Abstract
There are many cases of dementia in Japan, the number is now over 3,000,000, and this situation is expected to only worsen given Japan's rapidly aging population. Because of this, most neurosurgeons are required to see dementia patients as part of their daily practice. There are four drugs used to treat Alzheimer's disease (AD) in Japan. Clinical registry of an AD drug trial was finished in 2011 in Japan. This trial showed that it is very important to choose the proper drug for each stage of dementia and BPSD. A compact version of the AD guideline was published in 2012. It contains a typical flow chart for the diagnosis and treatment policy in AD. Donepedil, garantamine, rivastigmine, and memantine were all shown to slow the decline in memory and ADL in AD patients, reduce the amount of care time, and also reduce patient care and drug expense. Donepedil which has good effect and few side-effects is a good drug for AD. Galantamine is good for patients with cerebrovascular disease and AD, especially. Rivastigmine is good for improving IADL in early AD. Memantine's strength is its ability to maintain memory function for a long time. Furthermore, good circumstances, proper care and adequate rehabilitation are also important to maintain patients' memory function and QOL.
