Medication’s role in management of Alzheimer’s and Dementia

Introduction

Alzheimer’s disease is a progressive neurodegenerative disorder that affects the brain resulting in memory loss and cognitive impairments. It is the main cause of dementia (a continuous decline in thinking) and memory loss in the elderly. Sometimes Alzheimer’s and dementia are used interchangeably. However, there is a difference between these two. AD is a type of dementia. Dementia is a broader term for impaired thinking, remembering, and decision-making abilities. Alzheimer’s disease is the most common type of dementia causing memory loss and thinking in elderly persons. It is caused by the formation of plaques and neurofibrillary tangles in the brain tissues and the loss of interactions between the neurons. Alzheimer’s Dementia develops progressively from mild,  to moderate, to severe. Cognitive Impairments develop over 5-8 years after the onset of the disease.

RISK FACTORS FOR ALZHEIMER’S DISEASE: 

Alzheimer’s disease is a multifactorial neurodegenerative disease that causes brain atrophy. Experts have determined the following risk factors involved in the development of AD.

• Age: It affects mostly the elderly people especially after the age of 65.
• Family History : People with a family history of AD are more prone to it at a later age.
• Genetics: Certain genes have also been identified as involved in the initiation and development of AD. Apolipoprotein E (APOE ) is one of them. 

SYMPTOMS OF ALZHEIMER’S DISEASE:

Alzheimer’s disease is a progressive disorder. Its symptoms start with difficulty in remembering recent events or conversations. Symptoms of AD are:

• Memory loss: Memory loss is the main symptom of Alzheimer’s disease. A person finds it difficult to take new information and remember them resulting in losing objects, forgetting about events or appointments, or even getting lost.

• Cognitive deficit: Cognitive impairment develops as the disease progresses resulting in difficulty thinking and concentrating. A person feels impairment in multitasking and finance management.

• Problem with recognition: A person with Alzheimer’s disease finds it difficult to recognize faces or objects. 

• Difficulty Speaking, reading, or writing: Alzheimer’s disease progression with the development of speaking difficulty. A person may find it burdensome to make correct speech or writing.

• Changes in behavior and personality: Alzheimer’s disease is characterized by changes in the behavior and personality of the patients. They become angry, upset, compulsive, or socially inappropriate in later stages of the disease. 

MANAGEMENT OF ALZHEIMER’S AND DEMENTIA:

Management of Alzheimer’s and dementia includes early diagnosis and prompt pharmacological treatment strategy for the patients and counseling for the caregivers. The patient and the caregivers must agree with the physician's advice regarding the duration of treatment and cost of the pharmacological therapy. A complete medical and psychiatric evaluation of patients must be done before the initiation of treatment.

MEDICINE TREATMENT:

There is no medical treatment for reversing the death of baron cells. Medications can alleviate the symptoms and temporarily improve the quality of life. However, medication must be accompanied by effective management of associated conditions alongside AD and behavioral therapy of the patients.

• Medications for Cognitive Symptoms: Cholinesterase inhibitors help alleviate the symptoms. These drugs improve nerve connections and help in memory loss, confusion, and judgment problems. Drugs approved by FDA are donepezil, galantamine, and rivastigmine to treat the symptoms of AD. Aducanumab is the only disease-modifying drug approved by the FDA for the treatment of Alzheimer’s.

• Emotion and Behaviour treatment: Behavioural changes such as irritability, anxiety, depression, and sleeplessness are common in AD. Medications to relieve these symptoms may include antidepressants and antipsychotic drugs .

CAREGIVER ROLE IN ALZHEIMER’S AND DEMENTIA:

Caregiving for a person with Alzheimer’s disease is a challenging and stressful journey. However, it becomes difficult to ignore the diminishing cognitive, physical, and psychological abilities of your loved ones. Caregivers can play a significant role in alleviating the torture of patients with Alzheimer’s disease during each specific stage.

• Caregiving in the early stages of Alzheimer’s disease: This includes accepting the diagnosis, dealing with conflicting emotions, and utilizing all the available resources for the management. Caregivers can help in lifestyle changes and managing the stress of the patients.

• Caregiving in the middle stages of Alzheimer’s disease: In this stage, patients require more support as the disease progresses resulting in extensive memory loss and difficulty with speech and communication. Caregivers help them get involved in daily activities such as going out for a walk in the park and exercise.

• Caregiving in the late stages of Alzheimer’s disease: In this advanced stage, your loved ones require 24-hour care. Patients find it difficult to walk, eat or manage personal care. They are vulnerable to infections along with incontinence, hallucinations, and delirium. Caregivers also need group support in managing these problems which may be provided in memory care facilities in Los Angeles.

MEMORY CARE FACILITIES IN LOS ANGELES:

Memory care centers help patients with Alzheimer’s disease and the caregivers provide complete support in the management of debilitating health. Senior living communities in Los Angeles provide the best memory care facilities in the city. Some of the best centers are:

• Melrose Gardens

• City View Assisted Living

• Yorkshire Village Memory Care