Alzheimer's Treatment

Alzheimer’s disease is a progressive disease that triggers brain cell deterioration. Over time, this makes things like remembering, learning, controlling emotions, and even basic tasks difficult or impossible. The disease has no known cure. It progresses in stages, with most people living somewhere between four to eight years after being diagnosed. Treatments exist that can slow, but not stop, the disease’s progress. (Learn More — Alzheimer’s Disease) Two types of drugs have been approved by the FDA to treat Alzheimer’s disease: Cholinesterase inhibitors and memantine. Both change the way the brain interacts with important chemicals that are key to learning, memory, and other functions. These medications can’t heal damaged cells in the brain, but they can slow further damage. However, they do become less effective over time. (Learn More — Drug Treatments) If you have Alzheimer’s disease, a major factor in staying independent longer and increasing your overall quality of life is modifying your lifestyle. Your home will be a safer place if you readily know where things are, what day it is, and what you are supposed to do. Developing habits while you are fairly cognitively aware can make things less confusing and frightening as your disease progresses. (Learn More — Adjusting Your Lifestyle) As Alzheimer’s worsens, you will need support from a caregiver (often a family member or close friend). This person should be someone you trust, who you have adequately prepared while you are still mostly independent and able to remember important details, like passwords and financial information. Remember that this process will be emotionally draining for your caregiver, as well as for you. They are going to watch your disease progress, which can be hard for someone who loves you, especially when one day you may not know who they are. (Learn More — Finding Support and Giving Support)

Alzheimer’s Disease

This progressive brain disease causes brain cells to degenerate and die. It is the most common cause of dementia, a symptom characterized by a decline in cognition, social skills, and the ability for rational behavior. Over time, Alzheimer’s disease reduces your ability to function on your own. You may forget details you otherwise would not, including people’s faces and names. Alzheimer’s has no cure. Available treatments can only slow the progress of the disease, not reverse it. Severe complications caused by a decline in brain function will eventually lead to death. At a certain point, the disease will require that you stop working, and it will likely make many of your old hobbies too difficult for you. Discuss your symptoms with those closest to you: Aim to find a proper support network that will be able to support you as the disease progresses, while you still have the cognitive function to be involved in making such choices. The disease progresses in stages, but the rate at which it does varies greatly. Most patients live four to eight years after their diagnosis, but some patients live with Alzheimer’s for as long as two decades. While Alzheimer’s is undeniably frightening for many, treatment can increase the amount of time you are able to live independently and boost your overall quality of life. There are a variety of treatments and services available to Alzheimer’s patients. The disease is continuously being researched to find new treatments and ways to improve patients’ quality of life.

Drug Treatments

As stated above, Alzheimer’s disease has no cure. Treatment can slow the progression of certain symptoms, but this slowing is temporary. As your symptoms progress, your treatment will need to evolve alongside them. Some medications can help to reduce symptoms, although they are not effective for everyone. If the approved medications are not an option for you, ask your doctor about enrolling in a clinical drug trial, which can give you access to experimental treatments that may help. The Alzheimer’s medications currently approved by the FDA come in two groups:

• Cholinesterase inhibitors (Aricept, Razadyne, Exelon): One major cause of Alzheimer’s symptoms is decreased production of acetylcholine in the brain, a chemical messenger key to judgment, thought, memory, and alertness. Cholinesterase inhibitors help prevent acetylcholine from breaking down in your brain, making it more available for your brain to use.

   

  These drugs don’t heal destroyed nerve cells, and they can only slow Alzheimer’s symptoms, not reverse them. They lose effectiveness over time, as the brain will produce less acetylcholine as the disease progresses.

  Common side effects associated with cholinesterase inhibitors include diarrhea, nausea, and vomiting. Some people with cardiac arrhythmias will be unable to take this kind of medication.

  If your doctor determines inhibitors are right for you, the exact one you are prescribed will depend on the severity of your symptoms. Some inhibitors like donepezil (Aricept) can be used during any stage of the disease, while others, like the skin patch form of rivastigmine (Exelon), are specifically for severe Alzheimer’s.

• Memantine (Namenda, Namzaric): Specifically for moderate to severe Alzheimer’s symptoms, memantine works by regulating glutamate activity in the brain. This chemical messenger is important for a variety of brain functions, most notably memory and learning. Memantine is sold as Namenda, although a version that combines memantine and donepezil (a cholinesterase inhibitor) is also available (Namzaric). Namenda may cause headaches, dizziness, agitation, and confusion. Namzaric has a slightly different set of common side effects, which include nausea, diarrhea, headache, and dizziness.

