Treatment for Dementia: What You Need to Know

Certain medications can temporarily relieve and help manage dementia symptoms related to memory and cognitive function. However, the effectiveness of medications may vary from person to person. Two common medications are as follows: ^[01]

• Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), attempt to slow the rate of memory decline in dementia patients. These drugs work by preventing the breakdown of acetylcholine, a chemical that helps brain cells communicate with each other. This type of medication is most often used to treat people with mild to moderate Alzheimer’s disease.
• Memantine (Namenda, Ebixa) helps protect against further brain cell damage in patients who have vascular dementia. This drug regulates glutamate, a chemical messenger in the brain associated with learning and memory. Memantine is approved for the treatment of moderate to severe Alzheimer’s disease.

Medication types for dementia behaviors

Treatment for dementia behaviors — like mood changes, sleep problems, and aggression — may be achieved through medications. These medications treat symptoms and may include: ^[01]

• Sleep aids
• Mood stabilizers
• Antidepressants
• Anti-anxiety drugs
• Anticonvulsants
• Antipsychotics

However, these medications can have serious side effects, so it’s important to discuss their safety and risks with an expert, says Hashmi.

“As geriatricians, we try to use these medications sparingly,” he says. “They need to be matched to the behavior. It’s not one size fits all.”

Why medications should be regularly reevaluated

Any prescriptions should be reevaluated on a regular basis, especially if they’re not working or providing enough benefit to outweigh side effects, explains Hashmi.

“The endeavor is always to slowly wean off any of these medications. The less you take, the less chance of exposure to side effects and the better people feel.”

A number of alternative therapies may also help manage dementia symptoms and improve quality of life. Caregivers of dementia patients have a wealth of resources at their hands today, from new dementia apps and technologies to an array of personalized therapies.

“Medication — actual pills or patches or any type of medication — is only 2% of what we can currently do for someone with dementia,” says Hashmi. “The 98% is actually non-medication.”

There are a variety of therapies that may be helpful for people with dementia. These can include the following:

• Occupational therapy. It can help seniors with mild to moderate dementia by teaching coping behaviors and strategies to compensate for memory loss and cognitive decline.
• Music therapy. Listening to soothing, familiar music or singing songs can potentially reduce agitation and aggression. Depending on the music, it can also help promote relaxation during bedtime or promote wakefulness if excessive sleepiness is a symptom during the day.
• Pet therapy. This type of therapy may reduce anxiety, agitation, irritability, depression, and loneliness. Many memory care communities provide pet therapy or have a pet resident, as many dog breeds can make exceptional therapy animals for seniors. Some dog breeds are especially favored as dementia therapy service animals.
• Aromatherapy. The sensory experience of aromatherapy may relieve agitation. Diluted lemon balm or lavender oil can be applied to the skin or sprayed in the air to create a soothing environment that promotes relaxation. Other forms of aromatherapy include citrus to help awaken the senses in the morning and other oils to stimulate appetite.
• Massage therapy. Some studies show that massage and touch therapy can help reduce agitation and encourage people with dementia to eat and feel more comfortable all around. This is highly dependent upon the person though, and it’s best when professional massage therapists are employed.
• Art therapy. This type of therapy is believed to help slow cognitive decline and improve quality of life, but more studies are needed to confirm benefits for people with dementia.

Let our care assessment guide you

Yes — cognitive rehabilitation can potentially help people with dementia. This type of rehab helps people in the early stages of dementia maintain memory and cognitive function for as long as possible. It also teaches compensation strategies to help people with declining cognition.

There are lifestyle changes that can potentially help your loved one manage their dementia symptoms. But more research needs to be done on many of these strategies to better understand their effectiveness.^[02]

Healthy habits for prevention and treatment

Research suggests that there is a connection between the risk of developing dementia and the health of your heart and blood vessels.^[03] Taking steps to improve vascular health holistically, through diet and exercise, can lower the risk of developing dementia.

“What’s good for the heart is good for the mind,” Hashmi says.

As such, he encourages dementia patients to adopt healthy lifestyle changes, such as the following:

• Quit smoking
• Eat foods from a heart- and brain-healthy diet plan
• Establish a daily exercise routine

Additionally, studies show that people with dementia who have a regular exercise routine can better perform daily tasks and see improvements in mood and depression.

Dietary supplements for dementia

Many dietary supplements have been studied for dementia treatment, including ginkgo biloba, vitamin B, and omega-3 fatty acids. However, results haven’t shown significant benefits.^[04] Talk to a doctor before giving your loved one with dementia any dietary supplements or herbal medicine. This will help prevent side effects and interactions with other drugs.

Behavior management strategies for people with dementia

Behavior management strategies, such as labeling drawers and using an alarm to remember tasks, can help caregivers provide a more structured environment, and identify and avoid triggers for problematic behaviors. The goal of these strategies is to gently redirect the attentions of a family member with dementia.

Doctors generally prefer to try non-drug strategies like these for difficult dementia behaviors first, Hashmi says.

Talk with a Senior Living Advisor

Possibly — an early diagnosis may give your family member a better chance of benefiting from treatment. This is why it’s important to see a doctor if you notice changes in your loved one’s behavior and memory. Understanding what’s causing your loved one’s symptoms early on can help your family member get prompt access to the right therapies and care for their condition.

Keep in mind that some individuals may respond better to certain treatments than others. Some treatment options are more well-established while others are still being researched. Additionally, emerging research may create new dementia treatments in the future, which could include gene therapy or new pharmaceutical developments.

Read more:What Do Dementia Patients Think About?

“Other families, other caregivers are going through the same thing,” Hashmi says. He encourages caregivers to find sources of support — whether in the form of respite care or support groups — and to plan ahead. As dementia progresses, your loved one may need more care than you’re able to provide.

Being proactive about understanding your local memory care options and planning for care needs protects both you and your loved one. Connect with A Place for Mom’s Senior Living Advisors for personalized guidance on senior care options that may fit your loved one’s unique needs. They can help you discover memory care options within your area and budget, all at no cost to you.

A Place for Mom and Cleveland Clinic: Supporting seniors and their families

This article was developed in conversation with Ardeshir Hashmi, MD, section chief of the Cleveland Clinic’s Center for Geriatric Medicine, as part of a series of articles featuring expert advice from Cleveland Clinic geriatricians.

Note: The interview with Ardeshir Hashmi, MD, was conducted on June 28, 2021 and featured in a prior version of this article by Sarah Pratte. Content in the article has been updated as of December 2023.

Read more:How Much Does In-Home Dementia Care Cost? Surprising Facts and Resources