By Dr Ananya Mandal, MD
While there is no cure for Alzheimer’s disease, there are medications that can prevent or slow down progression of the disease, as well as improving some symptoms of the condition.
Alzheimer's disease progresses slowly, with initial symptoms presenting as memory problems and confusion, for example, and then progressing to complete disorientation and failure to recognize even family members or friends. Eventually, patients become unable to carry out day-to-day tasks and become completely dependent on caregivers. The rate of progression varies from person to person. Alzheimer’s disease can progress for around ten years but when patients do eventually die, the cause of death is usually related to another complication such as pneumonia, which accounts for up to two thirds of deaths in these patients.
Some of the treatment approaches used to manage patients with Alzheimer’s disease include the following:
- Medications – Five medications are currently prescribed, including donepezil, galantamine, rivastigmine and memantine. However, the benefit of using these drugs is small and none have yet been shown to significantly delay or slow disease progression.
- As the reduced activity of cholinergic neurons is a well known feature of Alzheimer’s disease, acetylcholinesterase inhibitors are used to slow the breakdown of acetylcholine (ACh) and therefore increase the level of ACh in the brain. These drugs have been shown to benefit patients with mild-to-moderate disease and some studies suggest a benefit for those with advanced disease.
- Antipsychotic drugs may be prescribed to combat symptoms such as aggression or psychosis but have been linked to side effects such as cognitive decline and stroke, which prevents their regular use. The long-term use of antipsychotics has previously been linked to an increased risk of death.
- During the early to middle phase of disease progression, changes can be made to the living environment and lifestyle to help increase the safety of patients and reduce the demands made on carers. For example, safety locks may be installed and labels used to ensure household items are clearly identified. Food may be pureed or a feeding tube used to tackle any swallowing problems.
- As Alzheimer’s disease progresses and patients start to have difficulty maintaining their personal hygiene and health, problems such as poor dental health and malnutrition arise. Such conditions require professional management, which may be heavily relied upon during the advanced stages of disease.
- Behavioral interventions are also used to help identify and manage living habits that lead to problems such as incontinence, for example.
Reviewed by Sally Robertson, BSc
Last Updated: Oct 16, 2014