How Is Alzheimer's Disease Treated?
Reviewed by: HU Medical Review Board | Last reviewed: June 2022 | Last updated: March 2023
Alzheimer's is a complex disease with multiple components, and the treatment of Alzheimer's disease is also multi-faceted. There is no cure for the disease, and there is no treatment that will help stop or get rid of the symptoms or even slow the progression of the disease. Instead, treatment aims to help patients maintain their cognitive functioning, manage behavioral symptoms, and alleviate some of the symptoms that may be most bothersome and impair quality of life.1
Treatment often depends on the stage of Alzheimer's a patient is in and the accompanying symptoms. Since symptoms can change over time and vary in severity, treatment plans may shift or remain a fluid work-in-progress. This is why it's helpful for people with Alzheimer's disease to have attuned caregivers and see the doctor regularly for check-ups. Treatment can include medications for memory, behavior, or mood; and non-drug treatments for behavior.
Medications used to treat Alzheimer's
There are several different kinds of medications that are thought to help with memory and cognitive functioning. Depending on what stage of Alzheimer's the person has, there are different medications better suited to different stages.
Drugs used for memory, cognitive functioning, or general functioning work on brain chemicals called neurotransmitters. Depending on the drug, they work on different neurotransmitters that have different effects on brain cell function. Cholinesterase inhibitors are often used in mild to moderate Alzheimer’s disease and can help reduce some symptoms, including early behavioral symptoms of Alzheimer's disease.1
These drugs include:
The neurotransmitter acetylcholine is important for memory and cognition. One of the characteristics of Alzheimer's disease is a loss of neurons that make acetylcholine. Cholinesterase breaks down acetylcholine. Cholinesterase inhibitors increase the levels of acetylcholine in the brain to improve cognition and memory. As Alzheimer's progresses and symptoms become more widespread or severe, other medications like Namenda (memantine), an NMDA antagonist, are prescribed. These medications improve symptoms but do not prevent disease progression as more amyloid plaques and neurofibrillary tangles form and neurons die. Current research has been focusing on finding new treatments to prevent disease progression.
Medications may also be used to help treat depression, anxiety, agitation, psychosis, and sleeplessness associated with Alzheimer's disease. These are used with caution only after a doctor has conducted a complete exam and ruled out other possible causes for the symptoms. Often non-drug treatments will be tried first for things like behavior or mood symptoms.
Non-drug treatments used to treat Alzheimer's
Managing behavioral symptoms of Alzheimer's disease is typically done with non-drug treatments and strategies first, and then if none of the strategies work, medication is used. Techniques used to treat anxiety, depression, or agitation can include2:
- Creating a calming environment and reducing triggers
- Checking for medication interactions and side effects
- Checking for personal comfort, toileting needs, pain, etc
- Responding in a calm, soothing way
- Changes in nutrition
- Increased social activity
- Cognitive behavioral therapy or other interventions by a psychologist
If the person's behavior is not manageable with various coping tools or changes in the environment, talk with a doctor about possible medications that might be helpful.
Complementary & alternative treatments for Alzheimer's
Complementary and alternative (CAM) treatments are not the same thing.
Complementary treatments are non-mainstream treatments used with conventional medicine, whereas alternative treatments are non-mainstream treatments used instead of traditional medicine.3 For instance, if someone with Alzheimer's takes conventional treatments and participates in music therapy, this would be complementary treatment; if they refused traditional treatments and instead took only herbal supplements, this would be an alternative treatment.
Some CAM may be expensive and have been shown in research trials not to be effective. Some CAM could also be dangerous. A doctor must be consulted about any CAM used to ensure that it does not interfere with the conventional treatment or pose any risks to the patient.
Alzheimer's disease is a complex disease affecting a person and their life in various ways, which is why treatment is also multi-factorial. Different treatments are used at other times, and each person's course of treatment may look different. Talk with the doctor about what treatments are most appropriate at any given time, and if something's not working for the patient, let the doctor know so that other treatment possibilities can be explored.