Guidelines for the treatment of Alzheimer’s disease from the Italian Association of Psychogeriatrics

Caltagirone, Carlo; Bianchetti, Angelo; Luca, Monica Di; Mecocci, Patrizia; Padovani, Alessandro; Pirfo, Elvezio; Scapicchio, Pierluigi; Senin, Umberto; Trabucchi, Marco; Musicco, Massimo

doi:10.2165/00002512-200522001-00002

Cited by 55Dementia and Cognitive Impairment ResearchAlzheimer's disease research and treatmentsCholinesterase and Neurodegenerative Diseases

Guidelines for the treatment of Alzheimer’s disease from the Italian Association of Psychogeriatrics

Caltagirone, Carlo, Bianchetti, Angelo, Luca, Monica Di, Mecocci, Patrizia, Padovani, Alessandro, Pirfo, Elvezio, Scapicchio, Pierluigi, Senin, Umberto +2 more·2005·Drugs & Aging

DOI 10.2165/00002512-200522001-00002

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Abstract

A committee of experts from the Italian Association of Psychogeriatrics compiled the following report, which was then approved by a Steering Committee (comprising 20 specialists in neurology, psychiatry or geriatrics) from the Association and by two Alzheimer associations representing patients and families: the Italian Association for Alzheimer's Disease and the Italian Federation for Alzheimer's Disease. The report is based on a comprehensive review of the scientific literature on the treatment of Alzheimer's disease, discusses methodological aspects of dementia management, and details the limitations of current therapies. These guidelines are, in general, consistent with the principles of evidence-based medicine; however, for some controversial or poorly investigated issues, the guidelines integrate scientific evidence with experience and opinions from experts working in the clinical setting. In particular, the clinical experience of experts has been used to define recommendations for starting and interrupting pharmacotherapy, and to critically review evidence about the efficacy of non-pharmacological interventions. The principal pharmacotherapeutic interventions covered in the guidelines are acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine, and tacrine) and memantine. The main non-pharmacological interventions reviewed are memory training, reality orientation therapy, and combined non-pharmacological interventions. Other issues covered are opportunities for Alzheimer's disease prevention, various modalities of care, and the treatment of comorbidities.

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Input from consumers or consumer bodies was explicit in nine guidelines.
“Input from consumers or consumer bodies (e.g., Kidney Health Australia, the Italian Association for Alzheimer's Disease) was explicit in nine guidelines [36, 38, 48–54].”
From Dementia Risk Reduction in Primary Care: A Scoping Review of Clinical Guidelines Using a Behavioral Specificity Framework (2022) · cites this paper as [53]
Four guidelines explicitly mentioned General Practitioners (GPs) as actors in reducing dementia risk; nurses were explicitly mentioned in six guidelines.
“Four guidelines explicitly mentioned General Practitioners (GPs) as actors in reducing dementia risk [36, 38, 53, 57]; nurses were explicitly mentioned in six guidelines [2, 36, 38, 46, 48, 53].”
From Dementia Risk Reduction in Primary Care: A Scoping Review of Clinical Guidelines Using a Behavioral Specificity Framework (2022) · cites this paper as [53]
Guidelines recommending the management of risk factors typically suggested that healthcare professionals follow existing clinical guidelines for individual risk factors.
“Guidelines recommending the management of risk factors typically suggested that healthcare professionals follow existing clinical guidelines for individual risk factors [2, 45, 51–53, 57].”
From Dementia Risk Reduction in Primary Care: A Scoping Review of Clinical Guidelines Using a Behavioral Specificity Framework (2022) · cites this paper as [53]
Discussion was the most commonly recommended DRR action, mentioned by all but two of the 18 included guidelines.
“As Table 2 shows, discussion was the most commonly recommended action, mentioned by all but two guidelines [38, 53].”
From Dementia Risk Reduction in Primary Care: A Scoping Review of Clinical Guidelines Using a Behavioral Specificity Framework (2022) · cites this paper as [53]
It would technically be possible to follow five of the included guidelines without ever mentioning dementia to patients.
“It would technically be possible to follow five of the included guidelines without ever mentioning dementia to patients [38, 45, 52–54].”
