This study suggests that while significant depressive symptoms are strongly associated with increased cognitive complaints, they are not associated necessarily with objective cognitive impairment.
Background:Delusions are clinically important symptoms in dementia with Lewy bodies (DLB). The purpose of this review is to examine the level of evidence for treatment of delusions in DLB. Methods:To achieve this objective Medline was searched. Studies were included in the review if they were prospective, separated delusions from hallucinations and were tested in patients with DLB. Results:The review yielded a total of six studies. Although all studies showed effectiveness, only one study using rivastigmine had an adequate patient sample size and used a randomized controlled design. Conclusion:Further studies are required before a definitive conclusion can be reached about effective treatments.
Delusions are commonly encountered symptoms in patients with Alzheimer’s disease and may lead to significant morbidity. The purpose of this article is to review all clinical trials to date focusing on the management of delusions in patients with Alzheimer’s disease to determine the level of evidence for treatment. To achieve this objective, Medline was searched using the key words delusions, dementia, Alzheimer’s disease and psychosis. Three main categories of treatment were identified: atypical antipsychotics, cholinesterase inhibitors, and other miscellaneous treatments. It was concluded that all forms of treatment were effective although the greatest burden of evidence existed for risperidone and donepezil. Side effects were noted in all forms of treatment and included somnolence and extrapyramidal effects for antipsychotic medications, whereas gastrointestinal effects were more prevalent in studies involving cholinesterase inhibitors. Further large scale, double-blind, randomized, controlled studies are required before a definitive conclusion can be reached. To our knowledge this is the only systematic review of this area.
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