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Living with dementia can be a challenging and stressful experience that can affect all facets of daily life. It can also have an impact on the lives of loved ones and family members. While it may be difficult to adjust to the changes that come with dementia, there are resources to make the journey easier. With the right treatment and support, those living with dementia can continue to lead healthy, meaningful lives.
There is currently no cure for dementia. However, various treatments and medications are available to help manage symptoms, slow disease progression, and improve quality of life. Treatment options may include medication, lifestyle changes, supportive care, and behavioral therapies. It’s important to always consult a healthcare provider who can determine the best treatment options for dementia.
Continue reading to learn more about dementia and the different types of dementia treatments available, as well as the potential benefits and side effects of these treatments.
What is dementia?
Dementia is not a specific disease. Rather, it is a general term that encompasses a decline in cognitive function beyond what is expected from normal aging. Dementia can affect memory, problem-solving, mood, personality, behavior, and the ability to perform everyday activities. In 2020, almost 6 million adults aged 65 years and older were diagnosed with Alzheimer’s disease, and, by 2050, almost 13 million people will have dementia related to Alzheimer’s.Dementia is typically caused by damage or the loss of function of nerve cells in the brain, and it can occur due to various reasons. There are different types of dementia, each with different symptoms or characteristics.
Dementia caused by Alzheimer's disease is the most common type of dementia, accounting for
60% to 80% of cases. Other forms of dementia include vascular dementia, Lewy body dementia, and frontotemporal dementia. Dementia can also arise due to different disorders, such as Huntington's disease, Creutzfeldt-Jakob disease, and Parkinson’s disease.Temporary symptoms of dementia can develop from certain infections, thyroid problems, or the use of certain medications. These symptoms can usually be reversed after treating the underlying causes.
Symptoms of dementia
Symptoms of dementia can vary depending on the type of dementia and the severity of the condition. Common dementia symptoms may include:- Memory loss, or unusual forgetfulness about recent events
- Disorientation and confusion, particularly in familiar places
- Difficulty with problem-solving and planning
- Difficulty with language and communication
- Loss of motivation and interest in activities
- Loss of ability to perform daily activities
- Changes in mood and behavior, such as depression, anxiety, or aggression
How is dementia diagnosed?
Diagnosing dementia can be difficult without a complete assessment and other tests. Dementia is usually diagnosed by a geriatrician, a doctor who specializes in the care of older adults. It may also be diagnosed by other specialists, such as neurologists, psychiatrists, and neuropsychologists.A healthcare provider may want to assess whether dementia is present through a number of ways. In general, they’ll conduct a physical exam, ask about the person’s medical history, and conduct laboratory tests to check for
certain biomarkers that could indicate an underlying problem that causes dementia. By assessing a person’s symptoms and overall medical history, a healthcare provider can also rule out certain conditions that may be causing dementia.It's important to note that the diagnosis of dementia can be challenging and take time. It's also important to be aware that there are many conditions that can cause symptoms similar to dementia, so getting an accurate diagnosis is crucial.
Dementia treatment options
The primary goal of dementia treatment options is to manage symptoms and slow down the progression of the syndrome. Treatment generally includes a multi-faceted approach involving medication and non-medication options. There are several oral medications that work in different ways to treat symptoms of dementia. The right medication will depend on the cause of dementia.In addition to medications, non-drug therapies may be recommended. These treatment options may include behavioral therapy, supportive care, and healthy lifestyle changes. For example, a person with dementia can undergo occupational therapy to maintain their ability to perform daily activities.
Joining a support group can provide information and emotional support for an affected person and their family.Treatment for dementia is often personalized based on an individual's needs, preferences, and overall health. As a long-term endeavor, dementia treatment often requires the commitment of the affected individual, their caregivers, and their loved ones.
