Dementia Treatments and Medications

Living with dementia can be a challenging and stressful experience that can affect all facets of daily life. It can also have an impact on the lives of loved ones and family members. While it may be difficult to adjust to the changes that come with dementia, there are resources to make the journey easier. With the right treatment and support, those living with dementia can continue to lead healthy, meaningful lives.

There is currently no cure for dementia. However, various treatments and medications are available to help manage symptoms, slow disease progression, and improve quality of life. Treatment options may include medication, lifestyle changes, supportive care, and behavioral therapies. It’s important to always consult a healthcare provider who can determine the best treatment options for dementia.

Continue reading to learn more about dementia, the different types of dementia treatments available, and their potential benefits and side effects.

What is dementia?

Dementia is not a specific disease. Rather, it is a general term that encompasses a decline in cognitive function beyond what is expected from normal aging. Dementia can affect memory, problem-solving, mood, personality, behavior, and the ability to perform everyday activities. In 2020, almost 6 million adults aged 65 years and older were diagnosed with Alzheimer’s disease, and, by 2050, almost 13 million people will have dementia related to Alzheimer’s.

Dementia is typically caused by damage or the loss of function of nerve cells in the brain, and it can occur due to various reasons. There are different types of dementia, each with different symptoms or characteristics.

Dementia caused by Alzheimer's disease is the most common type of dementia, accounting for 60% to 80% of cases. Other forms of dementia include vascular dementia, Lewy body dementia, and frontotemporal dementia. Dementia can also arise due to different disorders, such as Huntington's disease, Creutzfeldt-Jakob disease, and Parkinson’s disease.

Temporary symptoms of dementia can develop from certain infections, thyroid problems, or the use of certain medications. These symptoms can usually be reversed after treating the underlying causes.

Symptoms of dementia

Symptoms of dementia can vary depending on the type of dementia and the severity of the condition. Common dementia symptoms may include:

• Memory loss, or unusual forgetfulness about recent events

• Disorientation and confusion, particularly in familiar places

• Difficulty with problem-solving and planning

• Difficulty with language and communication

• Loss of motivation and interest in activities

• Loss of ability to perform daily activities

• Changes in mood and behavior, such as depression, anxiety, or aggression

Dementia is a progressive problem, meaning that symptoms will typically worsen over time. However, an early diagnosis can make a difference in getting appropriate treatment to slow progression and manage symptoms.

How is dementia diagnosed?

Diagnosing dementia can be difficult without a complete assessment and other tests. A geriatrician, a doctor who specializes in the care of older adults, usually diagnoses dementia. However, other specialists, such as neurologists, psychiatrists, and neuropsychologists, may also diagnose it.

A healthcare provider may want to assess whether dementia is present in several ways. In general, they’ll conduct a physical exam, ask about the person’s medical history, and conduct laboratory tests to check for certain biomarkers that could indicate an underlying problem that causes dementia. By assessing a person’s symptoms and overall medical history, a healthcare provider can also rule out certain conditions that may be causing dementia.

It's important to note that the diagnosis of dementia can be challenging and take time. It's also important to be aware that there are many conditions that can cause symptoms similar to dementia, so getting an accurate diagnosis is crucial.

Dementia treatment options

The primary goal of dementia treatment options is to manage symptoms and slow down the progression of the syndrome. Treatment generally includes a multi-faceted approach involving medication and non-medication options. There are several oral medications that work in different ways to treat symptoms of dementia. The right medication will depend on the cause of dementia.

In addition to medications, non-drug therapies may be recommended. These treatment options may include behavioral therapy, supportive care, and healthy lifestyle changes. For example, a person with dementia can undergo occupational therapy to maintain their ability to perform daily activities. Joining a support group can provide information and emotional support for an affected person and their family.

Treatment for dementia is often personalized based on an individual's needs, preferences, and overall health. As a long-term endeavor, dementia treatment often requires the commitment of the affected individual, their caregivers, and their loved ones.

Dementia medications

There are different classes of medications used to treat dementia symptoms or the underlying cause. These drug classes include:

Cholinesterase inhibitors

In people with Alzheimer’s disease, low levels of acetylcholine are associated with symptoms of dementia. Acetylcholine is a chemical or neurotransmitter that plays a role in the communication between nerve cells. Cholinesterase inhibitors block the enzyme responsible for breaking down acetylcholine, leading to higher levels of acetylcholine in the brain. These medications can help improve memory, thinking, and behavior in patients with Alzheimer's disease. Examples include:

• Aricept (donepezil)

• Exelon (rivastigmine)

• Razadyne (galantamine)

Common side effects may include nausea, vomiting, and loss of appetite.

NMDA receptor antagonists

Memantine, known by the brand name Namenda, is an NMDA receptor antagonist used to treat moderate to severe dementia from Alzheimer’s disease. It works by regulating the activity of a neurotransmitter called glutamate in the brain, which can help improve memory and thinking. It is used to manage dementia symptoms, but it cannot cure the underlying disease. Side effects may include dizziness, confusion, and headache.

Monoclonal antibodies

Aducanumab is an FDA-approved monoclonal antibody medication that targets the beta-amyloid proteins that form plaques in the brain. These plaques can disrupt communication between nerve cells, contributing to symptoms of dementia. Aducanumab, known by the brand name Aduhelm, is administered via intravenous (IV) infusion. It is prescribed to treat mild cognitive impairment and slow disease progression. Common side effects of aducanumab include amyloid-related imaging abnormalities (ARIA), headaches, and falls.

Orexin receptor antagonist

Insomnia or difficulty sleeping can affect many people with dementia. Suvorexant, known by the brand name Belsomra, treats insomnia by blocking the effects of orexin, a neurotransmitter involved in the sleep-wake cycle. Studies have shown that suvorexant is effective for treating insomnia associated with mild to moderate Alzheimer’s disease. Side effects of suvorexant include headaches, abnormal dreams, and drowsiness the following day after taking the medication.

What is the best medication for dementia?

The following table shows common medications prescribed to treat Alzheimer’s disease. It is important to remember that these drugs do not cure dementia. Moreover, this is not a complete list of drugs used for dementia. A physician or healthcare provider will prescribe the appropriate medications tailored to a person’s needs.

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The best medication for dementia