Both nonpharmacologic and pharmacologic interventions are needed to optimally treat the cognitive, behavioral and psychological symptoms of Alzheimer's disease.
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There is no cure for Alzheimer's disease, so the chief goals of treatment are to:
- maintain quality of life
- maximize function in daily activities
- enhance cognition, mood and behavior
- foster a safe environment
- promote social engagement, as appropriate
Key elements of a strategy to maximize dementia outcomes include regular monitoring of patient's health and cognition, education and support to patients and their families
, initiation of pharmacologic and nonpharmacologic treatments as appropriate, and evaluation of patient/family motivation to volunteer for a clinical trial
Treating cognitive symptoms
Alzheimer's medications cannot alter disease progression, but the five FDA-approved Alzheimer's drugs that treat the symptoms of Alzheimer's disease can temporarily slow the worsening of symptoms and improve quality of life for those with Alzheimer's and their caregivers.
Managing behavioral symptoms
Behavioral and psychological symptoms of dementia (BPSD), especially agitation, aggression, depression and psychosis, are the leading causes for assisted living or nursing facility placement.1
Early recognition and treatment can reduce the costs of caring for these patients and improve the quality of life of the patient and caregiver.
Monitoring Alzheimer's disease
After a diagnosis of Alzheimer's disease is made and a treatment plan implemented, patients should return for evaluation on a regular basis. Both cognitive and behavioral symptoms of dementia tend to change as the disease progresses, so regular visits allows adaptation of treatment strategies to current needs. Patients with dementia may not be a reliable resource for history-taking, so encourage a family member, friend or caregiver to accompany the patient to all visits.
Nonmedical issues patients need to address
Your patients and their families may be using or have questions about alternative treatments, “prevention” food and vitamins, or “memory/brain booster” supplements.
There are legitimate concerns about using these drugs as an alternative or in addition to physician-prescribed therapy. Effectiveness and safety are unknown, purity is unknown, adverse reactions are not routinely monitored, and dietary supplements can have serious interactions with prescribed medications.
Learn more: Alternative Treatments
Over the past 25 years, researchers have learned a lot about the pathology of Alzheimer's, so there are several promising new targets for drug therapies.
Learn more: Treatment Horizon
There is no definitive evidence, but risk factors identified in epidemiologic studies and randomized clinical trials show that cardiovascular risk factors, such as hypertension, hypercholesterolemia and smoking, increase the risk for cognitive decline. Other studies have found that remaining physically active and socially and intellectually engaged can have a positive impact on cognition.
Learn more: Prevention
Importance of the caregiver – your care partner
Most patients with Alzheimer's disease have a primary caregiver — often a family member — who is crucial to ensuring appropriate care for your patient with dementia. Caregivers often strive to meet all of the health and personal needs of the person with dementia, but they often neglect their own. Many caregivers report high levels of stress, which can contribute to illness. Nearly 40 percent suffer from depression. Physicians and other health care professionals can help by looking for signs of caregiver burnout, treating medical problems and referring them to support services, such as the Alzheimer's Association's 24/7 Helpline (800.272.3900). Our Alzheimer's caregiving information
offers guidance on how to maintain physical and mental health
in the midst of caregiving, as well as advice on how to manage their loved one's daily care
, enhance their daily life, and respond to behaviors
Help and support for your patients
- 24/7 Helpline 800.272.3900: We can help your patients and their caregivers with questions and local support resources.
- Find a support group: Patients with Alzheimer's or another dementia and caregivers can find support and get advice at a local Alzheimer's Association support group. Our message boards are also a good place to find advice and support..
- Alzheimer's Navigator: Free online tool designed specifically for individuals with Alzheimer's disease and their caregivers, helping them create customized action plans and providing access to information, support and local resources.
Yaffe K, Fox P, Newcomer R, et al. "Patient and Caregiver Characteristics and Nursing Home Placement in Patients with Dementia." JAMA. 2002;287(16):2090–2097.