Treatment for Alzheimer's Disease

The treatment of Alzheimer's disease includes drugs such as cognitive enhancers and psychological techniques. Learn more!

Written and verified by la psicóloga Laura Ruiz Mitjana.

Last update: 18 January, 2023

Alzheimer’s disease causes Alzheimer’s dementia, the most common cause of dementia; according to DSM-IV-TR, it covers 55-65% of all cases. Although according to Belloch (2008), the figures are a little lower (35%). But is there a treatment for Alzheimer’s disease?

Alzheimer’s currently has no cure; however, its cognitive symptoms can be delayed, and symptoms secondary to the disease (depression, anxiety, irritability…) can also be alleviated. In this article, we’ll talk about the pharmacological and psychological treatments used for Alzheimer’s disease.

Medicines

On a medical level, different types of drugs are used in the treatment of Alzheimer’s disease. For example, cognitive enhancers are drugs that try to slow the progression of the symptoms of the disease.

To combat psychological symptoms, antidepressants, antipsychotics, mood stabilizers, etc. are used. For their part, cognitive enhancers improve the mental processes of some people, but their effectiveness in each individual can vary greatly.

The United States Food and Drug Administration (FDA) has approved two types of drugs for the treatment of the cognitive symptoms of Alzheimer’s:

• Cholinesterase inhibitors
• N-methyl D-aspartate (NMDA) antagonists

Cholinesterase inhibitors

These drugs work by preventing the breakdown of acetylcholine in the brain, a chemical that facilitates the communication of nerve cells in the areas of memory, learning, and thought processes.

In this regard, research has found lower levels of this substance in the brains of people with Alzheimer’s dementia.

That’s why the hope is that by protecting or increasing the levels of this substance through these drugs, the functioning of the brain can improve or stabilize (Casey et al., 2010). Currently, and according to the same authors, there are three approved and prescribed cholinesterase inhibitor drugs for this disease:

• Aricept (donepezil): For the treatment of mild, moderate, and severe Alzheimer’s
• Exelon (rivastigmine): For mild to moderate cases
• Razadyne (galantamine): Also for mild to moderate cases.

N-methyl D-aspartate (NMDA) antagonists

The only drug in this class is namenda (memantine), which is approved for moderate to severe Alzheimer’s disease (Casey et al., 2010). This medicine regulates the levels of glutamate (an amino acid) in the brain.

Adequate levels of glutamate facilitate learning, but an excess of the substance can cause the death of brain cells. Namenda has been shown to be effective in slowing the progression of Alzheimer’s symptoms.

Psychotropic drugs

Psychotropic drugs are also used as a treatment for Alzheimer’s disease; specifically, they’re used to control the behavioral and psychological symptoms of dementia. Among them, the following stand out:

• Antipsychotics
• Antidepressants
• Anxiolytics
• Mood stabilizers
• Drugs for insomnia (also called hypnotics or sleeping pills)

Although these can be very effective medications, they also have side effects. Depending on the type of drug, we find the following:

• Hypertensive crisis
• Neuroleptic malignant syndrome
• Insomnia
• Sickness
• Sweating
• Constipation
• Dry mouth
• Drowsiness
• Etc.

Over-the-counter drugs

As over-the-counter medications for Alzheimer’s and its related symptoms, we find painkillers. These include but aren’t limited to acetaminophen or non-steroidal anti-inflammatory drugs. Analgesics are used to achieve analgesia, that is, to relieve and reduce pain (either headaches, muscle pain, or generalized pain).

Home remedies and lifestyle

Non-pharmacological or psychological approaches, that is, those more focused on a change in the person’s lifestyle, focus on treating behavioral, psychological, and emotional symptoms in a more “natural” way. As we said, through a change in lifestyle.

Physical exercise

In the case of Alzheimer’s, it can be beneficial to include regular physical exercise in the patient’s life. Exercise doesn’t have to be intense, but simply include some kind of routine that keeps you in a state of activity (and always taking into account your situation).

In fact, challenging behaviors or feelings of frustration often appear in these people, and these are often the result of not getting enough physical activity.

In this regard, according to a study by Kratz (2017), getting up and going for a walk, participating in a group aerobic activity class, or doing small stretching exercises, can help satisfy this need.

At the same time, exercise is known to have the potential to improve cognition in some people, in addition to improving mood by promoting the release of substances such as endorphins.

Behavioral measures

The evaluation of the patient’s behavior involves identifying their behaviors and observing what antecedents they have, that is, what triggers that behavior, according to Kratz in an article (2017). It can help us as caregivers of a patient with Alzheimer’s.

For example, if you identify that showers cause agitation, you can try a bath. It’s about modifying the antecedents of negative behavior in order to keep them from appearing.

Validation therapy

Validation therapy is beneficial in preventing the escalation of problematic behaviors and is carried out from a change in one’s perspective. For example, if the sick person is asking to see their mother (who may have passed away many years ago), instead of confronting them with the truth, you can ask them to talk about her.

According to Tondi et al. (2007), validation therapy (also called emotional validation), is a strategy that can be very effective in calming the agitated or upset person. At the same time, other types of therapy are also used, focused on improving the anxiety and depressive symptoms of the patient, better problem-solving abilities, etc.

Meaningful and enjoyable activities

People who suffer from dementia due to Alzheimer’s disease (or any other type of dementia) can feel lonely and bored and even suffer from depression. According to a study by Mendiola-Precoma et al. (2016), they may not even be able to clearly verbalize these feelings.

For this reason, it’s important to offer them opportunities to interact with others, still have certain responsibilities (such as washing dishes, running certain errands…), performing tasks that they find gratifying (such as singing their favorite songs, drawing, listening to music…).

All of this activates the person, improves their mood, and can greatly reduce feelings of restlessness and boredom.

Cognitive stimulation

Cognitive stimulation is aimed at maintaining cognitive skills that are still functioning. That is, it seeks to delay cognitive decline as much as possible.

It also seeks to improve the functions that begin to deteriorate. In this regard, being mentally active has proven useful in maintaining skills such as memory or thinking.

Cognitive stimulation can be performed in different ways; through cards directed at it (with a computer or paper), games, reading a book, completing a puzzle, doing sudoku, etc.

Final Recommendations regarding treatment for Alzheimer’s disease

If a close relative has been diagnosed with Alzheimer’s disease, the best thing you can do is seek professional help to initiate appropriate treatment. Emotional support is also very important in these cases, not only for the patient, but also for their family members.

Receiving news of this type is very hard, but with the necessary help, knowing as much as possible about the disease, and anticipating the needs of the person, we can begin to trace the path to improve their quality of life. In these cases, learning about the disease will be essential.