Treatment For Mild To Moderate Alzheimers
Treating the symptoms of Alzheimers can provide people with comfort, dignity, and independence for a longer period of time and can encourage and assist their caregivers as well. Galantamine, rivastigmine, and donepezil are cholinesterase inhibitors that are prescribed for mild to moderate Alzheimers symptoms. These drugs may help reduce or control some cognitive and behavioral symptoms.
Scientists do not yet fully understand how cholinesterase inhibitors work to treat Alzheimers disease, but research indicates that they prevent the breakdown of acetylcholine, a brain chemical believed to be important for memory and thinking. As Alzheimers progresses, the brain produces less and less acetylcholine, so these medicines may eventually lose their effect. Because cholinesterase inhibitors work in a similar way, switching from one to another may not produce significantly different results, but a person living with Alzheimers may respond better to one drug versus another.
Before prescribing aducanumab, doctors may require PET scans or an analysis of cerebrospinal fluid to evaluate whether amyloid deposits are present in the brain. This can help doctors make an accurate diagnosis of Alzheimers before prescribing the medication. Once a person is on aducanumab, their doctor or specialist may require routine MRIs to monitor for side effects such as brain swelling or bleeding in the brain.
Key Features Of Dementia
A person having dementia means that all five of the following statements are true:
- A person is having difficulty with one or more types of mental function. Although its common for memory to be affected, other parts of thinking function can be impaired. The 2013 DSM-5 manual lists these six types of cognitive function to consider: learning and memory, language, executive function, complex attention, perceptual-motor function, social cognition.
- The difficulties are a decline from the persons prior level of ability. These cant be lifelong problems with reading or math or even social graces. These problems should represent a change, compared to the persons usual abilities as an adult.
- The problems are bad enough to impair daily life function. Its not enough for a person to have an abnormal result on an office-based cognitive test. The problems also have to be substantial enough to affect how the person manages usual life, such as work and family responsibilities.
- The problems are not due to a reversible condition, such as delirium, or another reversible illness. Common conditions that can cause or worsen dementia-like symptoms include hypothyroidism, depression, and medication side-effects.
- The problems arent better accounted for by another mental disorder, such as depression or schizophrenia.
What Does A Neurologist Do
If a patient is referred to a neurologist for memory or cognitive issues, likely theyll undergo some testing. Blood tests help determine if, for example, a vitamin deficiency or thyroid dysfunction is a treatable cause of the impairment, McMurtray said. Patients might also undergo brain imaging to detect any abnormalities, such as signs of a stroke, bleeding or tumors.
If Alzheimers or another form of dementia is the diagnosis, then the neurologist will start treatment options to help slow disease progression. Most of the value we add, McMurtray explained, is with the initial workup, the diagnosis, and making sure there isnt another cause. After that, we start medications. And we might check with the patient once a year to see how theyre doing or more frequently if needed.
Thats why a geriatrician can be a great asset to your care team. A geriatrician can absolutely serve as a primary care physician and would be able to address additional medical problems that the patient might have, McMurtray said. Whereas the neurologist would mainly be evaluating and treating the dementia.
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How Can I Find The Right Doctor And Resources
Word of mouth is still one of the most reliable sources of trusted information, so dont hesitate to ask among friends and associates whose loved ones have been diagnosed with Alzheimers disease for recommendations on doctors, services, programs, etc. Other good referral sources are your loved ones primary care doctor, your local medical center, nearby memory care facilities, Local Resources at alz.org, and a careful Internet search of neurologists in your area .
You may also wish to consult the Alzheimers Disease Centers , sponsored by the National institute on Aging. The Alzheimers Association has a 24/7 helpline that may be of service on several fronts. For an idea of what to look for in a top-notch doctor across various specialties, check out the Mayo Clinics expertise and rankings.
Treatment For Alzheimers Disease
Alzheimers disease is a chronic, progressive condition, meaning there is no cure, though medication can help to slow the progression of symptoms such as memory loss and confusion and preserve a persons ability to perform everyday tasks. Our specialists also work to ensure that family members and caregivers receive the support they need.
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What Does A Geriatrician Do
You might be wondering when you or a loved one should switch from seeing a primary care provider to seeing a geriatric specialist.
You could see a geriatrician when you want to optimize your health as an older adult, said Anne Gifford, M.D., a geriatrician in the Division of Geriatrics at Vanderbilt. Or you can also see a geriatrician when you start to notice that youre not performing in the way that you used to as a younger adult and you want to have an evaluation by someone whos trained to see older adults.
Geriatricians focus on geriatric syndromes, such as bone mineral issues, recurrent falls, blood pressure changes, decreased appetite and weight loss, depression, anxiety and social isolation, just to name a few.
They understand the aging body, Gifford said, and they understand the complexities of medication changes and the different ways that the body adjusts to aging.