From Dementia Risk Reduction in Primary Care: A Scoping Review of Clinical Guidelines Using a Behavioral Specificity Framework (2022) · cites this paper as [53]

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A double-blind comparison of the efficacy and safety of paroxetine and imipramine in the treatment of depression with dementia
Katona, C., Hunter, B. N., & Bray, J. (1998) · International Journal of Geriatric Psychiatry · doi:10.1002/(sici)1099-1166(199802)13:2 · Cited by 148 · see citing works
Impact of Special Care Unit for Patients with Advanced Alzheimer's Disease on Patients' Discomfort and Costs
Volicer, L., Collard, A. F., Hurley, A. C., Bishop, C. E., Kern, D. C., & Karon, S. L. (1994) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1994.tb06856.x · Cited by 144 · see citing works
A Controlled Clinical Trial of Sertraline in the Treatment of Depression in Nursing Home Patients With Late-Stage Alzheimer's Disease
Magai, C., Kennedy, G., Cohen, C. I., & Gomberg, D. (2000) · The American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200002000-00009 · Cited by 143 · see citing works
Alzheimer’s disease: Insights from epidemiology
McDowell, I. (2001) · Aging Clinical and Experimental Research · doi:10.1007/bf03351474 · Cited by 140 · see citing works
Efficacy and Safety of Neuroleptics in Behavioral Disorders Associated With Dementia
Lanctôt, K. L., Best, T. S., Mittmann, N., Liu, B. A., OH, P. I., Einarson, T. R., & Naranjo, C. A. (1998) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v59n1010 · Cited by 136 · see citing works
What happens when donepezil is suddenly withdrawn? An open label trial in dementia with Lewy bodies and Parkinson's disease with dementia
Minett, T., Thomas, A. J., Wilkinson, L., Daniel, S., Sanders, J., Richardson, J. L., Littlewood, E., Myint, P., Newby, J., & McKeith, I. G. (2003) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.995 · Cited by 136 · see citing works
Effect of Light on Agitation in Institutionalized Patients With Severe Alzheimer Disease
Ancoli‐Israel, S., Martin, J. L., Gehrman, P., Shochat, T., Corey‐Bloom, J., Marler, M., Nolan, S., & Levi, L. (2003) · American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200303000-00010 · Cited by 134 · see citing works
A randomized, controlled, clinical trial of activity therapy for apathy in patients with dementia residing in long‐term care
Politis, A., Vozzella, S., Mayer, L. S., Onyike, C., Baker, A. S., & Lyketsos, C. G. (2004) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.1215 · Cited by 132 · see citing works
Activities of Daily Living in Alzheimer's Disease: Neuropsychiatric, Cognitive, and Medical Illness Influences
Tekin, S., Fairbanks, L. A., O'Connor, S. M., Rosenberg, S., & Cummings, J. L. (2001) · American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200102000-00013 · Cited by 129 · see citing works
Effects of Music on Alzheimer Patients
LORD, T. R., & Garner, J. E. (1993) · Perceptual and Motor Skills · doi:10.2466/pms.1993.76.2.451 · Cited by 128 · see citing works
Ginkgo biloba Extract EGb 761® in Dementia: Intent-to-treat Analyses of a 24-week, Multi-center, Double-blind, Placebo-controlled, Randomized Trial
Kanowski, S., & Hoerr, R. (2003) · Pharmacopsychiatry · doi:10.1055/s-2003-45117 · Cited by 127 · see citing works
A prospective comparison of the use of nasogastric and percutaneous endoscopic gastrostomy tubes for long-term enteral feeding in older people
Dwolatzky, T., BEREZOVSKI, S., Friedmann, R., Paz, J., Clarfield, A. M., Stessman, J., HAMBURGER, R., Jaul, E., Friedlander, Y., Rosin, A. J., et al. (2001) · Clinical Nutrition · doi:10.1054/clnu.2001.0489 · Cited by 127 · see citing works
Efficacy and tolerability of memantine in patients with dementia syndrome. A double-blind, placebo controlled trial.
Ditzler, K. (1991) · PubMed · Cited by 126 · see citing works
Pharmacotherapy of Alzheimer's disease: is there a need to redefine treatment success?
