Management of Dementia with Cortical Atrophy

Medication Considerations

The European Society of Cardiology recommends continuing evidence-based antihypertensive therapy, including first-line agents such as ACE inhibitors, ARBs, dihydropyridine CCBs, or thiazides, for cardiovascular protection in patients with dementia and hypertension 1, 4
The European Society of Cardiology suggests targeting a blood pressure of <140/90 mmHg, or <130/80 mmHg if well tolerated, in patients with dementia and hypertension 1, 3
The American Heart Association recommends measuring blood pressure in both sitting and standing positions due to increased orthostatic hypotension risk in elderly patients with dementia 3, 5

The Mayo Clinic recommends against using antipsychotics as first-line therapy for patients with dementia, due to the increased risk of mortality and worsening of cognitive function 2
The Mayo Clinic suggests that antipsychotics should only be used for severe behavioral disturbances, such as agitation, aggression, or psychosis, that pose safety risks and have failed non-pharmacological interventions 2
The Mayo Clinic recommends against using antidepressants as first-line therapy for patients with dementia, unless there is evidence of comorbid major depressive disorder 2