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All About Dementia Treatment
When someone in your life shows the signs of dementia, just
figuring out what to do next can feel overwhelming. As caregivers,
we can feel angry, devastated or simply powerless. Arming yourself
with information can help: researching what dementia treatment
options are out there and which ones might be right for your loved
one. Depending on what the specific cause of the
dementia is, you might choose to treat the underlying condition
or its symptoms. There are also a number of alternative treatments,
home remedies and assisted living options to make day-to-day life
more comfortable and ease the difficulties caused by dementia.
Treating the Underlying Causes of Dementia
When mental difficulties are caused by treatable conditions, the
best course of dementia treatment can be to tackle these underlying
health problems. Drug treatments have been proven effective in
treating some aspects of
Alzheimer's disease; likewise, drugs that treat
high blood pressure and other conditions leading to
stroke can also prevent the resulting vascular dementia.
Dementia caused by nutritional deficiencies, thyroid disease or
heart problems can also be treated by addressing the underlying
illness.
Dementia Treatment for Symptoms
With some causes of dementia, curing the underlying condition
isn't possible, and so dementia treatment focuses on easing the
symptoms. This can help reduce distress and disruption for the
caregiver as well as the patient. Different types of drug
treatments, of course, apply to different categories of
symptoms:
- Cognitive symptoms are generally treated with cholinesterase
inhibitors or memantine, which boost the brain's communication
networks and improve cognitive functioning.
- Muscular symptoms may be treated with anti-Parkinson's
medication, though this type of dementia treatment can have
unwanted side effects.
- Behavioral symptoms and delusions are controlled using
antipsychotic drugs, antidepressant medication or sedatives,
although these, too, may have side effects.
Alternative and Non-Drug Treatments for Dementia
Alternative and drug-free options are another way to approach
the issue of dementia treatment. Alternative remedies that some
have found helpful include vitamin E, omega-3s, coenzyme Q10,
ginkgo biloba and huperzine A. Remember that some herbal treatments
can interfere with regular drug treatment, so be sure to check with
a professional before administering any alternative medicine.
There are also many non-drug dementia treatments and therapies
to address specific issues--such as speech therapy for language
problems--or simply to help patients relax, such as massage
therapy, aromatherapy, music therapy and regular exercise. Some
types of exercise stimulate the brain and body, such as tai chi,
which was recently shown to promote cognitive improvement in the
elderly. Regular mental activity, whether through puzzles, computer
games or other stimulating hobbies, also protects against future
brain shrinkage and improves mental acuity.
Home Dementia Treatments
Caregivers can create a safe, supportive, and healthy home
environment for loved ones with dementia by following a few simple
guidelines:
- Make sure the home environment is safe, calm and stable
- Communicate clearly and slowly, using gestures when
appropriate
- Encourage regular exercise and a healthy lifestyle
- Anticipate your loved one's needs
- Help manage physical and behavioral problems
- Make use of reminders, notes, and rituals to aid memory
- Take care of the caregiver-seek out support or counseling if
you need it!
Assisted Living or Home Care?
One of the most important considerations in dementia treatment
is whether and when to place a family member in assisted
living or long-term care. Sometimes, the progression of disease
gets to a point where caregivers can no longer emotionally,
physically or financially support their loved one. For those who
favor home care, treatment options such as a visiting nurse or
adult day care can be excellent ways to relieve some of the
pressure on caregivers.
Regardless of which options you prefer, remember that
professional resources and assistance--including support groups and
community organizations--are always available to help you get your
loved one the dementia treatment that is right for him/her.
Medications and Dementia Care
The treatment of dementia depends entirely on the nature of the
underlying cause and whether it is considered reversible or not. In
general, the reversible causes of dementia, such as vitamin
deficiency or metabolic disorders, can be treated very successfully
with straightforward methods. For example, doctors can halt and
reverse the dementia effects of hypothyroidism by prescribing the
appropriate thyroid hormone; depression can now be managed very
effectively by combining psychotherapy with antidepressant
medications; and if certain medications were causing side effects
of dementia, simply stopping usage of the offending drugs will
resolve the dementia. However, because most dementia cases are
irreversible, treatment will usually involve medications to ease
the symptoms and the creation of a safe and supportive environment
to help the patient function as well as he can for as long as
possible. (For additional information on dementia care at home,
please read our companion article Dementia
Care At Home).
There are currently five prescription drugs that have been
developed for Alzheimer's disease (AD) that can delay and slow the
progression of dementia in patients with AD. Four of these drugs
are called cholinesterase inhibitors, and are usually known by
their brand names:
- Aricept®
- Exelon®
- Razadyne® (formerly known as
Reminyl®)
- Cognex® (no longer actively marketed)
They work by preventing the breakdown of a brain chemical called
acetylcholine, and are usually only effective in mild to moderate
cases of dementia. Because these will only work for a limited time
to delay symptoms, it is important to start treatment as early as
possible for maximum effect, which is why early diagnosis is so
critical.
There is also a fifth drug, Namenda®, which is used
to treat moderate to severe cases of dementia and works by an
entirely different mechanism. It regulates another brain chemical
called glutamate and helps to prevent cell death, but as in the
other four drugs it can only delay the progression of the dementia
and cannot "cure" it. Namenda® may be used in
conjunction with any of the four cholinesterase inhibitors.
While these medications were developed and approved for use in
patients with AD, they have been found to be very helpful in
patients with Lewy Body Dementia (LBD) and, to a lesser extent,
patients with vascular dementia.
One of the most important things that doctors will usually do
first in dementia care is to treat any associated depression with
appropriate medications and psychotherapy. Even if the dementia is
not "caused" by an underlying depression (pseudodementia), treating
the depression can greatly improve the patient's overall condition
and quality of life.
Sleep disorders can be treated with the appropriate medications
as well, although shorter acting sedatives in lower doses are
usually preferred. These sedatives can also be used to treat
anxiety if necessary.
The attending physician may also recommend treating any
associated psychosis or behavioral agitation with antipsychotic
medications if those symptoms are present. These drugs have been
found to be somewhat effective in reducing hallucinations and
behavioral problems, but they have no tbeen approved for use in
dementia patients by the FDA and their use is considered very
controversial.
Dementia Research Progress
Each year, advances in research science and biomedical
technology continue to shed new light on the underlying nature of
the brain diseases that cause dementia. And with the aging baby
boomer population, the government is on a mission to learn more
about dementia and cure
Alzheimer's disease by 2025.
With these new discoveries come renewed hope that scientists
will someday soon develop an effective cure or preventive for the
millions who suffer from it. But while progress has been rapid, it
is not always steady, tidy, nor linear, so it's extremely
difficult, if not impossible, for the average person to keep up
with the latest dementia information. That's why it's so important
to consult with a qualified physician (such as a geriatric
internist, a geriatric psychiatrist or a neurologist) who is
informed of the most recent advances in diagnosis and treatment.
Talk to your doctor about the options, resources, and dementia
information available to you in your area-she or he may be just the
right person who can help you, or may be able to refer you to a
specialist who can. If you suspect that you or someone you love may
have dementia, don't wait to act-the sooner you find out what's
wrong, the sooner you or your loved one can be helped.
Read these blog posts to get the latest news and tips
on dementia.
Sources:
- Mayo Clinic, 2012
- Medline Plus, 2011
- University of Maryland Medical Center, 2011
- WebMD, 2012
- ScienceDaily.com, 2010