Treatment of Alzheimer’s disease

Alzheimer’s disease is a common health problem among elderly population. It is estimated that more than 5% of individuals above 70 years of age have Alzheimer’s disease and equal number of individuals have significant memory loss to create problem in day to day activities. The cost of caring a patient with advanced Alzheimer’s disease is estimated to be much more than $50,000 per year, which poses a serious economic hardship to the family members of the patient, not to mention the emotional toll it has on the family members.

At present there is no specific treatment for Alzheimer’s disease (AD) and for this reason the treatment of Alzheimer’s disease is challenging task. There are also no specific pharmacological agents (medications) available for treatment of the disease. Despite problem of not having any specific pharmacological agent for treatment, the aim or focus of the treatment is reduce/prevent behavioral and neurological problems associated with Alzheimer’s disease.

The successful management of Alzheimer’s disease requires building rapport with the patient, family members, and other caregivers by the treating physician. In the initial stages of the disease (AD) when memory loss is not significant use of notebooks and daily reminders can be of great help. The AD patients should not be allowed to drive and independence restricted, which may create agitation, and anger, but essential. The day care centers for adults and help from local and national support groups can be of great value.

Depression raging from mild to moderate severity is common among patients of Alzheimer’s disease and need appropriate management with antidepressants or cholinesterase inhibitors.

The USFDA (United States Food and Drug Administration) has approved (current status) donepezil, rivastigmine, galantamine, memantine, and tacrine (no more used due to high hepatotoxicity of the drug) for treatment of Alzheimer’s disease. There are also many other drugs and herbal preparations which are used in treatment of Alzheimer’s disease, most of which are not approved by FDA, but are used with variable success. Ginkgo biloba is one such drug which has gained most attention, as in one study it was found to improve cognitive function, although only modestly. At present a large study is underway to find the effects of Ginkgo biloba in treatment of Alzheimer’s disease.

There are also many other drugs which shows beneficial effects on Alzheimer,s disease, such as antioxidants (vitamin E, selegiline etc.), NSAIDs (nonsteroidal anti-inflammatory drugs), hypolipidemic (lipid lowering) drugs statins, estrogen replacement therapy in women etc.

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