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There is currently no disease-modifying treatment though several symptomatic medications exist with modest benefit on cognition. Acetylcholinesterase inhibitors have a consistent benefit across all stages of dementia; their benefit in mild cognitive impairment and prodromal AD is unproven. Memantine has a smaller benefit on cognition overall which is limited to the moderate to severe stages, and the combination of a cholinesterase inhibitor and memantine may have additional efficacy. Evidence for the efficacy of vitamin E supplementation and medical foods is weak but might be considered in the context of cost, availability, and safety in individual patients. Apparently promising disease-modifying interventions, mostly addressing the amyloid cascade hypothesis of AD, have recently failed to demonstrate efficacy so novel approaches must be considered.<\/jats:p>","DOI":"10.1136\/bmj.l6217","type":"journal-article","created":{"date-parts":[[2019,12,6]],"date-time":"2019-12-06T16:26:53Z","timestamp":1575649613000},"page":"l6217","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":260,"title":["Cognitive symptoms of Alzheimer\u2019s disease: clinical management and prevention"],"prefix":"10.1136","author":[{"given":"Elizabeth","family":"Joe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M","family":"Ringman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,12,6]]},"reference":[{"key":"key20191208000129_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01124-1"},{"key":"key20191208000129_ref2","first-page":"34","article-title":"Early-onset Alzheimer disease and its variants","volume":"25","author":"Mendez","year":"2019","journal-title":"Continuum (Minneap Minn)"},{"key":"key20191208000129_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2015.09.069"},{"key":"key20191208000129_ref4","doi-asserted-by":"publisher","DOI":"10.1159\/000315513"},{"key":"key20191208000129_ref5","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.46.1.130"},{"key":"key20191208000129_ref6","doi-asserted-by":"publisher","DOI":"10.1038\/nm0896-864"},{"key":"key20191208000129_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-291X(84)80190-4"},{"key":"key20191208000129_ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-010-0719-5"},{"key":"key20191208000129_ref9","doi-asserted-by":"publisher","DOI":"10.1038\/nature19323"},{"key":"key20191208000129_ref10","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-010767"},{"key":"key20191208000129_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00258-6"},{"key":"key20191208000129_ref12","doi-asserted-by":"publisher","DOI":"10.1002\/gps.4583"},{"key":"key20191208000129_ref13","unstructured":"Wolters Kluwer. 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