Skill Checkup: A 70-Year-Old Woman With History of Depression and Mild Cognitive Impairment Presents With Memory Lapses

Jasvinder P. Chawla, MD, MBA


December 22, 2022

The typical therapeutic approach in patients with mild AD involves monotherapy with a ChEI along with mental exercises, with the goal of preventing or delaying future cognitive decline. In placebo-controlled clinical trials, ChEIs have shown moderate benefit on measures of cognitive function and activities of daily living, slowing declines on cognitive and functional measures. The efficacy of mental exercises alone for slowing disease progression in AD is currently unknown.

The partial NMDA antagonist memantine is FDA-approved for the treatment of moderate to severe AD. It can be used alone or in combination with ChEIs. Studies suggest memantine in combination with donepezil affects cognition in moderate to severe AD but not in mild to moderate AD.

Editor's Note: Skill Checkups are wholly fictional or fictionalized clinical scenarios intended to provide evidence-based educational takeaways.

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