Tips For Choosing A Medical Provider
Once youve developed a potential list of AD providers, its time to contact their office and determine if they could be the right doctor for your loved one. Examples of questions to ask on the first phone call can include:
- What insurance types do you accept?
- What types of services are offered for those with AD?
- Are there any special qualifications or behavioral needs your practice works with or doesnt work with ?
- How is the staff trained in AD and dementia? Do any support staff members have special credentials related to AD care?
Another deciding factor could be the level of experience the provider has in treating people with AD. Some seek board certification in gerontology or in their chosen medical field. This means the doctor has undergone continuing education and further testing to prove they have extensive knowledge on a particular subject.
Many medical practices will also offer a free meet and greet appointment during which you meet the medical provider and tour the office to ensure its the best fit for a loved one. You may also wish to ask if the provider can give you references or testimonials from their patients. Speaking to others can help you determine what it would be like to see this doctor on a regular basis.
Is A Neurologist The Best Choice
Considering the myriad specialists in the treatment of Alzheimers, a good best bet after a visit with ones primary care doctor is a neurologist versed in Alzheimers and conditions affecting the elderly.
A neurologist will have the knowledge, training and experience with the inner workings of the brain required to either begin a care plan or intelligently refer a patient to another qualified expert in thisarea perhaps even one of the aforementioned superspecialists.
Whats exciting is that neurology is the field in which the most leading research on brain disorders is occurring. Doctors in this field will likely be the most informed on new findings, medications, trials, and studies.
Specialized Care For Cognitive Disorders
Diagnosis of a cognitive impairment can bring up questions and uncertainty. Our Cognitive Care Network, in partnership with the University of Kansas Alzheimers Disease Center, provides education and support for individuals and families living with this diagnosis. We know its important to diagnose mild cognitive impairment , Alzheimers disease and other dementias early. This helps the person diagnosed, family members and providers work together to support wellness and positive changes. Our interdisciplinary teams health empowerment model aids understanding and management of these cognitive changes.
Call us at more information.
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Medication To Slow Disease Progression
There is also medication that may be able to reduce the rate of cognitive decline and slow down the progression of Alzheimers disease. In July 2021, the FDA gave accelerated approval for a drug known as aducanumab .
This drug may be able to help reduce the amyloid protein deposits in the brain, one of the markers of Alzheimers disease. These protein deposits interfere with the function of brain cells, causing them to lose touch with each other and eventually die.
Clinical trial results in people with early-stage Alzheimers disease showed that the drug helped reduce the rate of cognitive and functional decline in some participants. For instance, they had better memory and orientation and were better able to manage finances and perform household chores.
Side effects of this drug include allergic reactions, headaches, and increased risk of falling. People may also experience amyloid-related imaging abnormalities , which can include confusion, dizziness, nausea, vision changes, and temporary swelling in certain parts of the brain that is sometimes accompanied by small spots of blood on the surface of the brain.
According to Marottoli, this drug, as well as other similar agents under investigation, may actually alter the underlying process of Alzheimers disease, rather than just helping with the symptoms.
However, the approval of this drug is quite controversial. Many questions remain about the practical benefit, logistics, and costs of this medication, says Marottoli.
Medication To Improve Symptoms
There are different types of medications that can help treat the cognitive and behavioral symptoms of Alzheimers disease.
These medications can treat the manifestations of the disease but do not affect the underlying disease process, says Richard Marottoli, MD, MPH, a geriatrician at Yale Medicine who specializes in treating Alzheimers disease.
Patients are often given low doses of medication at first and then monitored to see how well they are responding to it. The dosage is gradually increased depending on how they are tolerating it. While higher doses can sometimes be more effective, they can also result in stronger side effects.
Discuss any symptoms and side effects you or a loved one are experiencing with a healthcare provider, so they can determine the best course of treatment and adjust medication if required.
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Drug And Nondrug Treatments For Alzheimers Disease
There is currently no cure for Alzheimers disease, but drug and nondrug treatments may help manage symptoms.
Alzheimers disease causes a gradual decline in memory, thinking, and other cognitive function.
People with Alzheimers dementia are increasingly unable to meet the demands of daily life. During the final stage of the disease, they become fully reliant on others for care.
While there is no way to stop the progression of the disease, there are medicines that can help sharpen the mind for a short while.
Five drugs approved by the Food and Drug Administration slow worsening of symptoms for about 6 to 12 months, on average, for about one-half the people who take them.
The medication Namenda, for instance, may help people with later-stage Alzheimers maintain the ability to use the bathroom independently for several extra months.
Other drugs can improve behavioral symptoms of Alzheimers dementia, like depression and aggression, offering relief to both patients and caregivers.
How Is Alzheimer’s Disease Treated
Alzheimers disease is complex, and it is therefore unlikely that any one drug or other intervention will ever successfully treat it in all people living with the disease. Still, in recent years, scientists have made tremendous progress in better understanding Alzheimers and in developing and testing new treatments, including several medications that are in late-stage clinical trials.
Several prescription drugs are already approved by the U.S. Food and Drug Administration to help manage symptoms in people with Alzheimers disease. And, on June 7, 2021, FDA provided accelerated approval for the newest medication, aducanumab, which helps to reduce amyloid deposits in the brain and may help slow the progression of Alzheimers, although it has not yet been shown to affect clinical symptoms or outcomes, such as progression of cognitive decline or dementia.
Most medicines work best for people in the early or middle stages of Alzheimers. However, it is important to understand that none of the medications available at this time will cure Alzheimers.
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Medication For Behavioral Symptoms
As Alzheimers disease progresses, it can cause several behavioral symptoms such as wandering, restlessness, sleeplessness, aggression, agitation, anxiety, and depression.
These symptoms can take a toll on the patient as well as their caregivers. Treating these symptoms can make patients more comfortable and make it easier to care for them.
These are some of the types of medication that can help:
- Anti-anxiety medicationcan help treat agitation.
- Anticonvulsant drugs can help treat severe aggression.
- Antidepressantscan help treat depression, anxiety, restlessness, and aggression.
- Antipsychotics can help treat symptoms like hallucinations and paranoia.
- Sleep aids can help you sleep through the night.
However, these medications can cause severe side effects in people with Alzheimers disease. Side effects can include confusion, dizziness, sleepiness, mood swings, and increased chances of falling.
Because of the side effects they cause, it is only advisable to use these medicines occasionally or for short periods of time. They are often used as a last resort after carefully considering the risks and side effects and only if other strategies have failed.
Antipsychotic drugs, in particular, should only be used if your healthcare provider agrees that the symptoms are serious, as the side effects are severe and these medications can increase the risk of death in some older people with Alzheimers disease.
Dementia And Alzheimer’s Disease
Dementia and Alzheimerâs disease are not the same thing. The truth is that Alzheimerâs disease is just one of many causes of dementia. While thereâs no cure for Alzheimerâs disease right now, some of the other causes of dementia are treatable. And, if caught early enough, the damage caused by Alzheimerâs disease can be slowed, and patients can maintain their quality of life for longer.
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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.
What Treatments Might A Neurologist Prescribe For Dementia
There are a few medications that are approved for the treatment of Alzheimer Disease. These include cholinesterase inhibitors .
These medications work by modulating neurotransmitters in the brain and have some modest symptomatic benefit in patients with dementia.
Another category of medication includes Memantine, which is an NMDA-receptor antagonist. This works by blocking a different neurotransmitter which may protect the brain.
This also has been shown to have very modest benefits.
Neurologists may prescribe medications to help certain symptoms of dementia, such as behavioral disturbances, hallucinations, sleep problems, depression, agitation, and aggression.
These may include antidepressants, antipsychotics and various other medications.
Nutrition, physical therapy and cognitive rehab are also things a neurologist may consider in the multidisciplinary approach to dementia care.
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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.
When You Cant Be There
There may be times when you canât go to a doctor visit with your loved one and someone else takes them. If this happens, youâll want to be sure that you find out how it went.
Ask the person whoâll be with your loved one to take notes. They should write down the name and phone number of someone to call if you have questions. Also, have them ask the doctor for written instructions about any changes in care.
If needed, call the nurse or doctor after the appointment to get a report on how the visit went.
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Can Exercise Make A Difference
There is some preliminary evidence that exercise can improve cognitive skills in people with early-stage Alzheimers disease.
For a University of Kansas study, published in February 2017 in the journal PLoS ONE, subjects took part in a supervised exercise program involving 150 minutes of walking per week.
After six months, some but not all of the subjects performed better on tests measuring memory and thinking skills. These subjects also showed a slight increase in brain size.
Compassionate Care For Patients With Memory Loss
Watching a loved one experience memory loss is challenging, and the journey can be emotionally taxing for both you and the person going through it. While this is difficult, it is important to keep in mind that living with memory loss does not mean living in misery. A cure for dementia and Alzheimers may not yet be available, but we have come a long way in making life easier and more comfortable for those who go through it.
Our compassionate team of medical professionals provide comprehensive care and treatments for patients with memory loss. In addition to caring for the patient, we are also here to help their loved ones with counseling and referrals to community resources. We know this is a difficult time for all involved, and our goal is to help your entire family through it.
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Where To Go What To Eat
Because an Alzheimer’s diagnosis isn’t always easy to confirm, getting a second opinion is often recommended. Once a diagnosis is made, choosing a doctor or team of doctors can be difficult, as the person may have unique needs in regard to time, services or symptoms. Another important consideration is finding a doctor that accepts the person’s insurance.
Friends and family, as well as local health care providers and Alzheimer’s Service, can provide recommendations for doctors or specialists. You also should research the level of experience the medical professional has in treating the disease.
The most important consideration should be finding a doctor the caregiver and affected person can trust and how this doctor advocates for the treatment and care of that person. The relationship should be one of mutual understanding on the plan of care throughout the journey of the disease.
Questions about Alzheimer’s disease or a related disorder can be sent to Dana Territo, the Memory Whisperer, director of services at Alzheimer’s Services of the Capital Area at or visit the organization at 3772 North Blvd., Baton Rouge.
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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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.
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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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.