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Statins advised in dementia

All elderly patients with dementia and memory difficulties should be prescribed drugs for cardiovascular disease to help slow their cognitive decline, a conference was told last week.

Speaking at Primary Care 2007 in Birmingham, Dr Patrick Brooke, primary care consultant for the Mental Health Foundation, told delegates treating elderly people who had dementia with statins was an effective way of maintaining their physical and psychiatric health.But Dr Brooke warned against a similar approach with mild cognitive impairment. 'All dementia patients should be on ACE inhibitors or statins to slow down the progression of coronary heart disease, and by extension then their cognitive decline,' he said.'Most dementia patients will also have chronic kidney disease or coronary heart disease as well, so even though the evidence is not there it is not unfeasible to put them all on statins or ACE inhibitors. I would do it, personally.'Dr Brooke, a GPSI in memory in Newbury, Berkshire, and a member of the gerontology council of the Royal Society of Medicine, said milder forms of dementia, such as mild cognitive impairment, should not necessarily be treated with medication as often it did not develop into full-blown dementia.'Only 10% of patients with mild cognitive impairment will progress to dementia each year – so 90% will not,' he said. 'There is evidence that treating people with mild cognitive impairment may actually make them worse and so I would urge you not to treat unless necessary, particularly if the patient's behaviour, though odd or distressing to carers or family, doesn't cause any harm.'

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