Seeing a geriatrician, then, is a logical first step when memory concerns or cognitive complaints crop up. A geriatrician might refer a patient to a neurologist when a movement disorder or Alzheimers or another form of dementia is suspected.
Were happy to meet with anybody who is curious about their health, is curious about their aging, is curious about their cognition, Gifford added.
Your Best Choice May Not Be Your Family Doctor
Although a preliminary diagnosis may begin with your primary care doctor, theyll most likely refer you to a specialist. Some people express a preference to continue seeing their family doctor because its someone they know and trust. Others may feel disheartened by their diagnosis and question the use of seeing a specialist.
Thats an understandable concern, but misinformed. New research is published every month about findings in Alzheimers treatment. Although scientists havent yet found a cure, they have uncovered much that is helpful for people who have been diagnosed.
Dementia is a rapidly developing area of study, and its likely that the family doctor wont be as up to date with the latest information. This may be especially true in the case of early onset Alzheimers, where symptoms and treatment are less well-known among most regular doctors.
Seeing a specialist will ensure your loved one benefits from the most recent therapies and medications.
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Neurologists: Do Seniors With Alzheimer’s Need One
When a loved one is diagnosed with dementia stemming from Alzheimers, understanding your options can be an emotional and difficult process. Though there is no cure, there are treatments available that can help reduce symptoms and help your loved one maintain their quality of life. While most experts agree that anyone with any form of dementia should see a specialist, there are several types to choose from. That can make it difficult to know what course of action to take.
One effective option is to visit neurologists specializing in dementia near you who can offer guidance. They can conduct a thorough neurological exam and recommend subsequent Alzheimers treatment. Combining a neurologists evaluation with the findings of other types of Alzheimers doctors near youpsychiatrists, psychologists and geriatricianscan help make the path to finding the best treatment for your loved one even clearer.
Treatments For Alzheimers Disease
There isnt a cure for Alzheimers disease, so the goal of treatment is to improve or maintain cognitive and behavioral symptoms as long as possible. Treatment may include:
Medications
Two types of medications, cholinesterase inhibitors and memantine, are FDA-approved drugs used to treat cognitive symptoms of Alzheimers diseases. These medications may help with memory loss, problems with thinking and confusion. Medications such as antidepressants, anticonvulsants, anti-anxiety medications and sleep medications may be used to treat depression, behavioral, sleep or anxiety issues associated with Alzheimers disease.
Exercise and nutrition
Exercise and nutrition are important parts of a comprehensive Alzheimers treatment plan. Exercise can help relieve some of the behavioral or movement symptoms associated with Alzheimers disease. Exercise keeps the body active, promotes heart health, can improve mood and help promote sleep. Eating a healthy diet is crucial in maintaining health as well as to avoid nutrition-related conditions such as dehydration, malnutrition and constipation.
Environment
Research is being done to understand the causes of Alzheimers disease so that treatments or cures can be developed.
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What Is Alzheimers Disease
Alzheimers disease is a progressive brain condition that impacts a persons ability to think, remember and perform day-to-day tasks.
It is the most common form of dementia accounting for 60-80 percent of all dementia cases. More than 5 million Americans suffer from Alzheimers disease. Most of these people are over 65.
Expert Compassionate Dementia Care In San Diego
Dementia is the loss of brain function which affects memory, cognitive skills, behavior and speech. The most common form of dementia is Alzheimers disease, a condition which causes a progressive decline in brain function. Other causes of dementia include degenerative brain disorders, such as Lewy body dementia, Parkinsons dementia, frontotemporal dementia and vascular dementia due to strokes.
Alzheimers disease and other related dementias are a difficult diagnosis not only for patients, but for their friends and family as well. At Scripps, our experienced neurologists and medical teams care for people with dementia with deep knowledge, understanding and compassion.
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Your Brain Gets Less Oxygen Due To Afib
Because the heart cant pump blood efficiently, Afib deprives your body and brain of regular, oxygen-rich blood flow, Hills explains. One of the earlier theories was that the brain, especially the areas that are associated with memory and processing information, simply wasnt getting enough oxygenand that was leading to dementia. In fact, people 65 and older with Afib who already had been diagnosed with cognitive decline were four times more likely to develop dementia over a 10-year period, per the same Circulation study.
Alzheimers Diagnosis And Stages
Currently, theres no specific test to diagnose Alzheimers and related dementia. Screening for dementia is most often done with your primary care physician. Neurologists, geriatricians, neuropsychologists and psychiatrists are often called upon as part of the team to properly diagnose and manage patients with these disorders.
Scripps primary care and specialist physicians diagnose dementia based on a thorough medical evaluation, including:
- Medical history
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Memory Care At Barclay Friends
Depending on ones degree of Alzheimers disease or dementia, supportive community living may be an appropriate care choice. Barclay Friends dedicated memory care environment adopts a person-centered approach, tailored to each residents individual preferences and interests. Residents have the right to participate in decisions about their lives. Staff offer residents choices by doing with rather than doing for. Whats more, our attending physicians personally know each resident and their unique health situations and can offer referrals to a neurologist or other specialists, if needed.
