In the 100 years since Alzheimer's disease was discovered, we've come a very long way. And while we don't yet have a cure for the disease, people who respond to medication can stabilise or decline at a slower rate.
Currently, there are two classes of medications available in Australia that can help with the symptoms typically associated with Alzheimer's disease such as decline in memory, language, thinking abilities and motor skills. These are called cholinesterase inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists.
How they work
There has been much interest in using drugs to treat Alzheimer's disease since the 1970s. That's when it was discovered that people with the disease have less of the chemical acetylcholine in their brains because of degeneration of the nerve cells that produce it. Acting as a messenger between nerve cells in the brain, acetylcholine is thought to be involved in memory, learning and reasoning.
Cholinesterase is an enzyme produced by the body that breaks down acetylcholine. It is believed that the cholinesterase inhibitors reduce the production of cholinesterase, which results in an increase in the amount of acetylcholine in the brain, and in turn may help reduce or stabilise the symptoms of Alzheimer's disease.
How they help
Cholinesterase inhibitors may help improve, stabilise, or slow the decline of symptoms such as memory and other mental functions, as well as the ability to perform activities of daily living.
How they work
Glutamate is another chemical messenger in the brain that may be important for learning and memory. It is thought that in the brains of people with Alzheimer's disease, glutamate levels rise in the vicinity of sick nerve cells, and actually make the cells worse, contributing to the symptoms of the disease. It is believed that NMDA-antagonists act by normalising the levels of glutamate, and in this way can help reduce some of the symptoms of the disease.
How they help
NMDA-antagonists are meant for people with moderately severe to severe Alzheimer's disease, and they can help slow or stabilise the decline in cognition and the ability to perform activities of daily living.
Several healthy lifestyle choices may also alter the progression of Alzheimer's disease, so medication should not be considered the only treatment. The following non-pharmacological approaches can help maintain brain health, and may help slow the onset of symptoms:
- Staying physically active: being active reduces cardiovascular disease risks, which are associated with an increased risk of developing Alzheimer's disease. Additionally, moderate activity promotes the circulation of blood to the brain, nourishing brain cells with oxygen and nutrients. And of course, being physically active is part of a healthy lifestyle.
- Remaining mentally active: keeping the brain engaged strengthens its networks of connections, maintaining brain function. Giving the brain challenges helps overcome monotony and routine, and lets a person use new or little used mental pathways.
- Maintaining social connections: staying socially engaged is associated with maintenance of brain function. Being connected means maintaining relationships with friends and family, and seeking out opportunities to socialise with others, through work, volunteer activities, and traveling.
- Managing stress: stress can cause vascular changes and chemical imbalances that have long-term effects on the brain. Reducing stressors and emphasising stress management may promote a healthier brain.
Non-pharmacological counselling-based approaches such as reality orientation, behaviour modification, music therapy and dance, and motivational therapy are advocated for people with dementia, though few have been scientifically validated. Consult your doctor if you would like to know more about these interventions.