Treatment - Alzheimer's disease

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
• medicine

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.

Talk to your doctor about any side any effects you may feel.

Acetylcholinesterase (AChE) inhibitors

These medicines are for early-to mid-stage Alzheimer's disease. They increase the levels of AChE. This is a substance in the brain that helps nerve cells communicate with each other. AChE levels drop as brain cells become damaged and die in Alzheimer's disease.

Types of AChE inhibitors include:

• Donepezil
• Galantamine
• Rivastigmine

They can only be prescribed by:

• psychiatrists
• geriatricians
• neurologists
• specialist GPs

You can keep taking AChE inhibitors as Alzheimer's progresses, if you do not have any side effects from them. There is 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 of AChE inhibitors

These can include:

• nausea
• vomiting
• loss of appetite

The side effects usually get better after 2 weeks of taking the medicine. If not, you may need to swap to another type.

Memantine

Memantine is usually prescribed for moderate to severe Alzheimer's Disease.

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.

Medicines to treat challenging behaviour

In the later stages of dementia, many people will develop what's known as behavioural and psychological symptoms of dementia (BPSD).

The symptoms of BPSD can include:

• increased agitation
• anxiety
• wandering
• aggression
• delusions and hallucinations

These changes in behaviour can be very distressing for both the person with Alzheimer's disease and their carer.

Antipsychotic medicines or antidepressants are sometimes prescribed to treat the symptoms of BPSD.

Antipsychotic medicines

Antipsychotic medicines can help with:

• severe agitation
• aggression
• hallucinations

Antipsychotic medicines can cause side effects.

Find out more about antipsychotic medicines

Antidepressants

You may need an antidepressant if Alzheimer's is causing severe anxiety. But anxiety can often be treated in other ways. For example, with music therapy.

Find out more about antidepressants

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

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

Therapy for memory problems

Therapy and activities can play an important role in helping people live well with Alzheimer's.

Here are the main types.

Cognitive stimulation therapy

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

These include:

• talking about 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 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 to 8 weeks.

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 (a type of therapy focusing on your emotions)
• 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, your favourite music or things you own.

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.

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 centres
• respite care

Support is also available from understandtogether.ie and Alzheimer Society of Ireland