Despite there still being no cure for Alzheimer’s disease, there are now treatments in place to prolong onset and ease symptoms. These are provided as both medication and support strategies.
Two main medications are offered: AchE inhibitors and Memantine. Typically, cholinesterase or Acetylcholinesterase (AChE) inhibitors are prescribed by specialists as standard first-line therapy. With this, one of three tablets are prescribed: rivastigmine, donepezil, or galantamine. All three tablets have varying effects and respond differently to each patient. These AChE inhibitors prevent the breakdown of acetylcholine (ACh), a key part of the body’s parasympathetic nervous system. In the onset of Alzheimer’s, Acetylcholinesterase breaks down acetylcholine, which plays a huge role in memory retention, focus and learning.
Memantine, meanwhile, is not an AChE. It is typically used as second-line therapy for patients with moderate to severe levels of the disease. It can also be used for those who have a bad reaction to AChE. There is also evidence to point toward the medicine easing some of the more distressing symptoms, such as aggression or delusions.
Memantine works by helping to prevent the substance glutamate from damaging the brain. Glutamate is very healthy for the body and contributes to memory. However, it is thought those with developed Alzheimer’s release an excessive amount of glutamate in their brain. This is harmful as it overstimulates healthy brain cells, which can cause irreparable damage or cell death. Memantine can also delay the worsening cognition of the brain through dementia.
Both medications have side effects, although these are not significant or long-term. Whilst neither will be able to stop the brain from eventually succumbing to the disease, the slowing down of symptoms can provide a slightly better quality of life for both the patient and their family.
At different stages of dementia, most patients will develop what's known as behavioural and psychological symptoms of dementia (BPSD). The effects can vary, from hallucinations to verbal and physical aggression, apathy and euphoria. Aside from medication, other treatments and support can be provided for both the patient and their family.
Therapies can be provided in the form of listening to music or having a massage. Music or dancing can lift their mood or inspire confidence. Cognitive Stimulation Therapy (CST) helps with memory retention and problem-solving skills. Cognitive rehabilitation can help the patient to adjust to their cognitive state, such as retraining previously learned skills.
Reminiscence and life story work is another way of retraining the brain. Going through a photo album with the patient can help rediscover old memories or even just cheer them up. It’s easy to forget that symptoms such as apathy can be made worse by the patient feeling anxious or depressed about their condition. Mood-boosting activities are a good response to this but if the specialist feels it’s necessary, they will prescribe anti-depressants in addition to the treatment.
One day, we may find a cure for Alzheimer’s. In the meantime, all we can do is ease and slow down the symptoms, whilst ensuring to retain the quality of life for those affected.