Treating The Signs Of Vascular Dementia
Vascular dementia can cause problems like depression, anxiety and falls. The stroke or dementia team can work with you to find ways around many of these problems. You might have medication for anxiety, or physiotherapy to reduce falls.
MedicationSometimes medication may be used to improve your mood if you are feeling very down or depressed. Medication can also help with some of the problems seen in advanced vascular dementia. However, there are risks in taking these drugs, so its important that you talk through all the advantages and disadvantages with your family and doctor before you decide to try them.
Rehabilitation therapyMemory and stroke services often have a team of experts that can help with various dementia problems. If your dementia is causing physical problems, such as falls, then you may be able to work with a physiotherapist to try to improve them.
A speech and language therapist may be able to help you with any communication problems that youre having. An occupational therapist will also be able to work with you to make sure that you can be as independent as possible, particularly in your home environment.
Types Of Medication For Difficult Behaviors In Dementia
Most medications used to treat difficult behaviors fall into one of the following categories:
1.Antipsychotics. These are medications originally developed to treat schizophrenia and other illnesses featuring psychosis symptoms.
Commonly used drugs: Antipsychotics often used in older adults include:
- For a longer list of antipsychotics drugs, see this NIH page.
Usual effects: Most antipsychotics are sedating, and will calm agitation or aggression through these sedating effects. Antipsychotics may also reduce true psychosis symptoms, such as delusions, hallucinations, or paranoid beliefs, but its rare for them to completely correct these in people with dementia.
Risks of use: The risks of antipsychotics are related to how high the dose is, and include:
- Increased risk of falls
- Increased risk of stroke and of death this has been estimated as an increased absolute risk of 1-4%
- A risk of side-effects known as extrapyramidal symptoms, which include stiffness and tremor similar to Parkinsons disease, as well as a variety of other muscle coordination problems
- People with Lewy-body dementia or a history of Parkinsonism may be especially sensitive to antipsychotic side-effects in such people, quetiapine is considered the safest choice
2. Benzodiazepines. This is a category of medication that relaxes people fairly quickly. So these drugs are used for anxiety, for panic attacks, for sedation, and to treat insomnia. They can easily become habit-forming.
Can Dementia Be Prevented
Although dementia cannot be prevented, living a health-focused life might influence risk factors for certain types of dementia. Keeping blood vessels clear of cholesterol buildup, maintaining normal blood pressure, controlling blood sugar, staying at a healthy weight basically, staying as healthy as one can can keep the brain fueled with the oxygen and nutrients it needs to function at its highest possible level. Specific healthful steps you can take include:
- Follow a Mediterranean diet, which is one filled with whole grains, vegetables, fruits, fish and shellfish, nuts, beans, olive oil and only limited amounts of red meats.
- Exercise. Get at least 30 minutes of exercise most days of the week.
- Keep your brain engaged. Solve puzzles, play word games, and try other mentally stimulating activities. These activities may delay the start of dementia.
- Stay socially active. Interact with people discuss current events keep your mind, heart, and soul engaged.
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National Institute For Health And Clinical Excellence Guidance
Although they are not a cure, ChEIs currently offer the best hope in treating AD. Initially the availability in the UK of ChEIs for the treatment of AD depended on where patients lived rather than their clinical need, so called post code prescribing. The National Institute for Health and Clinical Excellence 2001 guidelines for the treatment of AD with ChEIs recommended their use.
The economic model used by NICE also did not reflect the use of ChEIs in clinical practice, where treatment is discontinued in patients who do not respond. The NICE model, however, assumes that all patients continue with treatment irrespective of response. Their analysis, therefore, included patients who had not responded and were not gaining any benefit from treatment but were still accumulating costs. In clinical practice these patients treatment would be discontinued and the cost curtailed.
Patients, carers, clinicians, and interested organisations have been confused by the change of stance by NICE in their new draft guidelines, as the evidence for the effectiveness of ChEIs has improved since their original guidelines, which recommended the treatments. At the time of writing, NICE have postponed their final assessment and are considering further information.
How Well Do Dementia Treatments Work
It is thought that about half the people treated with a cholinesterase inhibitor will see an improvement in symptoms which affect thinking and memory. Whether they help with other symptoms such as aggression and agitation has still not been confirmed. The improvement in symptoms is usually only seen for about 6-12 months.
For memantine, some studies have shown that it can slow down the progression of symptoms in some cases.
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How Should I Take These Medicines
It is usual to start with a low dose. This is then increased over a period of weeks to a target treatment dose. The dose is increased slowly because when you first start taking these medicines you may develop some unpleasant side-effects – for example, diarrhoea, feeling sick and being sick .
Most people who develop side-effects find that after a period of time these go away. If you are tolerating a low dose well, your doctor will increase your dose, if needed. How often the dose is increased depends upon which medicine you are taking. For example, if you are taking galantamine, the dose is increased every four weeks. If you are taking rivastigmine tablets, the dose is increased every two weeks.
