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Alzheimer’s Disease Medications: What You Really Need to Know

Alzheimer’s Disease Medications Overview:

Alzheimer’s disease medications have been prescribed over the last couple of decades and have had some benefit for individuals suffering from this devastating disease. However, it is essential to recognize that medications for Alzheimer’s disease and other forms of dementia are not a cure and have some limitations in preventing the continuing deterioration of the brain. The American Academy of Neurology concluded that these drugs which are primarily cholinesterase inhibitors “should be considered in patients with mild to moderate Alzheimer’s disease although studies suggest a small average degree of benefit.” Clinicians who prescribe these drugs frequently will give them for about a two months trial and may discontinue their use if no improvement is seen.

Alzheimer’s Disease Overview:

In order to determine the necessity for Alzheimer’s disease medications, first you must have a good understanding of the disease and its various forms. Alzheimer’s disease is a progressive deterioration of the brain that significantly impairs memory, thinking, problem-solving and eventually activities of daily living. It is most commonly found among the elderly, and currently is believed to account for 50% to 60% of all cases of dementia. It is estimated that by the year 2050 a possible estimated 11.3 million to 16 million Americans may suffer from Alzheimer’s disease.

It is not currently understood what causes Alzheimer’s disease, although several factors have been identified which may impact upon its development including family history and genetics and advanced age. Some estimates state that approximately 10% of individuals over the age of 65 may have the disease and nearly half of individuals over the age of 85 may be affected by the disease as well.

It is believed that Alzheimer’s disease causes a loss of brain cells resulting in memory loss, language difficulties, problems performing familiar tasks, disorientation to time and place, problems in abstract thinking, changes in mood or behavior, and even changes in personality. The disease process is varied and progressive and may occur over several years or many.

Alzheimer’s Disease Medications and Diagnosis:

In order to determine whether Alzheimer’s disease medications are necessary or appropriate, a definitive diagnosis is required. The most well defined diagnosis can only be conducted by examining the brain tissue upon autopsy. Obviously, prior to an autopsy, in order to have the most probable diagnosis, a complete medical examination needs to be completed evaluating a complete medical history, physical assessment, neurologic and mental evaluation, radiological findings and laboratory tests by a doctor familiar with the disease and the testing process associated with Alzheimer’s disease. There is no one test that can be conducted at this time to determine whether Alzheimer’s disease exists. Research and clinical experience has found that the disease progression for Alzheimer’s can vary from 3 to 20 years after the onset and possibly another 8 to 10 years after it has been diagnosed. This extensive diagnostic process will be conducted prior to prescribing any Alzheimer’s disease medications.

Alzheimer’s Disease Medications and Treatment:

Currently there are no medical treatments or medications known to cure or even stop the progression of Alzheimer’s disease although several have been found to delay the progression. Currently the most widely used Alzheimer’s disease medications are:
donepezil (Aricept),
rivastigmine (Exelon),
galantamine (Razadyn, Reminyl),
memantine (Namenda)
and tacrine (Cognex).

These medications are believed to primarily increase a neurotransmitter (brain messenger) called acetylcholine in the brain, which is believed to be affected by the Alzheimer’s disease process.

Alzheimer’s Disease Medications and the Progression of the Disease:

The Alzheimer’s disease medications currently on the market cannot cure or even stop the progression of the disease process. However, they are believed to limit the severity of the symptoms of confusion and memory loss for a period of time and to delay its progression.

Two types of medications have been approved by the US Food and Drug Administration (FDA) to treat the symptoms of Alzheimer’s disease. The first is the cholinesterase inhibitors which includes Aricept, Exelon and Razadyn and memantine (Namenda). These are used to treat some of the basic symptoms of memory loss, confusion, disorientation, problem solving and reasoning. More recently there is a medication that combines one of the cholinesterase inhibitors (donepezil) with memantine called Namzaric.

