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OBJECTIVE To evaluate cognitive failures of patients visiting pharmacies and to study utilization of drugs for dementia therapy in Lithuania. METHODS 153 patients completed a Cognitive Failure Questionnaire (CFQ) at pharmacy. The ATC/DDD method was used to evaluate utilization of drugs licensed for dementia treatment, including C04AE (peripheral vasodilators), N04BD (MAO inhibitors), N06D (anti-dementia drugs), N06BX (nootropics), N07C (anti-vertigo), and A11HA (plain vitamin E) preparations. RESULTS 53 of 153 study participants (34.6%) scored over 45 CFQ points and reported cognitive failure, assessed by three factors: F1 - forgetfulness, F2 - distractibility and F3 - false triggering. All three factors correlate with age and the most significant extent has memory performance (Spearman's rank correlation coefficient (rs) F1 - rs = 0.85, p < 0.01; F3 - rs = 0.79, p < 0.01, and F2 - rs = 0.4, p < 0.01) and do not depend on gender or educational background. Total use of anti-dementia drugs and food supplements decreased from 27.08 DDD/1,000 inhabitants/day in 2006 to 26.46 DDD/1,000 inhabitants/day in 2011. Nicergoline 6.26 DDD/1,000 inhabitants/day and cinnarizine 6.16 DDD/1,000 inhabitants/ day - were the most prescribed medications in 2011. Total costs for anti-dementia drugs increased from EUR 8.91 million to EUR 11.63 million during the same period. The largest amount of EUR 3.166 million was spent on nicergoline. Older people were more likely than younger people to report using prescription drugs (rs = 0.468; p < 0.01), while younger population used more supplements (rs = -0.227; p = 0.005). CONCLUSIONS Trend of anti-dementia drugs use in Lithuania is similar to other EU countries; however, there are some deviations from dementia treatment guidelines, particularly in terms of nicergoline and cinnarizine recommendations.