Winblad, B. G., Brodaty, H., Gauthier, S. G., Morris, J. C., Orgogozo, J., Rockwood, K. J., Schneider, L. S. S., Takeda, M., Tariot, P. N., & Wilkinson, D. G. (2001) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.496 · Cited by 126 · see citing works
Reducing anxiety in Alzheimer's disease family caregivers: The effectiveness of a nine-week cognitive-behavioral intervention
Akkerman, R. L., & Ostwald, S. K. (2004) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/153331750401900202 · Cited by 124 · see citing works
Effects of Supporting Community‐Living Demented Patients and Their Caregivers: A Randomized Trial
Eloniemi-Sulkava, U. R., Notkola, I.-L. K., Hentinen, M., Kivelä, S., Sivenius, J., & Sulkava, R. O. (2001) · Journal of the American Geriatrics Society · doi:10.1046/j.1532-5415.2001.49255.x · Cited by 123 · see citing works
A nursing intervention to decrease depression in family caregivers of persons with dementia
Buckwalter, K. C., Gerdner, L. A., Kohout, F. J., Hall, G. R., Kelly, A. W., Richards, B. S., & Sime, M. (1999) · Archives of Psychiatric Nursing · doi:10.1016/s0883-9417(99)80024-7 · Cited by 123 · see citing works
Influence of anosognosia on treatment outcome among dementia patients
Attix, D. K., Welsh-Bohmer, K. A., & Schmechel, D. E. (2001) · Neuropsychological Rehabilitation · doi:10.1080/09602010042000097 · Cited by 123 · see citing works
Memantine in the treatment of mild to moderate dementia syndrome. A double-blind placebo-controlled study.
Görtelmeyer, R., & Erbler, H. C. (1992) · PubMed · Cited by 122 · see citing works
A multinational, randomised, 12‐week study comparing the effects of donepezil and galantamine in patients with mild to moderate Alzheimer's disease
Jones, R. W., Soininen, H. S., Häger, K., Aarsland, D., Passmore, P., Murthy, A. K., Zhang, R., & Bahra, R. (2004) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.1038 · Cited by 118 · see citing works
Safety and tolerability of divalproex sodium in the treatment of signs and symptoms of mania in elderly patients with dementia: results of a double-blind, placebo-controlled trial
Tariot, P. N., Schneider, L. S. S., Mintzer, J. E., Cutler, A. J., Cunningham, M. R., Thomas, J. W., & Sommerville, K. W. (2001) · Current Therapeutic Research · doi:10.1016/s0011-393x(01)80042-4 · Cited by 118 · see citing works
A pilot study on a home‐based caregiver training program for improving caregiver self‐efficacy and decreasing the behavioral problems of elders with dementia in Taiwan
Huang, H., Shyu, Y. L., Chen, C.-F., Chen, S., & Lin, L. (2003) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.835 · Cited by 116 · see citing works
A follow‐up study of change in quality of life among persons with dementia residing in a long‐term care facility
Lyketsos, C. G., Gonz�lez-Salvador, T., Chin, J. J., Baker, A. S., Black, B. S., & Rabins, P. V. (2003) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.796 · Cited by 116 · see citing works
Sodium valproate in the treatment of aggressive behavior in patients with dementia—a randomized placebo controlled clinical trial
Sival, R. C., Haffmans, P. M. J., Jansen, P. A. F., Duursma, S. A., & Eikelenboom, P. (2002) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.653 · Cited by 115 · see citing works
Aromatherapy and behaviour disturbances in dementia: a randomized controlled trial
Smallwood, J., Brown, R., Coulter, F., Irvine, E., & Copland, C. (2001) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.473 · Cited by 115 · see citing works
Effectiveness of Music Therapy 1:1 Intervention with Individuals Having Senile Dementia of the Alzheimer's Type
Groene, R. W. (1993) · Journal of Music Therapy · doi:10.1093/jmt/30.3.138 · Cited by 112 · see citing works
An Economic Evaluation of Donepezil in Mild to Moderate Alzheimer’s Disease: Results of a 1-Year, Double-Blind, Randomized Trial
Wimo, A. B., Winblad, B. G., Engedal, K., Soininen, H. S., Verhey, F. R. J., Waldemar, G., Wetterholm, A.-L., Mastey, V., Haglund, A., Zhang, R. H., et al. (2002) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000066669 · Cited by 112 · see citing works
Prevention of Weight Loss in Dementia with Comprehensive Nutritional Treatment
