Skip to main content

Management

  • Chapter
  • First Online:
  • 778 Accesses

Abstract

This chapter examines various aspects of the management of cognitive disorders, including provision of information and pharmacotherapy, both licensed and novel treatments. The effects of a number of policy directives issued under the auspices of the United Kingdom government in recent years are examined: none appears to contribute to closure of the dementia diagnosis gap. The place of neurology-led services for dementia within an integrated dementia care pathway is considered.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Abernethy Holland AJ, Larner AJ. Central nervous system/brain tumour 2-week referral guidelines: prospective 3-year audit. Clin Oncol. 2008;20:201–2.

    Article  PubMed  CAS  Google Scholar 

  • Abernethy Holland AJ, Larner AJ. Yttrium-90 implantation. Prog Neurol Psychiatry. 2009;13(5):27.

    Google Scholar 

  • AD2000 Collaborative Group. Long-term donepezil treatment in 565 patients with Alzheimer’s disease (AD2000): randomised double-blind trial. Lancet. 2004;363:2105–15.

    Article  CAS  Google Scholar 

  • Ahmadi-Abhari S, Guzman-Castillo M, Bandosz P, et al. Temporal trend in dementia incidence since 2002 and projections for prevalence in England and Wales to 2040. BMJ. 2017;358:j2856.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ali R, Barborie A, Larner AJ, White RP. Psychiatric presentation of sporadic Creutzfeldt-Jakob disease: a challenge to current diagnostic criteria. J Neuropsychiatry Clin Neurosci. 2013;25:335–8.

    Article  PubMed  Google Scholar 

  • Alzheimer’s Society. Dementia UK. A report into the prevalence and cost of dementia prepared by the Personal Social Services Research Unit (PSSRU) at the London School of Economics and the Institute of Psychiatry at King’s College London, for the Alzheimer’s Society. London: Alzheimer’s Society; 2007.

    Google Scholar 

  • Alzheimer’s Society. Mapping the dementia gap: study produced by Tesco, Alzheimer’s Society and Alzheimer’s Scotland. London: Alzheimer’s Society; 2011.

    Google Scholar 

  • Alzheimer’s Society. Mapping the Dementia Gap 2012. Progress on improving diagnosis of dementia 2011–2012. London: Alzheimer’s Society; 2013.

    Google Scholar 

  • Alzheimer’s Society. Dementia UK—overview. 2nd ed. London: Alzheimer’s Society; 2014.

    Google Scholar 

  • American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed., text revison (DSM-IV-TR). Washington: American Psychiatric Association; 2000.

    Google Scholar 

  • Atri A, Shaughnessy LW, Locascio JJ, Growdon JH. Long-term course and effectiveness of combination therapy in Alzheimer disease. Alzheimer Dis Assoc Disord. 2008;22:209–21.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Banerjee S, Willis R, Matthews D, Contell F, Chan J, Murray J. Improving the quality of care for mild to moderate dementia: an evaluation of the Croydon Memory Service Model. Int J Geriatr Psychiatry. 2007;22:782–8.

    Article  PubMed  Google Scholar 

  • Baum ML. The neuroethics of biomarkers. What the development of bioprediction means for moral responsibility, justice, and the nature of mental disorder. Oxford: Oxford University Press; 2016.

    Book  Google Scholar 

  • Birks J. Cholinesterase inhibitors for Alzheimer’s disease. Cochrane Database Syst Rev. 2006;(1):CD005593.

    Google Scholar 

  • Birks J, Grimley Evans J. Ginkgo Biloba for cognitive impairment and dementia. Cochrane Database Syst Rev. 2009;(1):CD003120.

    Google Scholar 

  • Bonello M, Larner AJ, Alusi SH. Myoclonus-dystonia (DYT11) with novel SGCE mutation misdiagnosed as a primary psychiatric disorder. J Neurol Sci. 2014;346:356–7.

    Article  PubMed  CAS  Google Scholar 

  • Bowie P, Branton T, Holmes J. Should the Mini Mental State Examination be used to monitor dementia treatments? Lancet. 1999;354:1527–8.

    Article  PubMed  CAS  Google Scholar 

  • British Medical Association. Revisions to the GMS Contract 2006/07. Delivering investment in general practice. London: British Medical Association; 2006.

    Google Scholar 

  • Brodaty H, Green A, Koschera A. Meta-analysis of psychosocial interventions of caregivers of people with dementia. J Am Geriatr Soc. 2003;51:657–64.

    Article  PubMed  Google Scholar 

  • Brooke P, Bullock R. Validation of a 6 item cognitive impairment test with a view to primary care usage. Int J Geriatr Psychiatry. 1999;14:936–40.

    Article  PubMed  CAS  Google Scholar 

  • Brunet MD, McCartney H, Heath I, et al. There is no evidence base for proposed dementia screening. BMJ. 2012;345:e8588.

    Article  PubMed  Google Scholar 

  • Cagliarini AM, Price HL, Livemore ST, Larner AJ. Will use of the Six-Item Cognitive Impairment Test help to close the dementia diagnosis gap? Aging Health. 2013;9:563–6.

    Article  CAS  Google Scholar 

  • Campbell DT. Reforms as experiments. Am Psychol. 1969;24:409–29.

