Treatments for Dementia

There is at present no cure for dementia. But there are medicines and other treatments that can help with dementia symptoms.  Two of the most commonly prescribed medicines for dementia are cholinesterase inhibitors of acetylcholinesterase inhibitors or memantine or also called Namenda.  Doctors use these mainly to treat the symptoms, however there are other alternative treatments also


Medicines to treat dementia


Most of the medications available are used to treat Alzheimer's disease as this is the most common form of dementia. They can help to temporarily reduce symptoms.  The following medicines are used to temporarily improve dementia symptoms and they work by boosting levels of a chemical message.


The main medicines are:

Acetylcholinesterase inhibitors


These medicines prevent an enzyme from breaking down a substance called acetylcholine in the brain, which helps nerve cells communicate with each other.

Donepezil (also known as Aricept), rivastigmine (Exelon) and galantamine (Reminyl) are used to treat the symptoms of mild to moderate Alzheimer's disease. Donepezil is also used to treat more severe Alzheimer's disease.


Memantine


Memantine (also known as Namenda) is given to people with moderate or severe Alzheimer’s disease.  It is suitable for those who can’t take or are unable to tolerate acetylcholinesterase inhibitors.  It works by blocking the effects of an excessive amount of a chemical in the brain called glutamate. 

Side effects can include headaches, dizziness and constipation, but these are usually only temporary.


Medicines to treat challenging behaviour


​In the later stages of dementia, a significant number of people will develop what is known as behavioural and psychological symptoms of dementia (BPSD).  The symptoms of BPSD can include:

  • increased agitation

  • aggressive behaviour

  • anxious behaviour

  • delusions

  • wandering off

  • hallucinations

These changes in behaviours can be quite distressing for both the family and the person suffering from dementia. There are some coping methods that may help but if coping strategies do not work there are medicines such as risperidone or haloperidol which may help combat aggression or extreme distress by calming the person with dementia.  Antidepressants may also be sometimes given to help. 


Cognitive Stimulation Therapy


​CST involves taking part in group activities and exercises designed to improve:

  • memory 

  • language skills

  • Problem-solving skills

This form of therapy will benefit people suffering with mild to moderate dementia


Cognitive rehabilitation


​This technique involves working with a trained professional, such as an occupational therapist and a relative or friend to achieve a personal goal, or to complete an everyday task.  Cognitive rehabilitation works by getting you to use parts of your brain that are working to help build up strength on the parts that are not working.  In the early stages of dementia, it can help to use this treatment to cope better with the condition. 


Reminiscence and your life story


Reminiscence work involves talking about things and events from your past.  It usually involves using props such as photos, favourite possessions or music.  

Life story work involves a compilation of photos, notes and keepsakes from your childhood to the present day.  It can be either a physical book or a digital version. 

These approaches are sometimes combined.  Evidence shows that they can improve mood and wellbeing.  They also help you and those around you to focus on your skills and achievements rather than on your dementia. 


Lifestyle and home remedies


Dementia symptoms and behavioural problems will progress over time. These are some suggestions a family member of carer might try at home:

  • Enhance communication. When talking with your loved one, maintain eye contact. Speak slowly in simple sentences, and don't rush the response. Present one idea or instruction at a time. Use gestures and cues, such as pointing to objects.

  • Encourage exercise. The main benefits of exercise in people with dementia include improved strength, balance and cardiovascular health. Exercise may also be helpful in managing symptoms such as restlessness. There is growing evidence that exercise also protects the brain from dementia, especially when combined with a healthy diet and treatment for risk factors for cardiovascular disease. Some research also shows that physical activity might slow the progression of impaired thinking in people with Alzheimer's disease, and it can lessen symptoms of depression.

  • Engage in activity. Plan activities the person with dementia enjoys and can do. Dancing, painting, gardening, cooking, singing and other activities can be fun, can help you connect with your loved one, and can help your loved one focus on what he or she can still do.

  • Establish a nighttime ritual. Behavior is often worse at night. Try to establish going-to-bed rituals that are calming and away from the noise of television, meal cleanup and active family members. Leave night lights on in the bedroom, hall and bathroom to prevent disorientation. Limiting caffeine, discouraging napping and offering opportunities for exercise during the day might ease nighttime restlessness.

  • Keep a calendar. A calendar might help your loved one remember upcoming events, daily activities and medication schedules. Consider sharing a calendar with your loved one.

  • Plan for the future. Develop a plan with your loved one while he or she is able to participate that identifies goals for future care. Support groups, legal advisers, family members and others might be able to help. You'll need to consider financial and legal issues, safety and daily living concerns, and long-term care options.


Alternative medicine

Several dietary supplements, herbal remedies and therapies have been studied for people with dementia. But at this time there is no convincing evidence for any of these.


​Use caution when considering taking dietary supplements, vitamins or herbal remedies, especially if you're taking other medications. These remedies aren't regulated, and claims about their benefits aren't always based on scientific research.


While some studies suggest that vitamin E supplements may be helpful for Alzheimer's disease, the evidence is not convincing and large doses may pose risks. Vitamin E supplementation is not currently recommended, but including vitamin E in the diet through foods such as nuts is suggested to promote brain health.


Care and support for the person with the disease


​Here are some suggestions you can try to help yourself cope with the disease:

  • Learn as much as you can about memory loss, dementia and Alzheimer's disease.

  • Write about your feelings in a journal.

  • Join a local support group.

  • Get individual or family counseling.

  • Talk to a member of your spiritual community or another person who can help you with your spiritual needs.

  • Stay active and involved, volunteer, exercise, and participate in activities for people with memory loss.

  • Spend time with friends and family.

  • Participate in an online community of people who are having similar experiences.

  • Find new ways to express yourself, such as through painting, singing or writing.

  • Delegate help with decision-making to someone you trust.

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