There is currently no pharmacological treatment for cognitive decline. Management strategies focus on maintaining functional independence and addressing the behavioral and psychological symptoms often associated with dementia. The treatment of behavioral and mood disorders requires the right dosage/benefit ratio between non-pharmacological and pharmacological therapies. Counseling plays a crucial role in the overall care of individuals with cognitive decline. These individuals may be at increased risk for mobility issues and recurrent falls. Therefore, it is important to identify and correct contributing factors, such as visual or hearing impairments. For those with sleep apnea, continuous positive airway pressure therapy may offer benefits. While depression is common in this population, there is no conclusive evidence that treating depression improves cognitive function. Antidepressants with strong anticholinergic effects should be avoided, as the use of these medications has been shown to negatively affect cognition in older adults. Nevertheless, antidepressants and antipsychotics are still important for treating some typical characters of dementia, such as depression, agitation, sleep disorders, anxiety, and sundowning.

Developing an algorithm can assist healthcare professionals for managing patients with MCI and dementia by helping to navigate overly complex clinical scenarios, particularly when patients are elderly, frail, and undergoing multiple treatments. Figure 2 provides treatment options for patients once a diagnosis is confirmed.