Alzheimer’s Treatment and Medications

Watching a loved one live with Alzheimer’s disease is difficult for the entire family. This degenerative condition is a form of dementia that causes memory loss and cognitive impairment over time.

Someone in the early stages of Alzheimer’s could face minor challenges, such as remembering how to do daily tasks. However, as the condition progresses, the patient may not remember his or her family and become dependent on others for care. Sadly, there is no cure for Alzheimer's. However, there are several treatment methods available to help slow this progression.

Although a complex and challenging disease for patients and their loved ones to cope with, understanding the scope of Alzheimer’s and its treatment options may comfort all who are affected. We’ll discuss what Alzheimer’s disease is, how the condition is diagnosed, and the medications and remedies that are available.

What is Alzheimer's?

Alzheimer’s disease is an irreversible, degenerative condition that affects memory, cognition, and behavior typically in those who are in their mid-60s or older. This progressive form of dementia cannot be cured, though treatment may help slow the progression of symptoms and help those who are affected maintain mental function.

Alzheimer’s disease is a complex, ongoing condition with seven stages. Early signs include trouble with memory and doing familiar daily tasks such as cooking or operating the microwave. As the disease progresses, memory loss and confusion worsen. Patients may have trouble recognizing friends and family members, along with experiencing hallucinations, delusions, and paranoia. The most severe stages of Alzheimer’s leave patients in a state where they can’t communicate and become completely dependent on others.

Dr. Alois Alzheimer, a German physician, first identified the disease in 1906 during an autopsy of a patient who experienced profound memory loss and psychological changes. When examining her brain, he noticed extreme abnormalities in the physical structure of her brain. Modern research has identified these main abnormalities associated with Alzheimer’s as plaque deposits of the beta-protein amyloid and neurofibrillary tangles, also known as tau tangles, in the brain. Other physical changes in the brain include chronic inflammation, loss of neuronal connections, and cell death. All of these changes in the brain are extremely harmful and are responsible for the symptoms of dementia Alzheimer’s patients experience.

Current research is aimed at finding more effective ways to identify cases of Alzheimer’s as early as possible. To do so, it is important to detect the brain degeneration that causes the cognitive issues people face. These changes can begin to occur as early as a decade before the first signs of symptoms, so, with better detection, treatment can start much sooner than it does today.

Alzheimer’s is common in older adults, affecting nearly 5.8 million people in the US. The exact cause of Alzheimer’s is unknown, but researchers have identified certain risk factors such as age, genetics, and a family history of the disease that make people more susceptible to Alzheimer’s. Some younger people are affected by a form of the condition known as early-onset Alzheimer’s, though these cases only account for less than 5% of cases.

How is Alzheimer's diagnosed?

People who begin experiencing memory issues or those who have a high risk for Alzheimer’s may visit their healthcare provider for a diagnosis of the condition. Alzheimer’s cannot be truly diagnosed until post-mortem examinations of the brain tissues, but certain tests and lab imaging can identify possible or probable cases of Alzheimer’s. In possible cases of Alzheimer’s, dementia may be due to other causes. In probable cases, no other cause of dementia is found.

“There is no single test that can help a doctor diagnose Alzheimer’s,” says Nodar Janas, MD, the medical director at Upper East Side Rehabilitation and Nursing Center in Manhattan, New York. “When a doctor does work to diagnose the disease, they review medical history and go through a series of tests to measure cognitive impairment, identify behavioral changes, and assess functional abilities and several other functions.”

During your medical history review, your doctor will ask you or a family member questions relating to your family medical history, current, and past health conditions and medications, and certain lifestyle factors relating to diet, alcohol/drug use, and physical activity level. Next, your doctor may perform cognitive tests by asking you what day it is or other simple orienting questions. These tests can be performed over time to monitor the mental functioning and progression of symptoms. Your doctor can also use these tests to rule out other possible causes of dementia or impairments.

Lab tests and imaging can also be used to detect probable Alzheimer’s cases. These include magnetic resonance imaging (MRI), computed tomography (CT) scans, and positron emission tomography (PET) scans. An MRI can detect structural issues, inflammation, and bleeding in the brain. CT scans can help your doctor identify any abnormal brain characteristics, and PET scans detect plaque build-ups, a key indicator of Alzheimer’s. Your doctor may also order blood tests to scan for potential genes that put you at a higher risk of developing Alzheimer’s.

Alzheimer's treatment options

Unfortunately, there is no cure for Alzheimer’s disease. This progressive condition is complex and typically cannot be successfully treated with only one drug or intervention. The current approach for treating Alzheimer’s focuses on helping patients maintain normal cognitive function for as long as possible, along with slowing memory loss and other symptoms such as behavioral changes.

Treatment options for Alzheimer’s include medications for maintaining mental functioning or managing behavioral problems. Your doctor may also recommend alternative forms of natural treatment to slow the progression of the condition, such as maintaining a healthy diet and exercising.

Alzheimer's medications

The U.S. Food and Drug Administration (FDA) has approved two groups of medications for treating Alzheimer’s. These include cholinesterase inhibitors and memantine, an NMDA receptor antagonist. Keep in mind that these medications do not cure Alzheimer’s disease, but they can help treat symptoms and help patients maintain mental function.

Cholinesterase inhibitors

Cholinesterase inhibitors are drugs that work to block the enzyme cholinesterase, which is responsible for the breakdown of acetylcholine. Because maintaining the presence of acetylcholine in the brain is crucial, cholinesterase inhibitors are the most common drug type used for the treatment of dementia in patients with Alzheimer’s. This neurotransmitter plays a key role in cognitive functions such as memory, learning, and attention.

Common cholinesterase-inhibiting drugs used to treat Alzheimer’s include Aricept (donepezil), Exelon (rivastigmine), and Razadyne (galantamine). Each of these drugs can be used to treat mild to moderate cases of Alzheimer’s. Donepezil can be used to treat severe cases as well. The common side effects of these medications are mild and include vasodilation, increased perspiration, constriction of the pupils, and increased production of saliva and tears. Overall, cholinesterase inhibitors have been known to have a modest effect in treating Alzheimer’s patients’ symptoms.

Memantine

Namenda (memantine) is an NMDA receptor antagonist that works by decreasing abnormal brain activity and controlling the amount of glutamate, a chemical involved with learning and memory, in the brain. Memantine can slow memory loss and help improve cognition and mental functioning in Alzheimer’s patients so people can do everyday tasks with more ease.

Common side effects of memantine include dizziness, confusion, and aggression. More severe side effects include shortness of breath and hallucinations, and you should contact your doctor if you experience any unusual effects from taking the medication. Memantine does not cure Alzheimer’s disease or prevent loss of mental abilities in the future, but it can help effectively slow the progression of the disease in mild, moderate, and severe cases.

Every journey with Alzheimer’s disease is unique, so the best medication differs by patient. Certain factors, such as age, medical history, and stage of the disease, can affect a patient’s response to treatment.

That being said, there are a few common medications that are known to help manage symptoms in patients with Alzheimer’s. These include those listed in the table below.

What are the best medications for Alzheimer's disease?

The following table lists common medications used to treat Alzheimer's disease. It is not a complete list and does not take into account a person's medical history or possible contradictions with medications that are being used for other conditions.

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The best medications for Alzheimer's disease