Keller, H., Gibbs-Ward, A. J., Boudreau, L. D., Goy, R. E., Pattillo, M. S., & Brown, H. M. (2003) · Journal of the American Geriatrics Society · doi:10.1046/j.1365-2389.2003.51307.x · Cited by 111 · see citing works
Reality Orientation and Dementia: A Controlled Trial of Two Approaches
Hanley, I. G., McGuire, R., & Boyd, W. D. (1981) · The British Journal of Psychiatry · doi:10.1192/bjp.138.1.10 · Cited by 111 · see citing works
Results of a Randomized Placebo-Controlled Study of Memory Training for Mildly Impaired Alzheimer's Disease Patients
Cahn, D. A., Malloy, P. F., Rebok, G. W., & Ott, B. R. (2003) · Applied Neuropsychology · doi:10.1207/s15324826an1004_3 · Cited by 110 · see citing works
Long-Term Effects of Phosphatidylserine, Pyritinol, and Cognitive Training in Alzheimer's Disease
Heiß, W.-D., Kessler, J., Mielke, R., Szelies, B., & Herholz, K. (1994) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000106702 · Cited by 107 · see citing works
The relationship between quality of life, Mini-Mental State Examination, and the Instrumental Activities of Daily Living in patients with Alzheimer?s disease
Wlodarczyk, J. H., Brodaty, H., & Hawthorne, G. (2004) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2003.12.004 · Cited by 105 · see citing works
The Effects of Olanzapine in Reducing the Emergence of Psychosis Among Nursing Home Patients With Alzheimer's Disease
Clark, W. S., Street, J. S., Feldman, P. D., & Breier, A. (2001) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v62n0108 · Cited by 101 · see citing works
Proof of efficacy of the Ginkgo biloba special extract EGb 761 in outpatients suffering from mild to moderate primary degenerative dementia of the Alzheimer type or multi-infarct dementia
Kanowski, S., Herrmann, W. M., Stephan, K., Wierich, W., & Hörr, R. (1997) · Phytomedicine · doi:10.1016/s0944-7113(97)80021-9 · Cited by 99 · see citing works
Response of Patients With Alzheimer Disease to Rivastigmine Treatment Is Predicted by the Rate of Disease Progression
Farlow, M. R., Hake, A. M., Messina, J. C., Hartman, R. D., Veach, J., & Anand, R. (2001) · Archives of Neurology · doi:10.1001/archneur.58.3.417 · Cited by 97 · see citing works
Treatment with controlled-release lovastatin decreases serum concentrations of human β-amyloid (Aβ) peptide
Friedhoff, L. T., Cullen, E. I., Geoghagen, N. S. M., & Buxbaum, J. D. (2001) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145701002310 · Cited by 97 · see citing works
The effects of a psychomotor activation programme for use in groups of cognitively impaired people in homes for the elderly
Boey (1999) · Pure Amsterdam UMC · doi:10.1002/(sici)1099-1166(199908)14:8 · Cited by 95 · see citing works
The Impact of Validation Group Therapy on Nursing Home Residents With Dementia
Toseland, R. W., Diehl, M., Freeman, K., Manzanares, T., Naleppa, M. J., & McCallion, P. (1997) · Journal of Applied Gerontology · doi:10.1177/073346489701600102 · Cited by 94 · see citing works
The effects of light therapy on mini-mental state examination scores in demented patients
Graf, A., Wallner, C., Schubert, V., Willeit, M., Wlk, W., Fischer, P. A., Kasper, S. F., & Neumeister, A. (2001) · Biological Psychiatry · doi:10.1016/s0006-3223(01)01178-7 · Cited by 93 · see citing works
Functional, Cognitive and Behavioral Effects of Donepezil in Patients with Moderate Alzheimer's Disease
Gauthier, S. G., Feldman, H., Hecker, J. R., Vellas, B. J., Emir, B., Subbiah, P., & on Behalf of The Donepezil MSAD Study Investigators’ Group (2002) · Current Medical Research and Opinion · doi:10.1185/030079902125001029 · Cited by 84 · see citing works
The Physician Decision-Making Process in Transferring Nursing Home Patients to the Hospital
Brooks, S. W. (1994) · Archives of Internal Medicine · doi:10.1001/archinte.1994.00420080110011 · Cited by 84 · see citing works
Efficacy of Quetiapine and Risperidone Against Depressive Symptoms in Outpatients With Psychosis
Sajatovic, M., Mullen, J. A., & Sweitzer, D. E. (2002) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v63n1211 · Cited by 83 · see citing works

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2 of the 286 references couldn’t be matched to a known paper.

