Medical treatments and interventions for the management of dementia symptoms

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Medical treatments and interventions for the management of dementia symptoms

Dementia is a degenerative disease that is considered irreversible. While there is ongoing research to better understand the mechanisms and develop new interventions, early diagnosis and appropriate management of symptoms remain the two most critical components for increasing the quality of life for patients with dementia and their caregivers. Lifestyle interventions, support services, and effective communication strategies also contribute to the well-being of those affected by dementia. And because dementia in all forms is irreversible, care is typically centered around having the highest quality of life for whatever stage of dementia a person is experiencing.

Medical treatments and interventions for the management of dementia symptoms | Lynn Smargis CSA, CDP Senior Care Authority

Types of Dementia

Dementia encompasses a group of disorders characterized by declining cognitive function that interferes with daily life. People with a dementia diagnosis are typically over 60 years of age. However, people as young as their early 40s can also be diagnosed with dementia, which is rare. In addition, some patients may have more than one type of dementia. 

For example, a person might have both Alzheimer’s disease and vascular dementia simultaneously, or they could be diagnosed with Alzheimer’s and Lewy bodies (explained below). When you have more than one type of dementia, this is known as having mixed dementia. While there are many types of dementia, these are the most common forms of the disease that people are diagnosed with when receiving a dementia diagnosis.

Alzheimer’s disease is the most universal cause of dementia, accounting for almost half of all cases. Alzheimer’s is characterized by the accumulation of abnormal proteins, such as beta-amyloid plaques and tau tangles in the brain, leading to the death of neurons and a progressive decline in cognitive function. This disease affects all demographics, but you are more likely to have Alzheimer’s if you’re female, Black, or Hispanic.

Vascular dementia is the second most common form of dementia and results from reduced blood flow to the brain, often due to stroke or other vascular issues. The brain can no longer function efficiently because of reduced blood flow to the brain. Symptoms include typical dementia symptoms such as memory loss and personality change. In addition, patients with vascular dementia can also see an increase in incontinence, visual disturbances, and difficulty with balance and walking, putting them at significant fall risk.

Lewy Body dementia is abnormal protein deposits known as Lewy bodies in the brain. This type of dementia shares symptoms with both Alzheimer’s disease and Parkinson’s disease, including cognitive fluctuations, visual hallucinations, and motor symptoms.

Frontotemporal dementia affects the frontal and temporal lobes of the brain, which control logical thought. FD often presents with changes in personality, behavior, and language. Unlike Alzheimer’s disease, memory may remain relatively intact in the early stages of frontotemporal dementia, so the patient does not start with significant memory loss as in most other forms of dementia.

Parkinson’s Disease dementia is a dementia caused by Parkinson’s disease. It is a movement-based disorder that can also lead to cognitive decline and dementia in some individuals. The dementia associated with Parkinson’s disease often develops in the later stages (Stages 3 and 4) of the condition.

Huntington’s disease is a genetic disorder that effects Caucasians the most and can lead to dementia. This genetic disorder is characterized by progressive motor dysfunction, cognitive decline, and psychiatric symptoms.

Creutzfeldt-Jakob disease is a rare, rapidly progressive, and fatal brain disorder that is caused by abnormal prion proteins and leads to severe neurological symptoms, including dementia.

Normal Pressure Hydrocephalus is when excess cerebrospinal fluid accumulates in the brain’s ventricles, leading to difficulty walking, urinary incontinence, and cognitive decline.

Dementia Treatments do not Reverse Dementia

And because there is no cure for dementia, the available treatments primarily focus on managing symptoms and improving quality of life. While the effectiveness of medical treatments can vary depending on the type of dementia, there are some standard dementia care management practices that can be utilized depending on the types of symptoms the person with dementia is experiencing.

Dementia is typically characterized by the gradual and irreversible loss of cognitive function due to damage or degeneration of brain cells. The underlying causes of dementia vary, and they often involve complex changes in the brain that cannot be easily reversed. Here are some reasons why dementia is generally considered irreversible.

Why is Dementia Considered Irreversible?

Neurodegeneration is the process of brain cells, called neurons, becoming damaged and then dying off. Once neurons are damaged or die, they typically cannot regenerate or be replaced. Dementia is associated with specific pathological changes in the brain, such as the accumulation of abnormal proteins such as beta-amyloid plaques and tau tangles in Alzheimer’s disease and other structural abnormalities. These changes contribute to the decline in cognitive function.

The human brain is highly complex, with our cognitive function dependent on intricate networks of neurons and neurotransmitters. Restoring normal function to these networks once disrupted is a significant challenge and has yet to be achieved. Because of the many variables of dementia and the complexity of our brain, there is a lack of disease-modifying treatments for the reduction of symptoms. 

Currently, there are no widely accepted disease-modifying treatments for most forms of dementia. Medications available for some types of dementia, such as cholinesterase inhibitors and memantine, primarily focus on managing symptoms rather than reversing the underlying pathology.

Researchers are actively exploring potential disease-modifying treatments for dementia, and clinical trials are ongoing. These efforts aim to target the specific mechanisms that contribute to cognitive decline and, ideally, slow or halt the progression of the disease. However, finding effective treatments for dementia is a complex scientific challenge, and success in this area has been elusive so far.

Common Medical Treatments for Dementia

Cholinesterase Inhibitors such as Donepezil (Aricept), Rivastigmine (Exelon), and Galantamine (Razadyne) are often prescribed for Alzheimer’s disease. They work by increasing acetylcholine levels, a neurotransmitter deficient in the brains of people with Alzheimer’s disease. Cholinesterase inhibitors may help improve cognitive symptoms in some individuals.

NMDA Receptor Antagonists, like the formulation in Memantine (Namenda), are typically used to regulate moderate to severe Alzheimer’s disease. This drug regulates glutamate, another neurotransmitter involved in learning and memory. Memantine may help improve cognitive function and daily activities.

Combination therapy can offer patients more relief of symptoms by prescribing a combination of cholinesterase inhibitors and memantine to address different aspects of the disease and potentially enhance the overall therapeutic effect.

Managing underlying conditions such as high blood pressure, diabetes, or high cholesterol can increase the quality of life for someone with dementia, as these health conditions can contribute to the progression of dementia.

Individuals with dementia and their caregivers must work closely with medical professionals, developing a comprehensive care plan regularly maintained by medical professionals. Regular medical check-ups, monitoring of symptoms, and adjustments to the treatment plan are essential components of dementia care.

Remember that advancements in dementia research may lead to new treatment options, so staying informed about the latest developments is essential. Always consult with healthcare professionals for the most up-to-date information and personalized advice based on individual circumstances. One of the best resources to connect with for information surrounding dementia is the Alzheimer’s Association, which offers free resources and help lines to those dealing with dementia. 

Lynn Smargis, CSA, CDP, cared for her parents for six years when they both were diagnosed with cancer within a year of each other. Familiar with the challenges of eldercare, Lynn has taken on the role of Senior Care Advisor in the Portland area to work with families who are struggling with finding the right care for their loved ones. Reach out to her for a complimentary consultation by scanning the QR code.

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