Dementia guide

What are the treatments for dementia?

There is at present no cure for dementia. But there are medicines and other treatments that can help with dementia symptoms.

Medicines to treat dementia

Most of the medications available are used to treat Alzheimer's disease as this is the most common form of dementia. They can help to temporarily reduce symptoms or slow down progression of the disease.

The main medicines are:

Acetylcholinesterase inhibitors

These medicines prevent an enzyme from breaking down a substance called acetylcholine in the brain, which helps nerve cells communicate with each other.

Donepezil (also known as Aricept), rivastigmine (Exelon) and galantamine (Reminyl) are used to treat the symptoms of mild to moderate Alzheimer's disease. Donepezil is also used to treat more severe Alzheimer's disease.

There is evidence that these medicines can also help treat dementia with Lewy bodies and Parkinson's disease dementia, as well as people who have a mixed dementia diagnosis of Alzheimer's disease with vascular dementia.

There is little difference between these medicines in their effectiveness. However, rivastigmine may be preferred if hallucinations are one of the main symptoms.

Side effects can include nausea and loss of appetite. These usually get better after two weeks of taking the medication.

Memantine

This medicine (also known as Namenda) is used for moderate or severe Alzheimer's disease. It's suitable for those who can't take or are unable to tolerate acetylcholinesterase inhibitors. It works by blocking the effects of an excessive amount of a chemical in the brain called glutamate.

Side effects can include headaches, dizziness and constipation, but these are usually only temporary. 

Medicines to treat related conditions

There are some conditions, such as heart problems, that can affect symptoms of dementia, particularly vascular dementia. It is important that these are diagnosed and treated.

These conditions include:

Medicines to treat challenging behaviour

In the later stages of dementia, a significant number of people will develop what is known as "behavioural and psychological symptoms of dementia (BPSD)". The symptoms of BPSD can include:

  • increased agitation
  • anxiety
  • wandering
  • aggression
  • delusions
  • hallucinations

These changes in behaviour can be very distressing, both for the person with dementia and for the person caring for them. However, there are coping strategies that can help.

If coping strategies don't work, risperidone, an antipsychotic medicine, can be prescribed as a short-term treatment (up to six weeks) for those showing persistent aggression or extreme distress.

This is the only medicine licensed for people with moderate to severe Alzheimer's disease where there is a risk of harm to themselves or others.

Risperidone should be used at the lowest dose and for the shortest time possible as it has serious side effects. The decision to prescribe a medicine should be taken by a consultant psychiatrist.

Antidepressants may sometimes be given if depression is suspected as an underlying cause of anxiety.

Alternative remedies

Some people with dementia and their carers use complementary remedies, such as gingko biloba, curcumin or coconut oil. However, there is not enough evidence to say whether such remedies are effective.

It's best to be wary of any products that claim to benefit people with dementia. If you're thinking of taking such a product or supplement, it's important to consult a doctor first. Some remedies interact with prescribed medicines and they should never be taken as a substitute.

Treatments that don't involve medicines

Medicines for dementia symptoms are important, but are only one part of the care for a person with dementia. Other treatments, activities and support – for the carer, too – are just as important in helping people to live well with dementia.

Cognitive stimulation therapy

Cognitive stimulation therapy (CST) involves taking part in group activities and exercises designed to improve:

  • memory
  • problem-solving skills
  • language ability

Evidence suggests that CST benefits people with mild to moderate dementia.

Cognitive rehabilitation

This technique involves working with a trained professional, such as an occupational therapist, and a relative or friend to achieve a personal goal, such as learning to use a mobile phone or other everyday tasks.

Cognitive rehabilitation works by getting you to use the parts of your brain that are working to help the parts that are not. In the early stages of dementia, it can help you cope better with the condition.

Reminiscence and life story work

Reminiscence work involves talking about things and events from your past. It usually involves using props such as photos, favourite possessions or music.

Life story work involves a compilation of photos, notes and keepsakes from your childhood to the present day. It can be either a physical book or a digital version.

These approaches are sometimes combined. Evidence shows that they can improve mood and wellbeing. They also help you and those around you to focus on your skills and achievements rather than on your dementia.

You'll find more details about these treatments in the Alzheimer's Society's The Dementia Guide: Living well after diagnosis.

Find out about other activities and how to live well with dementia.

Find dementia information and support services


Page last reviewed: 17/06/2017

Next review due: 17/06/2019

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