    Article  Google Scholar 

  • Campbell H, Hotchkiss R, Bradshaw N, Porteous M. Integrated care pathways. BMJ. 1998;316:133–7.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Cannon P, Larner AJ. Errors in the scoring and reporting of cognitive screening instruments administered in primary care. Neurodegener Dis Manag. 2016;6:271–6.

    Article  PubMed  Google Scholar 

  • Chiu E. What’s in a name: dementia or dysmentia? Int J Geriatr Psychiatry. 1994;9:1–4.

    Article  Google Scholar 

  • Coleman LM, Fowler LL, Williams ME. Use of unproven therapies by people with Alzheimer’s disease. J Am Geriatr Soc. 1995;43:747–50.

    Article  PubMed  CAS  Google Scholar 

  • Cruts M, van Duijn CM, Backhovens H, et al. Estimation of the genetic contribution of presenilin-1 and -2 mutations in a population-based study of presenile Alzheimer disease. Hum Mol Genet. 1998;7:43–51.

    Article  PubMed  CAS  Google Scholar 

  • Curran S, Wattis JP, editors. Practical management of dementia: a multi-professional approach. 2nd ed. Oxford: Radcliffe Medical Press; 2011.

    Google Scholar 

  • Davey RJ, Jamieson S. The validity of using the mini mental state examination in NICE dementia guidelines. J Neurol Neurosurg Psychiatry. 2004;75:343–4.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Davies M, Larner AJ. Clinical misdiagnosis of Alzheimer’s disease: getting it wrong again. Eur J Neurol 2009;16(Suppl3):351 (abstract 2036).

    Google Scholar 

  • Davies M, Larner AJ. Frontotemporal dementias: development of an integrated care pathway through an experiential survey of patients and carers. Int J Care Pathways. 2010;14:65–9.

    Article  Google Scholar 

  • Department of Health. Transforming the quality of dementia care: consultation on a National Dementia Strategy. London: Department of Health; 2008.

    Google Scholar 

  • Department of Health. Living well with dementia: a National Dementia Strategy. London: Department of Health; 2009.

    Google Scholar 

  • Department of Health. Prime Minister’s Challenge on Dementia. Delivering major improvements in dementia care and research by 2015. London: Department of Health; 2012a.

    Google Scholar 

  • Department of Health. Using the Commissioning for Quality and Innovation (CQUIN) payment framework. Guidance on the new national goals 2012–13. London: Department of Health; 2012b.

    Google Scholar 

  • Department of Health. Prime Minister’s Challenge on Dementia 2020. London: Department of Health; 2015.

    Google Scholar 

  • Desikan RS, Fan CC, Wang Y, et al. Genetic assessment of age-associated Alzheimer disease risk: development and validation of a polygenic hazard score. PLoS Med. 2017;14(3):e1002258.

    Article  PubMed  PubMed Central  Google Scholar 

  • Diamond B, Johnson S, Torsney K, et al. Complementary and alternative medicines in the treatment of dementia: an evidence-based review. Drugs Aging. 2003;20:981–98.

    Article  PubMed  CAS  Google Scholar 

  • Doody RS, Raman R, Farlow M, et al. A phase 3 trial of semagacestat for treatment of Alzheimer’s disease. N Engl J Med. 2013;369:341–50.

    Article  PubMed  CAS  Google Scholar 

  • Doran M, Larner AJ. Prominent behavioural and psychiatric symptoms in early-onset Alzheimer’s disease in a sib pair with the presenilin-1 gene R269G mutation. Eur Arch Psychiatry Clin Neurosci. 2004;254:187–9.

    Article  PubMed  CAS  Google Scholar 

  • Doran M, Larner AJ. NICE/SCIE dementia guidance: time to reconsider. Adv Clin Neurosci Rehabil. 2008;8(1):34–5.

    Google Scholar 

  • Doran M, Harvie AK, Larner AJ. Antisocial behaviour orders: the need to consider underlying neuropsychiatric disease. Int J Clin Pract. 2006;60:861–2.

    Article  PubMed  CAS  Google Scholar 

  • Dowd SB, Davidhizar R. Can mental and physical activities such as chess and gardening help in the prevention and treatment of Alzheimer’s? Healthy aging through stimulation of the mind. J Pract Nurs. 2003;53(3):11–3.

    PubMed  Google Scholar 

  • Dubois B, Tolosa E, Katzenschlager R, et al. Donepezil in Parkinson’s disease dementia: a randomized, double-blind efficacy and safety study. Mov Disord. 2012;27:1230–8.

    Article  PubMed  CAS  Google Scholar 

  • Dysken MW, Sano M, Asthana S, et al. Effect of vitamin E and memantine on functional decline in Alzheimer disease: the TEAM-AD VA cooperative randomized trial. JAMA. 2014;311:33–44.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ellul J, Archer N, Foy CM, et al. The effects of commonly prescribed drugs in patients with Alzheimer’s disease on the rate of deterioration. J Neurol Neurosurg Psychiatry. 2007;78:233–9.

    Article  PubMed  CAS  Google Scholar 

  • Emre M, Aarsland D, Albanese A, et al. Rivastigmine for dementia associated with Parkinson’s disease. N Engl J Med. 2004;351:2509–18.

    Article  PubMed  CAS  Google Scholar 

  • Erkinjuntti T, Roman G, Gauthier S, Feldman H, Rockwood K. Emerging therapies for vascular dementia and vascular cognitive impairment. Stroke. 2004;35:1010–7.

