Alzheimer’s disease is a devastating and dreaded disease for which limited treatment exists. It is characterized by memory loss, disorientation, confusion, and problems with reasoning and thinking.
Treatments fall into three categories: Medications, communication, and modification of the environment.
Alzheimer’s disease is treated by drugs called cholinester inhibitors and by drugs that regulate the activity of glutamate. Cholinester inhibitors treat cognitive symptoms. The drugs Arecept, Exelon, and Razadyne are cholinester inhibitors. They prevent the breakdown of acetycholine, a chemical messenger important for memory and thinking skills. The drugs keep levels of acetylcholine high, even when the brain cells making them have died off. About one half of those taking these drugs experience modest improvement.
Memantine regulates the activity of glutamate. Glutamate plays an essential role in learning and memory. Too much glutamate allows too much calcium into cells, leading to the death of these cells. Glutamate is thought to protect cells against too much glutamate. It has shown to benefit cognitive and psychomotor functioning, activities of daily living, and reduction of dependence on the care of others. It is well tolerated.
In addition to drugs that act directly on the symptoms of Alzheimer’s disease are those that help with emotional or behavioral problems. Alzheimer’s patients often experience depression and/or anxiety and antidepressants and anti anxiety medications have proved helpful. In it’s later stages, Alzheimer’s may cause sufferers to experience and exhibit severe agitation.
Anti psychotics like Rerperdol, Seroquel, or Zyprexa may be prescribed.
There are clinical trials on other medications going on all the time and it might be beneficial for the patient to participate in one.
Of the non-drug treatments it is very important to learn how to communicate with the person with Alzheimer’s disease. It is very important to communicate within the person’s “reality.” For you, reality is this living room in the twenty first century. For the person with Alzheimer’s, reality may be a small store in 1915 people with persons long dead. You must learn to communicate within this world and not contradict or correct the person’s view of reality. Correction is very confusing, frightening, and anger provoking. Try to note what might trigger agitation and alter your own behavior so that you don’t cause an outburst.
Researchers have learned that a low stimulus environment helps. Keep low levels of light, especially at mealtimes. Minimize distractive clutter in the room the person occupies. Try to provide consistent background noise by running a fan or playing the person’s favorite music. Place objects that cue memory-photos, momentos, familiar furniture.
Moderate exercise, good nutrition, and social interaction also help. Many people go to day programs that benefit them and give a much-needed break to their caregivers.
There are a few things that can be done that might prevent or delay the onset of Alzheimer’s disease. One is the regular use of NSAIDs such as aspirin, ibuprofin, or naproxen appears to decreases the risk of Alzheimer’s and to slow mental decline. This may work by reducing the amount of inflammation involved in the production of nerve tangles and plaques. Celebrex is being studied as a preventative and also as a treatment medication. Taking the vitamins A, C, and E may help. Nicotine appears to prevent Alzheimer’s disease but, of course, smoking has its own myriad of problems.