How Is Alzheimer's Disease Treated?
Alzheimer’s is a complex disease with multiple components to it, 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 progression of the disease. Instead, the aims of treatment are to help patients maintain their cognitive functioning, manage behavioral symptoms, and alleviate some of the symptoms that may be most bothersome and impairing 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, as well as 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 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 Razadyne (galantamine), Exelon (rivastigmine), and Aricept (donepezil).
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, and only after a doctor has conducted a complete exam and ruled out any other possible causes for the symptoms. Often times 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 that are used with conventional medicine, whereas alternative treatments are non-mainstream treatments that are used instead of conventional medicine.3 For instance, if someone with Alzheimer’s 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 to not be effective. Some CAM could also be dangerous. It is imperative that a doctor is consulted about any CAM being used, to ensure that it does not interfere with the established treatment being given or pose any risks to the patient.
Alzheimer’s disease is a complex disease and affects a person and their life in a variety of ways, which is why treatment is also multi-factorial. Different treatments are used at different 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.