Prise en charge thérapeutique de la démence

The treatment of Alzheimer's disease and vascular dementia has benefited from recent therapeutic trials. The symptomatic treatment of Alzheimer's disease has been improved with the use of anticholinesterase drugs. In the prevention of dementia, trials are currently carried out to test new drugs such as calcium inhibitors, immunotherapy, agents acting on the beta-amyloid pathway (inhibitors of beta and gamma secretases), neuronal growth factors, and neuronal transplantation which are also promising avenues. The links between Alzheimer's disease and vascular dementia have been recently highlighted. Epidemiological data showed a positive correlation between the presence of vascular risk factors (high-blood pressure, diabetes, hypercholesterolemia, atrial fibrillation) and cognitive decline or dementia (degenerative or vascular-type). The screening of these factors could result in appropriate prevention of dementia with antihypertensive drugs, cholesterol lowering agents, antidiabetic and antiplatelets agents. Recent data from therapeutic trials showed the preventive effect of antihypertensive drugs in the treatment of Alzheimer's disease and vascular dementia.