    Article  PubMed  CAS  Google Scholar 

  • Evans M, Ellis A, Watson D, et al. Sustained cognitive improvement following treatment of Alzheimer’s disease with donepezil. Int J Geriatr Psychiatry. 2000;15:50–3.

    Article  PubMed  CAS  Google Scholar 

  • Farlow M, Potkin S, Koumaras B, Veach J, Mirski D. Analysis of outcome in retrieval dropout patients in a rivastigmine vs placebo, 26-week, Alzheimer disease trial. Arch Neurol. 2003;60:843–8.

    Article  PubMed  Google Scholar 

  • Fearn S, Larner AJ. Have Quality and Outcomes Framework Depression Indicators changed referrals from primary care to a dedicated memory clinic? Ment Health Fam Med. 2009;6:129–32.

    Google Scholar 

  • Feldman HH, Ferris S, Winblad B, et al. Effect of rivastigmine on delay to diagnosis of Alzheimer’s disease from mild cognitive impairment: the InDDEx study. Lancet Neurol. 2007;6:501–12.

    Article  PubMed  CAS  Google Scholar 

  • Feldman HH, Pirttila T, Dartigues JF, et al. Treatment with galantamine and time to nursing home placement in Alzheimer’s disease patients with and without cerebrovascular disease. Int J Geriatr Psychiatry. 2008;24:479–88.

    Article  Google Scholar 

  • Ferrante di Ruffano L, Hyde CJ, McCaffery KJ, Bossuyt PM, Deeks JJ. Assessing the value of diagnostic tests: a framework for designing and evaluating trials. BMJ. 2012;344:e686.

    Article  PubMed  Google Scholar 

  • Ferri CP, Prince M, Brayne C, et al. Global prevalence of dementia: a Delphi consensus study. Lancet. 2005;366:2112–7.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fisher CAH, Larner AJ. Frequency and diagnostic utility of cognitive test instrument use by general practitioners prior to memory clinic referral. Fam Pract. 2007;24:495–7.

    Article  PubMed  CAS  Google Scholar 

  • Friedland RP, Fritsch T, Smyth KA, et al. Patients with Alzheimer’s disease have reduced activities in midlife compared with healthy control group members. Proc Natl Acad Sci U S A. 2001;98:3440–5.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Gale TM, Larner AJ. Six-Item Cognitive Impairment Test (6CIT). In: Larner AJ, editor. Cognitive screening instruments. A practical approach. 2nd ed. London: Springer; 2017. p. 241–53.

    Chapter  Google Scholar 

  • Geldmacher DS, Provenzano G, McRae T, Mastey V, Ieni JR. Donepezil is associated with delayed nursing home placement in patients with Alzheimer’s disease. J Am Geriatr Soc. 2003;51:937–44.

    Article  PubMed  Google Scholar 

  • Ghadiri-Sani M, Larner AJ. Cognitive screening instrument use in primary care: is it changing? Clin Pract. 2014;11:425–9.

    Article  CAS  Google Scholar 

  • Goldman JS, Farmer JM, Wood EM, et al. Comparison of family histories in FTLD subtypes and related tauopathies. Neurology. 2005;65:1817–9.

    Article  PubMed  CAS  Google Scholar 

  • Hancock P, Larner AJ. Cambridge Behavioural Inventory for the diagnosis of dementia. Prog Neurol Psychiatry. 2008;12(7):23–5.

    Article  Google Scholar 

  • Hancock P, Larner AJ. Clinical utility of Patient Health Questionnaire-9 (PHQ-9) in memory clinics. Int J Psychiatry Clin Pract. 2009;13:188–91.

    Article  PubMed  CAS  Google Scholar 

  • Hancock P, Larner AJ. Cornell Scale for Depression in Dementia: clinical utility in a memory clinic. Int J Psychiatry Clin Pract. 2015;19:71–4.

    Article  PubMed  Google Scholar 

  • Heath Y. Evaluating the effect of therapeutic gardens. Am J Alzheimers Dis Other Demen. 2004;19:239–42.

    Article  PubMed  Google Scholar 

  • Hogan DB, Ebly EM. Complementary medicine use in a dementia clinic population. Alzheimer Dis Assoc Disord. 1996;10:63–7.

    Article  PubMed  CAS  Google Scholar 

  • Holmes C, Lovestone S. Long-term cognitive and functional decline in late onset Alzheimer’s disease: therapeutic implications. Age Ageing. 2003;32:200–4.

    Article  PubMed  Google Scholar 

  • Howard R, McShane R, Lindesay J, et al. Donepezil and memantine for moderate-to-severe Alzheimer’s disease. N Engl J Med. 2012;336:893–903.

    Article  Google Scholar 

  • Jackson D, Roberts G, Wu ML, Ford R, Doyle C. A systematic review of the effect of telephone, internet or combined support for carers of people living with Alzheimer’s, vascular or mixed dementia in the community. Arch Gerontol Geriatr. 2016;66:218–36.

    Article  PubMed  Google Scholar 

  • Jorm AF, Rogers B, Christensen H. Use of medications to enhance memory in a large community sample of 60-64 year olds. Int Psychogeriatr. 2004;16:209–17.

