Cognitive decline

The compounds used to palliate the mnemonic and cognitive decline associated with dementia include cerebral vasodilators and the so-called nootropic agents. These materials enhance cerebral metaboHsm. Agents which enhance neurotransmitter function are in most cases cholinergic. 

O Alzheimer s disease is characterized by progressive cognitive decline including memory loss, disorientation, and impaired judgment and learning. 

AD is a progressive disease, which over time affects multiple areas of cognition. The symptoms of AD can be divided into cognitive symptoms, non-cognitive symptoms (i.e., behavioral), and functional symptoms for assessment and treatment purposes. Table 32-4 describes the stages of cognitive decline.25,26... 

C. The course is characterized by gradual onset and continuing cognitive decline. 

Stage 3 Mild cognitive decline Friends, family, and coworkers begin to notice deficiencies problems with names or words become evident performance issues become evident retention of reading material declines losing valuable objects decline in planning and organizational abilities. 

Stage 4 Moderate cognitive decline (mild or early-stage AD) Medical interview detects clear-cut deficiencies decreased knowledge of current events impaired ability to perform difficult mathematical problems (e.g., serial 7 s) decreased ability to perform complex tasks (managing finances) decreased recall of personal history individuals may become withdrawn and subdued. 

Stage 5 Moderately severe cognitive decline (moderate AD) Major gaps in memory appear and assistance with day-to-day activities is necessary inability to recall details such as current address and telephone number may begin difficulty with orientation to place and time less challenging mathematical problems may become difficult (e.g., serial 4 s or 2 s) can still recall their own name and those of spouse and children. 

LB has seen a neurologist to address her cognitive decline and behavioral issues and is at the clinic for follow-up after obtaining her assessments and labs. 

Riedel, W. and Jolles, J., Cognition enhancers in age related cognitive decline. Drugs Aging, 8(4), 245-474, 1996. 

Nootropics Slow cognitive decline in dementia Aricept, tacrine... 

Cenacchi B, Bertoldin T, Farina C, Fiori MG and Crepaldi G (1993). Cognitive decline in the elderly A double blind, placebo-controlled multicenter study on efficacy of phosphati-dylserine administration. Aging, Clinical and Experimental Research, 5, 123-133. 

Lyketsos CG, Garrett E, Liang KY and Anthony M (1999). Cannabis use and cognitive decline in persons under 65 years of age. American Journal of Epidemiology, 149, 794—800. 

Kang J, Asherio A and Grodstein F. 2005. Fruit and vegetable consumption and cognitive decline in aging women. Am Neurol 2005 713—720. 

Letenneur L, Proust-Lima C, Le Gouge A, Dartigues JF and Barberger-Gateau P. 2007. Flavonoid intake and cognitive decline over a 10-year period. Am J Epidemiol 165(12) 1364—1371. 

Alzheimer s disease is the most common form of age-related dementia and one of the most serious health problems in the industrialized world. AD is an insidious and progressive neurodegenerative disorder that accounts for the vast majority of dementia and is characterized by global cognitive decline and the accumulation of P-amyloid deposits and neurofibrillary tangles in the brain. Family history is the second greatest risk factor for... 

Hock, C., Konietzko, U., Streffer, J. R. et al. Antibodies against (3-amyloid slow cognitive decline in Alzheimer s disease. Neuron 38 547-554,2003. 

The onset of AD is almost imperceptible, but deficits progress over time. Cognitive decline is gradual, and behavioral disturbances may be present in moderate stages. Table 67-1 shows the stages of AD. 

The patient may have vague memory complaints initially, or the patient s significant other may report that the patient is "forgetful," Cognitive decline is gradual over the course of illness. Behavioral disturbances may be present in moderate stages. Loss of daily function is common in advanced stages. 

Recent trials do not support the use of estrogen to prevent or treat cognitive decline. 

Reducing benzodiazepine use in elderly patients is important for several reasons. Long-term use of benzodiazepines can accelerate cognitive decline in elderly patients (Paterniti et al. 2002). The elderly experience excessive sedation from benzodiazepines compared with younger individuals (Lechin et al. 1996). Benzodiazepine use by elderly patients are not only associated with cognitive side effects... 

McShane R, Keene J, Gedling K et al. (1997) Do neuroleptic drugs hasten cognitive decline in dementia Prospective study with necropsy follow up. BMJ 314(7076) 266-270 Mortimer AM, Shepherd CJ, Rymer M et al. (2005) Primary care use of antipsychotic drugs an audit and intervention study. Ann Gen Psychiatry 4 18 DOI 10.1186/1744-859X-4-18 Mulsant BH, Pollock BG, Kirshner M et al. (2003) Serum anticholinergic activity in a community-based sample of older adults relationship with cognitive performance. Arch Gen Psychiatry 60(2) 198-203... 

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