legemiddelbehandling

Demens, legemidler

Demens

Pasientinformasjon

Geriatri

Kliniske kapitler

Håndboken

Norsk Elektronisk Legehåndbok

Generelt

Donepezil (Donepezil®, Aricept®)

Rivastigmin (Rivastigmin®, Exelon®)

Galantamin (Galantamin®, Reminyl®)

Memantin (Memantin, Ebixa®, eller Nemdatine®)

Vurdering av effekt

Vil du vite mer?

Demens ved Alzheimers sykdom

--&gt; https://www.helsedirektoratet.no/retningslinjer/demens

Helsedirektoratet. Demens. Nasjonal faglig retningslinje. Først publisert 16.08.2017. Sist faglig oppdatert 31.10.2022. 

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McKhann GM, Knopman DS, Chertkow H, et al.. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7(3): 263-9. pmid:21514250 

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Hyman BT, Phelps CH, Beach TG, et al. National Institute on Aging-Alzheimer's Association guidelines for the neuropathologic assessment of Alzheimer's disease. Alzheimers Dement. 2012 Jan;8(1):1-13. doi: 10.1016/j.jalz.2011.10.007. PMID: 22265587 

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Rongve A, Årsland D, Graff C. Alzheimers sykdom og genetikk. Tidsskr Nor Legeforen 2013; 133: 1449-52. doi:10.4045/tidsskr.12.0873 

Raulin AC, Doss SV, Trottier ZA, Ikezu TC, Bu G, Liu CC. ApoE in Alzheimer's disease: pathophysiology and therapeutic strategies. Mol Neurodegener. 2022 Nov 8;17(1):72. doi: 10.1186/s13024-022-00574-4. PMID: 36348357; PMCID: PMC9644639. 

Alzheimer A. Uber eine eigenartige Erkrankung der Hirnrinde. Allgemeine Zeitschrift fur Psychiatrie und Psychisch-Gerichtliche Medizin. 1907. 64: 146-148. 

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Bowler JV. Modern concept of vascular cognitive impairment. Br Med Bull 2007; 83: 291-305. pmid:17675645 

--&gt; https://butikk.aldringoghelse.no/demens/forekomst-av-demens-i-norge

Gjøra L, Kjelvik G, Strand BH, et al. Forekomst av demens i Norge. Utgitt av Forlaget aldring og helse 2020. ISBN 978-82-8061-579-4 (PDF). 

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Seshadri, S, Beiser, A, Kelly-Hayes, M, Kase, CS, Au, R et al. The lifetime risk of stroke: estimates from the Framingham Study. Stroke 2006; 37(2): 345-50. PMID: 16397184 

--&gt; https://www.aldringoghelse.no/demens/fakta-om-demens/

Nasjonalt senter for aldring og helse. Demens. Fakta om demens. Siden lest 31.01.2023. 

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Scheltens P, Blennow K, Breteler MM, et al. Alzheimer's disease. Lancet. 2016 Jul 30;388(10043):505-17. Epub 2016 Feb 24.pmid: 26921134 

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Small GW, Siddarth P, Ercoli LM, et al.. Healthy behavior and memory self-reports in young, middle-aged, and older adults. Int Psychogeriatr 2013; 25(6): 981-9. pmid:23425438 

Hunskår S (red.). Allmennmedisin. S. 419. Gyldendal Norsk Forlag AS. Gyldendal Akademisk, 2003. 

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Breijyeh Z, Karaman R. Comprehensive Review on Alzheimer's Disease: Causes and Treatment. Molecules. 2020 Dec 8;25(24):5789. doi: 10.3390/molecules25245789. PMID: 33302541 

Serrano-Pozo A, Frosch MP, Masliah E, Hyman BT. Neuropathological alterations in Alzheimer disease. Cold Spring Harb Perspect Biol. 2011 Sep. 3(9):a006189. 

Haass C, De Strooper B. Review: neurobiology - the presenilins in Alzheimer's disease - proteolysis holds the key. Science 1999; 286: 916-19. 

Journal of the American Medical Association

Green RC, Schneider LS, Amato DA, et al. Effect of tarenflurbil on cognitive decline and activities of daily living in patients with mild Alzheimer disease: A randomized controlled trial. JAMA 2009; 302: 2557-64. 

