Alzheimer’s Disease: Treatments and Behavioral Triggers

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While there is currently no cure for Alzheimer's disease, drug and non-drug treatments have been developed to help with both cognitive and behavioral symptoms and improve the quality of life for people with this type of dementia.

The Food and Drug Administration has approved two categories of drugs to treat the cognitive symptoms (memory loss, confusion, and problems with thinking and reasoning) of Alzheimer's disease. These categories are cholinesterase inhibitors (which include drugs such as Aricept and Exelon), as well as memantine drugs, such as Namenda.

As Alzheimer’s progresses, brain cells die and connections among cells are lost, cognitive symptoms worsen. Current medications cannot stop the damage that Alzheimer’s causes to brain cells, but they can help lessen or stabilize symptoms for a period of time by affecting certain chemicals that carry messages between the brain's nerve cells.

Sometimes, doctors prescribe both types of medications together. Some doctors also prescribe high doses of vitamin E to help manage the cognitive changes of Alzheimer's disease. In addition, antidepressants are often prescribed for mood, anxiolytics for anxiety and/or restlessness, and antipsychotic medications for hallucinations.

Aside from the frustration caused by memory loss associated with Alzheimer’s disease, friends, family and health care providers often find the behavioral changes caused by Alzheimer's disease to be incredibly challenging and distressing.

The primary cause of behavioral symptoms is related to the deterioration of brain cells. Some medications, along with certain environmental influences and/or medical conditions can cause the behavioral symptoms of Alzheimer’s disease to worsen.

In the early stages of the disease, people may experience behavioral and personality changes, including, but not limited to, irritability, anxiety, depression, anger, aggression, general emotional distress, physical or verbal outbursts, restlessness, pacing, delusions and/or sleep disturbances.

Change can be very stressful, particularly for people with Alzheimer’s disease, as it becomes tiring and terrifying when trying to make sense out of what seems like an increasingly confusing world. Accordingly, parents and caregivers should keep in mind that certain events often trigger the aforementioned behavioral symptoms.

Some of the post common and profound situational triggers may include adjusting to a new environment (e.g., moving to a new home or nursing home, admission to a hospital), as well as changes in caregiver arrangements.

Be sure to contact a health professional if your loved one with Alzheimer’s disease demonstrates sudden behavior changes. While these behavioral symptoms may result from the disease’s affect on the brain, there are other treatable conditions that can contribute to behavioral changes.

For example, since many people with Alzheimer's take prescription medication for other health issues, it’s possible that interactions among drugs and/or drug side effects can affect behavior. In addition, as the disease progresses and symptoms worsen, people with Alzheimer's have increasing difficulty communicating their needs and/or what they’re experiencing.

Therefore, patients may be unable to communicate about pain or symptoms of common illnesses. As you can imagine, pain often leads to restlessness or agitation. In addition, problems with hearing or vision can exacerbate confusion and frustration for Alzheimer’s patients, furthering a sense of isolation.

Sources:

For Edge on Alzheimer’s, Testing Early Treatments. Web. www.nytimes.com. Accessed 3 Jan. 2012. http://www.nytimes.com/ref/health/healthguide/alzheimers_ess.html

Treatments for Alzheimer’s Disease. Web. www.alz.org. Accessed 3 Jan. 2012. http://www.alz.org/alzheimers_disease_treatments.asp

Alzheimer’s Disease: Treatments & Care. Web. www.alzinfo.org. Accessed 3 Jan. 2012.
http://www.alzinfo.org/treatment-care

Reviewed January 4, 2012
by Michele Blacksberg RN
Edited by Jody Smith

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