Medications for the Early to Moderate Stages of Alzheimer’s Disease:

The medications that are currently used to treat the early to moderate stages of Alzheimer’s disease all fall within the classification of cholinesterase inhibitors. These medications are used to treat the symptoms of memory loss, language difficulties and the basic thinking and reasoning skills.

The cholinesterase inhibitors are believed to prevent the breakdown of acetylcholine, which is a neurotransmitter in the brain. This chemical messenger is very important in the process of learning and memory and is involved in the communication process between nerve cells. It is believed to be necessary to keep the acetylcholine levels high in the brain if possible. By keeping the levels of these chemical messengers high it seems to delay or slow down the progression of the disease process. The effectiveness however varies from individual to individual. These medications are usually well-tolerated although side effects have been noted to include nausea, vomiting, increased frequency of bowel movements and loss of appetite.

Alzheimer’s Disease Medications for the Moderate to Severe Stages:

The only medications prescribed for the moderate to severe stages of Alzheimer’s disease are memantine (Namenda) and a combination of memantine and donepezil referred to as Namzaric. Memantine is usually prescribed to improve memory, reasoning, language skills, attention and the ability to perform simple tasks. Memantine can be used alone or with donepezil (Aricept). There has been some research that indicates that taking a cholinesterase inhibitor such as Aricept along with memantine may be helpful. Namzaric combines the two into one medication.

Memantine is believed to regulate glutamate in the brain which is a chemical involved in information processing, as well as storage and retrieval of information. It has been found to improve the mental and daily functioning for some people. No medication however is harmless and side effect free, with some of the basic side effects including confusion, dizziness, headache and constipation.

Alzheimer’s Disease Medications and the Future:

Medications used to treat Alzheimer’s disease are relatively new and have been developed primarily over the last couple of decades. Currently, there is no cure for Alzheimer’s disease and medications are used to moderate and possibly delay the progress of the disease. Research is constantly being developed using people with mild cognitive impairment compared to healthy volunteers used as control subjects. However, we are only on the cutting edge of developing effective Alzheimer’s disease medications.

Some information adapted by Paul Susic Ph.D. Licensed Psychologist from Worst Pill Best Pills: A Consumer’s Guide to Avoiding Drug-Induced Death or Illness and additional information from alz.org.

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Alzheimer’s Disease: Causes, Symptoms and Diagnosis

Alzheimer’s Disease Introduction:

The most common form of dementia is Alzheimer’s disease. Although it is very uncommon before the age of 60, the incidence of Alzheimer’s disease becomes more common as an individual ages. Although it seems to effect only about 1% to 3% of people between the age of 60 to 64, the incidence of developing this dementia increases to approximately 30% for those over the age of 85. In the United States, as many is 4 million people may currently have the disease.

In Alzheimer’s disease, the brain deteriorates in a specific way resulting in the loss of nerve cells in the brain. Specific abnormalities develop in the brain cells referred to as tangles (neurofibrillary tangles) and plaques (senile or amyloid plaques) which then form between the nerve cells. It is also believed that there is disruption resulting in a reduction in the neurotransmitter (brain messenger between the cells) acetylcholine.
Some individuals may also have atherosclerosis, which then may lead to strokes. The strokes made then result in a vascular dementia, sometimes resulting in a mixed dementia. Mixed dementia is when an individual has both vascular dementia and Alzheimer’s disease or another form of dementia.

Cause of Alzheimer’s Disease:

At the present time, the cause of Alzheimer’s disease is unknown. The current belief in the medical community is that the development of Alzheimer’s disease may be as a result of some combination of genetics and the environment, although the environmental factors contributing to its development are not currently known. Although it is not known the relative contributions between genes and the environment, it is known to run in families and may possibly be more inheritable among individuals who develop it at an early age.

Alzheimer’s Disease Symptoms and Progression:

Alzheimer’s disease symptoms are very similar to the symptoms of other forms of dementia including a loss of memory, language problems, disorientation, behavioral problems and difficulties in activities of daily living. A person with Alzheimer’s disease is not required to have all of these symptoms however.
A couple of the more prominent changes in memory observed in people with Alzheimer’s disease is that changes are subtle and progressive. Some of the early changes may be almost unnoticeable at first but will progressively become worse over time, and will eventually get to the point of being totally disruptive in an individual’s activities of daily living.

