Alzheimer's disease

5. Treatment and support

There is currently no cure for Alzheimer's disease, but there is a lot that can be done to enable someone to live well with the condition. This will involve drug and non-drug care, support and activities.

The person should have a chance to talk to a professional about their diagnosis. This could be a psychiatrist or mental health nurse, a clinical psychologist, occupational therapist or GP. Information on the support that is available and where to go for further advice is vital in helping someone to stay physically and mentally well. Professionals such as the GP and staff at the memory service or local Alzheimer's Society can advise on what might best meet the needs of the individual and of those caring for them.

There are drug treatments for Alzheimer's disease that can temporarily alleviate some symptoms or slow down their progression in some people. (The names in brackets are common brands of these drugs.)

A person in the mild or moderate stages of Alzheimer's disease or mixed dementia will often be prescribed a drug such as donepezil (eg Aricept), rivastigmine (eg Exelon) or galantamine (eg Reminyl). The drug may help with memory problems, improve concentration and motivation, and help with aspects of daily living such as cooking, shopping or hobbies. A person in the moderate or severe stages of Alzheimer's disease or mixed dementia may be offered a different kind of drug: memantine (eg Ebixa). This may help with mental abilities and daily living, and ease distressing or challenging behaviours such as agitation and delusions. 

If someone is depressed or anxious, talking therapies (such as cognitive behavioural therapy) or drug treatments (such as antidepressants) may also be tried. Counselling may help the person adjust to the diagnosis.

There are many ways to help someone remain independent and cope with memory loss. These include practical things like developing a routine or using a weekly pill box. There are other assistive technology products available such as electronic reminders and calendar clocks.

It is beneficial for a person with Alzheimer's to keep up with activities that they enjoy. Many people benefit from exercising their mind with reading or puzzles. There is evidence that attending sessions to keep mentally active helps (cognitive stimulation). Life story work, in which someone shares their life experiences and makes a personal record, may help with memory, mood and wellbeing. As the dementia worsens, many people enjoy more general reminiscence activities.

Over time, changes in the person's behaviour such as agitation or aggression become more likely. These behaviours are often a sign that the person is in distress. This could be from a medical condition such as pain; because they misunderstood something or someone; or perhaps because they are frustrated or under-stimulated. Individualised approaches should look for, and try to address, the underlying cause. General non-drug approaches often also help. These include social interaction, music, reminiscence, exercise or other activities that are meaningful for the person. They are generally tried before additional drugs are considered, particularly antipsychotics.

Anyone caring for the person is likely to find these behaviours distressing. Support for carers is particularly important at such times.