Alzheimer's Disease - Treatments And Controls

First of all, it must be clear that Alzheimers disease cannot be cured and it is not possible to recover the affected functions. At the moment, it is possible to slow down its advance but not to stop.

Treatment is destined to slow down evolution of the disease, to handle conduct problems, confusion and agitation, to modify the atmosphere of home and, most important, to offer support to the family. As the disease evolves, it can cause more damage to the family whom to the patient himself.

Treatment with Medicines.

Medicines that protect the cholinergic system: At the present time there are three medicines available to slow down the advance of disease and, possibly, to improve cognitive function. These are: tacrine (Cognex), donepezil (Aricept) and rivostigmine (Exelon). All these three affect acetylcholine level (neurotransmitter) in the brain and all have potential collateral effects like nauseas and vomits. (ALMEIDA, 2006)

Tacrine, first medicine of this type approved, also produces an elevation of hepatic enzymes and must take four times a day. Nowadays it is used rarely.

About the other two drugs, Aricept has been available at a longer time. It is taken once a day and researches demonstrated that it shows some improvement or stabilizes cognitive operation and, additionally, it is well tolerated.

Exelon, a new medicine, seems to be equally effective and it takes two times a day. In the next future appearance of new drugs was programmed to treat this disease.

In order to improve cognitive function it might be necessary to suspend the medicines that make worse the confusion and that are not essential for the patient’s care. Among these, we can cite anti cholinergic medicines, analgesic, cimetidina, depressing of the centric nervous system, anti staminics, tablets to sleep and other medicines. (ANDRADE, 2006)

Antiinflammatory Medicines: antiinflammatory medicines non steroids AINES, that include aspirin and ibuprofen, are under investigation. The corticosteroids are the antiinflammatory medicines most frequently prescribed, but the use in the long term is not recommendable.

Estrogen and other hormones: It seems to be that estrogen substitution therapy decelerates progression and inclusively prevents Alzheimers disease, thus creating interest in other possible hormonal therapies.

Antirust: A study found that the great doses (2000 IU) of VITAMIN and, selegiline or both in combination can slightly slow down the advance of the disease or its symptoms.

Conduct Problems

All underlying problems that contribute to the confusion must be identified and treated. Among them they are the cardiac insufficiency, low oxygen levels (hypoxia), thyroidal upheavals, nutritional anemia, infections and psychiatric conditions (like depression). Treatment of these medical and psychiatric upheavals often improves in great way the mental function of the patient.

Medicine administration can be required to control aggressivity, anxious or dangerous conducts. By the general, they are prescribed in low doses and they must adjust to the necessities of the patient.

Therapies of modification of conduct can be useful to control all unacceptable or dangerous conduct in some people and consist of compensating the presenting positive conducts while those unsuitable ones are ignored (within the safety limits). (BARKER, 2005)

Modification of Home Atmosphere

All person affected by Alzheimers disease needs support in her home as the disease worsening. All relatives or other people in charge of her care can help including/understanding as the person with Alzheimers disease perceives her world. Structured activities are due to foment some abilities that still conserve and to reduce the effects of some affected abilities.

The environs of the patient must be simplified and frequent reminders, notes, lists of routine tasks or directions for the daily activities are due to be provided. The person with Alzheimers disease must have the possibility of speaking on her challenges and of participating in her own well-taken care. (BOTTINO, 2006)

Other Practical Steps.

It is necessary to evaluate sensorial functions of the people with Alzheimers disease and they detect low levels, patient must be helped with apparatuses to increase his capacity to hear, lenses and cataract surgery. Good feeding and maintenance of health are important, although it is not generally necessary to follow diets special nor to take nutritional supplements.

Almeida OP, Forlenza OV, Lima NKC, et al. Psychiatric Morbidity Among The Elderly In A Primary Care Seting - Report From A Survey In São Paulo, Brazil. Int J Geriatr Psychiatry 12:728-736, 2006.

Andrade LHSG, Gentil Filho V, Lólio CA, Laurenti R. Epidemiologia Dos Transtornos Mentais Em Uma Área Definida De Captação Da Cidade De São Paulo, Brasil. Msa/Mnd 1:37-41, 2006.

Barker A, Jones R, Jennison C. A Prevalence Study Of Age-Associated Memory Impairment. Br J Psychiatry 167:642-8, 2005.

Bottino CM, Almeida OP. Can Neuroimaging Techniques Identify Individuals at Risk of Developing Alzheimer’s Disease? Int Psychogeriatr 9:389-403, 2006. n