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Shea YF, Chu LW, Chan AO, et al.. A systematic review of familial Alzheimer's disease: Differences in presentation of clinical features among three mutated genes and potential ethnic differences. J Fomos Med Assoc 2016 Feb; 115(2): 67-75. pmid:26337232 

--&gt; http://dx.doi.org/10.4045/tidsskr.20.0919

Knapskog A-B, Engedal K, Selbæk G, Øksengård A-R. Alzheimers sykdom – diagnostikk og behandling. Tidsskr Nor Legeforen 2021. doi:10.4045/tidsskr.20.0919 

Serrano-Pozo A, Betensky RA, Frosch MP, Hyman BT. Plaque-Associated Local Toxicity Increases over the Clinical Course of Alzheimer Disease. Am J Pathol. 2016 Feb;186(2):375-84. doi: 10.1016/j.ajpath.2015.10.010. Epub 2015 Dec 11. PMID: 26687817; PMCID: PMC4729270. 

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Gao Y, Tan L, Yu JT, Tan L. Tau in Alzheimer's Disease: Mechanisms and Therapeutic Strategies. Curr Alzheimer Res. 2018;15(3):283-300. doi: 10.2174/1567205014666170417111859. PMID: 28413986. 

Hampel H, Mesulam MM, Cuello AC, Farlow MR, Giacobini E, Grossberg GT, Khachaturian AS, Vergallo A, Cavedo E, Snyder PJ, Khachaturian ZS. The cholinergic system in the pathophysiology and treatment of Alzheimer's disease. Brain. 2018 Jul 1;141(7):1917-1933. doi: 10.1093/brain/awy132. PMID: 29850777; PMCID: PMC6022632. 

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Strac DS, Muck-Seler D, Pivac N. Neurotransmitter measures in the cerebrospinal fluid of patients with Alzheimer's disease: a review. Psychiatr Danub. 2015 Mar;27(1):14-24. PMID: 25751428 

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Scheltens P, De Strooper B, Kivipelto M, et al. Alzheimer's disease. Lancet. 2021 Apr 24;397(10284):1577-1590. doi: 10.1016/S0140-6736(20)32205-4. Epub 2021 Mar 2. PMID: 33667416 

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Escott-Price V, Shoai M, Pither R, Williams J, Hardy J. Polygenic score prediction captures nearly all common genetic risk for Alzheimer's disease. Neurobiol Aging. 2017 Jan;49:214.e7-214.e11. doi: 10.1016/j.neurobiolaging.2016.07.018. Epub 2016 Aug 5. PMID: 27595457. 

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Jones EL, Mok K, Hanney M, et al. Evidence that PICALM affects age at onset of Alzheimer's dementia in Down syndrome. Neurobiol Aging 2013; 34(10): 2441.e1-5. pmid:23601808 

Livingston G, Huntley J, et.al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet 2020 Aug 8;396(10248):413-446. Pmid: 32738937. 

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Marinelli JP, Lohse CM, Fussell WL, et al. Association between hearing loss and development of dementia using formal behavioural audiometric testing within the Mayo Clinic Study of Aging (MCSA): a prospective population-based study. Lancet Healthy Longev 2022. pmid:36410368 

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Jiang F, Mishra SR, Shrestha N, et al. Association between hearing aid use and all-cause and cause-specific dementia: an analysis of the UK Biobank cohort. Lancet Public Health 2023; 8: e329-e338. pmid:37062296 

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Coupland CAC, Hill T, Dening T, et al. Anticholinergic Drug Exposure and the Risk of Dementia A Nested Case-Control Study. JAMA Intern Med 2019; 179: 1084-93. pmid:31233095 

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Jayadevappa R, Chhatre S, Malkowicz B, et al. Association Between Androgen Deprivation Therapy Use and Diagnosis of Dementia in Men With Prostate Cancer. JAMA Netw Open 2019; 2: e196562. pmid:31268539 

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Pourhadi N, Mørch LS, Holm EA, Torp-Pedersen C, Meaidi A. Menopausal hormone therapy and dementia: nationwide, nested case-control study. BMJ 2023; 381: e072770. pmid:37380194 

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Sochocka M, Zwolińska K, Leszek J. The Infectious Etiology of Alzheimer's Disease. Curr Neuropharmacol. 2017;15(7):996-1009. PMID: 28294067 

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Athanasopoulos D, Karagiannis G, Tsolaki M. Recent Findings in Alzheimer Disease and Nutrition Focusing on Epigenetics. Adv Nutr. 2016 Sep 15;7(5):917-27. doi: 10.3945/an.116.012229. PMID: 27633107 

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Huat TJ, Camats-Perna J, Newcombe EA, et al. Metal Toxicity Links to Alzheimer's Disease and Neuroinflammation. J Mol Biol. 2019 Apr 19;431(9):1843-1868. doi: 10.1016/j.jmb.2019.01.018. Epub 2019 Jan 18. PMID: 30664867 

