Treatment:

Unfortunately, there is no cure for AD. The goals in treating AD are to:

• Slow the progression of the disease (although this is difficult to do)
• Manage behavior problems, confusion, sleep problems, and agitation
• Modify the home environment
• Support family members and other caregivers

DRUG TREATMENT

Most drugs used to treat Alzheimer's are aimed at slowing the rate at which symptoms become worse. The benefit from these drugs is often small, and patients and their families may not always notice much of a change.

Patients and caregivers should ask their doctors the following questions about whether and when to use these drugs:

• What are the potential side effects of the medicine and are they worth the risk, given that there will likely be only a small change in behavior or function?
• When is the best time, if any, to use these drugs in the course of Alzheimer's disease?

Two types of medicine are available:

• Donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne, formerly called Reminyl) affect the level of a chemical in the brain called acetylcholine. Side effects include indigestion, diarrhea, loss of appetite, nausea, vomiting, muscle cramps, and fatigue.
• Memantine (Namenda) is another type of drug approved for treating AD. Possible side effects include agitation or anxiety.

Other medicines may be needed to control aggressive, agitated, or dangerous behaviors. These are usually given in very low doses.

It may be necessary to stop any medications that make confusion worse. Such medicines may include painkillers, cimetidine, central nervous system depressants, antihistamines, sleeping pills, and others. Never change or stop taking any medicines without first talking to your doctor.

SUPPLEMENTS

Many people take folate (vitamin B9), vitamin B12, and vitamin E. However, there is no strong evidence that taking these vitamins prevents AD or slows the disease once it occurs.

Some people believe that the herb ginkgo biloba prevents or slows the development of dementia. However, high-quality studies have failed to show that this herb lowers the chance of developing dementia. DO NOT use ginkgo if you take blood-thinning medications like warfarin (Coumadin) or a class of antidepressants called monoamine oxidase inhibitors (MAOIs).

If you are considering any drugs or supplements, you should talk to your doctor first. Remember that herbs and supplements available over the counter are NOT regulated by the FDA.

Support Groups:

For additional information and resources for people with Alzheimer's disease and their caregivers, see Alzheimer's disease support groups.

Expectations (prognosis):

How quickly AD gets worse is different for each person. If AD develops quickly, it is more likely to worsen quickly.

Patients with AD often die earlier than normal, although a patient may live anywhere from 3 - 20 years after diagnosis.

The final phase of the disease may last from a few months to several years. During that time, the patient becomes immobile and totally disabled.

Death usually occurs from an infection or a failure of other body systems.

Complications:

• Loss of ability to function or care for self
• Bedsores, muscle contractures (loss of ability to move joints because of loss of muscle function), infection (particularly urinary tract infections and pneumonia), and other complications related to immobility during end stages of AD
• Falls and broken bones
• Loss of ability to interact
• Malnutrition and dehydration
• Failure of body systems
• Harmful or violent behavior toward self or others
• Abuse by an over-stressed caregiver

Calling your health care provider:

Call your health care provider if someone close to you experiences symptoms of senile dementia/Alzheimer's type.

Call your health care provider if a person with this disorder experiences a sudden change in mental status. (A rapid change may indicate other illness.)

Discuss the situation with your health care provider if you are caring for a person with this disorder and the condition deteriorates to the point where you can no longer care for the person in your home.