    Article  PubMed  Google Scholar 

  • Kaduszkiewicz H, Zimmermann T, Beck-Bornholdt H-P, van den Bussche H. Cholinesterase inhibitors for patients with Alzheimer’s disease: systematic review of randomised clinical trials. BMJ. 2005;331:321–3.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Kertesz A, Morlog D, Light M, et al. Galantamine in frontotemporal dementia and primary progressive aphasia. Dement Geriatr Cogn Disord. 2008;25:178–85.

    Article  PubMed  CAS  Google Scholar 

  • Kitchiner D, Bundred P. Integrated care pathways. Arch Dis Child. 1996;75:166–8.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Kivipelto M, Ngandu T, Laatikainen T, Winblad B, Soininen H, Tuomilehto J. Risk score for the prediction of dementia in 20 years among middle aged people: a longitudinal, population-based study. Lancet Neurol. 2006;5:735–41.

    Article  PubMed  Google Scholar 

  • Knopman DS, Kitto J, Deinard S, Heiring J. Longitudinal study of death and institutionalization in patients with primary degenerative dementia. J Am Geriatr Soc. 1988;36:108–12.

    Article  PubMed  CAS  Google Scholar 

  • Krupp LB, Christodoulou C, Melville P, Scherl WF, MacAllister WS, Elkins LE. Donepezil improved memory in multiple sclerosis in a randomized clinical trial. Neurology. 2004;63:1579–85.

    Article  PubMed  CAS  Google Scholar 

  • Kurlan R, editor. Handbook of secondary dementias. New York: Taylor and Francis; 2006.

    Google Scholar 

  • Kurrle S, Brodaty H, Hogarth R. Physical comorbidities of dementia. Cambridge: Cambridge University Press; 2012.

    Book  Google Scholar 

  • Lanctôt KL, Herrmann N, Yau KK, et al. Efficacy and safety of cholinesterase inhibitors in Alzheimer’s disease: a meta-analysis. CMAJ. 2003;169:557–64.

    PubMed  PubMed Central  Google Scholar 

  • Larner AJ. Alzheimer’s disease: targets for drug development. Mini-Rev Med Chem. 2002;2(1):1–9.

    Article  PubMed  CAS  Google Scholar 

  • Larner AJ. Use of the internet and of the NHS Direct telephone helpline for medical information by a cognitive function clinic population. Int J Geriatr Psychiatry. 2003;18:118–22.

    Article  PubMed  CAS  Google Scholar 

  • Larner A. I think I need a psychiatrist. BMJ. 2003b;326:273.

    Article  PubMed Central  Google Scholar 

  • Larner AJ. Cholinesterase inhibitor use at a cognitive function clinic. Prog Neurol Psychiatry. 2004a;8(4):14, 18, 20.

    Google Scholar 

  • Larner AJ. Secretases as therapeutic targets in Alzheimer’s disease: patents 2000-2004. Exp Opin Ther Patents. 2004b;14:1403–20.

    Article  CAS  Google Scholar 

  • Larner AJ. Gardening and dementia. Int J Geriatr Psychiatry. 2005a;20:796–7.

    Article  PubMed  CAS  Google Scholar 

  • Larner AJ. Two simple questions in the identification of dementia. J Neurol Neurosurg Psychiatry 2005b;76:1317 (abstract 023).

    Google Scholar 

  • Larner AJ. Searching the internet for medical information: frequency over time and by age and gender in an outpatient population in the UK. J Telemed Telecare. 2006a;12:186–8.

    Article  PubMed  CAS  Google Scholar 

  • Larner AJ. Medical hazards of the internet: gambling in Parkinson’s disease. Mov Disord. 2006b;21:1789.

    Article  PubMed  Google Scholar 

  • Larner AJ. Headache related to use of cholinesterase inhibitors: study of a Cognitive Function Clinic population. J Headache Pain. 2006;7:440–1.

    Article  PubMed  PubMed Central  Google Scholar 

  • Larner AJ. Neurological signs of aging. In: Pathy MSJ, Sinclair AJ, Morley JE, editors. Principles and practice of geriatric medicine. 4th ed. Chichester: Wiley; 2006d. p. 743–50.

    Google Scholar 

  • Larner AJ. Alzheimer 100. Adv Clin Neurosci Rehabil. 2006e;6(5):24.

    Google Scholar 

  • Larner AJ. Awareness and use of complementary therapies for AD. Prog Neurol Psychiatry. 2007a;11(8):27,29.

    Article  Google Scholar 

  • Larner AJ. Do cholinesterase inhibitors alter the course of dementia? Prog Neurol Psychiatry. 2007b;11(5):26–8.

    Article  Google Scholar 

  • Larner AJ. Neurologists still have a role in the dementia care pathway. Clin Med. 2007c;7:528–9.

    Article  CAS  Google Scholar 

  • Larner AJ. Antisocial behaviour and neuroacanthocytosis. A reply. Int J Clin Pract. 2007d;61:1419.

    Article  Google Scholar 

  • Larner AJ. Integrated care pathways in dementia: a challenge to National Institute for Health and Clinical Excellence/Social Care Institute for Excellence guidance. J Integr Care Pathways. 2007e;11:95–9.

    Article  Google Scholar 

  • Larner AJ. Idiopathic intracranial hypertension: towards an integrated care pathway. J Integr Care Pathways. 2007f;11:62–5.

    Article  Google Scholar 

  • Larner AJ. Neuropsychological neurology: the neurocognitive impairments of neurological disorders. Cambridge: Cambridge University Press; 2008a.