Discover memory care centered on doing with, not doing for.Barclay Friends offers a full continuum of care.
Which Other Specialists Might Be Helpful
Because Alzheimers is an all-encompassing disease that affects the overall health and well-being of the patient and often their family as well, the services of other professionals who are not medical doctors can also be beneficial. These include dementia social workers, nurses, geriatric nurse practitioners, and supportive senior care providers and/or communities.
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Signs Or Symptoms Of Alzheimers Disease
Alzheimers disease is a progressive disease where symptoms gradually develop over time. There are three stages of the disease mild, moderate and severe. The most common signs or symptoms of mild Alzheimers disease include:
- Loss of memory that is impacting simple day-to-day activities
- Difficulty solving problems
- Withdrawing from activities you once enjoyed
As the disease progresses, signs or symptoms intensify and can include:
- Wandering aimlessly
- Rambling or not making cohesive sentences when speaking to others
- Under or over dressing for the weather
- Severe mood swings
Late Alzheimers disease is the most severe stage of the condition and typically lasts one to three years. Patients with late Alzheimers disease may experience any of the following signs or symptoms:
- Inability to move on their own
- Loss of bowel or bladder function
- Inability to process information or articulate cohesive thoughts
- Severe mood swings
Some symptoms of mild Alzheimers may seem like part of the normal aging process. If you or a family member has multiple signs or symptoms, schedule an appointment your Mercy Health doctor to discuss.
How To Choose An Alzheimer’s Doctor
When it comes to Alzheimer’s disease, choosing an Alzheimer’s doctor is crucial to receiving the proper care and treatment. But who do you see? The medical field has split itself into so many specialties that finding the right professional can be a daunting task.
Your primary care physician is often the best place to start if more focused testing or treatment is needed, you may be referred to a specialist. However, primary care physicians don’t always refer patients to specialists, even when it could help clarify a diagnosis or supplement primary treatment. In these cases, its up to you to sort through the maze of medical professionals.
If you feel that you want more specialized care, use the following guide to help you determine what kind of expert will best meet your needs. Of course, always check to make sure professionals are licensed or certified to practice their specializations.
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Which Doctors Treat Alzheimers Disease
There is a dizzying host of medical professionals who deal with Alzheimers disease in one respect or another. Finding the right one once symptoms of Alzheimers appear can be confusing and overwhelming. Often, treatment from a combination of specialists will proffer the best overall care. Lets break it down:
Neurologist Or Memory Disorder Specialist
A neurologist is a specialist who is trained in nervous system disorders, especially issues with the brain, spinal cord, and peripheral nerves.2
As with most branches of medicine, neurologists can focus on different aspects of these disorders, or choose to concentrate their care on one disorder. This is something to consider when looking for a neurologist: ask them if they specialize in dementia or the care of Alzheimer’s patients.
In addition to a medical degree, neurologists complete an internship and then a residency in neurology that is at least three years long. If they decide to pursue further specialization like training in sleep medicine or want to focus on one disorder, they might have additional training after their residency.3
You might also see doctors labeled as memory disorder specialists. These can be neurologists, psychiatrists, psychologists, or geriatricians who specialize in diagnosing and treating dementia or other memory disorders.
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What Are Memory Clinics And Centers
Memory centers are essentially a one-stop shop for everything a patient and their family may need living day to day with Alzheimers disease. These clinics offer a multidisciplinary, comprehensive approach to care.
At these clinics youll find a number of specialists, including behavioral neurologists, neuropsychologists, and geriatricians. These centers provide comprehensive diagnostic and treatment services for Alzheimers disease and other types of dementia. These centers also offer access to physical and occupational therapists and social services.
Your primary care doctor may be able to refer you to a memory clinic in your area. Many large hospitals and medical centers have memory disorder divisions.
You might also find helpful information through the Alzheimers and Related Dementias Education and Referral Center , a service of the National Institute on Aging , which funds Alzheimers Disease Research Centers at major medical institutions across the United States. The ADRCs offer help with obtaining diagnosis and opportunities to volunteer to participate in clinical trials in addition to other services. You can find a list of ADRCs on the NIA website.
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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Referral To A Specialist
If a GP is unsure about whether you have Alzheimer’s disease, they may refer you to a specialist, such as:
- an elderly care physician
The specialist may be based in a memory clinic alongside other professionals who are experts in diagnosing, caring for and advising people with dementia and their families.
There’s no simple and reliable test for diagnosing Alzheimer’s disease, but the staff at the memory clinic will listen to the concerns of both you and your family about your memory or thinking.
They’ll assess your memory and other areas of mental ability and, if necessary, arrange more tests to rule out other conditions.