Treating People with Dementia

Initial stages

Alzheimer's disease patients with mild to moderate disease receive treatment based on medication from the acetylcholinesterase inhibitor family. Occasionally, these medications are administered to patients suffering from advanced-stage dementia.

These medications may help stabilize the patient’s cognitive, behavioural, and day-to-day functions and delay deterioration. Medication therapy may have a beneficial effect on the patient’s and caregiver’s quality of life and delay the need for nursing care hospitalization.

These medications are part of the health basket services, some are administered as a first-line treatment and some as an advanced treatment, according to the indications.

Common side effects: appetite suppression, weight loss, diarrhea, and sleep disorders.

Advanced stages

During the moderate to severe stages of dementia, medication therapy is given to regulate the glutamatergic system. This system plays a central role in learning and memory functions, and it is often impaired in dementia patients.
This medication therapy can help improve the patient’s cognitive and behavioral abilities.

These medications are part of the health basket services.

Common side-effects: stomach ache, diarrhea, and agitation.

Treatment duration

If side effects arise from taking the medication, or if there is a decline in the patient’s condition despite treatment, the medication may be adjusted or discontinued, in line with the family physician's recommendations. It is important to consult your physician before making any changes to your medication intake.

Many dementia patients may suffer from mental symptoms, including severe sleep disorders, depression, and anxiety. These symptoms may involve behavioral disorders such as false thoughts, hallucinations, aggression, etc.

These disorders cause considerable suffering to the patients, as well as their caregivers, and in many cases are the main cause of admission in a nursing care hospital.

Highlights for family members and caregivers

• Treating mental symptoms is done by a physician specializing in dementia and working in collaboration with the family physician. The treatment plan will take into account medical and environmental factors, as well as the quality of life of both the patient and their caregiver.
• It is important to rule out comorbidity (such as inflammation or medication side effects), that may cause confusion and behavioral disorders.

• Behavioural disorders do not always require medications.
• Medication therapy for behavioural disorders causes side effects for patients. Therefore, it is recommended to consider using such treatment if the behavioural disorders cause the patient significant suffering or pose a risk to themselves or others.
• Medication therapy will be given under medical supervision, and it will be modified or discontinued according to the family physician's assessment.

Severe disorders in the sleep-wake cycle are a well-known phenomenon among dementia patients.

A multidisciplinary approach is recommended for treating sleep disorders, which should include, initially, a non-pharmacological treatment, such as exposure to light, physical activity, and improving sleep hygiene. If no improvement is seen, medication therapy for sleep may be considered.