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Sachdeva A, Chandra M, Choudhary M, et al. Alcohol-Related Dementia and Neurocognitive Impairment: A Review Study. Int J High Risk Behav Addict 2016 ; 5(3): e27976. pmid:27818965 

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Hill NL, Mogle J. Alzheimer's disease risk factors as mediators of subjective memory impairment and objective memory decline: protocol for a construct-level replication analysis. BMC Geriatr 2018; 18(1): 260. pmid:30373526 

Snowden JS, Thompson JC, Stopford CL, et al. The clinical dianosis of early-onset dementias: diagnostic accuracy and clinicopathological relationships. Brain 2011; : doi: 10.1093/brain/awr189. 

Palmer K, Bäckman L, Winblad B, Fratiglioni L. Detection of Alzheimer's disease and dementia in the preclinical phase: population based cohort stud. BMJ 2003; 326: 245-50. 

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Pietroboni AM, Scarioni M, Carandini T, et al.. CSF β-amyloid and white matter damage: a new perspective on Alzheimer's disease. J Neurol Neurosurg Psychiatry 2017 ; Epub Oct 20: jnnp-2017-316603. pmid:29054920 

Øksengård AR, Haakonsen M, Dullerud R, Babovic A, Laake K, Engedal K. Bildediagnostiske metoder ved demensutredning. Tidsskr Nor Lægeforen 2002; 122: 710-4. 

Arevalo-Rodriguez I, Smailagic N, Roque I Figuls M, et al. Mini-Mental State Examination (MMSE) for the detection of Alzheimer`s disease and other dementias in people with mild cognitive impairment (MCI). Cochrane Database Syst Rev. 2015 Mar 5;3:CD010783. doi: 10.1002/14651858.CD010783.pub2 

--&gt; http://dx.doi.org/10.1002/14651858.CD011145.pub2

Creavin ST, Wisniewski S, Noel-Storr AH, Trevelyan CM, Hampton T, Rayment D, Thom VM, Nash KJE, Elhamoui H, Milligan R, Patel AS, Tsivos DV, Wing T, Phillips E, Kellman SM, Shackleton HL, Singleton GF, Neale BE, Watton ME, Cullum S. Mini-Mental State Examination (MMSE) for the detection of dementia in clinically unevaluated people aged 65 and over in community and primary care populations. Cochrane Database of Systematic Reviews 2016, Issue 1. Art. No.: CD011145. DOI: 10.1002/14651858.CD011145.pub2 

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Johnson KA, Schultz A, Betensky RA, et al. Tau positron emission tomographic imaging in aging and early Alzheimer disease. Ann Neurol 2016 Jan; 79(1): 110-9. pmid:26505746 

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Goldman JS. Genetic testing and counseling in the diagnosis and management of young-onset dementias. Psychiatr Clin North Am 2015; 38(2): 295-308. pmid:25998117 

--&gt; https://www.nice.org.uk/guidance/ng97

National Institute for Health and Care Excellence (NICE). Dementia: assessment, management and support for people living with dementia and their carers. NICE guideline [NG97] Published date: June 2018 

Merkuri N, Croy A, Henry S, et al. Comparing and benchmarking national dementia strategies and policies European Dementia Monitor 2017. Alzheimer Europe, 2017 

--&gt; http://dx.doi.org/10.1136/bmj.l6930

Walsh S, King E, Brayne C. France removes state funding for dementia drugs. BMJ 2019; 367: I6930. doi:10.1136/bmj.l6930 

Husebo BS, Ballard C, Sandvik R, Nilsen OB, Aarsland D. Efficacy of treating pain to reduce behavioural disturbances in residents of nursing homes with dementia: cluster randomised clinical trial. BMJ 2012; 343: d4065. 

Russ TC, Morling JR. Cholinesterase inhibitors for mild cognitive impairment. Cochrane Database of Systematic Reviews 2012; 9: CD009132. 

Tricco AC, Soobiah C, Berliner S, et al. Efficacy and safety of cognitive enhancers for patients with mild cognitive impairment: a systematic review and meta-analysis. CMAJ 2013; 185: 1393-401. pmid:24043661 

Birks J. Cholinesterase inhibitors for Alzheimer's disease. Cochrane Database of Systematic Reviews 2006; 1: CD005593. 

Raina P, Santaguida P, Ismaila A, et al. Effectiveness of cholinesterase inhibitors and memantine for treating dementia: evidence review for a clinical practice guideline. Ann Intern Med 2008; 148: 379-97. 

