'I Think Therefore I Am': Improving Cognition
'I Think Therefore I Am': Improving Cognition
Purpose of Review: In the absence of a specific treatment for dementia, the effective management of cognitive symptoms is a clinical priority.
Recent Findings: Although some differences have been observed in the profile of cognitive complaints observed in subtypes of dementia, there is increasing recognition of common, interacting neurobiological causes suggesting the need to seek a common treatment applicable to all causes of cognitive deterioration. There also exists increasing interest in intervening at the level of minor cognitive dysfunction by reducing risk factors for subclinical states.
Summary: Pharmacological treatment of cognitive disorder is beneficial but has only temporary benefit for a subgroup of patients. Pharmacogenetics may have an important future role to play in deciding which patients may best benefit from the treatment. Low side effect therapies such as cognitive therapy and acupuncture show some benefits but their utility in combination with pharmacotherapies remains to be demonstrated. Prevention of milder forms of cognitive disorder by controlling risk factors such as hypertension and diabetes may reduce rates of more severe cognitive degeneration. Persons with cognitive dysfunction are commonly excluded from making decisions about the implementation of cognition-enhancing treatments although they wish to do so.
Cognitive dysfunction is the central symptom of dementia and a cause of distress to both the person and their caregivers. It is the principal cause of a wide range of disabilities affecting attentional, mnesic, linguistic and visuo-spatial abilities. In the absence of an effective means of reversing the underlying neuropathology of the dementias, treatment has focused on slowing the cognitive deterioration with a view to extending functional independence for as long as possible. Recent advances in the treatment of the cognitive deficits seen in dementia have taken into account the subtypes of dementia and explore the possibilities of intervening preventively at preclinical phases of mild cognitive decline. Finally, the question is raised as to whether cognitive deficits in dementia prevent patients from making decisions about the treatment of their cognitive deficits.
Abstract and Introduction
Abstract
Purpose of Review: In the absence of a specific treatment for dementia, the effective management of cognitive symptoms is a clinical priority.
Recent Findings: Although some differences have been observed in the profile of cognitive complaints observed in subtypes of dementia, there is increasing recognition of common, interacting neurobiological causes suggesting the need to seek a common treatment applicable to all causes of cognitive deterioration. There also exists increasing interest in intervening at the level of minor cognitive dysfunction by reducing risk factors for subclinical states.
Summary: Pharmacological treatment of cognitive disorder is beneficial but has only temporary benefit for a subgroup of patients. Pharmacogenetics may have an important future role to play in deciding which patients may best benefit from the treatment. Low side effect therapies such as cognitive therapy and acupuncture show some benefits but their utility in combination with pharmacotherapies remains to be demonstrated. Prevention of milder forms of cognitive disorder by controlling risk factors such as hypertension and diabetes may reduce rates of more severe cognitive degeneration. Persons with cognitive dysfunction are commonly excluded from making decisions about the implementation of cognition-enhancing treatments although they wish to do so.
Introduction
Cognitive dysfunction is the central symptom of dementia and a cause of distress to both the person and their caregivers. It is the principal cause of a wide range of disabilities affecting attentional, mnesic, linguistic and visuo-spatial abilities. In the absence of an effective means of reversing the underlying neuropathology of the dementias, treatment has focused on slowing the cognitive deterioration with a view to extending functional independence for as long as possible. Recent advances in the treatment of the cognitive deficits seen in dementia have taken into account the subtypes of dementia and explore the possibilities of intervening preventively at preclinical phases of mild cognitive decline. Finally, the question is raised as to whether cognitive deficits in dementia prevent patients from making decisions about the treatment of their cognitive deficits.
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