Lewy body dementia management often includes which medication class to improve cognition?

• A. Cholinesterase inhibitors
• B. Antipsychotics
• C. Antibiotics
• D. Antidepressants

Answer: (A)

In Lewy body dementia, boosting acetylcholine in the brain helps with cognitive symptoms, so a cholinesterase inhibitor is the most effective choice. These drugs—such as donepezil, rivastigmine, and galantamine—block the enzyme that breaks down acetylcholine, increasing its availability and improving attention, memory, and executive function affected by the disease.

Antipsychotics can be used for hallucinations or agitation in some cases, but they’re not cognitive enhancers and Lewy body patients can have severe sensitivity to them, often worsening motor symptoms. Antibiotics don’t address cognitive impairment at all. Antidepressants may help mood or anxiety but don’t directly improve cognition in this context, though they may be used if depression is present.