Alzheimer's Disease

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Treatments

There is currently no prevention or cure for Alzheimer’s Disease. Patients may live with AD for 1 to 25 years, but the average is 8 to 10 years. Treatment consists of attempting to slow the progression of the disease, easing symptoms, managing behavioural issues, and providing the patient and carers with support and education. Early in the disease, those with AD may be able to live fairly normal lives with small amounts of assistance, such as memory aids and a structured environment. This is the time when the patient can make plans and participate in decisions about their future care.

Early diagnosis of AD may allow some people to receive moderate benefit from cholinesterase inhibitors, drugs that preserve intellectual ability by enhancing the function of acetylcholine (a neurotransmitter in the brain that allows nerves and parts of the brain to communicate with each other). Drugs available in the UK include galantamine , donepezil and rivastigmine. Memantine is another type of medication that works by protecting the brain from excess glutamate but is used in the later more severe stages of AD. The patient’s other drugs will be evaluated, and those that may worsen confusion, such as central nervous system depressants, antihistamines, sleeping pills, and analgesics will be stopped whenever possible.

Throughout the progression of AD, antidepressants and other drugs may also be used in small quantities, along with environmental modification (making the home environment safer and more familiar), to alleviate personality and behavioural issues such as depression, agitation, paranoia, and violence, and to make the patient more comfortable.

Research studies into the protective and therapeutic influences of substances such as nonsteroidal anti-inflammatory drugs (NSAIDs), oestrogen, and antioxidants like Vitamin E are on-going. Early results suggest that Vitamin E may be protective but that the others have little effect. None are recommended for routine use because the benefits are outweighed by the potential risks.

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