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Vitamin E
Treatments
Currently, there is no cure for Alzheimer’s and no way to stop the underlying death of brain cells. But drugs and non-drug treatments may help with both cognitive and behavioral symptoms. The most common cognitive symptoms of Alzheimer’s are those that affect memory, awareness, language, judgment and other thought processes. Many individuals with Alzheimer’s also exhibit behavioral symptoms to some degree. In early stages, people may experience personality changes such as irritability, anxiety or depression. In later stages, individuals may develop sleep disturbances, wandering impulses, agitation (physical or verbal aggression, general emotional distress, restlessness, pacing, shredding paper or tissues, yelling), delusions (firmly held beliefs in things that are not real) or hallucinations (seeing, hearing or feeling things that are not there). Cognitive symptoms: drug treatments Most of the time cognitive symptoms of Alzheimer’s disease are treated with drugs. Two types of drugs are currently approved by the U.S. Food and Drug Administration (FDA) to treat cognitive symptoms. 1. Cholinesterase (KOH-luh-NES-ter-ays) inhibitors prevent the breakdown of acetylcholine (a-SEA-til-KOHlean), a chemical messenger important for memory and learning. By keeping levels of acetylcholine high, these drugs support communication among nerve cells. They delay worsening of symptoms for six to 12 months for about half of the people who take them. Three cholinesterase inhibitors are commonly used to treat mild-to-moderate Alzheimer’s:
2. The second type of drug works by regulating the activity of glutamate, a different messenger chemical involved in information processing. Memantine (Namenda®), approved in 2003, is the only currently available drug in this class. It is approved to treat moderate-to-severe Alzheimer’s disease and may also temporarily delay the worsening of symptoms for some people. Doctors sometimes prescribe vitamin E for cognitive symptoms of Alzheimer’s disease. One large federally funded study showed that vitamin E slightly delayed loss of ability to carry out daily activities and placement in residential care. No one should use vitamin E to treat Alzheimer’s disease except under the supervision of a physician. The doses used in the federal study were relatively high, and vitamin E can negatively interact with other medications, including those prescribed to prevent blood from clotting. Many people find changes in the person’s behavior the most challenging and distressing effect of the disease. These include anxiety, agitation, aggression and sleep disturbances. They can have an enormous impact on care and quality of life for individuals living in both family situations and long-term residential care. The chief underlying cause of behavioral and psychiatric symptoms is the progressive damage to brain cells. Other possible causes of behavioral symptoms include:
Behavioral symptoms: treatments There are two types of treatments for behavioral symptoms: non-drug treatments and prescription medications. Non-drug treatments should be tried first. Non-drug treatments. Steps to developing non-drug treatments include: Identifying what has triggered behavior can often help in selecting the best approach. Often the trigger is a change in the person’s environment, such as:
Because people with Alzheimer’s gradually lose the ability to communicate, it is important to regularly monitor their comfort and anticipate their needs. Prescription medications can be effective in managing some behavioral symptoms, but they must be used carefully and are most effective when combined with non-drug strategies. Medications should target specific symptoms so that response to treatment can be monitored. Prescribing any drug for a person with Alzheimer’s is medically challenging. Use of drugs for behavioral and psychiatric symptoms should be closely supervised by a doctor and the family of the person with the disease. Whether the person with Alzheimer’s is treated with or without drugs, you should have a comprehensive care plan that:
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