    Book  Google Scholar 

  • Larner AJ. Delusion of pregnancy in frontotemporal lobar degeneration with motor neurone disease (FTLD/MND). Behav Neurol. 2008b;19:199–200.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Larner AJ. Commentary on Living Well with Dementia: A National Dementia Strategy. Adv Clin Neurosci Rehabil. 2009a;9(1):27–8.

    Google Scholar 

  • Larner AJ. Impact of the National Institute for Health and Clinical Excellence and Social Care Institute for Excellence’s dementia guidelines in a neurology-led memory clinic. Clin Med. 2009b;9:197–8.

    Article  CAS  Google Scholar 

  • Larner AJ. Transdermal rivastigmine for Alzheimer’s disease: skin deep or scratching the surface? Int J Clin Pract. 2010a;64:534–6.

    Article  PubMed  CAS  Google Scholar 

  • Larner AJ. Cholinesterase inhibitors—beyond Alzheimer’s disease. Exp Rev Neurotherapeutics. 2010b;10:1699–705.

    Article  CAS  Google Scholar 

  • Larner AJ. Cognitive impairment: update on current treatments and future prospects. In: Macallister R, editor. Horizons in Medicine 22. The proceedings of the Advanced Medicine Conference, vol. 2010. London: Royal College of Physicians; 2010c. p. 35–41.

    Google Scholar 

  • Larner AJ. Impact of the National Dementia Strategy in a neurology-led memory clinic. Clin Med. 2010d;10:526.

    Article  CAS  Google Scholar 

  • Larner AJ. Co-occurrence of bipolar disorder and cluster headache. Prog Neurol Psychiatry. 2010e;14(6):9–10.

    Google Scholar 

  • Larner AJ. Teleneurology by internet and telephone. A study in self-help. London: Springer; 2011a.

    Book  Google Scholar 

  • Larner AJ. Telemedicine and older people. GM Geriatr Med. 2011b;41:247–50,52.

    Google Scholar 

  • Larner AJ. Telemedicine and older neurology outpatients: use of NHS Direct and of the Internet in the UK. Can Geriatr J. 2011c;14:104–7.

    Article  PubMed  PubMed Central  Google Scholar 

  • Larner AJ. Impact of the 2011 NICE guidance on dementia drugs in a neurology-led memory clinic. Clin Med. 2012a;12:496.

    Article  CAS  Google Scholar 

  • Larner AJ. Neurological signs of aging. In: Sinclair A, Morley JE, Vellas B, editors. Pathy’s principles and practice of geriatric medicine. 5th ed. Chichester: Wiley; 2012b. p. 609–16.

    Google Scholar 

  • Larner AJ. Neuropsychological neurology: the neurocognitive impairments of neurological disorders (2nd edition). Cambridge: Cambridge University Press; 2013a.

    Book  Google Scholar 

  • Larner AJ. Delusion of pregnancy: a case revisited. Behav Neurol. 2013b;27:293–4.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Larner AJ. Impact of the National Dementia Strategy in a neurology-led memory clinic: 5-year data. Clin Med. 2014;14:216.

    Article  CAS  Google Scholar 

  • Larner AJ. Invited opinion piece: NICE guidelines on delaying and preventing dementia in later life. Adv Clin Neurosci Rehabil. 2015a;15(5):20.

    Google Scholar 

  • Larner AJ. Diagnostic test accuracy studies in dementia: a pragmatic approach. London: Springer; 2015b.

    Book  Google Scholar 

  • Larner AJ. A dictionary of neurological signs. 4th ed. London: Springer; 2016.

    Book  Google Scholar 

  • Larner AJ. Dementia and the health of the nation. In: Severn A, editor. Cognitive changes after surgery. London: Springer; 2018a (in press).

    Google Scholar 

  • Larner AJ. Metamemory: a construct with diagnostic utility in a cognitive disorders clinic? Int J Geriatr Psychiatry. 2018b;33:553–4.

    Article  PubMed  CAS  Google Scholar 

  • Larner AJ, Bracewell RM. Predicting Alzheimer’s disease: a polygenic hazard score. J R Coll Physicians Edinb. 2017;47:151–2.

    Article  PubMed  CAS  Google Scholar 

  • Larner AJ, Doran M. Broader assessment needed for treatment decisions in AD. Prog Neurol Psychiatry. 2002;6(3):5–6.

    Google Scholar 

  • Larner AJ, Doran M. Prion diseases: update on therapeutic patents, 1999-2002. Exp Opin Ther Patents. 2003;13:67–78.

    Article  CAS  Google Scholar 

  • Larner A, Storton K. Clinical review: Alzheimer’s disease. GP. 2011;28 January:32–4.

    Google Scholar 

  • Li Y, Hai S, Zhou Y, Dong BR. Cholinesterase inhibitors for rarer dementias associated with neurological conditions. Cochrane Database Syst Rev. 2015;(3):CD009444.

    Google Scholar 

  • Lincoln P, Fenton K, Alessi C, et al. The Blackfriars Consensus on brain health and dementia. Lancet. 2014;383:1805–6.

    Article  PubMed  Google Scholar 

  • Lipton AM, Marshall CD. The common sense guide to dementia for clinicians and caregivers. New York: Springer; 2013.

    Book  Google Scholar 

  • Livingston G, Sommerlad A, Orgeta V, et al. Dementia prevention, intervention, and care. Lancet. 2017;390:2673–734.

