Pharmacogenomics of Dementia: Personalizing the Treatment of Cognitive and Neuropsychiatric Symptoms

• Published in: Genes 2023-11, Vol.14 (11), p.2048
• Main Authors: Vuic, Barbara, Milos, Tina, Tudor, Lucija, Nikolac Perkovic, Matea, Konjevod, Marcela, Nedic Erjavec, Gordana, Farkas, Vladimir, Uzun, Suzana, Mimica, Ninoslav, Svob Strac, Dubravka
• Format: Article
• Language: English
• Subjects: Aged; Alzheimer Disease - drug therapy; Alzheimer's disease; Antidepressants; Antidepressive Agents - therapeutic use; Antipsychotic drugs; Antipsychotics; Anxiolytics; Brain; Cerebrovascular disease; Cognition; Cognitive ability; Dementia; Dementia disorders; Development and progression; Diabetes; Drug development; Drug interaction; Drug therapy; Enzymes; Executive function; Family medical history; Genes; Genetic factors; Health risk assessment; Humans; Lewy bodies; Lewy body disease; Memory; Metabolism; Metabolites; Mutation; Neurodegenerative diseases; Patients; Pharmacodynamics; Pharmacogenetics; Pharmacogenomics; Pharmacokinetics; Proteins; Quality of Life; Risk factors; Sedatives; Stroke; Vascular dementia
• ISSN: 2073-4425; 2073-4425
• DOI: 10.3390/genes14112048

Dementia is a syndrome of global and progressive deterioration of cognitive skills, especially memory, learning, abstract thinking, and orientation, usually affecting the elderly. The most common forms are Alzheimer's disease, vascular dementia, and other (frontotemporal, Lewy body disease) dementias. The etiology of these multifactorial disorders involves complex interactions of various environmental and (epi)genetic factors and requires multiple forms of pharmacological intervention, including anti-dementia drugs for cognitive impairment, antidepressants, antipsychotics, anxiolytics and sedatives for behavioral and psychological symptoms of dementia, and other drugs for comorbid disorders. The pharmacotherapy of dementia patients has been characterized by a significant interindividual variability in drug response and the development of adverse drug effects. The therapeutic response to currently available drugs is partially effective in only some individuals, with side effects, drug interactions, intolerance, and non-compliance occurring in the majority of dementia patients. Therefore, understanding the genetic basis of a patient's response to pharmacotherapy might help clinicians select the most effective treatment for dementia while minimizing the likelihood of adverse reactions and drug interactions. Recent advances in pharmacogenomics may contribute to the individualization and optimization of dementia pharmacotherapy by increasing its efficacy and safety via a prediction of clinical outcomes. Thus, it can significantly improve the quality of life in dementia patients.