Alzheimer’s Disease

People diagnosed with Alzheimer’s disease often assume that nothing can be done to help them. Andrew Erian, MD, a neurologist with Rockland Neurological Associates in West Nyack, NY, tells patients and their families while there currently are no cures, there are medications that can help manage the disease. “There are things we can do to slow down the disease and improve their symptoms,” he says.

Mild to moderate Alzheimer’s is treated with medications called cholinesterase inhibitors. These drugs may help delay or prevent symptoms from becoming worse for a limited time and may help control some behavioral symptoms. The medications are Razadyne (galantamine), Exelon (rivastigmine), and Aricept (donepezil).

For moderate to severe Alzheimer’s, the doctor may prescribe a medication called Namenda (memantine), which delays progression of some of the symptoms, and may allow patients to maintain certain daily functions a little longer than they would have without the medication. Other Alzheimer’s medications for moderate to severe Alzheimer’s are Aricept and Namzaric.
People with Alzheimer’s may have symptoms such as sleeplessness, wandering, agitation, anxiety, aggression, depression and restlessness. Doctors may prescribe medications such as antidepressants, sleep aids or anti-anxiety drugs or to lessen these symptoms. Anticonvulsants may be used to treat severe aggression.

Currently, there is much research in monoclonal antibody therapy, with the most recent specifically Aducanumab. This medication is an antibody directed against amyloid, or proteins, that can cause plaques resulting in Alzheimer’s. Currently it is offered in research settings and is FDA approved with specific criteria for who qualifies. If interested, this is a discussion to have with your neurologist.

Dr. Erian also recommends that caregivers consider making modifications to their home to decrease safety risks and increase the ability of the person with Alzheimer’s to remain more independent. “Reducing the risks of falls is very important,” he says. “Cooking is another area where safety can become an issue for a person with Alzheimer’s.”

General safety tips include:

  • Disabling automatic locks on storm/screen doors so the person does not get locked out
  • Hiding an extra set of keys outside the house in case your loved one mistakenly locks everyone out
  • Putting decals on glass doors to prevent your loved one from walking into the glass
  • Locking up household kitchen appliances that might present a danger
  • Storing sharp kitchen tools in locked cabinets
  • Storing medications in a locked cabinet to prevent your loved one from mistakenly eating potentially dangerous medicines
  • Removing furniture with sharp corners (or pad the corners)
  • Hiding car keys if necessary to prevent your loved one from driving

To prevent falls and improve mobility, consider installing a stair/elevator chair to help your loved one get up and down stairs; handrails in hallways and stairways; grab bars in the bathroom; a gate on the stairway; locks on doors to the cellar/basement and attic to prevent your loved one from walking up or down into potentially dangerous areas.

Caregivers need a lot of help and support as their loved one progresses through the stages of Alzheimer’s. Dr. Erian recommends they contact the Alzheimer’s Association for information on caring for loved ones with the disease, finding support groups and message boards, and getting information on planning for the future, including legal matters, care options, paying for care, safety, and Alzheimer’s and driving.

“I tell my patients and their families not to give up,” Dr. Erian says. “It’s important to ask for help. This is not an easy disease to deal with, and you shouldn’t do it alone.”