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Clinical practice with anti-dementia drugs: A revised (third) consensus statement from the British Association for Psychopharmacology
O'Brien, J. T., Holmes, C., Jones, M. S., Jones, R. W., Livingston, G., McKeith, I. G., Mittler, P. J., Passmore, P., Ritchie, C. W., Robinson, L. A., et al. (2017) · Journal of Psychopharmacology · doi:10.1177/0269881116680924 · Cited by 355 · see citing works
Efficacy of Music Therapy in the Treatment of Behavioral and Psychiatric Symptoms of Dementia
Raglio, A., Bellelli, G., Traficante, D., Gianotti, M., Ubezio, M. C., Villani, D., & Trabucchi, M. (2008) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0b013e3181630b6f · Cited by 333 · see citing works
“Because of these difficulties, recent guidelines from national and international associations recommend that the pharmacologic approach should not be the first-line treatment.(3,6) Nonpharmacologic approaches are longtime known to be useful in the treatment of BPSD.”
Background
Donepezil: an update
Seltzer, B. (2007) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.8.7.1011 · Cited by 256 · see citing works
“Guidelines published in several countries (see for example [170,171]) now recommend the routine use of cholinesterase inhibitors in at least some”
Background
Systematic appraisal of dementia guidelines for the management of behavioural and psychological symptoms
Azermai, M., Petrović, M., Elseviers, M. M., Bourgeois, J., Bortel, L. M. V., & Stichele, R. V. (2011) · Ageing Research Reviews · doi:10.1016/j.arr.2011.07.002 · Cited by 197 · see citing works
A Meta-Analysis of the Efficacy of Donepezil, Rivastigmine, Galantamine, and Memantine in Relation to Severity of Alzheimer's Disease
Santo, S. G. D., Prinelli, F., Adorni, F., Caltagirone, C., & Musicco, M. (2013) · Journal of Alzheimer s Disease · doi:10.3233/jad-122140 · Cited by 177 · see citing works
Clinical practice with anti-dementia drugs: a revised (second) consensus statement from the British Association for Psychopharmacology
O'Brien, J. T., & Burns, A. S. (2010) · Journal of Psychopharmacology · doi:10.1177/0269881110387547 · Cited by 163 · see citing works
Effect of a CYP2D6 polymorphism on the efficacy of donepezil in patients with Alzheimer disease
Pilotto, A., Franceschi, M., D’Onofrio, G., Bizzarro, A., Mangialasche, F., Cascavilla, L., Paris, F., Matera, M. G., Pilotto, A., Daniele, A., et al. (2009) · Neurology · doi:10.1212/wnl.0b013e3181b6bbe3 · Cited by 107 · see citing works
The Treatment of Alzheimer Disease
Winslow, B. T., Onysko, M. K., Stob, C. M., & Hazlewood, K. A. (2008) · Springer eBooks · doi:10.1007/978-3-540-87523-9_6 · Cited by 100 · see citing works
Effects of Music on Agitation in Dementia: A Meta-Analysis
Pedersen, S. K. A., Andersen, P. N., Lugo, R. G., Andreassen, M., & Sütterlin, S. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.00742 · Cited by 95 · see citing works
“Typical treatment in severe depression often includes antidepressants and anxiolytic pharmaceuticals to control emotional symptoms, and antipsychotic drugs to control hallucinations, delusions, and are aimed to also reduce agitation (Caltagirone et al., 2005).”
BackgroundInfluential
Outcomes at 12 Months in a Population of Elderly Patients Discharged From a Rehabilitation Unit
Bellelli, G., Magnifico, F., & Trabucchi, M. (2008) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2007.09.009 · Cited by 82 · see citing works
“ORIGINAL STUDIES effective in the mild and moderate stages.(36) Delirium may be prevented with multicomponent interventions that are known to reduce morbidity and mortality among elderly subjects.”
