Treatment of Alzheimer's disease in Brazil: I. Cognitive disorders

Abstract This article reports the recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology for the treatment of Alzheimer's disease (AD) in Brazil, with special focus on cognitive disorders. It constitutes a revision and broadening of the 2005 guidelines based on a consensus involving researchers (physicians and non-physicians) in the field. The authors carried out a search of articles published since 2005 on the MEDLINE, LILACS and Cochrane Library databases. The search criteria were pharmacological and non-pharmacological treatment of cognitive disorders in AD. Studies retrieved were categorized into four classes, and evidence into four levels, based on the 2008 recommendations of the American Academy of Neurology. The recommendations on therapy are pertinent to the dementia phase of AD. Recommendations are proposed for the treatment of cognitive disorders encompassing both pharmacological (including acetyl-cholinesterase inhibitors, memantine and other drugs and substances) and non-pharmacological (including cognitive rehabilitation, physical activity, occupational therapy, and music therapy) approaches. Recommendations for the treatment of behavioral and psychological symptoms of dementia due to Alzheimer's disease are included in a separate article of this edition.

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Treatment of Alzheimer's disease in Brazil: II. Behavioral and psychological symptoms of dementia

Dementia & Neuropsychologia ◽

10.1590/s1980-57642011dn05030006 ◽

2011 ◽

Vol 5 (3) ◽

pp. 189-197

Author(s):

Francisco de Assis Carvalho do Vale ◽

Ylmar Corrêa Neto ◽

Paulo Henrique Ferreira Bertolucci ◽

João Carlos Barbosa Machado ◽

Delson José da Silva ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Psychological Symptoms ◽

Cognitive Disorders ◽

Cochrane Library ◽

Special Focus ◽

Acetyl Cholinesterase ◽

Four Levels ◽

American Academy Of Neurology ◽

Behavioral And Psychological Symptoms

Abstract This article reports the recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology for the treatment of Alzheimer's disease (AD) in Brazil, with special focus on behavioral and psychological symptoms of dementia (BPSD). It constitutes a revision and broadening of the 2005 guidelines based on a consensus involving researchers (physicians and non-physicians) in the field. The authors carried out a search of articles published since 2005 on the MEDLINE, LILACS and Cochrane Library databases. The search criteria were pharmacological and non-pharmacological treatment of the behavioral and psychological symptoms of AD. Studies retrieved were categorized into four classes, and evidence into four levels, based on the 2008 recommendations of the American Academy of Neurology. The recommendations on therapy are pertinent to the dementia phase of AD. Recommendations are proposed for the treatment of BPSD encompassing both pharmacological (including acetyl-cholinesterase inhibitors, memantine, neuroleptics, anti-depressives, benzodiazepines, anti-convulsants plus other drugs and substances) and non-pharmacological (including education-based interventions, physiotherapy, occupational therapy, music therapy, therapy using light, massage and art therapy) approaches. Recommendations for the treatment of cognitive disorders of AD symptoms are included in a separate article of this edition.

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The Association between 5HT2A T102C and Behavioral and Psychological Symptoms of Dementia in Alzheimer’s Disease: A Meta-Analysis

BioMed Research International ◽

10.1155/2017/5320135 ◽

2017 ◽

Vol 2017 ◽

pp. 1-14 ◽

Cited By ~ 3

Author(s):

Liang Tang ◽

Yan Wang ◽

Yiwei Chen ◽

Lianghui Chen ◽

Shui Zheng ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Serotonin Receptor ◽

Motor Behavior ◽

Psychological Symptoms ◽

Meta Analysis ◽

Receptor Gene ◽

Cochrane Library ◽

The Cochrane Library ◽

Behavioral And Psychological Symptoms

The serotonin receptor gene (5-HT2A) has been reported to be a susceptible factor in behavioral and psychological symptoms of dementia (BPSD) in Alzheimer’s disease (AD). However, previous results were conflicting. We aim to investigate the association of 5-HT2A T102C with BPSD in AD using a meta-analysis. Studies were collected using PubMed, Web of Science, the Cochrane Library databases, Chinese National Knowledge Infrastructure (CNKI), and Embase. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess associations. Nine studies with 1899 AD patients with/without BPSD were included in this meta-analysis. The 102C and CC genotypes were associated with psychosis in AD (102C: p<0.00001, OR [95% CI] = 3.19 [2.12–4.79]; CC: p<0.00001, OR [95% CI] = 7.24 [3.60–14.59]). The TT genotype was significantly associated with hallucinations, aberrant motor behavior, and psychosis in AD (hallucinations: p=0.001, OR [95% CI] = 0.52 [0.36–0.77]; aberrant motor behavior: p=0.03, OR [95% CI] = 0.58 [0.35–0.95]; and psychosis: p=0.002, OR [95% CI] = 0.34 [0.17–0.67]). No association was observed between T102C alleles or genotypes and delusions, agitation/aggression, depression, and apathy (p>0.05). Thus, the 5HT2A T102C might be a susceptible factor for hallucinations, aberrant motor behavior, and psychosis in AD. The potential mechanism of this polymorphism in BPSD in AD requires further exploration.

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An overview of repetitive transcranial magnetic stimulation (rTMS) in Alzheimer’s disease

Salud Mental ◽

10.17711/sm.0185-3325.2017.022 ◽

2017 ◽

Vol 40 (4) ◽

pp. 171-178 ◽

Cited By ~ 1

Author(s):

Ruth Alcalá Lozano ◽

◽

Erik Daniel Morelos Santana ◽

Orely Osorio Rojas ◽

Jorge Julio González

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Transcranial Magnetic Stimulation ◽

Cognitive Rehabilitation ◽

Magnetic Stimulation ◽

Psychological Symptoms ◽

Repetitive Transcranial Magnetic Stimulation ◽

Cognitive Domains ◽

Dorsolateral Prefrontal ◽

Behavioral And Psychological Symptoms

Background. Alzheimer’s disease (AD) is the most frequent neurocognitive disorder. It affects 50% to 75% of the cases of dementia, and is characterized by a progressive cognitive decline that hinders behavior and functionality. Its etiology is still uncertain, and the efficiency of treatments is limited. Repetitive transcranial magnetic stimulation (rTMS) has been used as an alternative therapeutic strategy, but the clinical impact on Alzheimer’s disease has hardly been studied. Objective. To describe the effects of rTMS on cognition, the behavioral and psychological symptoms of dementia (BPSD), and functionality, considering the various modes of application. Method. The PubMed, ScienceDirect, and PsycInfo databases were consulted using key words relating to the topic of study. Articles published between 2006 and 2016 were selected. Results. The studies that have assessed the clinical effect of rTMS have used various parameters to stimulate and compare the different cortical areas, principally the dorsolateral prefrontal cortex. A variety of benefits have been proposed for patients with Alzheimer’s disease in cognitive domains such as language and episodic memory, as well as behavior and functionality in everyday activities. Discussion and conclusion. rTMS has been suggested as a possible treatment for AD, and the results indicate the need for further studies with different methodological designs and more participants, in addition to cognitive rehabilitation techniques. The objective is to identify the most efficient parameters for stimulation and to explore new cortical targets.

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