Dementia medications
There are different classes of medications used to treat dementia symptoms or the underlying cause. These drug classes include:Cholinesterase inhibitors
In people with Alzheimer’s disease, low levels of acetylcholine are associated with symptoms of dementia. Acetylcholine is a chemical or neurotransmitter that plays a role in the communication between nerve cells. Cholinesterase inhibitors block the enzyme responsible for breaking down acetylcholine, leading to higher levels of acetylcholine in the brain. These medications can help improve memory, thinking, and behavior in patients with Alzheimer's disease. Examples include:- Aricept (donepezil)
- Exelon (rivastigmine)
- Razadyne (galantamine)
NMDA receptor antagonists
Memantine, known by the brand name Namenda, is an NMDA receptor antagonist used to treat moderate to severe dementia from Alzheimer’s disease. It works by regulating the activity of a neurotransmitter called glutamate in the brain, which can help improve memory and thinking. It is used to manage dementia symptoms, but it cannot cure the underlying disease. Side effects may include dizziness, confusion, and headache.Monoclonal antibodies
Aducanumab is an FDA-approved monoclonal antibody medication that targets the beta-amyloid proteins that form plaques in the brain. These plaques can disrupt communication between nerve cells, which can contribute to symptoms of dementia. Aducanumab, known by the brand name Aduhelm, is administered via intravenous (IV) infusion. It is prescribed to treat mild cognitive impairment and slow disease progression. Common side effects of aducanumab include amyloid-related imaging abnormalities (ARIA), headaches, and falls.Orexin receptor antagonist
Insomnia or difficulty sleeping can affect many people with dementia. Suvorexant, known by the brand name Belsomra, treats insomnia by blocking the effects of orexin, a neurotransmitter involved in the sleep-wake cycle. Studies have shown that suvorexant is effective for treating insomnia associated with mild to moderate Alzheimer’s disease. Side effects of suvorexant include headaches, abnormal dreams, and drowsiness the following day after taking the medication.What is the best medication for dementia?
The following table shows common medications prescribed to treat Alzheimer’s disease. It is important to remember that these drugs do not cure dementia. Moreover, this is not a complete list of drugs used for dementia. A physician or healthcare provider will prescribe the appropriate medications tailored to a person’s needs.| Drug Name | Drug Class | Administration Route | Standard Dosage | Common Side Effects |
| Aduhelm (aducanumab) | Monoclonal antibody | IV infusion | 10 mg/kg given as an IV infusion over 1 hour every 4 weeks | Headaches, falls, swelling in areas of the brain (ARIA) |
| Aricept (donepezil) | Cholinesterase inhibitor | Oral | 5 mg daily. The dosage may be increased to 10 mg per day after 4 to 6 weeks | Nausea, vomiting, diarrhea, fatigue, insomnia |
| Exelon (rivastigmine) | Cholinesterase inhibitor | Transdermal | Apply 1 patch on the skin every 24 hours | Nausea, vomiting, diarrhea |
| Razadyne ER (galantamine) | Cholinesterase inhibitor | Oral | 8 mg once daily in the morning. The dosage may be increased to 16 mg per day after at least 4 weeks of 8 mg once daily. The dosage may be further increased to 24 mg per day after at least 4 weeks of 16 mg per day. | Nausea, vomiting, diarrhea, dizziness, headache, decreased appetite |
| Namenda (memantine) | NMDA receptor antagonist | Oral | 5 mg tablet once per day. The dosage may be increased to 10 mg twice daily in 5 mg weekly increments | Dizziness, headache, constipation, confusion |
| Namzaric (memantine and donepezil) | Cholinesterase inhibitor and NMDA receptor antagonist combination | Oral | 7 mg/10 mg once daily in the evening. The dosage may be increased to 28 mg/10 mg in 7 mg weekly increments | Nausea, vomiting, diarrhea, headache, dizziness |
| Belsomra (suvorexant) | Orexin receptor antagonist | Oral | 10 to 20 mg at night daily (within 30 minutes of going to bed and with at least 7 hours before the planned awakening time) | Drowsiness, headache, dizziness, abnormal dreams |
What are the common side effects of dementia medication?
Medications used to treat dementia can cause various side effects, depending on the drug being used. Side effects may range in severity from mild to severe. Side effects are generally mild and temporary, and they should resolve after the body adjusts to the medication or a higher dosage. Some people might not experience side effects at all.The most common side effects of dementia medication include:
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Trouble sleeping
- Abnormal dreams
- Dizziness
- Loss of appetite
- Fatigue
- Headaches
Consult a healthcare provider for medical advice about any persistent and worsening side effects. The dosage, medication, or treatment plan may be adjusted depending on the individual’s response to treatment. It is important to closely monitor any side effects or worsening symptoms of dementia so that treatment can be adjusted as needed.
This is not a complete list of side effects of dementia medications. A doctor or healthcare provider will determine the risk and benefits of certain medications, depending on the patient’s condition.