Alzheimer's Disease Management

The psychiatrist can play several important roles in the care of persons with Alzheimer’s diseaseand other dementing illnesses. Diagnostic issues for which psychiatrists have specific skills includeidentifying early cases, performing a differential diagnosis, and distinguishing reversible depressionfrom depression associated with irreversible dementia and irreversible dementia without depression.Treatment should include management of behavioral, noncognitive, and cognitive symptoms. Environmentaland pharmacologic therapies have proven efficacious in treating noncognitive behavioralsymptoms. Neuroleptic antipsychotic drugs are effective in treating aggressive behaviors and delusions.The treatment of cognitive symptoms currently rests on cholinergic enhancement. Finally, thepsychiatrist can play important roles in educating the public and supporting the distressed caregiver.