The first change noticed in people with Alzheimer’s disease is a change in recent or short-term memory. Also, personality changes may be noticed as well. Some have been known to develop emotional changes such as depression, anxiety or an unusual level of fearfulness. There may be a higher level of fluctuation emotions noticed as well. Also, in the earlier stages, individuals may also notice minor changes in language abilities such as difficulty finding the correct words, misusing words or using general rather than specific language. Also, they quickly develop problems in judgment and the ability to think abstractly.

Unfortunately, some individuals may begin to develop behavioral problems. These problems result in their becoming irritable, agitated and sometimes physically aggressive. Also, they may begin to pace or even wander. Many Alzheimer’s patients develop insomnia, having trouble either initiating or maintaining sleep and sometimes may confuse night and daytime.

As the disease process continues, some individuals may even develop psychosis. Psychotic symptoms associated with Alzheimer’s disease are usually hallucinations, paranoia and/or delusions.

The progression of Alzheimer’s symptoms and ultimately the disease process is very unpredictable with people usually living approximately 8 to 10 years after the earliest signs of the disease. In the initial phases of the disease process, individuals experience things pretty much in the way they always have, enjoying the same activities and entertainment. However, as in all dementias, eventually memory problems become so pronounced that they can no longer participate in activities they have always enjoyed and will eventually become totally dependent on others. Once Alzheimer patients get to the stage of not been able to walk anymore, most individuals will only live an average of about six months. There is a lot of variation however with some individuals becoming bedbound and continue to live for several years.

Alzheimer’s disease diagnosis:

One of the first distinguishing characteristics in diagnosing an individual with Alzheimer’s is whether the individual develops a dementia that seems to have a progressive pattern. The Alzheimer’s disease diagnosis is initially based upon the pattern of symptoms, usually asking the individual and family members or other caregivers about memory problems and other symptoms of deterioration in activities of daily living. The diagnosis will later include a physical examination and other tests such as mental status exam, urine and blood tests, possibly computed tomography (CT) or magnetic resonance imaging (MRI). Some of these tests are used to exclude other possible diseases and conditions which could either cause or exacerbate underlying memory problems. After completing these tests, doctors are usually fairly accurate in their diagnosis of Alzheimer’s disease.

Confirmation of the diagnosis of Alzheimer’s disease can only be done upon death when a sample of the brain tissue is then examined under a microscope. At that time, the previously mentioned neurofibrillary tangles and senile plaques may then be seen throughout the brain. Newer tests such as positron emission tomography (PET) and analysis of spinal fluid are also believed to have possible utility in assisting with confirmation of Alzheimer’s disease. At the present time however, these tests are not believed to be very accurate and are not used very often.

Treatment of Alzheimer’s disease:

Similar to the treatment of other dementias, cholinesterase inhibitors seem to sometimes stabilize or mildly improve memory and mental functioning, but they cannot stop the progression of Alzheimer’s disease. Although inconclusive as to its effectiveness, ginkgo biloba has sometimes been used as an herbal treatment for Alzheimer’s disease.

New drugs continue to be researched constantly which may prevent or slow down the progression of Alzheimer’s disease. One recent example is the use of nonsteroidal anti-inflammatory drugs (NSAID’s) which are commonly used in the treatment of arthritis. Vitamin E is believed to possibly prevent or slow the progression of the disease process, although research is currently inconclusive related to the use of this vitamin. Obviously, risk and benefits of these and all treatments should be discussed with the patient’s physician.

Finally, individuals diagnosed with Alzheimer’s disease also have a high incidence of atherosclerosis or conditions which make it worse. This is of concern in that those individuals will then be at high risk for stroke, which is obviously a serious concern which needs to be eliminated to the best degree possible.

