Treatment of Alzheimer's Disease

By reducing or eliminating as many of the risk factors, it should be possible to greatly reduce your chances of developing Alzheimer’s and other dementias. 
Studies on the results of various treatments have been mixed and more research is needed.  It is important to talk to your doctor before starting any new treatment for Alzheimer's (even for over-the-counter treatments), as some of these may even be harmful in certain circumstances.
When diagnosed and treated for Alzheimer's, you will need to have regular follow-up visits with your health care team.  In addition to regular checkups for overall health, your doctor will also want to regularly assess your level of daily functioning, mental status, mood, emotional state, and the status of your caregiver(s).
Emotional and psychological support is also very important for those affected by Alzheimer's.  Ask your health care provider to recommend Alzheimer's support groups in your area.
It is worthwhile to maintain a positive attitude.  While, currently, there is no cure for Alzheimer's, new drugs and treatments are regularly becoming available.  Research is continuing all around the world, and the next breakthrough may be just around the corner. 

Non-Medical Treatments

Research conducted over the past decade indicates that a healthy lifestyle and regular physical and mental activity may help delay the onset of Alzheimer’s Disease.  In addition, you will reduce your risk of cardiovascular disease.
Physical activity, good nutrition, and social interaction are important for keeping Alzheimer's patients as functional as possible.
Maintaining a calm, safe, structured environment also helps patients feel better and remain independent longer.

A Healthy Lifestyle

Although researchers do not yet understand many of the cellular processes that lead to Alzheimer’s, it appears that a healthy lifestyle can at least help delay its onset.  For example :

• Healthy diet may be able to control various Alzheimer’s risk factors such as high cholesterol levels and diabetes.
• Exercise may help manage cardiovascular risk factors, increase blood flow to the brain and stimulate nerve cell growth and survival.

In general, what is good for the heart is also good for the mind. 

Mental and Social Activity

A number of studies have reported that mental and social activities, such as reading, dancing, doing crosswords, painting, playing music, and singing in a choir could delay the onset of dementia.  It has been proposed that such activities increase brain activity, stimulate establishment of new connections between nerve cells and may even result in the production of new nerve cells.
Over the years of mental stimulation a brain can build many connections between nerve cells.  When such an active brain becomes affected by Alzheimer's disease some of these connections are disrupted, but the brain may be able to re-route the flow of information to intact connections and compensate for the death of other nerve cells.  Because of this, active brains that have many connections between nerve cells, tend to  remain free of the symptoms of dementia for longer.  In contrast, a flow of information in an inactive brain, that has few connections between nerve cells, is easily disrupted at the onset of Alzheimer's disease.

GETO Herbal Extract

A recent study conducted in China found that a herbal extract improved cognitive function in people with mild cognitive impairment, often a precursor to Alzheimer's.  The extract, known as GETO (for ginseng, epimedium herb, thinleaf milkwort root and two other herbs), has been used for centuries in traditional Chinese medicine.

Exercise

Recent studies at Japan's University of Tsukuba have found that an exercise program incorporating low-intensity calisthenics also improved the memory in elderly people with mild cognitive impairment.
The calisthenics, called Furfuri-Guppa, were combined with singing.  After one year in the exercise intervention program, 70 of participants showed a significant improvement in memory.

Drugs and Medication

Modern drugs can help sooth agitation, anxiety, depression, and sleeplessness, and may also help boost participation in daily activities.  Newer medications are also becoming available that can improve or preserve thinking skills, at least temporarily.
Please note : Regular reassessment is required while you are on any of these medications.  This helps doctors determine if the medicines are being tolerated without troublesome side effects.  These regular visits are also to make sure the patient is responding to the medication appropriately.
It is important to note that consumption of some nutritional supplements or medications can have serious side effects or interfere with other prescribed medications.  Please consult with your doctor before using any nutritional supplements or medications.

Vitamin B, E, Folic Acid, and Others

Several studies have investigated whether nutritional supplements and certain medications may reduce the risk of developing dementia.  Some of the findings are summarized below:

• It has been suggested that antioxidants, such as vitamins C and E, may reduce the risk of developing dementia. Interestingly, the protective effect of these vitamins was enhanced when they were acquired through food, rather then through supplements.
• Adequate intake of vitamin B and folate can help reduce homocysteine levels, and this may reduce the risk of developing Alzheimer’s disease.

Anti-Inflammatory Agents

As inflammation correlates with brain damage caused by Alzheimer’s disease it has been suggested that some anti-inflammatory agents may help delay dementia.  The effectiveness of anti-inflammatory agents in prevention has not been proven, but researchers now know that they are not very effective in treating Alzheimer’s disease.

Alcohol

Some studies have found that moderate alcohol (1-3 drinks per day) and caffeine intake may have a protective influence.  However, it is important to emphasize that alcohol and caffeine also have other negative effects that may outweigh their potential benefit in delaying dementia.

Diabetes Medications

Careful management of diabetes with medications that maintain blood glucose levels within a healthy range may also reduce the risk of developing Alzheimer’s disease.

Cholesterol Lowering Medicines

Cholesterol lowering drugs may lower the risk of developing Alzheimer’s disease.
Cholesterol lowering medicines known as statins, nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin, ginkgo biloba, and Eldepryl - a monoamine oxidase inhibitor – can also help a great deal.

