Alzheimer's disease - Treatment 

Treating Alzheimer's disease 

There's currently no cure for Alzheimer's disease, although medication is available that can temporarily reduce some symptoms or slow down the progression of the condition in some people.

Support is also available to help someone with the condition cope with everyday life.

Care plan

If you're diagnosed with Alzheimer's disease, it's helpful if your health and social care needs are assessed and plans made for the future.

A care plan is a way of ensuring you receive the right treatment for your needs. It involves identifying areas where you may need some assistance, such as:

• what support you or your carer need for you to remain as independent as possible
• whether there are any changes that need to be made to your home to make it easier to live in
• whether you need any financial assistance

Healthcare professionals (such as your GP or psychiatrist) and social care services (which is normally your local council working with the NHS), will usually both be involved in helping draw up and carry out care plans.

Read more about care plans for long-term conditions.

Medication

A number of medications may be prescribed for Alzheimer's disease to help temporarily improve some symptoms and slow down the progression of the condition.

Donepezil, galantamine and rivastigmine (known as AChE inhibitors) can be prescribed for people with early to mid-stage Alzheimer's disease. Memantine may be prescribed for people with mid-stage disease who cannot take AChE inhibitors, or for those with late-stage disease.

There's no difference in how well each of the three different AChE inhibitors work, although some people respond better to certain types or have fewer side effects.

All of these medications can only be prescribed by specialists such as psychiatrists, neurologists and geriatricians. They may be prescribed by your GP on the advice of a specialist.

If you're caring for someone with Alzheimer's disease, your views should be taken into account when prescribing medication, as well as at regular assessments. These assessments take place to ensure the medication is having a worthwhile effect and to identify and monitor side effects.

Read guidance from the National Institute for Health and Care Excellence (NICE) on donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer's disease.

Side effects

Donepezil, galantamine and rivastigmine can cause side effects such as:

• feeling and being sick
• dizziness
• diarrhoea
• headache
• agitation
• insomnia
• muscle cramps
• more rarely, slowing of the heartbeat – which can cause issues if you already have problems with your heart rhythm.

These side effects are more likely to occur at the beginning of therapy or when the dose is increased. Your doctor should review your medical history and your other medications to check the suitability and risk of interactions.

Common side effects of memantine include:

• dizziness
• headaches
• high blood pressure
• tiredness
• constipation
• shortness of breath
• more rarely, problems with walking or increased confusion
• very rarely, seizures

For more information about the possible side effects of your specific medication, refer to the patient information leaflet that comes with it or speak to your doctor.

Supportive measures and treatments

In addition to medication, treatment for Alzheimer's disease involves a wide range of other measures and treatments to help people with dementia live as independently as possible.

For example, an occupational therapist can identify problems or unsafe areas in your everyday life and help you to develop strategies or use alternative tools to manage these. They may suggest:

• ways of prompting and reminding yourself of important tasks – such as using diaries or calendars
• assistive technology – devices or systems to help maintain the independence and safety of people living with dementia
• adding grab bars and handrails to your home to help you move around safely
• other professionals visiting you at home and assisting with daily tasks to maintain your independence in the community

Psychological treatments, such as cognitive stimulation, may be offered to help improve your memory, problem solving skills and language ability.

Medication, other psychological therapies, such as cognitive behavioural therapy, music and art therapy, reminiscence and relaxation therapies may also be offered. These may help with managing depression, anxiety, agitation, hallucinations, delusions and challenging behaviour that can occur with Alzheimer's disease.

Read more about how dementia is treated.

Practical tips for people with Alzheimer's

If you have Alzheimer's disease, you may find it useful to:

• keep a diary and write down things you want to remember
• pin a weekly timetable to the wall
• put your keys in an obvious place, such as in a large bowl in your living room
• have a daily newspaper delivered to remind you of the day and date
• put labels on cupboards and drawers
• keep useful telephone numbers by the phone
• write yourself reminders – for example, put a note on the front door to remind you to take your keys with you if you go out
• programme people's names and numbers into your telephone
• set the alarm on your watch to act as a reminder
• install safety devices such as gas detectors and smoke alarms throughout your home

It may also be helpful to get in touch with a local or national Alzheimer's or dementia support group, such as the Alzheimer's Society, for more information and advice about living with Alzheimer's disease.

Find Alzheimer's support services in your area and read more about living well with dementia.

Advance care planning

People with dementia often live for many years after their diagnosis. However, as it's a progressive condition, it can be helpful and reassuring for both you and your family if you make plans for the future.

Advance care planning means considering, discussing and possibly recording your wishes and decisions for future care. It's about planning for a time when you may not be able to make some decisions for yourself.

In the earlier stages of the disease, you should have the opportunity to discuss with health professionals and your family about the future. This may involve the use of:

• advance statements
• advance decisions to refuse treatment
• lasting power of attorney
• preferred priorities for care

Read more about advance care planning.

Palliative care

Although the outlook is variable, dementia is a life-limiting illness and can begin to affect multiple body systems in the later stages.

End of life care, or palliative care, provides support for people with an incurable illness, so they're able to live as well and as comfortably as possible until their death. It also involves support for family members. Care may be provided at home, a hospice, a care home or hospital.

For people nearing the end of life, their care team should assess their needs, make them feel comfortable and allow them to die with dignity in a place of their choosing.

Read more about palliative care for dementia.