In the 1980s, we called dementia a “silent epidemic.”1 Recognition of the condition grew, especially with the announcement of former President Ronald Reagan’s affliction with the most common form, Alzheimer disease. Originally, efforts to improve dementia care seemed to focus on the difficulty of detection and differential diagnosis and ways to reduce excess disability.2 Since the development of US Food and Drug Administration–approved dementia drugs, focus nowadays seems to have shifted to prescribing these medications. These aggressively marketed drugs, prescribed because they supposedly reduce the rate of decline in people with Alzheimer disease, have generally been a disappointment. Indeed, increasing numbers of people are given these cholinesterase inhibitors, sometimes while they are taking anticholinergics—a contradictory combination.3,4 We need a new strategy for dementia care, and the study by Amjad et al5 in the current issue of JAMA Internal Medicine suggests the way forward.
Larson EB. Medical Care When Memory Fails. JAMA Intern Med. 2016;176(9):1378-1379. doi:10.1001/jamainternmed.2016.3566