Acetylcholinesterase Inhibitors

Alzheimer’s causes the destruction of neurons (brain cells).  It also destroys the important chemical messenger acetylcholine, which is responsible for memory and other cognitive skills.  While no drug has yet been shown to completely protect the brain against the effects of Alzheimer’s, drugs that protect acetylcholine from destruction appear to hold the symptoms at bay for a while longer.
These medications are known as acetylcholinesterase inhibitors and include :

• Aricept,
• Exelon, and,
• Reminyl.

For the acetylcholinesterase inhibitor drugs, the dose of medication is started low and gradually increased to the recommended level.  Tolerance (the drug no longer provides the same benefit) may occur.  It is also important to know that these medications are expensive, averaging in the neighborhood of $130 per month.  Your insurance or health cover may or may not cover the costs of this drug.

Reminyl Warning

In April 2005, Reminyl’s label was changed to include information about the deaths of 13 elderly patients who were taking the drug during a study.  The deaths were due to various causes, including heart attack and stroke.

Side Effects

The acetylcholinesterase inhibitors are generally well tolerated by the human body, but some troublesome side effects may occur.  These side effects include :

• nausea,
• vomiting,
• diarrhea, and,
• weight loss.

Often, changing to a lower dose or switching medications solves the problems.

Cholinesterase Inhibitors

The cholinesterase inhibitor, Cognex, is rarely used anymore due to serious liver side effects and the need for frequent blood testing.

Namenda

Another medicine, called Namenda, has recently been approved for use in the U.S.  This medication has a different action than the acetylcholinesterase inhibitors and the two types of drugs may be used together, at the same time.  This may increase the effectiveness of therapy.

Flurizan

All of the FDA-approved treatments now available only provide relief of cognitive symptoms; they do not attack underlying disease.
A recent study found that patients with mild Alzheimer's disease who take a drug called Flurizan were able to slow the disease-related decline in their activities of daily living (such as eating and dressing) by about 67 percent when compared with people on placebo.
Flurizan is the first of a new class of drugs known as selective amyloid beta- lowering agents, which are intended to affect the suspected underlying cause of the disease, a build-up of beta-amyloid protein.

Intravenous Immunoglobulin (IVIg)

In a trial involving eight people with mild to moderate Alzheimer's, researchers at Weill Medical College of Cornell University are trying to harness the body's immune system to fight Alzheimer's.
In this trial, intravenous immunoglobulin (IVIg) seemed to increase the levels of anti-beta-amyloid antibodies in the blood to a greater degree than seen before resulting in an average 45 percent decrease of amyloid.  Six of the eight patients experienced improvement in cognitive function and none of the patients had declining function.
Previous studies had noted that levels of these antibodies seemed to be lower in people with Alzheimer's.  IVIg is derived from human blood and contains high concentrations of antibodies.
Researches are not yet sure how this occurs.  For example, amyloid clearance might be due to a flushing effect (i.e., antibodies in the brain are working to flush out the protein) or a magnet-like effect (the antibodies are drawing or attracting the protein into the bloodstream).

Intranasal Insulin

Other studies have found that insulin delivered intranasally benefited individuals with both early Alzheimer's and abnormal insulin regulation.
Previous research has indicated that people with high levels of insulin in their blood may be at an increased risk of developing Alzheimer's.  This is because insulin congregates in the blood vessels and fails to reach the brain, where it is needed for various regulatory processes.
Another way to get insulin to the brain is through the nose, and in this study, conducted at the University of Washington School of Medicine and Veterans Affairs Puget Sound Medical Center, insulin delivered intranasally did improve memory recall for Alzheimer's patients.  The participants were able to remember a list of words after taking a higher insulin dose, the researchers report.

Support Groups

Various support groups may exist in your area to help you and your family cope with caring for someone with Alzheimer's Disease :

• These groups are usually designed for people in the early stage of dementia, together with a family member of friend.
• Initially, a six to eight week group program is held (two hour sessions, one day a week).
• Ongoing support groups are then offered (usually monthly).
• In each case two groups are conducted, one for people living with memory loss and the other for a family member of friend.
• People with memory loss can attend alone if they wish.
• These groups exist in various metropolitan and country locations.
• Groups are free of charge.

At group sessions, the following topics are discussed :

• Symptoms and diagnosis
• Adapting to changes
• Research and new drug treatments
• Practical strategies
• Relationships with family and friends
• Looking after yourself
• Planning for the future
• Community services
• Legal issues
• Where to from here?

The benefits of attending these group sessions include :

• Obtain information
• Have questions answered 
• Talk confidentially with others in a similar situation
• Discuss experiences and express feelings in a safe environment
• Focus on maintaining and enhancing skills and abilities
• Explore ways of managing now and into the future

Alzheimer's Disease Guide

Alzheimers Disease
History of Alzheimer's Disease
Types of Dementia
Risk Factors for Alzheimer's Disease
Diagnosing Alzheimer's Disease
Treatment of Alzheimer's Disease
Memory loss in Alzheimers disease
Disorientation and Alzheimers Disease
Disorientation and Alzheimers disease in the home
Alzheimers Disease and Personality
Alzheimer’s disease and Communication
Alzheimer’s disease and sexual behaviour
Alzheimers disease and Risk
Sleep and Alzheimer Disease
Malnutrition and Alzheimer’s disease