Dementia and neurocognitive disorders最新文献

{"title":"Cognitive Impairment Screening Test in Korea as a Screening Tool for Dementia: The Correlation Study of Subtest Scores With Korean Version of the Mini Mental State Examination 2nd Edition.","authors":"Minseong Kim, Doyun Heo, Seonkyeong Kim, Yunjin Lee, Yong Sung Kim, Wonjae Sung, Hee-Jin Kim","doi":"10.12779/dnd.2025.24.2.126","DOIUrl":"https://doi.org/10.12779/dnd.2025.24.2.126","url":null,"abstract":"<p><strong>Background and purpose: </strong>The Cognitive Impairment Screening Test in Korea (CIST-K) was designed to detect cognitive decline. Developed independently and widely used in Korea, it is yet to be validated with other screening tests. This study aimed to introduce normative data to the CIST-K and assess its clinical usefulness through correlation analysis with the Korean version of the Mini-Mental State Examination, 2nd edition (K-MMSE-2).</p><p><strong>Methods: </strong>We enrolled 85 participants from a tertiary university hospital in Korea, including patients diagnosed with mild cognitive impairment and Alzheimer's disease by experienced neurologists. Both the CIST-K and K-MMSE-2 were administered to assess the cognitive function of the participants, with scores from each subtest of the neuropsychological tests compared.</p><p><strong>Results: </strong>Multivariate correlation analysis, which was adjusted for age, sex, and education level, revealed a significant correlation between the two tests in orientation, memory, and attention. However, no significant correlation was found between the two tests in visuospatial and language functions.</p><p><strong>Conclusions: </strong>In conclusion, this study demonstrates that some subtests in the CIST-K align with corresponding scores on the K-MMSE-2. However, caution is advised when interpreting visuospatial and language test scores from the CIST-K. Further validity studies are necessary to enhance the sensitivity of each subtest.</p>","PeriodicalId":72779,"journal":{"name":"Dementia and neurocognitive disorders","volume":"24 2","pages":"126-134"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing Regional Aβ Cutoffs and Exploring Subgroup Prevalence Across Cognitive Stages Using BeauBrain Amylo^®.","authors":"Seongbeom Park, Kyoungmin Kim, Soyeon Yoon, Seongmi Kim, Jehyun Ahn, Kyoung Yoon Lim, Hyemin Jang, Duk L Na, Hee Jin Kim, Seung Hwan Moon, Jun Pyo Kim, Sang Won Seo, Jaeho Kim, Kichang Kwak","doi":"10.12779/dnd.2025.24.2.135","DOIUrl":"https://doi.org/10.12779/dnd.2025.24.2.135","url":null,"abstract":"<p><strong>Background and purpose: </strong>Amyloid-beta (Aβ) plaques are key in Alzheimer's disease (AD), with Aβ positron emission tomography imaging enabling non-invasive quantification. To address regional Aβ deposition, we developed regional Centiloid scales (rdcCL) and commercialized them through the computed tomography (CT)-based BeauBrain Amylo platform, eliminating the need for three-dimensional T1 magnetic resonance imaging (MRI).</p><p><strong>Objective: </strong>We aimed to establish robust regional Aβ cutoffs using the commercialized BeauBrain Amylo platform and to explore the prevalence of subgroups defined by global, regional, and striatal Aβ cutoffs across cognitive stages.</p><p><strong>Methods: </strong>We included 2,428 individuals recruited from the Korea-Registries to Overcome Dementia and Accelerate Dementia Research project. We calculated regional Aβ cutoffs using Gaussian Mixture Modeling. Participants were classified into subgroups based on global, regional, and striatal Aβ positivity across cognitive stages (cognitively unimpaired [CU], mild cognitive impairment, and dementia of the Alzheimer's type).</p><p><strong>Results: </strong>MRI-based and CT-based global Aβ cutoffs were highly comparable and consistent with previously reported Centiloid values. Regional cutoffs revealed both similarities and differences between MRI- and CT-based methods, reflecting modality-specific segmentation processes. Subgroups such as global(-)regional(+) were more frequent in non-dementia stages, while global(+)striatal(-) was primarily observed in CU individuals.