Some information adapted by Paul Susic Ph.D. Licensed Psychologist from the Merck Manual of Aging

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Dementia Types and Causes: Tell me About It.

Dementia Types and Causes: An Introduction

Dementia is a term that refers comprehensively to a variety of symptoms and diagnoses related to a multitude of different causes. Ultimately, dementia is a disorder that results in an individual developing difficulties in thinking, remembering, understanding, communicating and ultimately in controlling behaviors.

Dementia : An overview

The most prominent dementia type is Alzheimer’s disease. However, different forms of dementia affect different mental abilities and are manifested in very different ways. In addition to the way the symptoms are presented, they also progress in very different ways. Dementia by its very nature progresses. At the present time, it cannot be cured. Eventually people with dementia require complete care.

Although dementia can begin at any age, for the most part, it is a disease of the elderly. About 6% to 8% of people over the age of 65 have dementia. As people get older the rate of dementia continues to climb to a higher level with approximately 35% of people over the age of 85 having dementia. Even though it is a fact that the rate of dementia increases as people become more elderly, it is not inevitable as many people never develop dementia although they may get to the age of 100 and older.

Unfortunately, as people get older and begin to forget or misplace things they began to fear that they are developing dementia and in particular Alzheimer’s disease. Much of this forgetting is normal and not dementia, although some of these people may develop dementia at a later point in time.

Dementia Types and Causes:

The most common and most notorious dementia type is Alzheimer’s disease. Additionally, there are many other types of dementia such as vascular (multi-infarct) dementia which is a result of strokes and Lewy body dementia. Some people may have a mixed dementia which may include more than one dementia cause. Some of the less common dementias are as a result of Parkinson’s disease or a tumor or may be the result of normal-pressure hydrocephalus.
In Alzheimer’s disease as in some other dementias, the neurotransmitter acetylcholine in the brain may be low. These neurotransmitters are chemical messengers that help the nerve cells (neurons) to communicate with each other. In addition to helping with many different bodily functions, acetylcholine assists in learning, memory and concentration. Sometimes there are other changes that take place in the brain, although it is not clear whether they are the result or the cause of these specific types of dementia.

If certain disorders are not adequately treated dementia may increase. Some of these underlying disease processes are chronic obstructive pulmonary disease (COPD), diabetes and heart failure. When these diseases are adequately treated, many individuals have improvement in their dementia symptoms.

Medication and Dementia:

There are many medications that can temporarily cause or worsen symptoms of dementia. Some of the worst contributors to either causing or increasing symptoms of dementia are medications used to assist with sleeping such as over-the-counter sleep aids or sedatives, cold remedies and medication used to treat depression and anxiety. Some of these remedies can be purchased over-the-counter without a prescription. Also, drinking even moderate amounts of alcohol can increase the symptoms of dementia in a vulnerable individual.

Delirium is also known to cause symptoms that may be believed to be dementia. Delirium is a temporary disorder usually attributable to some underlying cause such as medication use, disease and even lifestyle changes such as hospitalization. Delirium is not considered to be a dementia type although it may be a causative factor.

Some information adapted by Paul Susic Ph.D. Licensed Psychologist (Health and Geriatric Psychologist) from The Merck Manual Health & Aging

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Dementia and Alzheimer’s Caregivers Make the Holidays Wonderful

Holidays may be hard:

The holidays are expected to be a bright and cheerful time, filled with family and friends. For those caring for another it can be a time filled with stress, disappointment, frustration and sadness. For individuals who have been experiencing MCI, Dementia or Alzheimer’s, they may feel even greater distress and a deeper sense of loss. This is caused by the changes he or she has experienced. Caregivers far too often are overwhelmed. Family may want too much from the senior and the caregiver as well. For the Caregiver, they can end up feeling pulled in many directions at the same time. They may want to participate in the holiday hub bub, and spend long periods of time with the other family members or have them to the house. This can be overwhelming physically, emotionally, and financially. Caregivers may be concerned about how family will react to the changes that have happened to the loved one as a result of the advancing of the disease.

