As the population ages worldwide, society must bear a series of burdens. One set stems from the increasing rate of dementia: Alzheimer, vascular, frontotemporal, Lewy body, mixed, and others. Medical science has found preventions for a few diseases, cures for a few more, and symptomatic relief for many others. But so far, science has been stymied in attempts to understand and cure the ravages of dementia. An upcoming issue of BTP will review current medications for Alzheimer disease and other dementias, but alas, efficacy is very limited. Someday we can expect preventions and cures, but today’s interventions are modest.
Doctors should seek to diagnose and treat coincident conditions that can trouble dementia patients and lead to disruptive behavior. Common examples are urinary tract and other infections, arthritic and other sources of pain, bedsores, and various ailments of the frail and elderly. Specific treatments like antimicrobials and nonspecific approaches like analgesics sometimes quell aggressive behavior. Of course, identifying environmental and interpersonal factors that can aggravate patients may allow for constructive intervention. Music, activities, and aromatherapies can soothe and comfort even advanced cases. We do what we can and always remember primum non nocere.
-Alan J. Gelenberg, M.D.
Editor, Biological Therapies in Psychiatry
Professor Emeritus, University of Arizona
Editor-in-Chief, Journal of Clinical Psychiatry