How Is Alzheimer’s Disease Treated?

Alzheimer’s disease (AD) is a progressive brain disorder that leads to a severe decline in people’s cognitive (brain-related) abilities, such as thinking, memory, language, learning, and judgment. The condition is most common in people aged 65 and above. Symptoms of AD can be difficult to manage as they tend to significantly interfere with daily activities.

Unfortunately, there is no known cure for AD at this time. However, treatments can help slow the disease from progressing rapidly and improve symptoms. The good news is that research on treatment options and prevention methods for AD remains ongoing—so there is hope that there are more effective ways to treat the condition as experts learn more about AD.

Currently, the first line of treatment for AD is medication. The goal of some medications is to treat symptoms, while the purpose of other medications is to slow disease progression. Along with medication, a healthcare provider may also recommend lifestyle changes.

Keep in mind: treatment for AD will vary from person to person and will often depend on the stage of Alzheimer’s disease they are in. For those in the early stages of AD, you may be able to follow your treatment plan on your own. However, as AD progresses, a loved one or professional caretaker will likely be supporting people living with the condition. 

Medications

The U.S. Food and Drug Administration (FDA) has so far approved seven medications to treat AD. Of these, five help treat symptoms while the other two medications work to slow disease progression.

Medications to Treat Symptoms

As Alzheimer’s disease progresses, people with the condition may experience rapid cognitive decline, making it difficult to complete tasks, remember details, and make decisions, among other symptoms. People with AD may also have a host of behavioral symptoms (e.g., losing interest in social activities) and psychological concerns (e.g., being sad, anxious, or aggressive) which can significantly reduce their quality of life.

These symptoms happen because AD can prematurely cause brain cells to die or limit your nerve cells from communicating with other nerve cells that help your body function properly. As a result, a healthcare provider may prescribe medication to temporarily provide relief for mild symptoms for some people with AD.

In most cases of AD, you or a loved one may be receiving care from a primary care provider or a neurologist (a doctor who specializes in the brain and spinal cord). A provider may recommend one of the following medications:

There are three primary types of medications to treat AD symptoms: cholinesterase inhibitor, glutamate regulators, and a combination of a cholinesterase inhibitor and glutamate inhibitor. 

Cholinesterase inhibitors try to stop the breakdown of acetylcholine—a natural brain chemical that your body uses for learning and memory. Generally, a healthcare provider prescribes this medication type if you or a loved one have mild-to-moderate AD. Side effects of these medications may include loss of appetite, needing to use the bathroom more often, and nausea or vomiting.

Glutamate regulators control glutamate—a brain chemical that helps you process information. These medications are often used to treat people with moderate-to-severe AD. Side effects of glutamate regulators include headache, constipation, dizziness, or confusion. 

People with severe AD symptoms will likely need a prescription for Namzaric (donepezil)—a combination of both a cholinesterase inhibitor and a glutamate regulator. 

Medications to Slow the Disease Process

Aside from medications that can help improve symptoms, the FDA has approved two medications that can help slow the progression of Alzheimer’s disease. Such drugs are known as disease-modifying therapies. While these medications cannot restore lost memories or cognitive functions that have already started to decline, they can help prevent rapid cognitive decline from occurring.

If your or your loved one’s healthcare provider thinks this medication may be beneficial, they may prescribe you one of the two medications:

While the FDA has granted accelerated approval for both of these drugs, further studies are still needed to confirm the effectiveness of these medications. Clinical trials for both medications remain ongoing and the results of these trials are expected to come out in 2030. Because of this, the Centers for Medicare and Medicaid Services (CMS) said that Medicare would only cover the cost of these medications for people actively participating in a clinical drug trial.

The approval of these medications has been controversial. Some researchers have spoken out about these medications stating that there isn’t enough evidence the medication works and that studies have not yet looked into the long-term effects of taking the drug. Similarly, experts have also opposed the use of Leqembi (lecanemab), as early clinical trials found that the medication caused swelling and mild bleeding in the brain.

The important takeaway: if you are interested in learning more about these medications, want information on how to enroll a loved one into a clinical trial, or are concerned about the use of these drugs for a loved one, talk to their primary healthcare provider or neurologist about any questions you have. 

You may also consider reaching out to another Alzheimer’s disease specialist for a second opinion. These experts can help you figure out the best way to move forward with your loved one’s treatment plan. 

Lifestyle Changes 

Non-medication treatments can’t affect biological processes in your or your loved one’s brain, but they can still help improve cognitive function and the ability to complete daily activities. Your or your loved one’s healthcare provider may recommend the following lifestyle strategies to maintain cognitive function and improve quality of life:

• Trying cognitively engaging activities such as reading, playing chess, or card games  
• Playing music, singing, or dancing
• Doing arts and crafts
• Getting physical exercise 
• Eating a nutritious diet that helps improve memory such as nuts, berries, leafy greens, and fish 
• Receiving care or support from a mental health professional
• Spending time with loved ones, animals, or support groups
• Participating in meaningful activities and hobbies that bring joy and improve mood 

People with moderate-to-severe AD may find it difficult to engage cognitively, socially, and physically. If you are taking care of a loved one who may have trouble with any of the above activities, it’s a good idea to find other activities they may enjoy. 

Regardless of what stage of AD someone is in, it’s important to avoid tasks that may be stressful, frustrating, or too difficult. To best care for the person living with the condition, consider finding activities that are engaging and supportive. 

Living With and Managing Alzheimer’s Disease

On average, people with AD live for about four to eight years after receiving a diagnosis. This can be stressful, scary, and sad for the person living with the condition and the people who love and care for them—and it’s OK to feel this way. Sometimes, the condition can be just as hard for the people who are providing care for the person with AD as it is for the person living with the condition. 

However, there are some things you can do to ensure your own well-being and the well-being of someone else who may be living with the condition. You may consider trying one or more of the following strategies:

• Maintain a familiar environment at home and keep a daily routine
• Create a calm and comfortable atmosphere by reducing distractions, lowering noise, or dimming the lights in the evening
• Keep a comfortable room temperature in your home
• Remove any sharp or harmful objects that can hurt you or your loved one
• Spend time with your loved one and other community members 
• Remind your loved one that you are there for them
• Ask others for support or let others take care of you when they offer 
• Reach out for mental health support from a licensed professional 
• Stay in touch with your or your loved one’s healthcare providers as the condition progresses for changes in treatment plans or resources for care workers and residential facilities that you may need