsening (Guideline); selegiline, other antioxidants, anti-inflammatories, and estrogen require further study. Antipsychotics are effective for agitation or psychosis in patients with dementia where environmental manipulation fails (Standard); and antidepressants are effective in depressed patients with dementia (Guideline). Educational programs should be offered to family caregivers to improve caregiver satisfaction and to delay the time to nursing home placement (Guideline). Staff of long-term care facilities should also be educated about AD to minimize the unnecessary use of antipsychotic medications (Guideline). Behavior modification, scheduled toileting, and prompted voiding reduce urinary incontinence (Standard). Functional independence can be increased by graded assistance, skills practice, and positive reinforcement (Guideline).

Original languageEnglish (US)
Pages (from-to)1154-1166
Number of pages13
JournalNeurology
Volume56
Issue number9
StatePublished - May 8 2001

Fingerprint

Practice Management
Dementia
Caregivers
Guidelines
Antipsychotic Agents
Selegiline
Drug Therapy
Neurobehavioral Manifestations
Behavior Therapy
Cholinesterase Inhibitors
Urinary Incontinence
Long-Term Care
Nursing Homes
Vitamin E
Psychotic Disorders
Antidepressive Agents
Estrogens
Anti-Inflammatory Agents
Antioxidants

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Doody, R. S., Stevens, J. C., Beck, C., Dubinsky, R. M., Kaye, J., Gwyther, L., ... Cummings, J. L. (2001). Practice parameter: Management of dementia (an evidence-based review): Report of the quality standards subcommittee of the American Academy of Neurology. Neurology, 56(9), 1154-1166.

Practice parameter : Management of dementia (an evidence-based review): Report of the quality standards subcommittee of the American Academy of Neurology. / Doody, R. S.; Stevens, J. C.; Beck, C.; Dubinsky, R. M.; Kaye, Jeffrey; Gwyther, L.; Mohs, R. C.; Thal, L. J.; Whitehouse, P. J.; DeKosky, S. T.; Cummings, J. L.

In: Neurology, Vol. 56, No. 9, 08.05.2001, p. 1154-1166.

Research output: Contribution to journalArticle

Doody, RS, Stevens, JC, Beck, C, Dubinsky, RM, Kaye, J, Gwyther, L, Mohs, RC, Thal, LJ, Whitehouse, PJ, DeKosky, ST & Cummings, JL 2001, 'Practice parameter: Management of dementia (an evidence-based review): Report of the quality standards subcommittee of the American Academy of Neurology', Neurology, vol. 56, no. 9, pp. 1154-1166.
Doody, R. S. ; Stevens, J. C. ; Beck, C. ; Dubinsky, R. M. ; Kaye, Jeffrey ; Gwyther, L. ; Mohs, R. C. ; Thal, L. J. ; Whitehouse, P. J. ; DeKosky, S. T. ; Cummings, J. L. / Practice parameter : Management of dementia (an evidence-based review): Report of the quality standards subcommittee of the American Academy of Neurology. In: Neurology. 2001 ; Vol. 56, No. 9. pp. 1154-1166.
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