Get honest about your family. If they have not been involved all year long, then they do not understand the changes that have occurred. As the primary caregiver, it is up to you to ensure they understand the circumstances surrounding your loved one, and respect that you know what is best for them.

Some simple rules of thumb:

Do not expect that any of your family members understand the changes that have taken place. They may not understand how the loved one will react with the entire family and extended family gathered together. You need to be the one to make sure everyone else understands that Dad or Mom may not be able to participate as they did in the past, and neither can you.

Extremely long drives to the sister that lives 90 miles away may not be feasible. These drives can be physically exhausting, and the strange house may cause unnecessary anxiety and acting out.

Large gatherings with lots of noise, and small children, are difficult. They may not be able to hear well with so many people talking and a lot of noise. This may very well cause your loved one much anxiety and fear. Your family may not have truly understood that Mom or Dad, may not remember their names, or confuse or forget grandchildren. They may take it personally, and have feelings of hurt and dismay.

About the Author:

Coach Chez is a recovery coach, helping individuals make lasting change in behavior and emotions. Senior Motivate 4 Success helps Seniors and Families find ways to deal with change as we age. Check us out at  Senior Motivate 4 Success and be sure to see our special program for the holidays at Holiday Program

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Dementia Types

Dementia is not defined as a disease, but rather many symptoms that result from a neurological impairment which can be caused by a number of different diseases. There are different stages of dementia. Mild or early stages of dementia are occasionally confused with pseudo-dementia, which usually proves to be depression.

The importance of this is that depression is reversible and dementia generally is not curable. Early detection of neurological diseases or problems in the nervous system are pivotal in controlling the symptoms of dementia. Family members and friends can also play a crucial role in assisting with the diagnosis and treatment of dementia types.

Often the onset of dementia is slow and initial symptoms may be overlooked or dismissed as personality quirks or changes. Keeping notes of actions or behaviors that seem to be peculiar may help in early detection.
What Are the Symptoms?
·         Memory loss seems to be the first and often most noticeable characteristic.
·         Depression often occurs and there can be difficulty in controlling moods.
·         At times there is no recognition of familiar faces or locations.
·         Inability to retain new information.
·         Hallucinations.
·         Suspicion and paranoia.

The most common cause of dementia is Alzheimer’s disease. Dementia affects the following areas of the brain: language, memory, decision-making, and learning. Dementia types vary because different diseases affect certain areas of the brain. There are approximately fifty other causes of dementia, two of which are Parkinson’s and Huntington’s disease. Illnesses that do not originate in the brain, such as kidney disease, can also lead to the development of dementia.

What is the Treatment?

The type of treatment for all dementia types greatly depends on the stage of the disease and occasionally what the origin is the disease is.
·         A well-balanced diet will improve or maintain an overall healthy lifestyle. There is little evidence to suggest any particular foods that aid in improvement for specific symptoms of dementia, but will contribute to better health.
·         Occasionally medication is prescribed to those patients struggling with sleep disorders, depression, or anxiety.
·         Monitoring diabetes, blood pressure, and cholesterol all contribute to minimizing symptoms of dementia.
·         Tools for remembering simple facts and activities are beneficial for dementia patients such as calendars, to-do lists, and instructional notes distributed throughout an individuals home.  

The diagnosis of Alzheimer’s disease can help minimize progressive symptoms of dementia. Medications can be prescribed to control development of further Alzheimer’s symptoms, which in turn protect those areas of the brain and minimize the contributions toward dementia. While dementia is related to parts of the brain, nervous system diseases also supply symptoms quite similar to those of dementia. The central nervous system controls areas such as depression, sleeping, and thinking, which all can be adverse symptoms of multiple dementia types.

About the Author:
Ian Pennington is an accomplished niche website developer and author. To learn more about Dementia Types, please visit Alzheimer’s Treatments Today for current articles and discussions.
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