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Dementia
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What A Health-Care Professional Can Do
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What A Health-Care Professional Can Do
Here are a few things that a health-care professional can do:
Keep you informed. Being diagnosed with dementia is overwhelming for both the patient and family. Feeling vulnerable and helpless is quite common and entirely understandable. Although your experience is a highly personal one, it is not unique. Many people with dementia and their families share similar experiences.
A health-care professional can help by giving you the information that you need to understand the disease. This should be provided in a format that you understand and at a pace you can handle. A health-care professional can also tell you about recent advances in research and treatment. Information will empower you to better control of your disease and your life.
Improve your five senses. A health-care professional can evaluate each of your five senses — sound, vision, touch, taste and smell — to identify and treat any abnormalities. You can also help heighten and reinforce each sense by using each one. By doing this, you'll be strengthening your mental and physical self.
Minimize your medication use. Medication interactions are a common cause of confusion in the elderly. Be sure to report every medication you take, including over-the-counter medications, and the dosage you use. Check with your doctor or pharmacist about any symptom that you suspect is a side effect or adverse drug interaction. Work with your doctor to try and decrease the amount of medication you take. Medications that you no longer use should be discarded to avoid confusion. However, never discontinue a medication without first checking with your doctor.
Identify other illnesses. Your doctor will want to evaluate whether there is a potentially reversible component to your dementia. He or she will also want to identify any other illness that you may have.
Treat complications. Each form of dementia has its own complications and characteristics. Some complications, such as depression, are commonly associated with all types of dementia. Other features and complications may be more unique to the type of dementia you have. Let your doctor know about new symptoms or other problems, even if you think they are not related to dementia.
Consider drug therapy. Medications have a role in the management of dementia and of its complications. Although there are no medications that cure dementia, they may slow down the rate of mental deterioration.
The choice of medication depends on the cause of your dementia.
- Alzheimer's disease. Alzheimer's disease affects a system of signal transmissions in the brain that is known as the cholinergic system. Medications have been developed to restore cholinergic function. There are four medications approved by the U.S. Food and Drug Administration (FDA) for the treatment of Alzheimer's disease that act on the cholinergic system. These are:
Drug | Trade name |
Donepezil | Aricept |
Galantamine | Reminyl |
Rivastigmine | Exelon |
Tacrine | Cognex |
Although these medications do not offer a cure, they can improve the symptoms of mild to moderate dementia.
Another drug, memantine (Namenda), works differently than the drugs mentioned above. Memantine is approved for the treatment of moderate to severe Alzheimer's disease.
In studies of patients with moderate to severe Alzheimer's disease, those who took Namenda by itself showed a slower decline in mental function when compared with those who took placebo (a sugar pill). In a separate study, those who took Namenda in combination with donepezil (Aricept) vs. donepezil alone, also showed a slower decline in mental function.
Treatment of the complications of Alzheimer's disease, including behavioral disorders, depression and sleep disturbance, requires careful assessment of social and environmental issues and the exclusion of other medical causes. Treatment should initially involve lifestyle changes. Should this fail, medications can then be considered.
- Multi-infarct dementia. The treatment of multi-infarct dementia is similar to the approach taken to prevent a stroke. Your doctor will recommend lifestyle changes and medications to modify risk factors such as tobacco use, high blood pressure, high cholesterol and elevated blood sugars.
- Lewy body disease. Lewy body disease is another type of dementia that can result in profound memory loss. People with Lewy body disease usually have additional symptoms that are similar to those seen in Parkinson’s disease. Drug therapy to help maintain memory is less effective compared to Alzheimer’s disease.
Provide regular follow-up. Regular medical check-ups are an important part of your treatment. A regular medical check-up will allow a health-care professional to maximize your care.
Last updated April 25, 2009