</p><p><strong>Conclusions: </strong>Our study established robust regional Aβ cutoffs using a CT-based rdcCL method and demonstrated its clinical utility in classifying amyloid subgroups across cognitive stages. These findings highlight the importance of regional Aβ quantification in understanding amyloid pathology and its implications for biomarker-guided diagnosis and treatment in AD.</p>","PeriodicalId":72779,"journal":{"name":"Dementia and neurocognitive disorders","volume":"24 2","pages":"135-146"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protective Genes Against Alzheimer's Disease: Case Review and Therapeutic Implications.","authors":"Nabiha Hossain, Yong Jeong","doi":"10.12779/dnd.2025.24.2.75","DOIUrl":"https://doi.org/10.12779/dnd.2025.24.2.75","url":null,"abstract":"<p><p>Alzheimer's disease (AD), a neurodegenerative disorder characterized by the accumulation of amyloid-beta plaques and tau tangles, shows cognitive decline. Recent genetic studies have identified over 30 variants that are resilient to AD pathology, offering new therapeutic opportunities. This review explores key protective mutations of <i>APOE3 Christchurch</i>, <i>RELN-COLBOS</i>, <i>FN1</i>, <i>APP A673T</i>, <i>BDNF Val66Met</i>, <i>SORL1</i>, <i>CR1</i>, <i>TREM2</i>, <i>PICALM</i>, and <i>INPP5 D</i> genes. These affect critical pathways, including lipid metabolism, synaptic function, tau regulation, and immune response. Potential treatments are discussed, including gene therapy and neuroprotective strategies, emphasizing a shift toward precision medicine focused on genetic resilience. By reviewing case studies and relevant literatures, the work explores the mechanisms by which these variants mitigate amyloid accumulation, tau pathology, neurodegeneration, and neuroinflammation, the key contributors to AD progression. Understanding these protective pathways offers critical insights into potential therapeutic applications, such as gene therapy, immune-modulating treatments, and personalized medicine approaches tailored to the individual's genetic profile. The findings highlight the potential to leverage genetic protection mechanisms to develop precision interventions for AD, offering new hope to prevent or delay disease onset and progression. These discoveries could transform future treatment strategies, shifting the focus from risk management to exploiting genetic resilience to combat AD.</p>","PeriodicalId":72779,"journal":{"name":"Dementia and neurocognitive disorders","volume":"24 2","pages":"75-90"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproducibility of Plasma Biomarker Measurements Across Laboratories: Insights Into ptau217, GFAP, and NfL.","authors":"Heekyoung Kang, Sook-Young Woo, Daeun Shin, Sohyun Yim, Eun Hye Lee, Hyunchul Ryu, Bora Chu, Henrik Zetterberg, Kaj Blennow, Jihwan Yun, Duk L Na, Hee Jin Kim, Hyemin Jang, Jun Pyo Kim","doi":"10.12779/dnd.2025.24.2.91","DOIUrl":"https://doi.org/10.12779/dnd.2025.24.2.91","url":null,"abstract":"<p><strong>Background and purpose: </strong>Plasma biomarkers, including phosphorylated tau (ptau217), glial fibrillary acidic protein (GFAP), and neurofilament light chain (NfL), are promising tools for detecting Alzheimer's disease (AD) pathology. However, cross-laboratory reproducibility remains a challenge, even when using identical analytical platforms such as single-molecule array (Simoa). This study aimed to compare plasma biomarker measurements (ptau217, GFAP, and NfL) between 2 laboratories, the University of Gothenburg (UGOT) and DNAlink, and evaluate their associations with amyloid positron emission tomography (PET) imaging.</p><p><strong>Methods: </strong>Plasma biomarkers were measured using Simoa platforms at both laboratories: the UGOT and DNAlink Incorporation. Diagnostic performance for predicting amyloid PET positivity, cross-laboratory agreement, and the impact of normalization techniques were assessed. Bland-Altman plots and correlation analyses were employed to evaluate agreement and variability.</p><p><strong>Results: </strong>Plasma ptau217 concentrations exhibited strong correlations with amyloid PET global centiloid values, with comparable diagnostic performance between laboratories (area under the curve=0.94 for UGOT and 0.95 for DNAlink). Cross-laboratory agreement for ptau217 was excellent (<i>r</i>=0.96), improving further after natural log transformation. GFAP and NfL also demonstrated moderate to strong correlations (<i>r</i>=0.86 for GFAP and <i>r</i>=0.99 for NfL), with normalization reducing variability.</p><p><strong>Conclusions: </strong>Plasma biomarker measurements were consistent across laboratories using identical Simoa platforms, with strong diagnostic performance and improved agreement after normalization. These findings support the scalability of plasma biomarkers for multi-center studies and underscore their potential for standardized applications in AD research and clinical practice.</p>","PeriodicalId":72779,"journal":{"name":"Dementia and neurocognitive disorders","volume":"24 2","pages":"91-101"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying Brain Atrophy Using a CSF-Focused Segmentation Approach.","authors":"Kyoung Yoon Lim, Seongbeom Park, Duk L Na, Sang Won Seo, Min Young Chun, Kichang Kwak","doi":"10.12779/dnd.2025.24.2.115","DOIUrl":"https://doi.org/10.12779/dnd.2025.24.2.115","url":null,"abstract":"<p><strong>Background and purpose: </strong>Brain atrophy, characterized by sulcal widening and ventricular enlargement, is a hallmark of neurodegenerative diseases such as Alzheimer's disease. Visual assessments are subjective and variable, while automated methods struggle with subtle intensity differences and standardization, highlighting limitations in both approaches. This study aimed to develop and evaluate a novel method focusing on cerebrospinal fluid (CSF) regions by assessing segmentation accuracy, detecting stage-specific atrophy patterns, and testing generalizability to unstandardized datasets.</p><p><strong>Methods: </strong>We utilized T1-weighted magnetic resonance imaging data from 3,315 participants from Samsung Medical Center and 1,439 participants from other hospitals. Segmentation accuracy was evaluated using the Dice similarity coefficient (DSC), and W-scores were calculated for each region of interest (ROI) to assess stage-specific atrophy patterns.</p><p><strong>Results: </strong>The segmentation demonstrated high accuracy, with average DSC values exceeding 0.9 for ventricular and hippocampal regions and above 0.8 for cortical regions. Significant differences in W-scores were observed across cognitive stages (cognitively unimpaired, mild cognitive impairment, dementia of Alzheimer's type) for all ROIs (all, <i>p</i><0.05). Similar trends were observed in the images from other hospitals, confirming the algorithm's generalizability to datasets without prior standardization.</p><p><strong>Conclusions: </strong>This study demonstrates the robustness and clinical applicability of a novel CSF-focused segmentation method for assessing brain atrophy. The method provides a scalable and objective framework for evaluating structural changes across cognitive stages and holds potential for broader application in neurodegenerative disease research and clinical practice.</p>","PeriodicalId":72779,"journal":{"name":"Dementia and neurocognitive disorders","volume":"24 2","pages":"115-125"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Clinical and Behavioral Characteristics of Mild Cognitive Impairment According to Amyloid Positivity: A Large Multi-Center Korean Cohort.","authors":"Seung Ae Kim, Yeshin Kim, Duk L Na, Sang Won Seo, Hyemin Jang","doi":"10.12779/dnd.2025.24.2.102","DOIUrl":"https://doi.org/10.12779/dnd.2025.24.2.102","url":null,"abstract":"<p><strong>Background and purpose: </strong>Mild cognitive impairment (MCI) is a transitional stage to dementia, Alzheimer's disease being a major cause. Although amyloid beta-positive (Aβ+) MCI has been well-characterized, Aβ-negative (Aβ-) MCI has not. This study compared the comprehensive clinical and behavioral characteristics of Aβ+ and Aβ- MCI in a large multi-center cohort to better understand the heterogeneity of MCI, and to identify contributing factors to cognitive impairment.</p><p><strong>Methods: </strong>A total of 686 MCI participants were included. Aβ positivity was determined using Aβ positron emission tomography imaging with a direct conversion Centiloid cutoff value of 25.5. Standardized assessment and questionnaires were used to collect a wide range of clinical information, including vascular risk factors, cognition, daily living function, neuropsychiatric symptoms, and lifestyle behavior. Groups were compared using independent <i>t</i>-tests and χ² tests.</p><p><strong>Results: </strong>Aβ+ participants (n=406) were older, predominantly female, and more likely to be ApoE4 carriers. In contrast, Aβ- participants (n=280) showed higher vascular risk factors, including diabetes, elevated body mass index, and higher C-reactive protein levels. Aβ+ participants exhibited worse global cognition and functional decline, with a higher prevalence of delusions and appetite disturbances. Meanwhile, Aβ- participants reported greater social engagement, but poorer sleep quality.</p><p><strong>Conclusions: </strong>This study highlights the distinct clinical and lifestyle profiles of Aβ+ and Aβ- MCI, illuminating the heterogeneity of MCI and its underlying factors in the Korean population.</p>","PeriodicalId":72779,"journal":{"name":"Dementia and neurocognitive disorders","volume":"24 2","pages":"102-114"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Cognitive and Depressive Status on Empathy in Healthy Elderly, Amnestic MCI, and Dementia of the Alzheimer's Type.","authors":"Seonyeong Yang, Sun Hwa Lee, Jaeho Kim, Soo-Jin Cho, Yeonwook Kang","doi":"10.12779/dnd.2025.24.1.54","DOIUrl":"10.12779/dnd.2025.24.1.54","url":null,"abstract":"<p><strong>Background and purpose: </strong>Empathy comprises cognitive and emotional components. However, the impairments in empathy among individuals with mild cognitive impairment (MCI) and dementia of the Alzheimer's type (DAT) are not well understood, particularly in the context of depression, which may exacerbate these deficits. This study aimed to evaluate the effects of neurodegeneration and depression on empathetic abilities.</p><p><strong>Methods: </strong>The study included 31 healthy elderly (HE) individuals, 30 patients with amnestic multi-domain MCI (amMCI), and 30 patients with DAT. Empathy was assessed using the Korean-Multifaceted Empathy Test (K-MET), and the Interpersonal Response Index (IRI). Participants were classified as depressed or non-depressed using the Geriatric Depression Scale. A two-way MANOVA was conducted to examine differences in empathy based on group and depressive status.</p><p><strong>Results: </strong>A significant interaction between group and depressive status was found for both cognitive and emotional empathy on the K-MET, but not on the IRI. In the depressed group, cognitive empathy scores were lower in the order of HE, amMCI, and DAT. Similarly, in the non-depressed group, the HE group performed better than both amMCI and DAT, with no significant difference between the latter two. Regarding emotional empathy, the depressed HE group scored higher than both amMCI and DAT, with no significant difference between these groups. In the non-depressed group, emotional empathy declined in the order of HE, amMCI, and DAT.</p><p><strong>Conclusions: </strong>These findings indicate that both neurodegeneration and depression significantly impair empathetic abilities, with declines in cognitive and emotional empathy evident at the MCI stage, regardless of depressive status.</p>","PeriodicalId":72779,"journal":{"name":"Dementia and neurocognitive disorders","volume":"24 1","pages":"54-68"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracking Cognitive Trajectories in Mild Cognitive Impairment Using a Machine Learning Technique of Subtype and Stage Inference.","authors":"Hui Jin Ryu, Kyoung Ja Kwon, Yeonsil Moon","doi":"10.12779/dnd.2025.24.1.44","DOIUrl":"10.12779/dnd.2025.24.1.44","url":null,"abstract":"<p><strong>Background and purpose: </strong>Recognizing cognitive decline patterns in mild cognitive impairment (MCI) is crucial for early screening and preventive interventions. However, studies on the trajectory of individual cognitive functions in MCI are limited. Thus, the purpose of this study was to identify subtypes and stages of cognitive decline in MCI using a machine learning method.</p><p><strong>Methods: </strong>A total of 944 subjects consisting of those who were cognitively normal and those with MCI were enrolled. Fifteen neuropsychological tasks were used in the analysis. The optimal number of subtypes was determined based on the cross-validation information criterion. Fifteen stages of cognitive trajectory were estimated for each subtype.</p><p><strong>Results: </strong>The following three subtypes were identified: amnestic-verbal subtype, dysexecutive subtype, and amnestic-visual subtype. Of 723 (76.6%) subjects who had reached stage 1 at least, amnestic-verbal subtype accounted for the most (n=340, 47.0%), followed by dysexecutive subtype (n=253, 35.0%) and amnestic-visual subtype (n=130, 18%). The amnestic-verbal subtype had significantly more males (amnestic-verbal: 41.8%, dysexecutive: 31.2%, and amnestic-visual: 28.5%), younger subjects (amnestic-verbal: 72.01 years, dysexecutive: 74.43 years, and amnestic-visual: 75.06 years), higher educational years (amnestic-verbal: 11.06 years, dysexecutive: 9.53 years, and amnestic-visual: 9.79 years), lower Clinical Dementia Rating sum of boxes (amnestic-verbal: 1.40, dysexecutive: 1.61, and amnestic-visual: 1.71), and lower Korean-Instrumental Activities of Daily Living score (amnestic-verbal: 0.20, dysexecutive: 0.27, and amnestic-visual: 0.26).</p><p><strong>Conclusions: </strong>Three types of MCIs were extracted using SuStaIn. Pathways of MCI deterioration could be different. The amnestic type could be bisected based on whether episodic verbal or visual memory is degraded first.</p>","PeriodicalId":72779,"journal":{"name":"Dementia and neurocognitive disorders","volume":"24 1","pages":"44-53"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Practice Guidelines for Dementia: Recommendations for the Pharmacological Treatment of Behavioral and Psychological Symptoms.","authors":"Gihwan Byeon, Dong Woo Kang, Yeshin Kim, Geon Ha Kim, Ko Woon Kim, Hee-Jin Kim, Seunghee Na, Kee Hyung Park, Young Ho Park, Jeewon Suh, Joon Hyun Shin, YongSoo Shim, YoungSoon Yang, Yoo Hyun Um, Seong-Il Oh, Sheng-Min Wang, Bora Yoon, Sun Min Lee, Juyoun Lee, Jin San Lee, Hak Young Rhee, Jae-Sung Lim, Young Hee Jung, Juhee Chin, Hyemin Jang, Yun Jeong Hong, Miyoung Choi, Jae-Won Jang","doi":"10.12779/dnd.2025.24.1.24","DOIUrl":"10.12779/dnd.2025.24.1.24","url":null,"abstract":"<p><strong>Background and purpose: </strong>Dementia often accompanies behavioral and psychological symptoms of dementia (BPSD), including agitation, aggression, depression, and psychosis, which impact patients' quality of life and caregiver burden. Effective management of BPSD is essential to support patient and caregiver well-being. This study presents evidence-based clinical practice guidelines for pharmacological treatments of BPSD in dementia, focusing on antipsychotics, antidepressants, cognitive enhancers, and other medications.</p><p><strong>Methods: </strong>This guideline was developed by the Korean Dementia Association's Quality Management Committee. Key questions were framed using the Population, Intervention, Comparison, Outcome methodology, followed by systematic literature searches. Randomized controlled trials were assessed for quality, and recommendations were graded based on evidence levels, employing the Grading of Recommendations, Assessment, Development and Evaluation system to establish strength and applicability.</p><p><strong>Results: </strong>Recommendations vary by medication type and symptom severity. Antipsychotics, such as risperidone, are conditionally recommended for managing aggression and psychosis in dementia, while antidepressants, specifically citalopram, are advised for agitation in Alzheimer's disease. Cognitive enhancers, including cholinesterase inhibitors and memantine, showed moderate efficacy for general BPSD improvement and rapid eye movement sleep behavior disorder in Lewy body dementia. Specific drugs, like pimavanserin, demonstrated efficacy in addressing psychosis in Alzheimer's patients.</p><p><strong>Conclusions: </strong>These guidelines provide a structured approach to pharmacological management of BPSD in dementia, addressing efficacy and safety profiles across drug categories. The recommendations emphasize personalized treatment plans to optimize therapeutic outcomes while minimizing risks, with a conditional approach suggested in cases with limited evidence.</p>","PeriodicalId":72779,"journal":{"name":"Dementia and neurocognitive disorders","volume":"24 1","pages":"24-43"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Practice Guidelines for Dementia: Recommendations for Cholinesterase Inhibitors and Memantine.","authors":"Yeshin Kim, Dong Woo Kang, Geon Ha Kim, Ko Woon Kim, Hee-Jin Kim, Seunghee Na, Kee Hyung Park, Young Ho Park, Gihwan Byeon, Jeewon Suh, Joon Hyun Shin, YongSoo Shim, YoungSoon Yang, Yoo Hyun Um, Seong-Il Oh, Sheng-Min Wang, Bora Yoon, Sun Min Lee, Juyoun Lee, Jin San Lee, Jae-Sung Lim, Young Hee Jung, Juhee Chin, Hyemin Jang, Miyoung Choi, Yun Jeong Hong, Hak Young Rhee, Jae-Won Jang","doi":"10.12779/dnd.2025.24.1.1","DOIUrl":"10.12779/dnd.2025.24.1.1","url":null,"abstract":"<p><strong>Background and purpose: </strong>This clinical practice guideline provides evidence-based recommendations for treatment of dementia, focusing on cholinesterase inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists for Alzheimer's disease (AD) and other types of dementia.</p><p><strong>Methods: </strong>Using the Population, Intervention, Comparison, Outcomes (PICO) framework, we developed key clinical questions and conducted systematic literature reviews. A multidisciplinary panel of experts, organized by the Korean Dementia Association, evaluated randomized controlled trials and observational studies. Recommendations were graded for evidence quality and strength using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology.</p><p><strong>Results: </strong>Three main recommendations are presented: (1) For AD, cholinesterase inhibitors (donepezil, rivastigmine, galantamine) are strongly recommended for improving cognition and daily function based on moderate evidence; (2) Cholinesterase inhibitors are conditionally recommended for vascular dementia and Parkinson's disease dementia, with a strong recommendation for Lewy body dementia; (3) For moderate to severe AD, NMDA receptor antagonist (memantine) is strongly recommended, demonstrating significant cognitive and functional improvements. Both drug classes showed favorable safety profiles with manageable side effects.</p><p><strong>Conclusions: </strong>This guideline offers standardized, evidence-based pharmacologic recommendations for dementia management, with specific guidance on cholinesterase inhibitors and NMDA receptor antagonists. It aims to support clinical decision-making and improve patient outcomes in dementia care. Further updates will address emerging treatments, including amyloid-targeting therapies, to reflect advances in dementia management.</p>","PeriodicalId":72779,"journal":{"name":"Dementia and neurocognitive disorders","volume":"24 1","pages":"1-23"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}