Treatment of Alzheimer disease is mainly palliative (given for comfort) and focuses on mitigating symptoms. Each symptom is treated based on its severity and the other symptoms that are affecting the individual. Most affected individuals will eventually need professional care in assisted living or nursing homes. They require constant supervision as memory loss becomes incapacitating. There are several pharmacological interventions and treatment regimens that are suggested. Patients who have depression are treated with antidepressants. Tacrine is often prescribed to help with some of the behavioral problems and provides modest cognitive benefits in a small percentage of patients. Aricept, Galantamine, and Exelon are more recent drugs used for a similar purpose, and are not believed to cause liver toxicity; the liver must be monitored in those taking Tacrine. Non-steroidal anti-inflammatory drAIDs) are currently being investigated for their use in treating patients with Alzheimer disease.
Coping with the disorder
There are strategies to cope with this disorder and these should be considered in the beginning stages of the disease. Coping mechanisms depend on whether there are family members available for support. If an individual is without family members, relying on community support through neighbors or volunteers of Alzheimer disease organizations will be necessary.
Many precautions can be made early on to avoid difficult or life-threatening situations later, while maintaining everyday activities in the home environment. Dealing with a person with Alzheimer disease with patience is important. Daily tasks should be performed when the person with Alzheimer disease feels best. Informing neighbors of the person's condition is an important first step. Arranging for assistance, depending on the stage of the disorder, will become necessary. As the ability to drive may be compromised fairly early in the disorder, transportation may need to be arranged. There are local chapters of the Alzheimer's Association that offer help with transportation requirements.
In the early period of the disease when memory loss is minimal, it is helpful for family and friends to interact with the affected person, reminding him or her to take medication, eat, keep appointments, and so forth. Family and friends can help sustain the Alzheimer patient's daily living activities. Keeping records is also helpful, particularly if several people are overseeing the patient's care. Additionally, organizing the household so that it is easy to find important items is recommended.
Other helpful coping mechanisms include posting signs to remind patients of important phone numbers, to turn off appliances, and to lock doors. It is important that all electrical cords and appliances are arranged to minimize distraction, and to prevent danger of falling or misuse. Assistance in handling finances is usually necessary. Providing an extra house key for neighbors and setting up a schedule to check on persons with Alzheimer disease is very helpful for both the patient and the family. By utilizing these and other family, neighborhood, and community resources, many people with early Alzheimer disease are able to maintain a successful lifestyle in their home environment for months or years.
Recovery and rehabilitation
For a person with Alzheimer disease, emphasis is placed on maintaining cognitive and physical function for as long as possible. Currently, there is no cure for Alzheimer and, once the symptoms develop, patients do not recover. Instead, they progressively worsen, usually over a period of years. This has many psychosocial and financial ramifications for the patient and the patient's caretakers. Social service workers can help families plan for long-term care, as persons with Alzheimer disease most often eventually require 24-hour assistance with feeding, toileting, bathing, personal safety, and social interaction. Taking care of patients in the later stages can be financially and psychologically draining. Various support systems are available through community mental health centers and national support organizations.
Clinical trials
There are currently many clinical trials for the treatment or prevention of Alzheimer disease sponsored by the National Institutes of Health (NIH). Large multi-center clinical trials such as a Phase III clinical trail are aimed at determining whether anti-inflammatory drugs delay agerelated cognitive decline. (Contact information: UCLA Neuropsychiatric Institute, Los Angeles, California, 90024. Recruiter: Andrea Kaplan, (310) 825-0545 or her email: akaplan@mednet.ucla.edu.) A Phase III clinical trial is also organized to test the drug Risperidone for the treatment of agitated behavior in Alzheimer's patients. (Contact information: Palo Alto Veterans Administration Health Care System, Menlo Park, California, 94025. Recruiter: Erin L. Cassidy, PhD, (650) 493-5000, ext.27013 or her email: ecassidy@stanford.edu.)
Other trials include:
- A study on Valproate to prevent cognitive and behavioral symptoms in patients. Contact information: Laura Jakimovich, RN, MS, (585) 760-6578 or her email: laura_jakimovich@urmc.rochester.edu .
- The drug Simvastatin, a cholesterol-lowering medication, is being studied to learn if it slows the progression of Alzheimer disease. Contact information: Stanford University, Palo Alto, California, 94304. Recruiter: Lisa M. Kinoshita, PhD, (650) 493-0571 or her email: lisakino@stanford.edu.
- A study of the efficacy and dose of the drug NS 2330 to improve cognition. Contact information: Peter Glassman, MD, PhD, (800) 344-4095, ext. 4776 or his email: pglassma@rdg.boehringer-ingelheim.com.
- A study of investigational medications for the treatment of Alzheimer patients. Contact information: Eli Lilly and Company, (877) 285-4559.
There are also many other studies that are investigating various other pharmacological agents such as vitamin E and other currently available drugs.
No comments:
Post a Comment