Background
Guidelines for psychosocial interventions in dementia care: a European survey and comparison
Vasse, E., Vernooij-Dassen, M. J. F. J., Cantegreil, I., Franco, M., Dorenlot, P., Woods, B. T., & Moniz-Cook, E. D. (2011) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2687 · Cited by 74 · see citing works
“They comprised one Italian guideline for clinical specialists (Caltagirone et al., 2005), one Spanish guideline for health and social care practitioners (Spanish Multidisciplinary Group, 2000), one German guideline for formal carers in institutional care (Bartholomeyczik et al.”
BackgroundMethodInfluential
A Systematic Review of Practice Guidelines and Recommendations for Discontinuation of Cholinesterase Inhibitors in Dementia
Renn, B. N., Asghar‐Ali, A. A., Thielke, S. M., Catic, A., Martini, S. R., Mitchell, B. G., & Kunik, M. E. (2017) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2017.09.027 · Cited by 61 · see citing works
Is Antidepressant Treatment Associated with Reduced Cognitive Decline in Alzheimer’s Disease?
Mossello, E., Boncinelli, M., Caleri, V., Cavallini, M. C., Palermo, E., Bari, M. D., Tilli, S., Sarcone, E., Simoni, D., Biagini, C. A., et al. (2008) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000121334 · Cited by 59 · see citing works
“Adding to these uncertainties, the clinical effects of pharmacologic treatment of depression associated with AD are controversial. Although a consensus exists that a treatment is usually indicated and that selective serotonin reuptake inhibitors (SSRI) are the first-line agents in this setting [”
Background
Treatment Guidelines for Alzheimer's Disease
Geldmacher, D. (2007) · The Primary Care Companion to The Journal of Clinical Psychiatry · doi:10.4088/pcc.v09n0205 · Cited by 57 · see citing works
Association between Prescription of Conventional or Atypical Antipsychotic Drugs and Mortality in Older Persons with Alzheimer’s Disease
Musicco, M., Palmer, K., Russo, A. G., Caltagirone, C., Adorni, F., Pettenati, C., & Bisanti, L. (2011) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000326213 · Cited by 49 · see citing works
“Although nonpharmacological interventions are considered the first-choice approach in BPSD, drug use is often unavoidable [”
Background
Brand new norms for a good old test: Northern Italy normative study of MiniMental State Examination
Foderaro, G., Isella, V., Mazzone, A., Biglia, E., Gangi, M. D., Pasotti, F., Sansotera, F., Grobberio, M., Raimondi, V., Mapelli, C., et al. (2022) · Neurological Sciences · doi:10.1007/s10072-021-05845-4 · Cited by 46 · see citing works
“In fact, it represents the official reference tool for prescription and monitoring of anticholinesterase inhibitors in Alzheimer’s disease indicated by Italian health authorities [3].”
Background
Risperidone, olanzapine and quetiapine in the treatment of behavioral and psychological symptoms in patients with Alzheimer's disease: Preliminary findings from a naturalistic, retrospective study
Rocca, P., MARINO, F., Montemagni, C., PERRONE, D., & Bogetto, F. (2007) · Psychiatry and Clinical Neurosciences · doi:10.1111/j.1440-1819.2007.01729.x · Cited by 42 · see citing works
“Furthermore, ‘Guidelines for the treatment of Alzheimer’s disease from the Italian Association of Psychogeriatrics’ recommended that SGA should be preferred over traditional agents for use in behavioral disturbances in AD.(15) This retrospective, naturalistic study was done to obtain preliminary data on the effects of…”
Background
Cessation versus Continuation of Galantamine Treatment after 12 Months of Therapy in Patients with Alzheimer's Disease: A Randomized, Double Blind, Placebo Controlled Withdrawal Trial
Scarpini, E. A., Bruno, G., Zappalà, G., Adami, M., Richarz, U., Gaudig, M., Jacobs, A., & Schäuble, B. (2011) · Journal of Alzheimer s Disease · doi:10.3233/jad-2011-110134 · Cited by 37 · see citing works
“On the basis of the evidence from this study, and in line with current guidelines [10], treatment should be continued in patients with AD who benefit from galantamine therapy, and interruption of therapy in specific patients should be undertaken with caution.”
