Unformatted text preview: impression of change based on interview with patient and caregiver. MMSE Targeted symptoms to resolve or to emerge. © TND 2005 ISSUES IN CLINICAL PRACTICE:
WHEN IS IT TIME TO STOP A CI? Intolerable sideeffects (ex. insomnia, nausea/vomiting/diarrhea, muscle cramps).
Clear deterioration of symptoms over the first 6 months.
Loss of response over time. > consider switching to another CI. © TND 2005 SWITCHING BETWEEN CI
(Morris et al, Clin Ther 23; Suppl A, A31-A39, 2001)
(Morris No wash out required unless unresolved side effects from first CI
Monthly titration of second CI
Monitor for efficacy and tolerability monthly for 3 months
Combinations of CI are not recommended © TND 2005 DIAGNOSTIC CRITERIA FOR
VASCULAR Decline in intellectual function interfering with daily life not due to physical effects of stroke(s) alone.
Evidence by Hx, physical and/or brain imaging of stroke(s).
Temporal relationship between dementia and cerebrovascular disease.
© TND 2005 LS mean change from baseline
ADAS-cog score Donepezil in VaD: LS Mean Change in
3 *** –
0 *** Donepezil 10 mg ***
improvement Baseline 1
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- Fall '13
- Physiology, placebo, donepezil, TND