There is currently no cure for Alzheimer's disease, but there are various medications that are available on prescription that can help delay the condition’s development.
Treatment for Alzheimer’s disease also involves creating a care plan. This identifies the type of assistance that you might need, and focuses on ways of providing this support.
Medication
Medication that may be prescribed for Alzheimer’s disease includes:
- donepezil (brand name Aricept)
- rivastigmine (brand name Exelon)
- galantamine (brand name Reminyl)
- memantine (brand name Ebixa)
Whether these medications are used will depend on the severity of your Alzheimer’s disease. This will be assessed with tests, such as the Mini Mental State Examination (MMSE). See Alzheimer’s disease - diagnosis for an explanation of the MMSE.
In the first instance, these medications can only be prescribed by a specialist who has experience in treating dementia, such as:
- a psychiatrist: a qualified medical doctor who has further training in treating mental health conditions
- a neurologist: a specialist in treating conditions that affect the nervous system (the brain and spinal cord)
- a physician (medical doctor) who specialises in care for the elderly
After this, your GP may be able to repeat your prescription, and you may be monitored by both your specialist and your GP. Your MMSE score will be reviewed every six months.
Moderate Alzheimer’s disease
If you have moderate Alzheimer's disease (if your MMSE score is between 10 and 20), the National Institute for Health and Clinical Excellence (NICE) recommends that you are prescribed:
- donepezil
- galantamine
- rivastigmine
The healthcare professionals treating you will decide which of these medicines is the most appropriate treatment for you.
Donepezil, galantamine and rivastigmine are known as acetylcholinesterase inhibitors. They work by preventing a chemical breakdown in the brain.
When nerve cells are damaged by brain deterioration they release a chemical called acetylcholine. By preventing the breakdown of acetylcholine, brain deterioration is also slowed.
Severe Alzheimer’s disease
In the UK, memantine is licensed to treat people with moderate to severe Alzheimer’s disease (an MMSE score of 20 or less). However, NICE does not recommend the use of memantine in people with moderately severe to severe Alzheimer’s (an MMSE score of 14 or less).
You may be prescribed memantine as part of a clinical trial (a type of medical research that tests one type of treatment against another). If you are currently taking memantine, you may continue to take it until you, your carers and your specialist consider it appropriate to stop.
Memantine works by blocking chemicals that are often released in large amounts in people with Alzheimer's disease. These chemicals can damage nerve cells and prevent messages moving to and from the brain.
Side effects
Donepezil, galantamine and rivastigmine (acetylcholinesterase inhibitors) can cause side effects including:
- nausea (feeling sick)
- vomiting
- diarrhoea
- headache
- fatigue (extreme tiredness)
- insomnia (difficulty getting to sleep or staying asleep)
- muscle cramps (when your muscles suddenly shorten and cause pain)
For more information about the possible side effects of a particular medication, refer to the patient information leaflet that comes with your medication, or see Medicines information.
Dementia
Alzheimer’s disease is the most common form of dementia. Dementia is a syndrome (a group of symptoms) that is associated with an ongoing decline in mental abilities. The treatment for Alzheimer’s disease will follow the same pattern as treatment for dementia.
If you have been diagnosed with any other conditions as well as Alzheimer’s disease, for example, depression or incontinence (when you unintentionally pass urine or stools), these may be treated separately.
Care assessment
If you have been diagnosed with Alzheimer's disease, your future health and social care needs will be assessed and a care plan will be drawn up. This will be coordinated by:
- healthcare professionals, such as your GP or psychiatrist
- social care services, which is normally your local council working in conjunction with the NHS
As part of your care assessment your functional capacity will be assessed. This involves identifying areas where you may need some assistance with your day-to-day activities. For example, areas that may be assessed include:
- whether you can drive safely
- whether you can wash, dress and feed yourself
- whether you have a support network, such as family and friends
- whether you need any financial assistance
Following the care assessment, a care plan can be drawn up to arrange support for any areas where you may need to have some help. The kind of care that you will receive may depend on what is available from your local primary care trust (PCT).
Support
The healthcare professionals who are treating you will aim to keep you living as independently as possible. Support can be provided in many different ways. For example:
- Grab bars and handrails can be added around your home, for example, to help you to get in and out of the bath.
- An occupational therapist can identify problem areas in your everyday life, such as dressing yourself, and help you to work out practical solutions.
- Cognitive stimulation programmes can be arranged. These involve taking part in activities and exercises to improve your memory, problem-solving skills and language ability.
See the Health A-Z topic about Dementia - treatment for more information.
You can find Alzheimer's support services in your area and, if necessary, choose a hospital for Alzheimer's disease.
Carer issues
If you are concerned about any issues to do with your care, or if you are caring for someone with Alzheimer’s disease, you can find information and advice on the Carers Direct section of the website. This includes advice about:
