Other Less Targeted Dementia Medications
There are several types of dementia, and each person will be affected differently by their specific disease as well as the side effects that might be present. While not designed with the intention to treat dementia, many medications are available that treat the often-debilitating effects of dementia. There are many symptoms associated with dementia, as well as associated with the medications taken to stall the progression of dementia, such as pain, nausea, insomnia, or general fatigue.
Its important to go over every possible side effect of medications you are considering taking, and carefully weighing the risks versus the benefits of using that drug. While it may seem like a juggling act, the good news is that there is a wealth of options available to treat any symptoms of dementia or medication-related side effect, so no matter your unique body chemistry, your doctor will be able to help you figure out the best way to improve your overall quality of life while living with dementia.
The Top Five Dementia Medications For Seniors
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Dementia is a common disease seen in older adults, affecting over 50 million people around the world, according to the World Health Organization . But, it is not a normal part of aging. Examples of typical memory loss experienced by people of all ages include occasionally forgetting but later remembering events, names, and phone numbers. When memory loss becomes disruptive to your daily life, it might be time to see your medical team about your cognitive health and discuss possible medications to help combat the symptoms of dementia, as well as check for physical signs of Alzheimers disease and related dementias.
Through careful research, we have created this guide to educate you on Alzheimers disease and related dementias, the top dementia medications as well as less-targeted dementia medications that can be useful in treating symptoms, and alternative options you might want to discuss with you or your loved ones doctor.
What To Do If A Doctor Jumps To A Diagnosis In A Single Visit
Unfortunately, some doctors do jump quickly to a dementia diagnosis in only one visit. Even worse, they dont properly document what led to their decision.
If this happens, you may want to seek a second opinion from a doctor who is willing and able to do more thorough evaluation and testing.
Yes, there is a chance that your older adults symptoms could mean that they have dementia.
Thats why an accurate diagnosis is essential for proper treatment.
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.
How Does Dementia Affect The Brain
It depends on the cause of dementia. With Alzheimers, it affects the brain by causing neurodegenerationor damage and death to specific brain cells in specific parts of the brainthat then spreads over time. We also see a loss of synapses in the brain that occurs out of proportion to the death of those brain cells. The leading view of Alzheimers is that its related to the formation of amyloid protein in the brain, but that is disputed. There are other changes happening, such as tau protein deposits, called tau tangles. Even if you believe the amyloid protein hypothesis, then you can ask why do the protein buildups occur ? We dont fully know.;
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Why Does Dementia Occur
Alzheimers is far and away the leading causeit accounts for about two-thirds of all late-onset dementia . Other disorders and diseases account for the rest. And why Alzheimers disease occurs is an unending and, perhaps, philosophical question. For example, you could ask, What are the changes in the brain that precede and are associated with the onset of symptoms? But then you would also have to ask why those occur. And so on. You could also ask: “What predisposes certain people to get Alzheimers disease?” The greatest risk factor is age. Among U.S. men and women ages 65 to 75, about 3% have Alzheimers; for ages 75 to 85, between 10 to 15% live with the disease; and for those older than 85, approximately 35% have it.
So, why is age a risk factor? We dont fully knowand thats a big area of current research. The second most important risk factor is family history and genetics: The major genetic risk factor is called apolipoprotein E4 , which might account for up to 40% of the risk. But why is APOE4 a risk factor? Again, we dont fully know. A nonhereditary risk factor is previous head injuries. And, of course, there is much ongoing research about lifestyle, including diet and exercise. So, theres not a clear-cut answer on why dementia occurs.;
Alternatives To Pharmaceutical Treatments
There have been many natural remedies to aging-related memory issues throughout history, and European and Eastern countries continue to refer patients experiencing memory loss-related troubles to a variety of holistic treatments, including:
- Huperzia serrata, a moss, is a traditional Chinese medicine. It is now being researched in pharmacology as the drug Huperzine A. Its been shown as both a powerful AChE inhibitor, as well as a protectant against further cellular damage due to various functions of dementia-type diseases. This supplement should not be taken in conjunction with other AChE inhibitors, for risk of serious side effects.
- Dietary changes like increasing the intake of healthy foods such as avocados, blueberries, and the spice turmeric, have been researched and shown to slow the cognitive decline brought about by dementia
- Exercise has been shown to produce a hormone known to battle dementia, named brain-derived-neurotrophic-factor, or BDNF, that greatly improves cognitive ability. Recent studies show that people with higher levels of BDNF have 33% less cognitive defects than those with lower levels of the hormone. See our list of the top 25 exercise videos and equipment for seniors to find tools to help you increase your BDNF levels safely at home, alone or with company.
What Conditions Can Be Mistaken For Dementia
There are certain conditions that can mimic dementia. It is essential to make sure these conditions are not responsible for the symptoms, as they are often reversible and treatable.
A good neurologist will rule out reversible causes and mimics of dementia.
There are certain red flags that should not be missed; these include young age, rapidly progressive dementia , or an abnormal or asymmetric neurologic exam such as weakness on one side of the body.
These will need an expedited and different type of evaluation than the standard dementia workup.
Many people confuse the signs of normal aging with dementia.
Normal aging does include a slight degree of cognitive decline including mild changes in memory and information processing. Some people visit their doctor for these symptoms, worried that they may have dementia.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition , American Psychiatric Association, Arlington 2013.
Knopman DS, DeKosky ST, Cummings JL, et al. Practice parameter: diagnosis of dementia . Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2001; 56:1143.
Knopman DS, Boeve BF, Petersen RC. Essentials of the proper diagnoses of mild cognitive impairment, dementia, and major subtypes of dementia. Mayo Clin Proc 2003; 78:1290.
Reisberg B, Doody R, Stöffler A, et al. Memantine in moderate-to-severe Alzheimers disease. N Engl J Med 2003; 348:1333.
Which Provider Is Best For Me
It is recommended that everyone with suspected dementia should see a specialist to receive a proper examination and diagnosis. There are many different kinds of medical professionals including primary care physicians, nurse practitioners, physicians assistants, neurologists, etc., and trying to find the right one can be a long and tedious experience. There are many different dementia-specific specialists:
- Geriatricians are primary care internists or family practitioners who specialize in complex conditions of older people. They can provide care for all of an older adults medical needs, but do not specialize in brain or memory problems.
- Geriatric psychiatrists specialize in the mental and emotional needs of older individuals. They conduct thorough memory, mood, sleep, and thinking evaluations, and are particularly good at assessing memory problems associated with life stress, depression, anxiety, excess drinking, or family conflicts.
- General neurologists and psychiatrists perform memory evaluations, but do not specialize in Alzheimers and may treat few people with dementia.
- Behavioral neurologists specialize in cognitive problems such as memory loss, and are very good at detecting subtle brain injuries such as a small stroke or an infection that may be causing the memory problems. They also conduct very thorough neurological and cognitive exams.
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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 Alzheimers 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.
What Is Vascular Dementia
Vascular dementia is a common complication from stroke. It occurs when your brain tissue is damaged due to a reduction in blood flow to your brain caused by a stroke or series of strokes. It can also result from other conditions that harm blood vessels or reduce circulation, depriving your brain of necessary oxygen and nutrients.
Vascular dementia can result in:
- Trouble with reasoning
- Poor judgment
- Loss of memory
Approximately one-fifth of people who suffer a stroke will have problems with mental ability. Vascular dementia is second only to Alzheimers disease as a leading cause of dementia.
If someone you love has vascular dementia, Northwestern Medicine is home to skilled neurologists*, rehabilitation specialists and other caring professionals who can provide the diagnosis, treatment and support you need.
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The Barriers To Diagnosis
When Mary-Beth Wighton was first trying to find help for baffling symptoms such as mood changes, a dip in driving ability and losing track of money, a doctor treated her as though she was simply making it up.
Another blamed it on marital troubles.
