Behandeling van dementie

• Treatment options for patients with dementia are limited. This article provides an overview of possible interventions, both pharmaceutical and nonpharmaceutical, for Alzheimer's disease, vascular dementia and mixed dementia. • Pharmaceutical treatment options include cholinesterase inhibitors, memantine and experimental medication. Cholinesterase inhibitors are only recommended for Alzheimer's disease and mixed dementia, not for vascular dementia or mild cognitive impairment. There is no proof of effectiveness for the other pharmaceutical options. • Interventions towards cardiovascular risk factors do not slow down cognitive decline. • Evidence is still lacking for other nonpharmaceutical interventions such as memory training and dietary supplements. Physical exercise may have a positive effect on dementia, but research is still ongoing. • Many patients with dementia exhibit behavioural changes such as agitation and depression. We recommend nonpharmaceutical interventions as a first step to lower the burden of this behaviour for both patients and caregivers.