See the leaflet that came with your medicine for more information.
Advancements In Amyloid And Tau
All thats not to say the treatment theories that held so much promise in the 90s and early 2000s have been totally abandoned, despite decades of failed clinical trials. Much of the research in the field continues to focus on amyloid, as well as tau another hallmark protein of Alzheimers disease that forms tangles inside the neurons.
This year, all eyes are on aducanumab, an anti-amyloid drug that is headed to the Food and Drug Administration for review. It was shown in clinical trials to reduce the amount of amyloid in the brains of people with early Alzheimers disease. U.S. drugmaker Biogen reports that participants who received high doses of the antibody saw improvements in memory and thinking skills, and were better able to perform activities of daily living, such as laundry and personal finances. If approved, aducanumab will be the first drug available to treat people with Alzheimers disease. Currently, the handful of dementia drugs available help only to alleviate symptoms.
Christopher H. van Dyck, M.D., professor of psychiatry, neurology and neuroscience and director of the Alzheimers Disease Research Unit at the Yale School of Medicine, points to two other amyloid-clearing therapies that are far along in the clinical trial process BAN2401 and gantenerumab . If aducanumab doesnt clear FDA review, youd bet on one of these becoming the first available treatment for Alzheimers disease, he says.
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Control Of Cardiovascular Disease
If the underlying cardiovascular diseases that have caused vascular dementia can be controlled, it may be possible to slow down the progression of the dementia. For example, after someone has had a stroke or TIA, treatment of high blood pressure can reduce the risk of further stroke and dementia. For stroke-related dementia in particular, with treatment there may be long periods when the symptoms don’t get significantly worse.
In most cases, a person with vascular dementia will already be on medications to treat the underlying diseases. These include tablets to reduce blood pressure, prevent blood clots and lower cholesterol. If the person has a diagnosed heart condition or diabetes they will also be taking medicines for these. It is important that the person continues to take any medications and attends regular check-ups as recommended by a doctor.
Someone with vascular dementia will also be advised to adopt a healthy lifestyle, particularly to take regular physical exercise and, if they are a smoker, to quit. They should try to eat a diet with plenty of fruit, vegetables and oily fish but not too much fat or salt. Maintaining a healthy weight and keeping to recommended levels of alcohol will also help. The GP should be able to offer advice in all these areas.
How Can You Cope With Being The Caretaker Of Someone With Dementia
It is important for someone who is the primary caregiver of a patient with dementia to have a strong network of support. This is needed both to aid in caring for the patient and to give the caregiver some intermittent relief. In the early stages, many caregivers function more as a helper or guide, providing reminders for different tasks. Later in the disease, caregivers may have to supply basic care to the patient, including assistance with bathing, dressing, and going to the bathroom.
Obtaining power of attorney status for financial and medical matters and determining when a patient is no longer able to perform certain activities, such as driving, are difficult but necessary actions. Local Alzheimer’s Association chapters are often helpful in completing these tasks. Enlisting the help of a patient’s physician or mandating an on-the-road driving assessment can place the responsibility of determining when a patient is no longer safe to drive on someone other than a caregiver or family member, as driving is often an action that many patients attempt to perform far past the time when it is safe to continue. There are many sources of assistance for caregivers of patients with dementia:
Alzheimer’s and Dementia Caregiver CenterAlzheimer’s Association
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Which Cholinesterase Inhibitor Should Be Started And By Whom
There is no real difference in the effectiveness of the three cholinesterase inhibitors. The few comparative studies published are small and have been conducted over a relatively short period. The results are inconsistent and offer no basis to make a clinical choice.
Rivastigmine has the reputation of more commonly causing side effects, particularly nausea and vomiting. This may be due to the initial dosing regimen being too quick slowing the titration period to four instead of two weeks will help reduce the side effects. To reduce nausea rivastigmine should be taken with food. As both galantamine and rivastigmine have additional modes of action, apart from acetylcholinesterase inhibition, many clinicians believe they are more effective in later stages of AD when AChE concentrations are low.
Dosing requirements for cholinesterase inhibitors
The current NICE guidelines stipulate that prescribing should be initiated by specialists but may be continued by general practitioners under a shared-cared protocol. This means that after an initial phase the patient receives their ChEI from the same source as their other medication which reduces confusion and improves the likelihood of compliance.
How Is Dementia Treated
Treatment of dementia depends on the underlying cause. Neurodegenerative dementias, like Alzheimers disease, have no cure, though there are medications that can help protect the brain or manage symptoms such as anxiety or behavior changes. Research to develop more treatment options is ongoing.
Leading a healthy lifestyle, including regular exercise, healthy eating, and maintaining social contacts, decreases chances of developing chronic diseases and may reduce number of people with dementia.
