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| Original Article | |||||
| Dementia and Neurocognitive Disorders 2025: 24: 1: 1-23 | |||||
| Clinical Practice Guidelines for Dementia: Recommendations for Cholinesterase Inhibitors and Memantine | |||||
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| Yeshin Kim ,1 Dong Woo Kang ,2 Geon Ha Kim ,3 Ko Woon Kim ,4 Hee-Jin Kim ,5 Seunghee Na ,6 Kee Hyung Park ,7 Young Ho Park ,8 Gihwan Byeon ,2 Jeewon Suh ,9 Joon Hyun Shin ,10 YongSoo Shim ,11 YoungSoon Yang ,12 Yoo Hyun Um ,13 Seong-il Oh ,14 Sheng-Min Wang ,15 Bora Yoon ,16 Sun Min Lee ,17 Juyoun Lee ,18 Jin San Lee ,14 Jae-Sung Lim ,19 Young Hee Jung ,20 Juhee Chin ,21 Hyemin Jang ,22 Miyoung Choi ,23 Yun Jeong Hong ,24 Hak Young Rhee ,25 Jae-Won Jang ,1 on behalf of Korean Dementia Association | |||||
| 1 Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea 2 Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea 3 Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea 4 Department of Neurology, Jeonbuk National University Medical School and Hospital, Jeonju, Korea 5 Department of Neurology, Hanyang University Hospital, College of Medicine, Hanyang University, Seoul, Korea 6 Department of Neurology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea 7Department of Neurology, College of Medicine, Gachon University Gil Medical Center, Incheon, Korea 8 Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea 9Department of Neurology, National Medical Center, Seoul, Korea 10Dr Shin’s Neurology Clinic, Wonju, Korea 11 Department of Neurology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea 12 Department of Neurology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University School of Medicine, Cheonan, Korea 13 Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea 14 Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea 15 Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea 16 Department of Neurology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea 17 Department of Neurology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea 18 Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea 19Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea 20 Department of Neurology, Hallym Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea 21Department of Psychology, Doheon Academy Hallym University, Chuncheon, Korea 22Department of Neurology, Seoul National University Hospital, Seoul, Korea 23 Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea 24 Department of Neurology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea 25 Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea | |||||
| Clinical Practice Guidelines for Dementia: Recommendations for Cholinesterase Inhibitors and Memantine | |||||
| Yeshin Kim ,1 Dong Woo Kang ,2 Geon Ha Kim ,3 Ko Woon Kim ,4 Hee-Jin Kim ,5 Seunghee Na ,6 Kee Hyung Park ,7 Young Ho Park ,8 Gihwan Byeon ,2 Jeewon Suh ,9 Joon Hyun Shin ,10 YongSoo Shim ,11 YoungSoon Yang ,12 Yoo Hyun Um ,13 Seong-il Oh ,14 Sheng-Min Wang ,15 Bora Yoon ,16 Sun Min Lee ,17 Juyoun Lee ,18 Jin San Lee ,14 Jae-Sung Lim ,19 Young Hee Jung ,20 Juhee Chin ,21 Hyemin Jang ,22 Miyoung Choi ,23 Yun Jeong Hong ,24 Hak Young Rhee ,25 Jae-Won Jang ,1 on behalf of Korean Dementia Association | |||||
| 1 Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea 2 Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea 3 Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea 4 Department of Neurology, Jeonbuk National University Medical School and Hospital, Jeonju, Korea 5 Department of Neurology, Hanyang University Hospital, College of Medicine, Hanyang University, Seoul, Korea 6 Department of Neurology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea 7Department of Neurology, College of Medicine, Gachon University Gil Medical Center, Incheon, Korea 8 Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea 9Department of Neurology, National Medical Center, Seoul, Korea 10Dr Shin’s Neurology Clinic, Wonju, Korea 11 Department of Neurology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea 12 Department of Neurology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University School of Medicine, Cheonan, Korea 13 Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea 14 Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea 15 Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea 16 Department of Neurology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea 17 Department of Neurology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea 18 Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea 19Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea 20 Department of Neurology, Hallym Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea 21Department of Psychology, Doheon Academy Hallym University, Chuncheon, Korea 22Department of Neurology, Seoul National University Hospital, Seoul, Korea 23 Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea 24 Department of Neurology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea 25 Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea | |||||
| Background and Purpose: This clinical practice guideline provides evidence-based recommendations for treatment of dementia, focusing on cholinesterase inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists for Alzheimer’s disease (AD) and other types of dementia. Methods: Using the Population, Intervention, Comparison, Outcomes (PICO) framework, we developed key clinical questions and conducted systematic literature reviews. A multidisciplinary panel of experts, organized by the Korean Dementia Association, evaluated randomized controlled trials and observational studies. Recommendations were graded for evidence quality and strength using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Results: Three main recommendations are presented: (1) For AD, cholinesterase inhibitors (donepezil, rivastigmine, galantamine) are strongly recommended for improving cognition and daily function based on moderate evidence; (2) Cholinesterase inhibitors are conditionally recommended for vascular dementia and Parkinson’s disease dementia, with a strong recommendation for Lewy body dementia; (3) For moderate to severe AD, NMDA receptor antagonist (memantine) is strongly recommended, demonstrating significant cognitive and functional improvements. Both drug classes showed favorable safety profiles with manageable side effects. Conclusions: This guideline offers standardized, evidence-based pharmacologic recommendations for dementia management, with specific guidance on cholinesterase inhibitors and NMDA receptor antagonists. It aims to support clinical decision-making and improve patient outcomes in dementia care. Further updates will address emerging treatments, including amyloid-targeting therapies, to reflect advances in dementia management. |
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| Key Words: Dementia; Alzheimer Disease; Cholinesterase Inhibitors; Memantine; Practice Guidelines | |||||
| 대한치매학회지 (Dementia and Neurocognitive Disorders) | |||||
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