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COPYRIGHT 2006 International Medical News Group
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Advanced/severe dementia manifests a cluster of signs and symptoms in addition to impaired cognition. These problems--some new, many with progressive worsening--present with such severity that the afflicted patient usually requires 24-hour supervision. Moreover, depressive symptoms, agitation, or psychotic symptoms--including paranoid delusions and hallucinations--are frequent comorbid conditions.
Although Dr. Shuster cites studies with encouraging findings, each of these studies has significant limitations. One examined a small cohort of 24 cholinesterase inhibitor (ChEI) recipients vs. 20 controls (Dement. Geriatr. Cogn. Dis. 2005;19:51-6), and two others were sponsored by pharmaceutical firms that made the ChEI drug under investigation (Int. J. Geriatr. Psychiatry 2004;19:243-9; Int. J. Geriatr. Psychiatry 2005;20:559-69). In addition, Dr. Howard Feldman and his colleagues acknowledge that their post hoc analysis of the effects of donepezil on subjects...
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