Forstl_2008_Nervenarzt_79_617

The majority of elderly demented patients suffers from mixed dementia, with Alzheimer's-type brain changes being the leading cause of cognitive impairment. Cholinesterase inhibitors and memantin improve cognitive performance in dementia, with a symptomatic parallel shift of 8 to 12 months. Disturbances of perception and behaviour can be prohibited or mitigated by antidementia drugs and improved with antidepressants, neuroleptics, and other substances. The somatic and cerebral comorbidity of demented patients offers further options for improving sensory input, cerebral availability of oxygen and glucose, and even secondary prevention. Technical support systems for demented patients which are already available remain largely underused. Psychosocial support is mandatory, even though the advantages of specific interventions have not been demonstrated with scientific rigour.