Medical treatment involves attempting to forestall the loss of brain function by increasing the amount of brain neurotransmitters. Neurotransmitters are brain chemicals that are responsible for transmitting information between nerves and are, therefore, responsible for much of the functioning of the brain. Certain of these neurotransmitters are lower in people with Alzheimer’s disease.
Drugs that increase acetylcholine. The most important of these neurotransmitters is acetylcholine. The drugs that can increase this neurotransmitter are called cholinesterase inhibitors and include drugs such as donepezil (Aricept®), galantamine (Reminy®), rivastigmine (Exelon®) and tacrine (Cognex®). These drugs don’t work in all patients, but when they do, they tend to slow the progression of the disease and improve memory and cognitive function.
Memantine. A new drug, memantine (Axura®, Akatinol®, Namenda®, Ebixa®), works through binding to so-called NMDA receptors in the brain. This is a different approach than using cholinesterase inhibitors and can be used at the same time.
Other medical treatments include using antiinflammatories such as over-the-counter or prescription non-steroidal antiinflammatories (NSAIDS), including acetaminophen, ibuprofen and others. Occasionally, estrogen therapy is used in women.
There are many natural substances and nutrients that have shown promise for the support and benefit of Alzheimer’s patients:
Ginkgo: Ginkgo is an herb that has been used in Chinese medicine for thousands of years. Recent research has supported its benefits for patients with dementia of all kinds, and especially for Alzheimer’s patients.
Acetyl-L- carnitine: Acetyl-L-carnitine is an amino acid that is used throughout the body for energy production. It is especially useful in Alzheimer’s disease because it helps to increase the amount of acetylcholine in the brain.
Coenzyme Q-10 (CoQ10): CoQ10 is part of the energy production in the body; it has been shown that supplementing with CoQ10 can support increased energy production throughout the body. CoQ10 has been shown to help Alzheimer’s patients when combined with B-vitamins and iron.
Dehydroepiandrosterone (DHEA): DHEA is the precursor to many hormones in the body. It has been found to be useful in people who have Alzheimer’s and who have been shown to have a deficiency in DHEA.
Dimethylaminoethanol (DMAE): DMAE is a chemical produced in the brain; it has been shown to be useful in a few small trials of people with Alzheimer’s disease.
Fish oil: Fish oil is one of the all-time best overall supplements. The essential fatty acids in fish oil are necessary for many of the functions of the body. Since the brain is mostly made up of nerves, and the nerves are largely made up of fatty acids, fish oil is a great supplement for people with Alzheimer’s disease.
Huperzine A: Huperzine A is an extract from a club moss used in Chinese medicine. Preliminary research shows that Huperzine A supports improved memory and cognitive function in people with Alzheimer’s disease.
Phosphatidylserine: Phosphatidylserine is found in high amounts in the brain and has been shown to be helpful in people with Alzheimer’s disease.
B-Vitamins: B-vitamins are helpful for both energy production and for mental performance.
- Folic acid, Vitamin B1 and Vitamin B12 have all been tested and shown to be helpful for Alzheimer’s patients.
- While not strictly a B-vitamin, Nicotinamide adenine dinucleotide (NADH), a relative of Vitamin B3, is essential for energy production throughout the entire body.
Vitamin E: Vitamin E is a strong antioxidant, and a low amount of vitamin E in the blood is closely associated with Alzheimer’s disease. Supplementing with Vitamin E has been shown to support slower progression of the disease.
There have been some preliminary studies that support the use of acupuncture in the treatment of Alzheimer’s disease. The studies have involved a small group of patients and no control group. While these are severe limitations, the results of these trials offer hope that acupuncture may be a successful addition to the treatment of Alzheimer’s disease.
Physical therapy can be every bit as important as mental activity for people with Alzheimer’s disease. Late in the disease, people tend to lose the ability to perform simple daily tasks and eventually even the ability to walk. Keeping the body moving also keeps the brain active and forestalls the loss of function.
Many physical therapists will help Alzheimer’s patients to move their bodies in an effort to keep their brain active. Complex movements, such as raising both the left arm and the right foot at the same time help to develop new brain connections and stimulate the brain in new ways.
The philosophy of “use it or lose it” strongly applies to Alzheimer’s patients. A person who is socially and physically active and engages in intellectual activities can forestall and help prevent the disease. Doing crossword puzzles, playing cards, reading and writing can all help keep the brain active.
Later in the disease, many patients will experience severe mental changes that can include paranoia, delusions and hallucinations. This, coupled with often severe insomnia, make it challenging to care for patients and may require consultation with a psychiatrist or moving to a care facility.
There is no doubt that there are activities people can engage in which are preventative for Alzheimer’s disease. People who exercise and stay active in social groups such as a church or other organization are much less likely to suffer from Alzheimer’s disease. To further emphasize the point, it has been shown that people who live alone are much more likely to have the disease.
Along with staying socially active, eating a balanced diet with plenty of fresh fruits and vegetables and foods providing beneficial nutrients such as omega 3 fatty acids is an important part of preventing Alzheimer’s disease.
Avoiding smoking, heavy drinking and street drugs can also keep Alzheimer’s disease at bay.
While it is clear that these lifestyle choices do help to prevent the disease, it is less sure what role they play once a person has the disease. The decision to change a lifestyle choice, such as smoking, falls to the individual and his or her caregivers.
Certainly, helping someone to stop smoking and begin an exercise program has more potential for helping than harming, but this must be weighed on an individual basis.
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