Treatment Approach to Alzheimer's Disease

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Unfortunately, there is no cure for AD. The goal in treating AD is to slow the progression of the disease and improve symptoms. The most promising treatments for AD include medications that increase the amount of acetylcholine in the brain (such as donepezil), antioxidants that scavenge free radicals (such as vitamin E and ginkgo biloba), lifestyle modifications (such as walking programs and relaxation training) to reduce anxiety and improve behavior. Studies suggest that music therapy, the use of music to relax patients and bolster the immune system, may be healing for those with AD as well. It is also important that family members of people with AD get emotional support and assistance with the demanding tasks of caregiving.

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Alzheimer's and Lifestyle

Research indicates that the following lifestyle modifications may help improve behavior in people with AD.

• A supervised walking program with a caregiver or other reliable companion may improve communication skills and diminish the risk of wandering.
• Bright light therapy may control insomnia and wandering.
• Calming music may reduce wandering and restlessness, boost brain chemicals, and improve behavior.
• Pet dogs can increase appropriate social behaviors.
• Relaxation training and other exercises that require focused attention (often used with refreshments as rewards) can improve social interaction and the ability to perform tasks.
• The Safe Return Program, implemented by the Alzheimer's Association, requires that a person with AD wear an identification bracelet. If he or she wanders, the caregiver can contact the police and the national Safe Return office, where information about the patient is stored and shared nationwide.

Individuals with AD may also have particular dietary concerns. They may require:

• Extra calories due to increased physical activity and restless wandering.
• Supervised meals and assistance with feeding. People with AD often forget to eat and drink, and, as a result, often become dehydrated.

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Alzheimer's Medications

The following medications increase the amount of acetylcholine, in the nervous system and slow the progression of AD:

• Donepezil—slows progression of AD in 30% to 50% of people with the disease; has few side effects
• Tacrine—10% to 20% of people who develop AD early in life show a positive response to this medication; not beneficial for people in the late stages of the disease; serious side effects include nausea, vomiting, diarrhea, and addiction
• Rivastigmine—side effects include dizziness, headache, nausea, vomiting, and diarrhea.

The following medications may ease the symptoms related to AD:

• Selective serotonin reuptake inhibitors (SSRIs)—increase activity of a brain chemical called serotonin; used to treat depression; because symptoms of depression often precede AD, SSRIs may slow the development of AD
• Methylphenidate—stimulates the brain to increase alertness; used to treat withdrawal and apathy
• Risperidone, olanzapine, or haloperidol—act as mood stabilizers and work on improving social interactions, mood, expression of mood, delusions, and paranoia; decreases aggression; haloperidol has serious side effects, including impaired control of movement
• Carbamazepine (or other antiseizure drugs)—stabilizes sodium levels in the brain; used to treat agitation

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Reviewed: 03/2006