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Dementia - Treatment

Alternative Names

Chronic brain syndrome; Lewy body dementia; DLB; Vascular dementia; Mild cognitive impairment; MCI

Treatment:

For information on how to take care of a loved one with dementia, see: Dementia - home care

The goal of treatment is to control the symptoms of dementia. Treatment depends on the condition causing the dementia. Some people may need to stay in the hospital for a short time.

Stopping or changing medications that make confusion worse may improve brain function.

There is growing evidence that some kinds of mental exercises can help dementia.

Treating conditions that can lead to confusion often greatly improve mental functioning. Such conditions include:

  • Anemia
  • Decreased oxygen (hypoxia)
  • Depression
  • Heart failure
  • Infections
  • Nutritional disorders
  • Thyroid disorders

Medications may be needed to control behavior problems caused by a loss of judgement, increased impulsivity, and confusion. Possible medications include:

  • Antipsychotics (haloperidol, risperdal, olanzapine)
  • Mood stabilizers (fluoxetine, imipramine, citalopram)
  • Serotonin-affecting drugs (trazodone, buspirone)
  • Stimulants (methylphenidate)

Certain drugs may be used to slow the rate at which symptoms worsen. The benefit from these drugs is often small, and patients and their families may not always notice much of a change.

  • Donepezil (Aricept), rivastigmine (Exelon), galantamine (Razadyne, formerly called Reminyl)
  • Memantine (Namenda)

A person's eyes and ears should be checked regularly. Hearing aids, glasses, or cataract surgery may be needed.

Psychotherapy or group therapy usually does not help because it may cause more confusion.

Expectations (prognosis):

People with mild cognitive impairment do not always develop dementia. However, when dementia does occur, it usually gets worse and often decreases quality of life and lifespan.

Complications:

Complications depend on the cause of the dementia, but may include the following:

  • Abuse by an overstressed caregiver
  • Increased infections anywhere in the body
  • Loss of ability to function or care for self
  • Loss of ability to interact
  • Reduced lifespan
  • Side effects of medications used to treat the disorder

Calling your health care provider:

Call your health care provider if:

  • Dementia develops or a sudden change in mental status occurs
  • The condition of a person with dementia gets worse
  • You are unable to care for a person with dementia at home
  • Reviewed last on: 8/29/2009
  • Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Brewer JB, Gabrieli JDE, Preston AR, Vaidya CJ, Rosen AC. Memory. In: Goetz CG, ed. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 5.

Farlow MR, Cummings JL. Effective pharmacologic management of Alzheimer's disease. Am J Med, 2007;120:388-397.

Burns A, Iliffe S. Alzheimer's disease. BMJ. 2009;338:b158.doi:10.1136/bmj.b158.

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