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Treatments and drugs
By Mayo Clinic staff
Drugs
Current Alzheimer's medications can help for a time with memory symptoms and other cognitive changes. Two types of drugs are currently used to treat cognitive symptoms:
- Cholinesterase inhibitors. These drugs work by boosting levels of a cell-to-cell communication chemical depleted in the brain by Alzheimer's disease. Most people can expect to keep their current symptoms at bay for a time. Less than half of those taking these drugs can expect to have any improvement. Commonly prescribed cholinesterase inhibitors include donepezil (Aricept), galantamine (Razadyne) and rivastigmine (Exelon). The main side effects of these drugs include diarrhea, nausea and sleep disturbances.
- Memantine (Namenda). This drug works in another brain cell communication network and slows the progression of symptoms with moderate to severe Alzheimer's disease. It's sometimes used in combination with a cholinesterase inhibitor.
Creating a safe and supportive environment
Adapting the living situation to the needs of a person with Alzheimer's is an important part of any treatment plan. You can take these steps to support a person's sense of well-being and continued ability to function:
- Remove excess furniture, clutter and throw rugs.
- Install sturdy handrails on stairways and in bathrooms.
- Ensure that shoes and slippers are comfortable and provide good traction.
- Reduce the number of mirrors. People with Alzheimer's may find images in mirrors confusing or frightening.
Exercise
Regular exercise is an important part of everybody's wellness plan — and those with Alzheimer's are no exception. Activities like a daily 30-minute walk can help improve mood and maintain the health of joints, muscles and your heart. Exercise can also promote restful sleep and prevent constipation. Make sure that the person with Alzheimer's carries identification if she or he walks unaccompanied.
People with Alzheimer's who develop trouble walking may still be able to use a stationary bike or participate in chair exercises. You may be able to find exercise programs geared to older adults on TV or on DVDs.
Nutrition
People with Alzheimer's may forget to eat, lose interest in preparing meals or not eat a healthy combination of foods. They may also forget to drink enough, leading to dehydration and constipation.
Offer:
- High-calorie, healthy shakes and smoothies. You can supplement milkshakes with protein powders (available at grocery stores, drugstores and discount retailers) or use your blender to make smoothies featuring your favorite ingredients.
- Water, juice and other healthy beverages. Try to ensure that a person with Alzheimer's drinks at least several full glasses of liquids every day. Avoid beverages with caffeine, which can increase restlessness, interfere with sleep and trigger frequent need to urinate.
Certain nutritional supplements are marketed as "medical foods" specifically to treat Alzheimer's disease. The Food and Drug Administration (FDA) does not approve products marketed as medical foods. Despite marketing claims, there's no definitive data showing that any of these supplements is beneficial or safe.
- Thies W, et al. 2012 Alzheimer's disease facts and figures. Alzheimer's & Dementia. 2012; 8:131.
- Halter JB, et al. Hazzard's Geriatric Medicine and Gerontology. 6th ed. New York, N.Y.: The McGraw-Hill Companies; 2009. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=540.. Accessed Nov. 18, 2012.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4.. Accessed Nov. 18, 2012.
- Basics of Alzheimer's disease. Alzheimer's Association. http://www.alz.org/national/documents/brochure_basicsofalz_low.pdf. Accessed Dec. 19, 2012.
- Alzheimer's disease fact sheet. National Institute on Aging. http://www.nia.nih.gov/NR/rdonlyres/7DCA00DB-1362-4755-9E87-96DF669EAE20/13991/ADFactSheetFINAL2510.pdf. Accessed Nov. 18, 2012.
- Alzheimer's disease information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/alzheimersdisease/alzheimersdisease.htm. Accessed Dec. 13, 2012.
- Desai AK. Revitalizing the aging brain. Medical Clinics of North America. 2011;95:463.
- Caring for a person with Alzheimer's disease. National Institute on Aging. http://www.nia.nih.gov/alzheimers/publication/caring-person-alzheimers-disease/understanding-ad. Accessed Dec. 19, 2012.
- Essentials of a diagnostic workup. Alzheimer's Association. http://www.alz.org/professionals_and_researchers_14902.asp. Accessed Dec. 19, 2012.
- Nowrangi MA. Epidemiology, assessment and treatment of dementia. Psychiatric Clinics of North America. 2011;34:275.
- Alternative treatments. Alzheimer's Association. http://www.alz.org/alzheimers_disease_alternative_treatments.asp. Accessed Dec. 19, 2012.
- Preventing Alzheimer's disease and cognitive decline. National Institutes of Health State-of-the-Science Conference Statement. http://consensus.nih.gov/2010/alzstatement.htm. Accessed Dec. 19, 2012.
- Farina N, et al. Vitamin E for Alzheimer's dementia and mild cognitive impairment. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002854.pub3/abstract. Accessed Dec. 10, 2012.
- Natural medicines in the clinical management of Alzheimer's disease. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Dec. 10, 2012.
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