Wighton told CTVNews.ca in a phone interview that it took four years and 12 misdiagnoses before a neurologist gave her the proper diagnosis: she had frontotemporal dementia .
Dementia refers to symptoms showing cognitive decline, such as issues with memory and executive function, with Alzheimers disease being the most common form of dementia. FTD is a type that affects younger patients more, and occurs when there is a loss of nerve cells in specific regions of the brain.
Wighton, who is 54, said it was typical for people with FTD to have a difficult time receiving a diagnosis.
Because we’re so young, the doctors look at us and say, well, you can’t possibly have dementia, she said. And so there was a medical stigma that people my age run up against.
With FTD, the initial presentation of the disease isnt the forgetfulness that is more commonly associated with dementia, she said. Instead, executive function and making decisions are harder for patients, and there are behavioural changes as well.
I was doing things that I wasn’t normally doing, she said. That wasn’t a normal thing for me to do.
But when she sought help, many doctors didnt know where to start.
Questions To Ask As You Put Together Your Alzheimers Healthcare Team
Naturally, you and your family will have a lot of questions for your doctors when youve been diagnosed with Alzheimers disease. Youll want to understand all the treatment options that may be available.
Youll also want to learn about all the risks and benefits of each option as your treatment plan evolves.
The following are examples of questions you may want to ask your primary care doctor or any specialists you may see:
- What is the usual course of Alzheimers disease?
- How long can a person with Alzheimers disease expect to function normally?
- What treatment options are available?
- What do you suggest would be the best treatment for me?
- If I take medication for my symptoms, how will you evaluate if it is working?
- What are the side effects of the currently available medications?
- At what stage of the disease might you suggest I stop taking medication?
- What clinical trials are available and how can I find out if I am eligible?
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What Does A Neurologist Examine For A Dementia Patient
After taking a careful history of the symptoms, a neurologist will begin with a general physical examination.
Part of this includes the neurologic exam.
A neurologic exam contains six major components; mental status exam, cranial nerve exam, motor exam, sensory exam, reflexes, and cerebellar exam.
Abnormalities on the neurologic exam may give the neurologist clues as to what the diagnosis is.
The mental status exam will assess for orientation, attention, memory, visuospatial function, and language. Some common tools are the MOCA and MMSE .
These are a short series of tasks a neurologist may ask you to fill out, and based on how you score, can help in categorizing the types of deficits and hint as to the type of dementia.
How To Choose The Best Healthcare Team
Your primary care physician can help you assemble your healthcare team and refer you to specialists for further evaluation and treatment as needed.
There are many primary care doctors who are comfortable with treating dementia, says Graff-Radford, This is especially true if they see a lot of older patients who have been diagnosed with Alzheimers.
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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.
Finding Memory Care Near You
The early challenges posed by dementia-related memory decline can be taken care of at home relatively easy, up until it becomes a struggle to remember daily tasks like eating, or when to take your medication. If unpaid bills and chores begin to pile up, it can pose a health and financial risk that is truly necessary when there are so many community options available now to help aging people live in a healthy and safe environment. For those interested in seeking out dementia-friendly communities with access to medical staff and lifestyle amenities like meals and chore services, visit assistedliving.org to find out more information about memory care facilities near you. If you need assistance paying for memory care or other aging-related expenses, you might qualify for a Medicaid waiver.
Who Can Diagnose Dementia
Visiting a primary care doctor is often the first step for people who are experiencing changes in thinking, movement, or behavior. However, neurologists doctors who specialize in disorders of the brain and nervous system are often consulted to diagnose dementia. Geriatric psychiatrists, neuropsychologists, and geriatricians may also be able to diagnose dementia. Your doctor can help you find a specialist.
If a specialist cannot be found in your community, contact the nearest medical school neurology department for a referral. A medical school hospital also may have a dementia clinic that provides expert evaluation. You can also visit the Alzheimers Disease Research Centers directory to see if there is an NIA-funded center near you. These centers can help with obtaining a diagnosis and medical management of conditions.