NE7.5 Cognitive enhancers

Age related changes to cognitive function: - Declining performance of: [blank_start]speed[blank_end] of processing, working memory, [blank_start]long[blank_end]-term memory - Preserved performance of: [blank_start]world knowledge[blank_end] Mild cognitive impairment affects 10-20% of people >[blank_start]65[blank_end] years, and affects [blank_start]men[blank_end] more than women. It is associated with [blank_start]depression[blank_end], polypharmacy, and uncontrolled [blank_start]CV[blank_end] risk factors.

Which of these is not a symptom of mild cognitive impairment? (MCI)

Which of these is not a cognition enhancing drug?

Treatment options are related to neurotransmitters in the brain regions controlling learning and memory, and temporarily improve dementia symptoms. [blank_start]Cholinesterase[blank_end] inhibitors: - E.g. donepezil, galantamine, rivastigmine • For [blank_start]mild[blank_end]-moderate cognitive symptoms • SEs: [blank_start]Nausea, vomiting, diarrhoea,[blank_end] dyspepsia; urinary incontinence; dizziness • Serious SEs: [blank_start]heart[blank_end] block and sinus [blank_start]bradycardia[blank_end] [blank_start]Glutamate antagonist[blank_end] ie Memantine • Moderate-[blank_start]severe[blank_end] cognitive symptoms OR when cholinesterase inhibitors [blank_start]contraindicated[blank_end] • SEs: c[blank_start]onstipation, hypertension, dyspnoea,[blank_end] headache, dizziness, drowsiness

Nootropics or ‘smart drugs’: 1. [blank_start]Methylphenidate[blank_end] • Rx: narcoplepsy, ADHD, ADD • Blocks DA reuptake 2. [blank_start]Modafinil[blank_end] • Rx: narcolepsy • Mechanisms unclear (wake promoting neurons in tuberomammillary nucleus, DAT) 3. [blank_start]Piracetam[blank_end] • Rx: essential tremor (section 29) • Facilitates cholinergic, dopaminergic, noradrenergic neurotransmission Long term side effects are unclear. Short term: [blank_start]headache, dizziness, nausea[blank_end], [blank_start]psychiatric[blank_end] disorders, [blank_start]cardiovascular[blank_end] symptoms