[Treatment of Alzheimer's disease: the current situation?]

Current evidence tends to support the notion that Alzheimer's disease may be postponed by implementing interventions toward the potential etiologic factors (both risk and protective factors) (i.e., primary prevention) and by early detection (i.e., secondary prevention). Epidemiologic research has provided sufficient evidence that vascular risk factors in middle-aged and older adults play a significant role in the development and progression of dementia and AD, whereas extensive social network and active engagement in mental, social, and physical activities may postpone the onset of the dementing disorder. The tertiary prevention may help stabilize cognitive functions, reduce agitation, control neuropsychiatric symptoms. This tertiary prevention aims to avoid functional disability, and if possible, to improve quality of life for patients with AD. Cognitive training may help maintain cognitive function, slow down cognitive decline, and improve wellbeing for people with mild dementia. Current pharmacological treatment widely used for AD and dementia, including cholinesterase inhibitors (donepezil, rivastigmine, and galantamine) and the N-methyl-D-aspartate-receptor antagonist (memantine), psychotropic medications are designed to target clinical symptoms of the disease such as cognitive and neuropsychiatric disturbances.