goal of much of the research activity in dementia is
to develop interventions for 'treatment' or even 'cure'. The classical bench to
bedside paradigm has been disappointing in dementia.
There is a long list of putative dementia
treatment compounds with favourable pre-clinical and early phase trial data
that have been neutral or even potentially harmful when assessed in phase III
studies. Lewy body dementia is a
common but frequently under diagnosed cause of dementia
often mistaken for the more familiar entity of Alzheimer
disease. Clinically the distinction is important, because it can have profound
implications for management. The diagnosis of Lewy bodydementia has
important implications. It is associated with a high incidence of neuroleptic
sensitivity, necessitating great caution in the use of these common
antipsychotic agents. Early studies indicate cholinesterase
inhibitors can be beneficial for treating the hallucinations and behaviour
disturbances that afflict these patients and might also improve cognition.