There is no cure for Alzheimer's disease. Certain medicines can improve memory and slow the progression of the disease in the early stages, while others can alleviate mood changes and other behavioural problems associated with the disease.
The goal of treatment in Alzheimer's disease is to manage the symptoms as far as possible.
- Aricept (donepezil hydrochloride) and Reminyl (galanthamine) work by slowing the breakdown of acetylcholine, the chemical that helps the neurons communicate with one another. It may help improve memory to some extent in people with mild to moderate Alzheimer’s disease.
- Ebixa (memantine) blocks NMDA glutamate receptors in the brain, providing neuroprotective effects from toxic levels of glutamate. It has been shown to slow the deterioration of the illness and to improve activities of daily living (ADL).
- A number of drugs can alleviate specific symptoms. Antidepressants, anti-anxiety, mood-stabilising and other medications (e.g. anti-psychotics) can be prescribed. These are usually added to deal with the neuropsychiatric symptoms of dementia e.g. insomnia, depression and anxiety symptoms, hallucinations or paranoia, aggression and agitation, etc.
- Several new drugs are still under investigation for potential benefits in Alzheimer’s disease, but as yet there is no cure.
Coping with Alzheimer’s at home
The immediate environment of someone with Alzheimer's disease can play an important role in helping him or her cope with the disease. It is important that family members looking after the person in the final stages of the illness realise this and modify the surroundings to reduce stress from environmental factors.
If you are a family member of someone with Alzheimer's disease you can take the following steps:
- Provide balanced nutrition and plenty of fluids.
- Keep pills and poisons safely locked away.
- Keep verbal instructions simple and short.
- Promote a feeling of safety. Keep the living environment familiar and stable by sticking to a routine.
- Have visual clues regarding time and place such as calendars, clocks and pictures of the season.
- If you have to leave the house, leave reminder notes and simple directions that your relative can remember and follow easily.
- Label objects.
- Ensure your relative has an ID bracelet with a phone number as people with Alzheimer's disease are inclined to wander and get lost.
- Because long-term memory is better than short-term memory in the early stages of the disease, your relative may enjoy reminiscing about pleasant past memories. Use family photo albums, old magazines and favourite family stories to bring these memories to the fore.
Looking after an Alzheimer's disease patient can be an emotionally draining experience for family members. If you are caring for someone with Alzheimer's disease, try to get relief from ordinary day-to-day chores in the home to help you cope with the deterioration of a loved one. The role of support groups and social workers cannot be overemphasised in this regard.
(Updated and reviewed by Dr Michael S. Mason, MB ChB, FC Psych (South Africa), Consultant Psychiatrist in private practice, Panorama Psychiatry and Memory Clinic, Cape Town March 2015.)
(Previously reviewed by Dr Frans Hugo, MBChB, M.Med Psychiatry)