There is no cure for Alzheimer's. Researchers are still trying to fully understand how the disease leads to memory loss and other problems with thinking and behavior. They hope to one day reverse those changes to prevent or stop the disease.
But if you or a loved one has Alzheimer’s, there are treatments that can make a difference. Some therapies ease the symptoms and help people do better for longer. Because the disease’s effects change over time, people often need to have their treatments adjusted, or they need to start new ones as different problems emerge.
Different types of drugs can treat memory loss, behavior changes, sleep problems, and other Alzheimer’s symptoms. They don’t stop the disease, but they can keep the problems from getting a lot worse for a few months or even years. All of them can have side effects, which can be more of a problem for older people.
Doctors may recommend one or more types of medicine depending on a person’s symptoms.
People with Alzheimer’s disease have a buildup of amyloid-beta plaques in the brain. The FDA has approved the drug aducanumab-avwa (Aduhelm) as the first therapy that targets and reduces these plaques. It's for people with early Alzheimer’s disease. It may cause swelling or bleeding in the brain.
Some drugs treat problems with mood, depression, and irritability. Those include:
For people who have anxiety or restlessness, medicines that can help include:
It's important to note that studies have linked some of these “antipsychotic drugs” to a higher risk of death for people with dementia. The FDA has placed a "black box" warning on these drugs describing these problems. But they can still be helpful for many people.
Many people have explored ways other than medication to treat Alzheimer’s disease or handle its symptoms. The science on whether or not they work has been mixed. For example:
Vitamin E. Scientists once thought this antioxidant might protect nerve cells from damage. But many doctors no longer recommend it for people with Alzheimer’s because there’s little evidence that it works.
Hormone replacement therapy (HRT). At one time, studies suggested that women who took hormone replacement therapy after menopause had a lower risk for Alzheimer's. The female hormone, estrogen, was thought to help nerve cells connect with each other and keep the brain from making plaques that build up between brain cells.
But more recent research found that HRT doesn’t help, and one study even showed that estrogen use might actually raise the risk of Alzheimer's rather than protect against it. HRT also may increase a person’s chances for heart attack, stroke, and breast cancer.
Music therapy. Some science shows that these treatments, which stimulate the senses, can improve mood, behavior, and day-to-day function for people with Alzheimer’s. Art and music may help trigger memories and help people reconnect with the world around them. Try singing with them and playing their favorite music.
Music therapy can help someone with Alzheimer’s in numerous ways. It can:
- Soothe them when they’re agitated
- Spark memories
- Engage their mind even in the disease’s later stages
- Improve their eating in some cases
Here are some tips for using music therapy for a person with Alzheimer’s:
- Golden oldies spark memories. Songs from the person’s youth often spark the most memories. In the later stages of Alzheimer’s disease, you may have to go back to songs learned in childhood. Encourage sing-a-longs.
- Toe-tapping beats stimulate activity. Up-tempo dance tunes can help stimulate both mental and physical activity in Alzheimer's patients. Encourage dancing, if possible.
- Easy listening can ease. Soothing music can help calm the anxiety and frustration felt by many people with Alzheimer’s disease. For example, lullabies at bedtime can help your loved one get into bed and fall asleep.
A person with Alzheimer’s disease may not be able to verbally communicate their likes and dislikes. Rely on other clues such as facial expressions to help you learn which songs are a hit and which aren’t. Ask friends or relatives for suggestions about the types of music or particular songs the person used to enjoy.
Art therapy. Painting, drawing, and other forms of art therapy can help people with Alzheimer’s disease express themselves. Expression through art can become especially important as a person’s ability to communicate through words deteriorates.
You can help. Here's how:
- Picture the past. Encourage a project that tells a story or evokes a memory. The project can be something that you talk about together, both while it’s in progress and after it’s finished.
- Be OK with free form. Keep instructions to a minimum to avoid confusion and frustration. Then, step out of the way as the work takes shape. If necessary, get things started by painting the first few brush strokes yourself to remind your loved one how it is done. Don’t forget that the picture is done when the person says it’s done, whether you think so or not.
- Don’t be a critic. If you don’t care for the colors chosen, keep it to yourself! Positive feedback and questions that encourage interaction are the best contributions you can make.
Pet therapy. People who used to enjoy being with pets may find contact with them enriching or soothing. Match the pet to the person’s needs. For example, a person who can walk may enjoy visiting with a dog. A person who is less mobile may enjoy petting a cat.
Previous hobbies. Pursuing interests that used to be familiar can help a person with Alzheimer’s feel more stable about their life. Consider gardening, cooking, or any other activity that the person used to enjoy. Try to work these activities into the person’s daily routines.
Supplements. Some people have tried alternative remedies, including coenzyme Q10, coral calcium, huperzine A, and omega-3 fatty acids to prevent or treat Alzheimer's disease. There’s not enough research to show whether or not they work.
The FDA doesn’t regulate supplements as it does medications, and the companies that make them don’t have to show if their products are safe or effective before they can sell them. Some supplements also can cause dangerous side effects or keep other medications you take from working. Always talk to your doctor before you start using a supplement.
Over-the-counter medications. For temporary pain relief, use acetaminophen or another pain medication that a doctor has approved. Follow the instructions on the label. If you use acetaminophen, don’t give them more than 3,000 milligrams per day. If they have liver disease, ask their doctor first. Tell them if the pain is severe or doesn’t go away.
Occupational therapy. This can evaluate your loved one’s strengths, weaknesses, and ability to understand where they most need help. With a therapist, they can work on improving some of their physical skills.
The therapist can also assist in making their home safer and better adapted to their needs. For example, an occupational therapist can:
- Organize their closet so only their clothes for the current season are available to them
- Make sure there’s a fence around their yard, so they won’t wander down the street
- Find easier versions of activities they used to enjoy, so they can continue doing them (such as puzzles)
Keep in mind that dementia might make it hard for them to tell you if they are in pain. The physical therapist can check on that and help treat any pain they are having.
Validation therapy. This is a type of counseling. The therapist will pay close attention to your loved one’s feelings. They might study their voice and body language, and put less importance on what they're actually saying. They can “validate” their feelings by saying things like, “I can see that you’re feeling angry.” Just knowing that someone understands can make them feel better.
Reality orientation. In these sessions, your loved one and their therapist will repeat information about the time, place, and other topics together on a regular basis. It can help them stay oriented to the present moment, and hopefully make them feel less confused. Also, putting things in their home like large clocks and calendars can make it easier.
Reality orientation is not for everyone. It may not be safe to practice with a person who believes they're in a different time or place. In that case, reality therapy could upset them.
Talk to your loved one’s doctor because some medications can cause symptoms similar to depression. They may want to prescribe antidepressant medications for your loved one, and might suggest counseling, as well. Other things that can help with depression include:
- Support groups
- Predictable daily routine
- Celebrations of small successes
- Being a part of family life
- Activities that they find inspiring
- Hearing repeatedly that they are loved and will get good care