Objective: To review the key nonpharmacological treatment approaches to the cognitive and functional symptoms of Alzheimer disease (AD). Methods:We searched and critically analyzed the most recent relevant literature pertaining to the nonpharmacological treatment of AD.

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The potential for older people to develop cognitive impairment as a consequence of major surgery with anaesthesia has been increasingly recognized over the last 10 years. This article reviews the evidence regarding the incidence, outcome and potential mechanisms of cognitive impairment and considers the specific implications for people with dementia.

There are now an estimated 700 000 people with dementia in the UK and one in three people currently end their life with dementia. Surgical procedures involving anaesthesia for people with dementia are therefore becoming increasingly commonplace. This article discusses the potential impact of anaesthesia on the development of cognitive impairment in older people, and explains why a better understanding of the impact of anaesthetic agents in people with dementia is imperative.