痴呆的治疗和康复
1. Treat cognitive symptoms of AD with Cholinesterase Inhibitors and Vitamin
E.
Consider the use of cholinesterase inhibitors in mild to moderate patients.
Cholinesterase inhibitors may improve quality of life and cognitive functions
including memory, thought and reasoning. They are proven effective for
people who are mildly to moderately affected by the disease, and are under
evaluation in patients with MCI and severe dementia. Therefore, the early
recognition and diagnosis of Alzheimer's disease is important. Consider
vitamin E to slow progression of AD; selegeline is also supported, albeit
by weaker evidence. Do not prescribe estrogen to treat AD.
2. Treat agitation, psychosis and depression.
The patient's paranoia, suspiciousness, combativeness or resistance
to maintaining personal hygiene can seem overwhelming to families and
caregivers and significantly impact quality of life. Evidence indicates
that several strategies can decrease problem behaviors. If environmental
manipulation fails to eliminate agitation or psychosis, use antipsychotics.
Selected tricyclics, MAO-B inhibitors and SSRIs should be considered to
treat depression.
3. Encourage caregivers to participate in Caregiver Educational Programs
and support groups.
Short term Caregiver Educational Programs can improve caregiver satisfaction.
Long term Caregiver Educational Programs can delay time to nursing home
placement for the AD patient. Caregiver training programs, and other support
systems (computer support networks, telephone support programs, adult
day care and other respite programs) may help delay time to nursing home
placement for AD patient, as well.
[引自www.aan.com]
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