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.

The Effectiveness of Reality Orientation in the Treatment of Alzheimer’s Disease

“…Pharmacological intervention is the main form of treatment for AD, although no drug has yet been able to reverse progression of the disorder. 7 Acetylcholinesterase inhibitors (AChEIs) are recommended for the treatment of all stages of dementia in AD. 7 Most recent reviews show that, among nonpharmacological approaches, cognitive enhancement activities are useful strategies for improving cognitive function in patients with dementia.…”

Atuação do enfermeiro na saúde do idoso acometido pela doença de alzheimer

“…Na fase moderada e avançada, recomenda-se a administração da Memantina (Namenda): administrado por via oral, nas duas primeiras semanas de tratamento a dose única diária é de 5mg. Após o período, administra-se duas doses, não podendo exceder 20mg diárias 5,9 .…”

Efeitos de programas de reabilitação multidisciplinar no tratamento de pacientes com doença de Alzheimer: uma revisão sistemática

“…As intervenções não farmacológicas, por exemplo, representam um importante complemento ao tratamento, podendo reduzir ainda mais as despesas com a doença 9 . Diferentes abordagens têm sido propostas, tais como reabilitação cognitiva, terapia ocupacional, atividade física, musicoterapia, terapia artística, entre outras intervenções 10,11 . Todas essas opções visam aliviar os déficits cognitivos e as alterações de comportamento e melhorar a qualidade de vida do paciente e de sua família 12 .…”