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Dementia and Comorbidities: An Overview of Diagnosis and Management

The University of Oklahoma College of Pharmacy, Department of Pharmacy: Clinical and Administrative Sciences, Oklahoma City, Oklahoma

Ryan M. Carnahan, PharmD, MS, BCPP

The University of Oklahoma College of Pharmacy, Department of Pharmacy: Clinical and Administrative Sciences, Tulsa, Oklahoma, ryan-carnahan{at}ouhsc.edu

The term "dementia" describes various neurodegenerative disorders that effect cognition, including Alzheimer disease, vascular dementia, and others. This article reviews the diagnosis and management of common types of dementia and comorbidities. Dementias are differentiated clinically by history, symptom presentation, and exclusion of other causes through laboratory and imaging studies. Cholinesterase inhibitors are useful but may not be effective for all types of dementia and provide only modest benefits. Certain medical comorbidities may increase the risk of dementia, although genetics are also important in its etiology. Psychiatric comorbidities in dementia include delirium, which is treated primarily by addressing underlying medical disorders, but antipsychotics can be useful for symptom management and patient comfort. Nonpharmacologic interventions are first-line treatments for other psychiatric comorbidities, although drug therapy may be useful in some cases. The management of patients with dementia presents many challenges and will continue to do so unless agents with pronounced disease-modifying capabilities are developed.

Key Words: Dementia • delirium • cognitive enhancers • comorbidities.

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