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Soysal P, Isik AT, Stubbs B, et al. Acetylcholinesterase inhibitors are associated with weight loss in older people with dementia: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry. 2016 Jun 3 . pmid:27261502 

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Årsland D, Engedal KA, Nygaard HA, Louhija J, Ulstein I, Holm M. Bruk av kolinesterasehemmere. Tidsskr Nor Lægeforen 2003; 123: 1500-3. 

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Landmark K, Reikvam Å. Kolinesterasehemmere mot demens - nyttig i klinisk praksis?. Tidsskr Nor Legeforen 2008; 128: 294-7. 

Howard RJ, Juszczak E, Ballard CG, et al. Donepezil for the treatment of agitation in Alzheimer's disease. N Engl J Med 2007; 357: 1382-92. 

Howard R, McShane R, Lindesay J, et al. Donepezil and memantine for moderate-to-severe Alzheimer's disease. N Engl J Med 2012; 366: 957-9. 

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Truong C, Recto C, Lafont C, et al. Effect of Cholinesterase Inhibitors on Mortality in Patients With Dementia: A Systematic Review of Randomized and Nonrandomized Trials. Neurology 2022. PMID: 36096687 

Qizilbash N. Treatment of Alzheimer's disease. I: Qizilbash N, Schneider L, Chui H, Tariot P, Brodaty H, Kaye J et al. Evidence-based dementia practice. Oxford: Blackwell Science, 2002: 467 - 588. 

Birks JS, Grimley Evans J. Rivastigmine for Alzheimer's disease. Cochrane Database Syst Rev. 2015 ;4:CD001191. PMID: 25858345. 

Statens legemiddelverk. Terapianbefaling. Nytt om legemidler 2003; 26, nr. 6: 10-6. 

O'Brien JT, Ballard CG. Drugs for Alzheimer's disease (ed). BMJ 2001; 323: 123-4. 

Engedal K, Brækhus A, Gjerstad L. Effekt av legemidler mot demens. Tidsskr Nor Lægeforen 2004; 124: 1641-2. 

Wilkinson D, Wirth Y, Goebel C. Memantine in patients with moderate to severe Alzheimer's disease: meta-analyses using realistic definitions of response. Dement Geriatr Cogn Disord. 2014;37(1-2):71-85. doi: 10.1159/000353801 

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McShane R, Areosa Sastre A, Minakaran N. Memantine for dementia. Cochrane Database of Systematic Reviews 2006, Issue 2. Art. No.: CD003154. DOI: 10.1002/14651858.CD003154.pub5. 

Schneider LS, Dagerman KS, Higgins JPT, McShane R. Lack of evidence for the efficacy of memantine in mild Alzheimer disease. Arch Neurol 2011; e-pub. 

Lopez OL, Becker JT, Wahed AS. Long-term effects of the concomitant use of memantine with cholinesterase inhibition in Alzheimer disease. J Neurol Neurosurg Psychiatry 2009; 80: 600-7. 

Farrimond LE, Roberts E, McShane R. Memantine and cholinesterase inhibitor combination therapy for Alzheimer's disease: a systematic review. BMJ 2012; 2: e000917. doi:10.1136/bmjopen-2012-000917 

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Birks J, Grimley Evans J. Ginkgo biloba for cognitive impairment and dementia. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD003120. DOI: 10.1002/14651858.CD003120.pub3. 

Vellas B, Coley N, Ousset PJ, et al. Long-term use of standardised ginkgo biloba extract for the prevention of Alzheimer's disease (GuidAge): a randomised placebo-controlled trial. Lancet Neurol 2012. doi:10.1016/S1474-4422(12)70206-5 

DeKosky ST, Williamson JD, Fitzpatrick AL et al. Ginkgo biloba for prevention of dementia. JAMA 2008; 300:2253-62. 

Snitz BE, O'Meara ES, Carlson MC, et al. Ginkgo biloba for preventing cognitive decline in older adults. JAMA 2009; 302: 2663-70. 

Ruths S, Straand J. Antipsykotiske midler mot uro ved demens - medisinsk behandling eller kjemisk atferdsregulering?. Tidsskr Nor Lægeforen 2005; 125: 1672-5. 

Schneider LS, Dagerman KS, Insel P. Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials. JAMA 2005; 294: 1934-43. 

Schneider LS, Tariot PN, Dagerman KS, et al. Effectiveness of atypical antipsychotic drugs in patients with Alzheimer`s disease. N Engl J Med. 2006; 355: 1525-38. 

Douglas IJ, Smeeth L. Exposure to antipsychotics and risk of stroke: self controlled case series study. BMJ 2008; 337: a1227. 