Never stop taking these medications without first talking to your doctor. If you experience any serious or uncomfortable symptoms, talk to your doctor immediately.

Adjusting Your Lifestyle

The key to managing Alzheimer’s disease symptoms is developing an environment that is tailored to you and your needs.

• Keep important items, such as your wallet, keys, phone, and valuables, in the same location every day.

  Many people keep them in a bowl in the kitchen or near the front door.

  Do not simply put things down wherever is convenient at a given moment. You want to develop a habit of keeping items in a specific spot. Only move them when you need them, putting them back in the designated spot when done.

• Keep a checklist for your medications, and check what medications you’ve already taken in a given day. Special pill cases exist for this purpose, where all the pills you are supposed to take in one day are held in a particular slot in the container. Develop a habit of checking the date, so you don’t accidentally take a different day’s dose.

• Automate finances when possible. Set up automatic deposits and payments for bills and credit card statements so you don’t have to remember them every month.

• Keep a schedule of every event and appointment you have, especially important ones like doctors’ visits. Check off each event as you go to prevent confusion about what you have done.

• Whenever possible, schedule things like doctor’s appointments for the same day and time every week.

• Remove unnecessary furniture and rugs. People with Alzheimer’s can more easily trip and hurt themselves. You should also purchase shoes and slippers that are comfortable and have good traction so they cannot easily slide on the floor.

• Consider removing all or most mirrors from the house. People with Alzheimer’s disease are more easily frightened by images in mirrors. They may be unable to recognize themselves in mirrors and find the images confusing.

• Wear a medical bracelet with identifying information. Get a device, such as a smartphone, that can be traced to your location. This helps to prevent you from getting seriously hurt in the event you wander away from home. People can more readily see you have a medical condition, and caretakers will be able to find you more easily.

• Install handrails around the house, especially in the bathroom. These will make it easier for you to avoid falls, as you can pull yourself up and ease yourself down more comfortably.

• Keep personal items like photographs around. These can help you better hold onto memories of loved ones and important moments in your life. Photographs can also help you confirm that someone is not a stranger, even if you do not fully remember their face.

People with Alzheimer’s disease sometimes forget to eat and drink enough. Similarly to appointments and events, it can be a good idea to keep a schedule. You can eat and drink similar things at similar times each day to make things even easier. Exercise is also important for maintaining a general sense of wellness. It can help with aches and pains, and improve a variety of other aspects of your health. It can even help with mood. There are exercise routines available for nearly every level of mobility.

Finding and Giving Support

One of the most important aspects of Alzheimer’s care is finding someone who can support you when you are unable to be independent. Often, this will be a spouse, child, or close friend. Some people may be able to afford a professional caretaker to help them. This professional may work alongside a family member, filling in the gaps when your loved one is unavailable. While Alzheimer’s can be extremely stressful for the person who has the disease, it will also be difficult for those around them. Caregiver stress is a serious issue. Do your best to address this potential problem and plan ahead while you are able to think clearly. Have a direct talk with your future caregiver. Walk them through your expectations, and confirm there is a plan in place to alleviate some of their burden when needed. This includes a support network that can step in and help sometimes. You will want a caretaker you trust, as you will likely need to hand over all your important private information in one form or another. This includes things like bank accounts and passwords. These details will become very difficult for you to remember after a while, and they are necessary for your care. Emotional well-being is important to monitor, for both you and your loved ones. Talk to your caregiver about any Alzheimer’s caregiver support groups in the area, where they can talk about the often stressful process of supporting someone with the disease.

References

Alzheimer's Disease: Symptoms & Causes. (December 8, 2018). Mayo Foundation for Medical Education and Research (MFMER).

Alzheimer’s Disease. Diagnosis & Treatment. (December 8, 2018). Mayo Foundation for Medical Education and Research (MFMER).

Alzheimer's and Dementia: What's the Difference? (February 24, 2018). Mayo Foundation for Medical Education and Research (MFMER).

Alzheimer's: Drugs Help Manage Symptoms. (April 19, 2019). Mayo Foundation for Medical Education and Research (MFMER).

Stages of Alzheimer's. Alzheimer's Association.

Caregiver Stress. Alzheimer's Association.