For patients with mild to moderate AD, such as the one in this case, ChEIs are recommended. These agents have shown modest benefit on measures of cognitive function and activities of daily living; slowing declines on cognitive and functional measures when compared with patients on placebo.
The partial NMDA antagonist memantine is also the Food and Drug Administration-approved in the treatment of AD and can be used alone or in combination with acetylcholinesterase inhibitors for moderate to severe disease, having shown consistent benefit on measures of function when compared with placebo. These symptomatic therapies have demonstrated similar outcomes in regard to improved cognition and global function, as well as temporary stabilization of activities of daily living. Most studies conclude that current neuropsychiatric symptoms improve, and emergence of new neuropsychiatric symptoms slows following treatment with symptomatic agents.
Secondary symptoms of AD, many of which develop as the primary disease progresses, are generally treated with psychotropic medications.
Editor's Note: Skill Checkups are wholly fictional or fictionalized clinical scenarios intended to provide evidence-based educational takeaways.
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Cite this: Shaheen E. Lakhan. Skill Checkup: A 71-Year-Old Woman With Signs of Self-Reported Cognitive Impairment and Primarily Short-Term Memory Loss - Medscape - Jan 31, 2023.