Ray WA, Chung CP, Murray KT, et al. Atypical antipsychotic drugs and the risk of sudden cardiac death. N Engl J Med 2009; 360: 225-35. 

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Ooms S, Ju YE. Treatment of Sleep Disorders in Dementia. Curr Treat Options Neurol 2016; 18(9): 40. pmid:27476067 

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Cao B, Rosenblat JD, Brietzke E, et al. Comparative efficacy and acceptability of antidiabetic agents for Alzheimer`s disease and mild cognitive impairment: A systematic review and network meta-analysis. Diabetes Obes Metab. 2018. PMID: 29790638 

Bentham P, Gray R, Sellwold E, et al. Aspirin in Alzheiemer's disease (AD 2000): a randomised open-label trial. Lancet Neurol 2008; 7: 41-9. 

Aisen PS, Schneider LS, Sano M, et al. High-dose B vitamin supplementation and cognitive decline in Alzheimer disease. JAMA 2008; 300: 1774-83. 

Malouf R, Grimley Evans J. Folic acid with or without vitamin B12 for the prevention and treatment of healthy elderly and demented people. Cochrane Database Syst Rev 2008; 8: CD004514. 

Dysken MW, Sano M, Asthana S, et al. Effect of vitamin E and memantine on functional decline in Alzheimer disease. JAMA 2014; 311: 33-44. doi:10.1001/jama.2013.282834 

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Roy S, Weinstock JL, Ishino AS, et al.. Association of Cognitive Impairment in Patients on 3-Hydroxy-3-Methyl-Glutaryl-CoA Reductase Inhibitors. J Clin Med Res 2017 Jul; 9(7): 638-649. pmid:28611866 

--&gt; http://dx.doi.org/10.1002/14651858.CD009002

Burckhardt M, Herke M, Wustmann T, et al. Omega-3 fatty acids for the treatment of dementia. Cochrane Database Syst Rev 2016 11;4:CD009002 

--&gt; http://dx.doi.org/10.1002/14651858.CD005379.pub3

Sydenham E, Dangour AD, Lim WS. Omega 3 fatty acid for the prevention of cognitive decline and dementia. Cochrane Database of Systematic Reviews 2012, Issue 6. Art. No.: CD005379. DOI: 10.1002/14651858.CD005379.pub3 

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Atri A, Frölich L, Ballard C, et al. Effect of Idalopirdine as Adjunct to Cholinesterase Inhibitors on Change in Cognition in Patients With Alzheimer Disease Three Randomized Clinical Trials. JAMA 2018; 319: 130-42. pmid:29318278 

--&gt; http://dx.doi.org/10.1016/S1474-4422(21)00263-5

Kehoe PG, Turner N, Howden B, et al. Safety and efficacy of losartan for the reduction of brain atrophy in clinically diagnosed Alzheimer's disease (the RADAR trial): a double-blind, randomised, placebo-controlled, phase 2 trial. Lancet Neurol 2021. doi:10.1016/S1474-4422(21)00263-5 

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Huang LK, Chao SP, Hu CJ. Clinical trials of new drugs for Alzheimer disease. J Biomed Sci. 2020 Jan 6;27(1):18. doi: 10.1186/s12929-019-0609-7. PMID: 31906949 

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van Dyck CH, Swanson CJ, Aisen P, et al. Lecanemab in Early Alzheimer's Disease. N Engl J Med. 2023 Jan 5;388(1):9-21. doi: 10.1056/NEJMoa2212948. Epub 2022 Nov 29. PMID: 36449413 

Graff MJ, Vernooij-Dassen MJ, Thijssen M et al. Community based occupational therapy for patients with dementia and their care givers: randomised controlled trial. BMJ 2006; 333: 1196 201. 

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Guure CB, Ibrahim NA, Adam MB, et al. Impact of Physical Activity on Cognitive Decline, Dementia, and Its Subtypes: Meta-Analysis of Prospective Studies. Biomed Res Int 2017; 9016924: Epub Feb 7. pmid:28271072 

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Brodaty H, Arasaratnam C. Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia. Am J Psychiatry 2012; 169: 946-53. PMID: 22952073 

--&gt; http://dx.doi.org/10.1136/bmjopen-2014-005247

Huntley JD, Gould RL, Liu K, et al. Do cognitive interventions improve general cognition in dementia? A meta-analysis and meta-regression. BMJ Open. 2015 Apr 2;5(4):e005247. doi: 10.1136/bmjopen-2014-005247 

--&gt; http://dx.doi.org/10.1002/14651858.CD005562.pub2

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