Revealing the mechanistic pathway of cholinergic inhibition of Alzheimer's disease by donepezil: a metadynamics simulation study
Ghosh, S. K., Jana, K., & Ganguly, B. (2019) · Physical Chemistry Chemical Physics · doi:10.1039/c9cp02613d · Cited by 37 · see citing works
Review: Donepezil in Severe Alzheimer's Disease
Winblad, B. G. (2009) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317509332094 · Cited by 37 · see citing works
Consensus statement on dementia education and training in Europe
Tsolaki, M., Papaliagkas, V. T., Anogianakis, G., Bernabei, R., Emre, M., Frölich, L., Visser, P. J., Michel, J., Pirttilä, T., Rikkert, M. G. M. O., et al. (2010) · The journal of nutrition health & aging · doi:10.1007/s12603-009-0238-z · Cited by 36 · see citing works
“The last decade has witnessed serious advances in the clinical diagnosis and treatment of Alzheimer's disease, several professional organizations and workgroups have developed consensus statements and guidelines for its’ Neurological Societies ( Received June 20, 2009 Accepted for publication September 2, 2009 ) has p…”
Is Long-Term Treatment of Alzheimer’s Disease with Cholinesterase Inhibitor Therapy Justified?
Seltzer, B. (2007) · Drugs & Aging · doi:10.2165/00002512-200724110-00001 · Cited by 36 · see citing works
In SilicoDesign and Search for Acetylcholinesterase Inhibitors in Alzheimer’s Disease with a Suitable Pharmacokinetic Profile and Low Toxicity
da Silva, V. B., de Andrade, P., Kawano, D. F., Morais, P. A. B., de Almeida, J. R., Carvalho, I., Taft, C. A., & da Silva, C. H. T. D. P. (2011) · Future Medicinal Chemistry · doi:10.4155/fmc.11.67 · Cited by 34 · see citing works
Ethical questions in the treatment of subjects with dementia. Part I. Respecting autonomy: awareness, competence and behavioural disorders
Defanti, C. A., Tiezzi, A., Gasparini, M., Gasperini, M., Congedo, M., Tiraboschi, P., Tarquini, D., Pucci, E., Porteri, C., Bonito, V., et al. (2007) · Neurological Sciences · doi:10.1007/s10072-006-0825-x · Cited by 30 · see citing works
“Alongside the cognitive and functional decline that is a constitutive element of its diagnosis, dementia also incorporates other disturbances known as behavioural and psychological symptoms of dementia (BPSD), whose frequency increases with the severity of the disease and may reach 90% in the most advanced cases [39].”
Background
Mini-Mental State Examination: a 30-year story
Mossello, E., & Boncinelli, M. (2006) · Aging Clinical and Experimental Research · doi:10.1007/bf03324660 · Cited by 30 · see citing works
Functional Disability in Early Alzheimer’s Disease – A Validation Study of the Italian Version of the Disability Assessment for Dementia Scale
Vreese, L. P. D., Caffarra, P., Savarè, R., Cerutti, R., Franceschi, M., & Grossi, E. (2008) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000113415 · Cited by 29 · see citing works
Effects of Citicoline as an Adjunct Treatment for Alzheimer’s Disease: A Systematic Review
Piamonte, B. L. C., Espiritu, A. I., & Anlacan, V. M. M. (2020) · Journal of Alzheimer s Disease · doi:10.3233/jad-200378 · Cited by 29 · see citing works
“Therecommendedtherapyforthetreatmentof ADaccordingtoguidelinesfromvariousinterna-tionalorganizationsandworkgroupsisstilllargely AChEIsformildtoseverediseaseandmemantine(an NMDA receptor antagonist) ± an AChEI for moderate to severe disease [22, 23].”
Rivastigmine in Alzheimer's disease: Cognitive function and quality of life.
