Pharmacotherapy and special aspects of cognitive disorders in the elderly

Abstract

Cognitive impairment significantly influences pharmacotherapy as a major barrier for successful adherence. This is outlined in more detail in chapter Adherence to Pharmacotherapy in the Elderly. Cognitive function compromises not only adherence and management of pharmacotherapy but also cognitive function itself, which is an important target for pharmacotherapy to slow further deterioration in case of dementia or delirium (see chapters Dementia and Central Nervous System (CNS) Medications and Delirium). Unfortunately, drugs may also cause harm by inducing unintended cerebral symptoms such as disorientation, delusion and hallucination (delirium), dizziness, adynamia, and forgetfulness. These adverse drug reactions are often missed or misinterpreted and hereby represent a main factor of inadequate prescribing cascades (Fig. 1).