How is Alzheimer’s disease treated?

Shilpa Srinivasan, MD

Geriatric Psychiatry

Alzheimer’s disease affects 6.2 million Americans – and even more family members – as individuals lose their memory, thinking skills and eventually their ability to complete simple everyday tasks. There is no cure for Alzheimer’s disease, and it is not reversible. However, there are treatments that can help slow the rate of decline. Geriatric psychiatrist, Shilpa Srinivasan, MD, explained what’s available, including a new treatment.

What treatments are available for Alzheimer’s disease?

Common treatments for Alzheimer’s dementia are medications referred to as cognitive enhancers. “Studies have shown they do not reverse the condition; however, they slow the rate of cognitive changes relative to not doing anything at all,” Dr. Srinivasan said.

Medications include:

• Donepezil (Aricept) – approved to treat all stages of Alzheimer’s disease
• Galantamine (Razadyne) – approved for mild to moderate stages of Alzheimer’s disease
• Rivastigmine (Exelon) – approved for mild to moderate stages of Alzheimer’s disease
• Memantine (Namenda) – approved for moderate to severe stages of Alzheimer’s disease
• Memantine/Donepezil (Namzaric) – approved for moderate to severe stages of Alzheimer’s disease

“These medications may not be suitable for everyone with Alzheimer’s dementia, depending on a patient’s underlying conditions, circumstances, and what stage of dementia they’re in. So, it’s critical that persons with dementia and their loved ones have a conversation with their healthcare team, including their primary care providers and specialists, to ensure that the treatment is appropriate for the individual at that time and will be monitored on an ongoing basis,” Dr. Srinivasan said.

Are there new developments in treatment for Alzheimer’s disease?

“Very recently, the FDA approved another new treatment – Aducanumab – which is radically different from the existing treatments that are available. It is the first new agent that has been approved by the Food and Drug Administration in almost a decade and a half,” Dr. Srinivasan said.

Aducanumab is administered as an IV infusion. “It’s so new that there really aren’t a lot of centers that have good protocols in place to offer it,” she said.

It’s also not appropriate for everyone. The medication is currently approved for persons who are diagnosed with mild cognitive impairment or mild dementia.

“What’s most important is customizing the treatment to the person and making sure that whatever treatments offered are appropriate for that person,” Dr. Srinivasan said.

And remember that medications are only part of the treatment.

“There are also non-medication interventions that are effective and can be meaningful for the quality of life of persons with dementia, their families and caregivers,” she said.

These interventions include:

• Social engagement
• Staying physically active
• Maintaining routines

Dementia support groups and other such endeavors, as well as counseling can be helpful, depending on individual needs and circumstances.