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Alzheimer's disease - Treatment

Treatment for Alzheimer's disease involves a combination of things. These include:

  • identifying what is causing the symptoms or behaviour and reducing the causes
  • therapies, interventions or activities to help support you
  • medication

There is no cure for Alzheimer's disease.

Medicines for memory problems

Medicines can help improve your memory or slow the symptoms from getting worse. But not everyone responds or continues to respond over time.

Acetylcholinesterase (AChE) inhibitors

These increase the levels of acetylcholine. This is a substance in the brain that helps nerve cells communicate with each other. Levels drop as brain cells become damaged and die in Alzheimer's disease.

They can only be prescribed by:

  • psychiatrists
  • geriatricians
  • neurologists
  • GPs with expertise in their use

These medicines are for early-to mid-stage Alzheimer's disease:

  • Donepezil
  • Galantamine
  • Rivastigmine

You can keep taking them as the disease progresses, if you don't have any side effects from them.

There's no difference in how well each of the 3 different AChE inhibitors work. Some people respond better to certain types or have fewer side effects.

Side effects include:

  • nausea
  • vomiting
  • loss of appetite

The side effects usually get better after 2 weeks of taking the medication. You may need to swap to another type.

Memantine

This medicine is not an AChE inhibitor. It works by blocking the effects of an excessive amount of a chemical in the brain called glutamate.

Memantine is used for severe Alzheimer's disease. You can also take it if you cannot take or are unable to tolerate AChE inhibitors. But it can't be prescribed for mild Alzheimer's disease.

You can take it for severe Alzheimer's disease if you are taking an AChE inhibitor. Side effects are usually temporary and can include:

  • headaches
  • dizziness
  • constipation

For more information about side effects, read the information leaflet or speak to your GP.

Therapy for memory problems

There are two main types of therapies for memory problems. 

Cognitive stimulation therapy

This involves taking part in activities that help with thinking and memory. These include:

  • discussion of past and present events and topics of interest
  • word games and puzzles
  • music
  • baking
  • gardening

These are usually done in small groups for around 45 minutes at least twice a week.

Cognitive rehabilitation

This involves you working with a trained professional and a relative or friend.

The aim is to achieve a personal goal, such as learning to use a mobile phone or other everyday tasks. 

The focus is not on improving your memory, but helping you to do the things you need to do in your everyday life. It works by getting you to use the parts of your brain that are working to help the parts that are not.

Dementia psycho-education programmes

Psycho-education programmes are for people with dementia, family carers or both. They provide information and support to better understand and cope with illness.

These are usually done in small groups for 2 hours a week for 4-8 weeks.

Behavioural and psychological symptoms of dementia (BPSD)

You may develop behavioural and psychological symptoms of dementia (BPSD).

Psychosocial interventions

Psychosocial interventions are therapies and activities that can help support you. The type of therapy or activity will depend on:

  • your symptoms
  • interests
  • your stage of dementia

Therapies and activities include:

  • music therapy
  • art therapy
  • aromatherapy
  • validation therapy
  • reality orientation
  • physical exercise
  • multi-sensory stimulation

Reminiscence and life story work

Reminiscence work involves talking about things and events from your past. It usually involves using props such as photos, favourite possessions or music.

Life story work involves keepsakes from childhood to the present day — such as photos or notes. It can be either a physical book or a digital version.

Medicines

You can use medication to help with things that cause you extreme distress. These include:

  • persistent aggression
  • hallucinations
  • agitation

Antipsychotic medicines

Antipsychotic medicines can help with:

  • severe agitation
  • aggression
  • hallucinations

Antipsychotic medicines can cause side effects. 

Antidepressants

You may need an antidepressant, if depression is a cause of severe anxiety. But anxiety is often best treated in other ways, for example, music therapy. 

Sometimes other medications are used to treat specific symptoms in BPSD. These will be prescribed "off-label". This means they are not licensed for BPSD.

It's OK for a doctor to do this. They must provide a reason for using them and tell you the risks and benefits.

Community supports

There are other supports in your community that can help you live as well as you can with dementia. These include:

  • dementia social clubs
  • Alzheimer Cafes
  • dementia advisors
  • day centers
  • respite care

understandtogether.ieand Alzheimer Society of Ireland

Content supplied by the NHS and adapted for Ireland by the HSE.

Page last reviewed: 21/03/2019
Next review due: 21/03/2022

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