    Article  PubMed  Google Scholar 

  • Lopez OL, Becker JT, Wisniewski S, Saxton J, Kaufer DI, DeKosky ST. Cholinesterase inhibitor treatment alters the natural history of Alzheimer’s disease. J Neurol Neurosurg Psychiatry. 2002;72:310–4.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Lopez OL, Becker JT, Saxton J, Sweet RA, Klunk W, DeKosky ST. Alteration of a clinically meaningful outcome in the natural history of Alzheimer’s disease by cholinesterase inhibition. J Am Geriatr Soc. 2005;53:83–7.

    Article  PubMed  Google Scholar 

  • Lopez OL, Becker JT, Wahed AS, Saxton J, Sweet RA, Wolk DA, Klunk W, DeKosky ST. Long-term effects of the concomitant use of memantine with cholinesterase inhibition in Alzheimer disease. J Neurol Neurosurg Psychiatry. 2009;80:600–7.

    Article  PubMed  CAS  Google Scholar 

  • Lovera JF, Kim E, Heriza E, et al. Ginkgo biloba does not improve cognitive function in MS: a randomized placebo-controlled trial. Neurology. 2012;79:1278–84.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mangialasche F, Solomon A, Winblad B, Mecocci P, Kivipelto M. Alzheimer’s disease: clinical trials and drug development. Lancet Neurol. 2010;9:702–16.

    Article  PubMed  CAS  Google Scholar 

  • Marson AG, Al-Kharusi AM, Alwaidh M, et al. The SANAD study of effectiveness of carbamazepine, gabapentin, lamotrigine, oxcarbazepine, or topiramate for the treatment of partial epilepsy: an unblinded randomised controlled trial. Lancet. 2007;369:1000–15.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Masoodi N. Review: cholinesterase inhibitors do not reduce progression to dementia from mild cognitive impairment. Ann Intern Med. 2013;158:JC2–3.

    Article  Google Scholar 

  • Matthews FE, Stephan BC, Robinson L, et al. A two decade dementia incidence comparison from the Cognitive Function and Ageing Studies I and II. Nat Commun. 2016;7:11398.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • McKee M, Karanikolos M, Belcher P, Stuckler D. Austerity: a failed experiment on the people of Europe. Clin Med. 2012;12:346–50.

    Article  Google Scholar 

  • McKeith I, Del Ser T, Spano P, et al. Efficacy of rivastigmine in dementia with Lewy bodies: a randomised, double-blind, placebo-controlled international study. Lancet. 2000;356:2031–6.

    Article  PubMed  CAS  Google Scholar 

  • McShane R, Areosa Sastre A, Minakaran N. Memantine for dementia. Cochrane Database Syst Rev. 2006;(2):CD003154.

    Google Scholar 

  • Mendez MF, Lauterbach EC, Sampson SM, ANPA Committee on Research. An evidence-based review of the psychopathology of frontotemporal dementia: a report of the ANPA Committee on Research. J Neuropsychiatry Clin Neurosci. 2008a;20:130–49.

    Article  PubMed  Google Scholar 

  • Mendez MF, Shapira JS, Woods RJ, Licht EA, Saul RE. Psychotic symptoms in frontotemporal dementia: prevalence and review. Dement Geriatr Cogn Disord. 2008b;25:206–11.

    Article  PubMed  Google Scholar 

  • Menon R, Larner AJ. Use of cognitive screening instruments in primary care: the impact of national dementia directives (NICE/SCIE, National Dementia Strategy). Fam Pract. 2011;28:272–6.

    Article  PubMed  CAS  Google Scholar 

  • Naidoo M, Bullock R. An integrated care pathway for dementia. Best practice for dementia care. London: Mosby International; 2001.

    Google Scholar 

  • National Audit Office. Improving services and support for people with dementia. London: National Audit Office; 2007.

    Google Scholar 

  • National Audit Office. Improving dementia services in England—an interim report. (www.nao.org.uk/publications/0910/improving_dementia_services.aspx). London: National Audit Office; 2010.

    Google Scholar 

  • National Institute for Clinical Excellence. Guidance on the use of donepezil, rivastigmine, and galantamine for the treatment of Alzheimer’s disease (Technology Appraisal Guidance No. 19). London: NICE; 2001.

    Google Scholar 

  • National Institute for Health and Care Excellence. Dementia, disability and frailty in later life—mid-life approaches to delay or prevent onset. NICE guidelines. London: NICE (www.nice.org.uk/guidance/ng16); 2015.

    Google Scholar 

  • National Institute for Health and Clinical Excellence. Donepezil, galantamine, rivastigmine (review) and memantine for the treatment of Alzheimer’s disease. Includes a review of NICE technology appraisal guidance 19. Nice technology appraisal guidance 111. London: NICE; 2006.

    Google Scholar 

  • National Institute for Health and Clinical Excellence. Final appraisal determination: donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer’s disease (review of NICE technology appraisal guidance 111). Technology appraisal 217. London: NICE; 2011.

    Google Scholar 

  • National Institute for Health and Clinical Excellence/Social Care Institute for Excellence. Dementia: supporting people with dementia and their carers in health and social care. NICE Clinical Guidance 42. London: National Institute for Health and Clinical Excellence (www.nice.org.uk/cG042); 2006.

