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Treating Alzheimer’s Symptoms
Given the complex nature of the condition, there is no one-size-fits-all treatment to cure Alzheimer’s disease (AD).1,2 Rather, Alzheimer’s treatment should be individualized based on each person’s symptoms, response to the treatment, and associated side effects.2,3 While there is no cure, the overall goals of treatment involve treating the underlying disease process, helping people preserve their mental capacity for longer, and managing behavioral symptoms.4
Just as with early detection and diagnosis of AD, starting treatment as early as possible can help improve quality of life and preserve daily functioning.2,5 Available pharmacologic treatments include mediations that can either temporarily treat symptoms of Alzheimer’s Disease related to memory or thinking, or those that treat the underlying cause for disease.6,7
Non-pharmacologic interventions do not change the underlying disease course; however, these interventions are often implemented to help maintain or improve cognitive function as well as reduce behavioral symptoms.2 Such intervention can include cognitive stimulation, music-based therapy, psychological treatment (ie, cognitive behavioral therapy), physical therapy/exercise, and a healthy diet.8,9
Medications That Treat Alzheimer's Symptoms
Prescription cholinesterase inhibitors (like donepezil, rivastigmine, and galantamine) and memantine, an N-methyl-D-aspartate (NMDA) receptor antagonist, are among the first drugs tried in people with AD.1 These drugs work by affecting neurotransmitters, special chemicals responsible for communication between nerve cells in the brain.1,11 By improving nerve cell communication, these drugs can help preserve mental function.11 However, they don’t work for everyone and since they don’t address the underlying disease process, they may only help for a limited amount of time.6,11
Medications Targeting Alzheimer's Disease Progression
Newer drugs, called monoclonal antibodies, may help improve the underlying disease process in AD.6 These medications targeting Alzheimer’s work by decreasing amyloid deposits in the brain.6,12-14 Currently, aducanumab and lecanemab have received FDA approval for the treatment of mild cognitive impairment (MCI) and early (mild) stage of AD, while others like donanemab and gantenerumab are in the research pipelines.6,11,16
Caring for people with AD is a team effort.17-20 Caregivers and medical providers work together to find the best treatment options and develop care plans as Alzheimer’s Disease progresses.20,21 Often caregivers will coordinate with their medical care team, which often includes doctors, nurses, therapists, pharmacists, and supportive care.17 This can also include elder law attorneys and geriatric care managers.17 Using a multidisciplinary approach to care can help both caregivers and patients achieve the best quality of life and health outcomes.
- Alzheimer’s Association®. What is Alzheimer’s disease? https://www.alz.org/alzheimers-dementia/what-is-alzheimers
- National Institute on Aging (NIA). Alzheimer’s Disease Fact Sheet. https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet
- Alzheimer’s Association®. Medications for memory, cognition and dementia-related behaviors. https://www.alz.org/alzheimers-dementia/treatments/medications-for-memory
- Alzheimer’s Association®. Management. https://www.alz.org/professionals/health-systems-medical-professionals/management
- Alzheimer’s Association®. Early detection and diagnosis. https://www.alz.org/professionals/public-health/public-health-topics/early-detection-diagnosis
- Alzheimer’s Association®. Treatments and research. https://www.alz.org/help-support/i-have-alz/treatments-research
- National Institute on Aging (NIA). How is Alzheimer’s Disease Treated. https://www.nia.nih.gov/health/how-alzheimers-disease-treated
- Alzheimer’s Association®. 2022 Alzheimer’s disease facts and figures: special report. More than normal aging: understanding mild cognitive impairment. Alzheimer’s Dement. 2022;18. https://www.alz.org/media/Documents/alzheimers-facts-and-figures.pdf
- Kumar A, Sidhu J, Goyal A, et al. Alzheimer Disease. StatPearls. 2022. https://www.ncbi.nlm.nih.gov/books/NBK499922/
- Behera S. Cognitive behavior therapy: Introduction, methodology and benefits of CBT. 1/9/2014. https://www.online-therapy.com/blog/cognitive-behavior-therapy-introduction-methodology-benefits-cbt/
- Press, D & Buss, SS. Treatment of Alzheimer Disease. UpToDate. https://www.uptodate.com/contents/treatment-of-alzheimer-disease
- Lily Press Release. Lilly releases donanemab data that demonstrated the relationship between reduction of amyloid plaque and slowing of cognitive decline. https://lilly.mediaroom.com/2021-07-29-Lilly-releases-donanemab-data-that-demonstrated-relationship-between-reduction-of-amyloid-plaque-and-slowing-of-cognitive-decline
- Swanson CJ, Zhang Y, Dhadda S, et al. A randomized, double-blind, phase 2b proof-of-concept clinical trial in early Alzheimer’s disease with lecanemab, an anti-Aβ protofibril antibody Alzheimers Res Ther. 2021;13:80.
- Klein G, Delmar P, Voyle N, et al. Gantenerumab reduces amyloid-β plaques in patients with prodromal to moderate Alzheimer’s disease: a PET substudy interim analysis. Alzheimers Res Ther. 2019;11:101.
- Tampi RR, Forester BP, Agronin M. Aducanumab: evidence from clinical trial data and controversies. Drugs Context. 2021;10:2021-7-3.
- Lecanemab (Leqembi®) Prescribing Information. January 2023. https://www.leqembi.com/-/media/Files/Leqembi/Prescribing-Information.pdf?hash=3d7bf1a2-5db2-4990-8388-81086f415676
- Ellison JM. Understanding the healthcare team in Alzheimer’s disease. 8/11/2021. https://www.brightfocus.org/alzheimers/article/understanding-health-care-team-alzheimers-disease
- Jurkowski CL. A Multidisciplinary Approach to Alzheimer’s Disease: Who Should Be Members of the Team? Am J Med. 1998;104(suppl 1);13S-16S.
- UCSF Department of Radiology & Biomedical Imaging. Radiology’s Role in Determining the Impact of Amyloid PET Imaging on Real-World Alzheimer’s Disease and Dementia Care. 6/19/2019. https://radiology.ucsf.edu/blog/radiologys-role-determining-impact-amyloid-pet-imaging-real-world-alzheimers-disease-and
- Alzheimer’s Association®. Caregiving. https://www.alz.org/help-support/caregiving
- Alzheimer’s Association®. Working with care providers. https://www.alz.org/help-support/caregiving/care-options/working-with-care-providers
All URL’s accessed January 27, 2023