Diagnosis and Treatment of Clinical Alzheimer's-Type Dementia [report]

Howard A. Fink, Laura S. Hemmy, Eric J. Linskens, Pombie C. Silverman, Roderick MacDonald, J. Riley McCarten, Kristine M.C. Talley, Priyanka J. Desai, Mary L. Forte, Margaret A. Miller, Michelle Brasure, Victoria A. Nelson (+7 others)
2020 unpublished
Key Messages Purpose of Review To summarize evidence on cognitive test accuracy for clinical Alzheimer's-type dementia (CATD) in suspected cognitive impairment; biomarker accuracy for Alzheimer's disease (AD) in dementia; and effects of CATD drug treatment. Key Messages • Many brief cognitive tests were highly (>0.8) sensitive and specific distinguishing CATD from normal cognition, but less from mild cognitive impairment. • Amyloid PET and MRI were highly sensitive and specific distinguishing
more » ... ic distinguishing autopsyconfirmed AD from non-AD dementia; FDG-PET was highly sensitive and moderately (>0.5 to <0.8) specific; CSF tests were moderately sensitive and specific. Data were limited on biomarkers added to clinical evaluation. • Cholinesterase inhibitors (ChI) were slightly better than placebo for cognition and function, but increased withdrawals due to adverse effects; evidence was insufficient for supplements. In moderate to severe CATD, memantine plus ChI slightly improved cognition versus ChI, but not function. • Donepezil and antidepressants appeared similar to placebo for agitation and depression, respectively; for other prescription drugs and all supplements, evidence was insufficient on behavioral and psychological symptoms.
doi:10.23970/ahrqepccer223 fatcat:tpy4yxy26jbxndlquh56k7mzki