Systematic management of vascular risk factors should be performed in patients with mild to moderate dementia as prevention of cerebrovascular pathology may impact on the progression of dementia (Good Practice statement). Individuals with dementia (without previous stroke) and atrial fibrillation should be treated with anticoagulants (weak recommendation). Discontinuation of opioids should be considered in certain individuals with dementia (e.g. for whom there are no signs or symptoms of pain or no clear indication, or suspicion of side effects; Good Practice statement). Behavioral symptoms in persons with dementia should not be treated with mild analgesics (weak recommendation). In all patients with dementia treated with opioids, assessment of the individual risk–benefit ratio should be performed at regular intervals. Regular, preplanned medical follow-up should be offered to all patients with dementia. The setting will depend on the organization of local health services and should, as a minimum, include general practitioners with easy access to dementia specialists (Good Practice statement). Individuals with dementia and agitation and/or aggression should be treated with atypical antipsychotics only after all non-pharmacological measures have been proven to be without benefit or in the case of severe self-harm or harm to others (weak recommendation). Antipsychotics should be discontinued after cessation of behavioral disturbances and in patients in whom there are side effects (Good Practice statement). For treatment of epilepsy in individuals with dementia, newer anticonvulsants should be considered as first-line therapy (Good Practice statement).
F.22 Improvement to existing health/diagnostic methods/procedures
COBISS.SI-ID: 55705603Alzheimer’s disease (AD) and related dementia is one of the growing threats to the sustainability of health and care systems in developed countries, and efforts to find therapies have had scant success. The main reasons for this are lack of efficient therapy, which is linked to too late discovery of the disease itself. With this in mind, biomarkers are recognized as an element which can bring a major contribution to research, helping elucidate the disease and the search for treatments. They are also playing an increasing role in early detection and timely diagnosis, which are considered the principal hopes of effective management in the absence of an effective drug. The current arsenal of biomarkers could already, if more widely deployed, provide an effective minimum service to patients and health systems. A concerted action by policy makers and stakeholders could drive progress in access to AD biomarker testing to provide an optimum service in the medium term. This paper discusses how to improve the use of and access to biomarker testing in the detection and diagnosis of AD and other diseases featuring dementia, and how EU healthcare systems could benefit. It outlines the challenges, lists the achievements to date, and highlights the actions needed to allow biomarker testing to deliver more fully on their potential in AD.
F.02 Acquisition of new scientific knowledge
COBISS.SI-ID: 43408131Objective: To compare dementia patients who suffer an ischemic stroke (IS) with non-dementia IS patients in: (1) access, complications and outcomes in treatment with intravenous thrombolysis (IVT), (2) hospital management with focus on hospitalization in specialized stroke units, performance of specific diagnostic tests, rehabilitation and hospitalization length, and (3) institution of pharmacological secondary stroke prevention during hospitalization and its maintenance over the years after IS. Hypotheses: In comparison to non-dementia IS patients, patients with dementia and IS: (1) have worse access to IVT, (2) have more complications and worse outcomes after IVT, (3) have worse access to specialized stroke units, receive less diagnostic tests and rehabilitation assessments, (4) have shorter hospitalization, and (5) are less likely to receive secondary stroke prevention therapy.
D.09 Tutoring for postgraduate students
COBISS.SI-ID: 61586691Objective: We aimed to (1) summarize current knowledge about the management of IS in patients with preexisting dementia; (2) assess the risks and benefits of warfarin, antiplatelets, and no treatment in patients with dementia and AF; (3) analyse the characteristics of dementia patients that died from IS and compare them to those who died from other causes.
D.09 Tutoring for postgraduate students
COBISS.SI-ID: 302130688Interview with a neurologist about dementia, cronic stress and brain "repair" in the future
F.35 Other
COBISS.SI-ID: 5237932