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Treatments and drugs
By Mayo Clinic staffTreatment of dementia may help slow or minimize the development of symptoms.
- Cholinesterase inhibitors. These drugs — donepezil (Aricept), rivastigmine (Exelon) and galantamine hydrobromide (Razadyne) — are Alzheimer's drugs that work by boosting levels of a chemical messenger involved in memory and judgment. Side effects can include nausea, vomiting and diarrhea. Although primarily used as Alzheimer's drugs, they're also used to treat vascular, Parkinson's and Lewy body dementias.
- Memantine (Namenda). This drug for Alzheimer's disease works by regulating the activity of glutamate, another chemical messenger involved in all brain function, including learning and memory. Its most common side effect is dizziness. Some research has shown that combining memantine with a cholinesterase inhibitor may have even better results. Although primarily used to treat Alzheimer's disease, it may help improve symptoms in other dementias.
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Other medications. Although no standard treatment for dementia exists, some symptoms can be treated. Additional treatments aim to reduce the risk factors for further brain damage.
Treatment of the underlying causes of dementia can also slow or sometimes stop its progress. To prevent a stroke, for example, your doctor may prescribe medications to control high blood pressure, high cholesterol, heart disease and diabetes. Doctors may also prescribe medication to treat conditions such as blood clots, anxiety and insomnia for people with vascular dementia.
In addition, some specific symptoms and behavioral problems can be treated with sedatives, antidepressants and other medications, but some of these drugs may worsen other symptoms.
Creutzfeldt-Jakob disease has no known treatments. Care is focused on making sure the person is comfortable.
- Chertkow H. Diagnosis and treatment of dementia: Introduction. Canadian Medical Association Journal. 2008;178:316.
- Feldman HH, et al. Diagnosis and treatment of dementia: 2. Dementia. Canadian Medical Association Journal. 2008;178:825.
- Dementia: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/dementias/detail_dementia.htm#1318919213. Accessed Jan. 3, 2009.
- National Institute on Aging. Frontotemporal dementia: Growing interest in a rare dementia. http://www.nia.nih.gov/Alzheimers/Publications/FTDreprint.htm. Accessed Jan. 11, 2009.
- Ersek M, et al. Tube feeding decisions for people with advanced dementia. The AGS Foundation for Health in Aging. http://www.healthinaging.org/public_education/pef/tube_feeding.php. Accessed Jan. 24, 2009.
- Dementia Guidelines for Early Detection, Diagnosis and Management of Dementia. New York, N.Y.: The American Geriatrics Society. http://www.americangeriatrics.org/products/positionpapers/aan_dementiaPF.shtml. Accessed Jan. 24, 2009.
- Farlow M. Moderate to severe Alzheimer disease — definition and clinical relevance. Neurology. 2005;65(suppl):S1.
- Hsiung G-YR, et al. Genetics and dementia: Risk factors, diagnosis, and management. Alzheimer's & Dementia. 2007;3:418.
- Patterson C, et al. General risk factors for dementia: A systematic evidence review. Alzheimer's & Dementia. 2007;3:341.
- Fuhrer R, et al. Exploring sex differences in the relationship between depressive symptoms and dementia incidence: Prospective results from the PAQUID study. Journal of the American Geriatric Society. 2003;51:1055.
- Wang H-X, et al. Late-life engagement in social and leisure activities is associated with a decreased risk of dementia: A longitudinal study from the Kungsholmen project. American Journal of Epidemiology. 2002:155:1081.
- Barberger-Gateau P. Diet and risk of dementia or cognitive decline. Alzheimers & Dementia. 2008;4(suppl):T181.
- Xu W-L, et al. Mid- and late-life diabetes in relation to the risk of dementia: A population-based twin study. Alzheimers & Dementia. 2008;4(suppl):T119.
- Biessels GJ, et al. Risk of dementia in diabetes mellitus: A systemic review. The Lancet Neurology. 2006;5:64.
- Kramer A, et al. Inflammation and Alzheimer's disease: Possible role of periodontal disease. Alzheimer's & Dementia. 2008;4;242.
- Tyas SL, et al. Risk factors for Alzheimer's disease: A population-based, longitudinal study in Manitoba, Canada. International Journal of Epidemiology. 2001;30:590.
- Hogan DB, et al. Diagnosis and treatment of dementia: 4. Approach to management of mild to moderate dementia. Canadian Medical Association Journal. 2008;179:787.
- Hogan DB, et al. Diagnosis and treatment of dementia: 5. Nonpharmacologic and pharmacologic therapy for mild to moderate dementia. Canadian Medical Association Journal. 2008;179:1019.
- Dementia. Alzheimer's Association. http://www.alz.org/alzheimers_disease_dementia.asp. Accessed Feb. 8, 2009.
- Steps to diagnosis. Alzheimer's Association. http://www.alz.org/alzheimers_disease_steps_to_diagnosis.asp#physexam. Accessed Feb. 9, 2009.
- Haan MN, et al. Homocysteine, B vitamins, and the incidence of dementia and cognitive impairment: Results from the Sacramento area Latino study on aging. The American Journal of Clinical Nutrition. 2007;85:511. http://www.ajcn.org/cgi/reprint/85/2/511. Accessed Feb. 9, 2009.
- Alternative treatments. Alzheimer's Association. http://www.alz.org/alzheimers_disease_alternative_treatments.asp#Coenzyme_Q10. Accessed Feb. 9, 2009.