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Who Cannot Take Medicines For Dementia
In general, most people are able to take these medicines. Caution may be needed in people with certain medical problems. For example, people with severe liver or kidney problems may not be able to take them, or they may need a lower dose. Care also needs to be taken in people who have had fits in the past.
Fdas Accelerated Approval Program
Aducanumab was approved through the FDAs Accelerated Approval Program, which provides a path for earlier approval of drugs that treat certain serious conditions. This helps people living with the disease gain earlier access to the treatment. The approval of aducanumab was based on the ability of the drug to reduce amyloid in the brain. When using the accelerated approval pathway, drug companies are required to conduct additional studies to determine whether there is in fact clinical benefit after the drug is approved. If the follow-up trial fails to verify clinical benefit, the FDA may withdraw approval of the drug. Results of the phase 4 clinical trial for aducanumab are expected to be available by early 2030.
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Top 27 Natural Home Remedies For Dementia Patients
Adults should drink 2-3 liters of water every day. Water helps to balance body heat and eliminate toxins from metabolism and industrial life. Your brain will grow stronger naturally. Water cleanses the skin, filters the kidney, and stimulates your appetite, so it energizes you and helps you to be healthier and more alert. This is actually what patients with dementia need.
Drinking plenty of water also helps you avoid unhealthy drinks like soda and high calorie fruit juices. The body only recognizes these unhealthy drinks, and then you will also require more calories. If you want more flavor, you can squeeze a few drops of lemon or pure fruit juice into the water to drink. However, be sure to use foods rich in calcium such as cauliflower to help keep your bones healthy. This is very necessary, especially as your age grows. Always carry a bottle of water. You will be surprised how easy it is to drink 1.5 to 2 liters of water a day. Drinking water is also much cheaper than having to buy other drinks when you feel thirsty, and this is better for the environment.
The effect of this connection leads to improved cognitive abilities, resulting in improved memory after drinking green tea. Scientists have also shown that green tea is good for the brain. They found beneficial effects of green tea with cognitive function. However, active ingredients that increase cognitive ability of green tea have not been found.
3. Diet Changes
Foods to eat:
Foods to avoid:
When Are Medicines For Dementia Usually Prescribed
Your GP will usually refer you to a doctor who specialises in treating dementia, to confirm that you have dementia. The specialist will then decide if you should have treatment. This decision to start treatment and which treatment to start depends on various things. These include what has caused your dementia, what your symptoms are and how severe your dementia is. Dementia is usually classed as being mild, moderate or severe. See also the separate leaflet called Memory Loss and Dementia.
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What Is The Treatment For Dementia
Treatment options for Alzheimer’s disease and other dementia are limited. While there are medications available to try to improve the symptoms of Alzheimer’s disease, the effect of these medications is limited. Physical exercise has been shown to be of some benefit in helping to maintain cognition. Staying engaged and participating in social events may also be of some help. To date, no treatment which can reverse the process of Alzheimer’s disease has been identified.
Is Dementia Treatable
First, its important to understand the difference in the terms treatable, reversible, and curable. All or almost all forms of dementia are treatable, in that medication and supportive measures are available to help manage symptoms in patients with dementia. However, most types of dementia remain incurable or irreversible and treatment results in only modest benefits.
Some dementias disorders, however, may be successfully treated, with patient returning to normal after treatment. These dementias are ones caused by:
- Side effects of medications or illicit drugs alcohol
- Tumors that can be removed
- Subdural hematoma, a buildup of blood beneath the outer covering of the brain that is caused by a head injury
- Normal pressure hydrocephalus, a buildup of cerebral spinal fluid in the brain
- Metabolic disorders, such as a vitamin B12 deficiency
- Hypothyroidism, a condition that results from low levels of thyroid hormones
- Hypoglycemia, a condition that results from low blood sugar
Dementias that are not reversible, but may still be at least partially responsive to medications currently available for memory loss or behavior-based problems include:
- Alzheimer’s disease
- Dementias associated with Parkinson’s disease and similar disorders
- AIDS dementia complex
- Creutzfeldt-Jakob disease
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What Are The Different Types Of Dementia
Various disorders and factors contribute to the development of dementia. Neurodegenerative disorders result in a progressive and irreversible loss of neurons and brain functioning. Currently, there are no cures for these diseases.
The five most common forms of dementia are:
- Alzheimers disease, the most common dementia diagnosis among older adults. It is caused by changes in the brain, including abnormal buildups of proteins, known as amyloid plaques and tau tangles.
- Frontotemporal dementia, a rare form of dementia that tends to occur in people younger than 60. It is associated with abnormal amounts or forms of the proteins tau and TDP-43.
- Lewy body dementia, a form of dementia caused by abnormal deposits of the protein alpha-synuclein, called Lewy bodies.
- Vascular dementia, a form of dementia caused by conditions that damage blood vessels in the brain or interrupt the flow of blood and oxygen to the brain.
- Mixed dementia, a combination of two or more types of dementia.
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