    Google Scholar 

  • Ngandu T, Lehtisalo J, Solomon A, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet. 2015;385:2255–63.

    Article  PubMed  Google Scholar 

  • Oken BS, Storzbach DM, Kaye JA. The efficacy of Ginkgo biloba on cognitive function in Alzheimer disease. Arch Neurol. 1998;55:1409–15.

    Article  PubMed  CAS  Google Scholar 

  • Panicker J, Larner AJ. Two-week wait referrals for CNS cancer—are they working? J Neurol Neurosurg Psychiatry. 2012;83(Suppl2):A30–1.

    Google Scholar 

  • Patterson C, Feightner JW, Garcia A, Hsiung GY, MacKnight C, Sadovnick AD. Diagnosis and treatment of dementia: 1. Risk assessment and primary prevention of Alzheimer disease. CMAJ. 2008;178:548–56.

    Article  PubMed  PubMed Central  Google Scholar 

  • Petersen RC, Thomas RG, Grundman M, et al. Vitamin E and donepezil for the treatment of mild cognitive impairment. N Engl J Med. 2005;352:2379–88.

    Article  PubMed  CAS  Google Scholar 

  • Prince M, Wimo A, Guerchet M, et al. World Alzheimer Report 2015. The global impact of dementia. An analysis of prevalence, incidence, cost and trends. London: Alzheimer’s Disease International; 2015.

    Google Scholar 

  • Provenzano G, Duttagupta S, McRae T, Mastey V, Ellis B, Ieni J. Delays in nursing home placement for patients with Alzheimer’s disease associated with treatment with donepezil may have health care cost-saving implications. Value Health 2001;4:158 (abstract).

    Google Scholar 

  • Rabins PV, Lyketsos CG, Steele CD. Practical dementia care. 3rd ed. New York: Oxford University Press; 2016.

    Google Scholar 

  • Rafii MS, Aisen PS. Advances in Alzheimer’s disease drug development. BMC Med. 2015;13:62.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Raina P, Santaguida P, Ismaila A, et al. Effectiveness of cholinesterase inhibitors and memantine for treating dementia: evidence review for a clinical practice guideline. Ann Intern Med. 2008;148:379–97.

    Article  PubMed  Google Scholar 

  • Randall A, Ellis R, Hywel B, Davies RR, Alusi SH, Larner AJ. Rapid cognitive decline: not always Creutzfeldt-Jakob disease. J R Coll Phys Edinb. 2015;45:209–12.

    Article  CAS  Google Scholar 

  • Rascovsky K, Hodges JR, Knopman D, et al. Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain. 2011;134:2456–77.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ritchie CW, Ames D, Clayton T, Lai R. Metaanalysis of randomized trials of the efficacy and safety of donepezil, galantamine and rivastigmine for the treatment of Alzheimer disease. Am J Geriatr Psychiatry. 2004;12:358–69.

    Article  PubMed  Google Scholar 

  • Rodda J, Carter J. Cholinesterase inhibitors and memantine for symptomatic treatment of dementia. BMJ. 2012;344:e2986.

    Article  PubMed  CAS  Google Scholar 

  • Rolinski M, Fox C, Maidment I, McShane R. Cholinesterase inhibitors for dementia with Lewy bodies, Parkinson’s disease dementia and cognitive impairment in Parkinson’s disease. Cochrane Database Syst Rev. 2012;(3):CD006504.

    Google Scholar 

  • Rosness TA, Haugen PK, Passant U, Engedal K. Frontotemporal dementia – a clinically complex diagnosis. Int J Geriatr Psychiatry. 2008;23:837–42.

    Article  PubMed  Google Scholar 

  • Royal College of Psychiatrists/Alzheimer’s Society. Services for younger people with Alzheimer’s disease and other dementias. London: Royal College of Psychiatrists/Alzheimer’s Society; 2006.

    Google Scholar 

  • Russ TC, Morling JR. Cholinesterase inhibitors for mild cognitive impairment. Cochrane Database Syst Rev. 2012;(9):CD009132.

    Google Scholar 

  • Sabia S, Dugravot A, Dartigues JF, et al. Physical activity, cognitive decline, and risk of dementia: 28 year follow-up of Whitehall II cohort study. BMJ. 2017;357:j2709.

    Article  PubMed  PubMed Central  Google Scholar 

  • Salloway S, Ferris S, Kluger A, et al. Efficacy of donepezil in mild cognitive impairment: a randomized placebo-controlled trial. Neurology. 2004;63:651–7.

    Article  PubMed  CAS  Google Scholar 

  • Sano M, Ernesto C, Thomas RG, et al. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer’s disease. The Alzheimer’s Disease Cooperative Study. N Engl J Med. 1997;336:1216–22.

    Article  PubMed  CAS  Google Scholar 

  • Sathasivam S, Doran M, Larner AJ. Frontotemporal lobar degeneration with motor neurone disease (FTLD/MND): presentations in psychiatric practice. Int J Psychiatry Clin Pract. 2008;12:138–41.

    Article  PubMed  CAS  Google Scholar 

  • Scharre DW, editor. Long-term management of dementia. Abingdon: Informa; 2010.

    Google Scholar 

  • Sharma P, Herrmann N, Rochon PA, et al. Perceptions of natural health products among patients attending a memory clinic. Am J Alzheimers Dis Other Demen. 2006;21:156–63.

