ALZHEIMERS-DISEASE MANAGEMENT

The psychiatrist can play several important roles in the care of perso ns with Alzheimer's disease and other dementing illnesses. Diagnostic issues for which psychiatrists have specific skills include identifyin g early cases, performing a differential diagnosis, and distinguishing reversible depression from depression associated with irreversible de mentia and Irreversible dementia without depression. Treatment should include management of behavioral, noncognitive, and cognitive symptoms . Environmental and pharmacologic therapies have proven efficacious in treating noncognitive behavioral symptoms. Neuroleptic antipsychotic drugs are effective in treating aggressive behaviors and delusions. Th e treatment of cognitive symptoms currently rests on cholinergic enhan cement. Finally, the psychiatrist can play important roles in educatin g the public and supporting the distressed caregiver.