Annicchiarico, R., Federici, A., Pettenati, C., & Caltagirone, C. (2007) · PubMed Central · Cited by 29 · see citing works
The effects of rivastigmine plus selegiline on brain acetylcholinesterase, (Na+, K+)-, Mg2+-ATPase activities, antioxidant status, and learning performance of aged rats
Carageorgiou, H. (2008) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s3272 · Cited by 26 · see citing works
“…butyrylcholinesterase (BuChE) inhibitor, indicated for treatment of mild to moderate AD (Anand et al 1996; Corey-Bloom et al 1998; Eskander et al 2005; Caltagirone et al 2005; Takeda et al 2006; Gonzalez-Gutierrez and Gobbart 2007) or for patients with rapid disease progression (Farlow et al 2005).”
Optimal management of Alzheimer’s disease patients: Clinical guidelines and family advice
Pantel, J. (2010) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s7106 · Cited by 23 · see citing works
Music playlists for people with dementia: Qualitative evaluation of a guide for caregivers
Garrido, S., Dunne, L., Stevens, C., & Chang, E. M. L. (2021) · Science Progress · doi:10.1177/00368504211014353 · Cited by 20 · see citing works
Variability in the Prescription of Cholinesterase Inhibitors and Memantine
Fernández, I. V., Bjerrum, L., Feja, C., & Rabanaque, M. J. (2009) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000253845 · Cited by 17 · see citing works
Dementia Risk Reduction in Primary Care: A Scoping Review of Clinical Guidelines Using a Behavioral Specificity Framework
Godbee, K., Guccione, L., Palmer, V. J., Gunn, J., Lautenschlager, N., & Francis, J. J. (2022) · Journal of Alzheimer's Disease · doi:10.3233/jad-220382 · Cited by 13 · see citing works
“For the “discuss” action, all but two guidelines [38, 53] recommended providing some form of DRR education [36, 37, 39, 46, 49, 51, 54–57] and/or advice [2, 36, 39, 45, 47, 48, 50–52, 57].”
BackgroundInfluential
Family Physicians’ Recommendations for the Treatment of Alzheimer’s Disease
Werner, P. (2007) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317506294844 · Cited by 12 · see citing works
“From the Department of Gerontology, University of Haifa, Israel.”
BackgroundInfluential
Commentary on “Health economics and the value of therapy in Alzheimer's disease.” Cholinesterase inhibitors in Alzheimer's disease—Evidence‐based or evidence‐biased?
Lanctôt, K. L., & Herrmann, N. (2007) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2007.04.389 · Cited by 12 · see citing works
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Authors: Caltagirone, C., Bianchetti, A., Luca, M. D., Mecocci, P., Padovani, A., Pirfo, E., Scapicchio, P., Senin, U., Trabucchi, M., & Musicco, M.
Affiliations: University of Rome Tor Vergata (IT)
Gruppo di Ricerca Geriatrica (IT)
University of Perugia (IT)
University of Brescia (IT)
University of Turin (IT)
Institute of Biomedical Technologies (IT)
Corresponding author: Caltagirone, Carlo
ORCID: Caltagirone, Carlo
Bianchetti, Angelo
Mecocci, Patrizia
Padovani, Alessandro
Venue: Drugs & Aging
Publisher: Springer Science and Business Media LLC
Published: 2005
Volume: 22
Issue: Suppl 1
Pages: 1???26
ISSN: 1170-229X (ISSN-L)
DOI: 10.2165/00002512-200522001-00002
OpenAlex: W2057760116
Cited by: 55
References: 286
Citations by year: 2026: 1 · 2025: 2 · 2023: 1 · 2022: 3 · 2021: 4 · 2020: 1 · 2019: 1 · 2017: 3 · 2016: 1 · 2015: 2 · 2013: 1
Type: conference abstract
Language: en
Open access: closed
Locations: Drugs & Aging (publishedVersion)
PubMed (publishedVersion)
Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
Health Sciences › Medicine › Pharmacology › Cholinesterase and Neurodegenerative Diseases
Keywords: Alzheimer's disease, dementia management, acetylcholinesterase inhibitors, memantine, non-pharmacological treatment, memory training, reality orientation therapy, pharmacotherapy, Alzheimer's disease prevention, comorbidities, treatment guidelines
MeSH terms: Aged, Alzheimer Disease, Cholinesterase Inhibitors, Clinical Trials as Topic, Depressive Disorder, Humans, Italy, Memantine, Psychotherapy, Excitatory Amino Acid Antagonists

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Guidelines for the treatment of Alzheimer’s disease from the Italian Association of Psychogeriatrics

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