Dementia Treatment

It is estimated that over one million people will be living with dementia in the UK by 2025.

Dementia is an umbrella category describing mental decline that is severe enough to interfere with daily living. It most commonly affects people over the age of 65.

There is currently no cure for dementia, although much can be done to support people living with the disease and those who care for them. Because dementia causes progressive mental deterioration, those living with dementia require an increasing amount of care as time goes on.

Besides the use of medication to manage symptoms, ongoing support for people with dementia and their families is an important component of treatment.

Types Of Dementia

Every type of dementia affects the working of the cells in specific areas of the person’s brain. This often causes symptoms such as memory loss, confusion, and problems with speech and understanding. These symptoms get worse over time.

There are over 200 subtypes of dementia with the most common being Alzheimer’s disease, vascular dementia, Lewy body dementia, frontotemporal dementia, and mixed dementia.

Alzheimer’s disease

Alzheimer’s disease is caused by a build-up of amyloid and tau proteins in the brain. These proteins cause the formation of plaques and tangles that block communication between nerve cells, preventing their proper functioning.

The symptoms of Alzheimer’s disease usually get worse over time. They include poor short-term memory, confusion, disorientation, repetitive speech, difficulty recognising people or objects, and difficulty performing everyday tasks.

Vascular dementia

Vascular dementia is the second most common type of dementia. It is caused by problems in the supply of blood to the brain, often due to strokes or ‘mini strokes’. Symptoms of vascular dementia include memory problems, disorientation, problems with bladder control, and difficulty with communication.

Lewy body dementia

Lewy body dementia is a progressive condition that affects movement and motor control. It makes tasks such as walking, getting dressed, and using cutlery difficult. Memory is often less affected than with other types of dementia.

A person with Lewy body dementia may be prone to falls or tremors, have trouble swallowing, have visual and auditory hallucinations, and experience disrupted sleep patterns.

It is called Lewy body dementia in honour of the neurologist (Friedrich H. Lewy) that discovered the characteristic protein structures – called Lewy bodies – associated with the condition.

Frontotemporal dementia

Frontotemporal dementia affects the frontal lobes of the brain, which controls behaviour, learning, personality, and emotions. This type of dementia is most common in people aged 45 to 65. It can cause inappropriate social behaviour and a lack of inhibition.

Mixed dementia

It is possible to have two types of dementia at the same time, most commonly Alzheimer’s disease and vascular dementia. Mixed dementia can cause a combination of symptoms.

Diagnosing Dementia

It is important to diagnose dementia as early as possible to access the right support and treatment early on. As dementia is a progressive disease, it is also prudent to plan for the future.

If you, or a loved one, display symptoms of dementia, do not delay a visit to your doctor. Your family doctor is likely to start by ruling out the possibility of other treatable conditions with similar symptoms. Such conditions may include chest infections, thyroid problems, circulatory issues, vitamin deficiency, sleep apnoea, stress, and depression.

Your doctor will take your medical and family history and enquire about your concentration, short-term memory, mood, and any behavioural changes. Based on this information, they may refer you for one or more tests, including blood tests, an MRI or CT scan, or a lumbar puncture.

An MRI or CT scan is used to examine the structure of the brain, while a lumbar puncture looks for abnormal levels of amyloid and tau proteins, which are linked to Alzheimer’s disease.

If your doctor suspects dementia, you may be referred to a memory clinic. Access to specialist healthcare can also be arranged through your doctor if needed. Your doctor will make a diagnosis based on the information collected from the assessments and tests.

Therapies To Manage Dementia

In the earlier stages of dementia, various therapies may be used before medication becomes necessary. These may include:

• Occupational therapy: An occupational therapist can show you how to make your home safer to prevent accidents such as falls.
• Changes to the environment: Reducing clutter and noise can make it easier for someone with dementia to function and focus. For safety reasons, certain objects, such as knives and car keys, might need to be put in a safe place. Cameras can be installed to alert a caregiver if the person with dementia wanders or has had a fall.
• Simplifying tasks: Breaking tasks into easier steps can be helpful. When daily life has structure and routine it helps to reduce confusion in people with dementia.

Medications That Manage Dementia

Medications can be used to temporarily improve dementia symptoms.

Acetylcholinesterase inhibitors are used to treat the symptoms of mild to moderate Alzheimer’s disease. They are also sometimes used to treat dementia with Lewy bodies and Parkinson’s disease dementia, as well as people who have a mixed dementia diagnosis (such as Alzheimer’s disease with vascular dementia).

Medications such as donepezil, rivastigmine, and galantamine prevent an enzyme from breaking down acetylcholine (a substance in the brain), which enables nerve cells to communicate with each other.

Memantine is given to people with moderate or severe Alzheimer’s disease, dementia with Lewy bodies and those with a combination of Alzheimer’s disease and vascular dementia. It works by blocking the effects of too much glutamate in the brain. It allows brain cells to work better for longer and can help reduce the symptoms of dementia for a time.

Medicines to treat challenging behaviour are often needed in the later stages of dementia. Changes in behaviour can be very distressing, both for the person with dementia and their caregivers. Antipsychotic medicines such as risperidone or haloperidol may be prescribed for those displaying persistent aggression or extreme distress.

Frequently Asked Questions