How is dementia treated?

The vast majority of causes of dementia cannot be cured, although research is continuing into developing drugs, vaccines and other medical treatments. There is also a lot that can be done to enable someone with dementia to live well with the condition. Care and support should be 'person-centred', valuing the person as a unique individual.

Non-drug treatments and support

A range of support, therapies and activities that don't require medication can help someone to live well with dementia. The GP, memory service or local Alzheimer's Society should be able to advise on what is available.

Support for the person and their carer after a diagnosis should give them a chance to talk things over with a specialist, ask questions about the diagnosis, and think about the future. Information should be given on where to get help if needed in the future and how to stay physically and mentally well.

Talking therapies, such as counselling, can help someone come to terms with their diagnosis. Another treatment called cognitive behavioural therapy (CBT) may be offered to help with depression or anxiety.

Cognitive rehabilitation can enable an individual to retain mental skills and raise their confidence. There is also lots that can be done at home to help someone with dementia remain independent and live well with memory loss. Support ranges from devices such as pill boxes or calendar clocks to practical tips on how to develop routines or break tasks into simpler steps.

Activities that help to keep the mind active, such as cognitive stimulation, are popular. As the condition progresses, many people with dementia enjoy reminiscence and life story work (in which the person is encouraged to share their life experiences and memories). Such activities may help improve someone's mental abilities, mood and wellbeing.

It is vital that people with dementia stay as active as they can - physically, mentally and socially. Everyone needs meaningful activities that they enjoy doing and which bring confidence and self-esteem.

Drug treatments

There are drugs that can help to improve the symptoms of dementia or that, in some cases, may stop them progressing for a while.

A person with mild to moderate Alzheimer's disease or mixed dementia may be prescribed donepezil (often known by the brand name Aricept), rivastigmine (eg Exelon) or galantamine (eg Reminyl). These may temporarily relieve memory problems and improve alertness, level of interest and daily living. In the moderate or severe stages of Alzheimer's disease someone may be offered memantine (eg Ebixa). This may help with mental abilities and daily living, and ease distressing or challenging behaviours and delusions.

Donepezil, rivastigmine and galantamine can be helpful for someone with dementia with Lewy bodies who has distressing hallucinations or delusions, or who has behaviours that challenge.

For a person with vascular dementia, drugs will be offered to treat the underlying conditions. These conditions often include high blood pressure, high cholesterol, diabetes or heart problems. Controlling these may help slow the progression of dementia.

A wide range of other drugs may be prescribed at different times for a person with dementia. These include drugs for depression or anxiety, sleeping tablets or antipsychotics. Note that some of these drugs can have severe side effects. Not all are recommended for all types of dementia. Health professionals will generally advise that a non-drug approach is tried first before prescribing medication.

Can dementia be prevented?

It is not usually possible to say for sure why a particular person has developed dementia. It is known that high blood pressure, lack of physical exercise and smoking - all of which lead to narrowing of the arteries - increase the risk of developing Alzheimer's disease and vascular dementia. There is evidence that a healthy lifestyle, especially in mid-life, can help reduce the risk of dementia. Regular physical exercise (eg cycling, brisk walking), maintaining a healthy weight, not smoking, and drinking only in moderation are all linked to a reduced risk of dementia.

It is important that conditions such as diabetes, heart problems, high blood pressure and high cholesterol are all kept under control. Getting depression treated early is also important.

A balanced diet may help to reduce risk. A balanced diet is one which is low in saturated fat, does not have too much salt, dairy or meat, and includes plenty of fish and fresh fruit and vegetables.

All these healthy lifestyle choices will also reduce the risk of other serious conditions such as stroke, heart disease and cancer.

It also seems that keeping socially and mentally active into later life may help lower the risk of dementia. Being socially active could include visiting friends or going to a place of worship, while being mentally active could include doing puzzles or reading.

SOURCE: Alzheimers Society