    Article  PubMed  Google Scholar 

  • Storton K, Davies M, Cagliarini AM, Larner AJ. Frontotemporal dementia: supportive role of the Alzheimer’s Society. Dement Geriatr Cogn Disord. 2012;34(Suppl1):113.

    Google Scholar 

  • Swash M, Brooks DN, Day NE, Frith CD, Levy R, Warlow CP. Clinical trials in Alzheimer’s disease. A report from the Medical Research Council Alzheimer’s Disease Clinical Trials Committee. J Neurol Neurosurg Psychiatry. 1991;54:178–81.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Tariot PN, Farlow MR, Grossberg GT, et al. Memantine treatment in patients with moderate to severe Alzheimer disease already receiving donepezil: a randomized controlled trial. JAMA. 2004;291:317–24.

    Article  PubMed  CAS  Google Scholar 

  • Thompson PA, Wright DE, Counsell CE, Zajicek J. Statistical analysis, trial design and duration in Alzheimer’s disease clinical trials: a review. Int Psychogeriatr. 2012;24:689–97.

    Article  PubMed  CAS  Google Scholar 

  • Topiwala A, Allan CL, Valkanova V, et al. Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: longitudinal cohort study. BMJ. 2017;357:j2353.

    Article  PubMed  PubMed Central  Google Scholar 

  • Trevitt CR, Collinge J. A systematic review of prion therapeutics in experimental models. Brain. 2006;129:2241–65.

    Article  PubMed  Google Scholar 

  • van de Glind EM, van Enst WA, van Munster BC, et al. Pharmacological treatment of dementia: a scoping review of systematic reviews. Dement Geriatr Cogn Disord. 2013;36:211–28.

    Article  PubMed  CAS  Google Scholar 

  • Varma AR, Snowden JS, Lloyd JJ, et al. Evaluation of the NINCDS-ADRDA criteria in the differentiation of Alzheimer’s disease and frontotemporal dementia. J Neurol Neurosurg Psychiatry. 1999;66:184–8.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Vellas B, Coley N, Ousset PJ, et al. Long-term use of standardised Ginkgo biloba extract for the prevention of Alzheimer’s disease (GuidAge): a randomised placebo-controlled trial. Lancet Neurol. 2012;11:851–9.

    Article  PubMed  CAS  Google Scholar 

  • Whitehead A, Perdomo C, Pratt RD, Birks J, Wilcock GK, Evans JG. Donepezil for the symptomatic treatment of patients with mild to moderate Alzheimer’s disease: a meta-analysis of individual patient data from randomised controlled trials. Int J Geriatr Psychiatry. 2004;19:624–33.

    Article  PubMed  Google Scholar 

  • Wilcock G, Howe I, Coles H, Lilienfeld S, Truyen L, Zhu Y, Bullock R, Members of the GAL-GBR2 Study Group. A long-term comparison of galantamine and donepezil in the treatment of Alzheimer’s disease. Drugs Aging. 2003;20:777–89.

    Article  PubMed  CAS  Google Scholar 

  • Wilcock GK, Black SE, Hendrix SB, Zavitz KH, Swabb EA, Laughlin MA, Tarenflurbil Phase II Study Investigators. Efficacy and safety of tarenflurbil in mild to moderate Alzheimer’s disease: a randomised phase II trial. Lancet Neurol. 2008;7:483–93. [Erratum Lancet Neurol. 2008;7:575].

    Article  PubMed  CAS  Google Scholar 

  • Williamson J, Larner AJ. Young-onset cognitive decline: not always variant Creutzfeldt-Jakob disease. Eur J Neurol. 2016;23(Suppl1):368. (abstract P21049).

    Google Scholar 

  • Winblad B, Cummings J, Andreasen N, et al. A six-month double-blind, randomized, placebo-controlled study of a transdermal patch in Alzheimer’s disease—rivastigmine patch versus capsule. Int J Geriatr Psychiatry. 2007;22:456–67.

    Article  PubMed  Google Scholar 

  • Winblad B, Gauthier S, Scinto L, et al. Safety and efficacy of galantamine in subjects with mild cognitive impairment. Neurology. 2008;70:2024–35.

    Article  PubMed  CAS  Google Scholar 

  • Wong SH, Steiger MJ, Larner AJ, Fletcher NA. Hereditary myoclonus dystonia (DYT11): a novel SGCE mutation with intrafamilial phenotypic heterogeneity. Mov Disord. 2010;15:956–7.

    Article  Google Scholar 

  • Wu YT, Fratiglioni L, Matthews FE, et al. Dementia in western Europe: epidemiological evidence and implications for policy making. Lancet Neurol. 2016;15:116–24.

    Article  PubMed  Google Scholar 

  • Zerr I, Kallenberg K, Summers DM, et al. Updated clinical diagnostic criteria for sporadic Creutzfeldt-Jakob disease. Brain. 2009;132:2659–68. [Erratum Brain. 2012;135:1335].

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Ziso B, Marsden D, Alusi S, Larner AJ. “Undifferentiated schizophrenia” revisited. J Neuropsychiatry Clin Neurosci. 2014;26:E62–3.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Larner, A.J. (2018). Management. In: Dementia in Clinical Practice: A Neurological Perspective. Springer, Cham. https://doi.org/10.1007/978-3-319-75259-4_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-75259-4_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-75258-7

  • Online ISBN: 978-3-319-75259-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics