DRUG-INDUCED DEMENTIA - INCIDENCE, MANAGEMENT AND PREVENTION

Drugs are a frequently cited cause of dementia. There is a paucity of data regarding the incidence of drug-induced dementia, but it has been estimated that over 10% of patients attending memory clinics have iat rogenic disease. Drugs may impair cognition indirectly via metabolic e ffects, such as hypoglycaemia, by alterations of immunological factors within the CNS, and by actions that interfere with synaptic transmiss ion. Classes of drugs most frequently responsible are the benzodiazepi nes, antihypertensives and drugs with anticholinergic properties. Each of these classes is likely to produce a different pattern of neuropsy chological deficits. Prevention of drug-induced dementia will be aided by: (i) minimising the number of drugs prescribed; (ii) using shorter -acting preparations; (iii) avoiding agents that cross the blood-brain barrier where possible; (iv) evaluating renal and hepatic function re gularly; and (v) briefly assessing cognitive function before treatment .