The Latest on Drugs, Treatments, and Scientific Views of Dementia

While some families are eager to get their loved ones into drug trials, my family has avoided that path. We had some horrible experiences with current FDA approved treatments and don’t believe that the potential benefits of unproven drugs outweigh risks that are hard to predict. Nevertheless, we are optimistic that science will eventually reveal the mysteries of dementia and produce more reliable treatment options. In my interview with Dr. Roy Hamilton of Penn’s Memory Center, I asked him to comment on the range of approaches currently being explored.

Before we took my Mom to the Memory Center, our family pursued some alternative approaches to fighting her symptoms. These included chelations and nutritional supplements. I asked Dr. Hamilton to assess the value of these and other homeopathic regimens for fighting the disease. He said, “Allopathic doctors – those who are educated in the Western medical tradition — must remain a little skeptical about these approaches” mainly because there is insufficient data to show if they are truly effective. But he agrees that this lack of data also makes it hard to say that alternative treatments have no value. From his perspective, it’s important to remember that even if alternative regimens are helpful to a dementia patient, “You can still have side effects or interactions with other aspects of your treatment. You need to consider that when combining them with other items prescribed by your doctor.”

Among drugs on the market today, the most effective include two FDA approved medications which are acetylcholinesterase inhibitors. Drugs in this category include Aricept, Exelon, and Razadyne. Gastrointestinal problems are the most common side effect of these drugs. Another treatment uses an NMDA receptor antagonist. This drug affects the receptor in the brain that is associated with neuroplasticity. Mementine is one drug which has fewer side effects but may be less efficacious in combating symptoms. Dr. Hamilton says that the general outlook for medication development has not been encouraging. Scientists are now experimenting with monoclonal antibodies which attack the protein that causes Alzheimer’s disease. Although these drugs are now in the last phase of clinical trials, some serious clinical side effects have been observed. One new line of research focuses on using resveratrol, a polyphenyl antioxidant from red-wine. The research in this area is too new to assess its potential value and weary caregivers, please note: Red wine is not a medicine!

I asked Dr. Hamilton how caregivers should deal with their own health in light of the common fear that we may get the disease ourselves. His advice is, “Stay intellectually active, physically active, and socially active. Follow a healthy diet. This is a good prescription to help anyone maintain cognitive function.” He also suggests joining a support group. Being a caregiver can be a very isolating experience, which “can be borne more easily when shared.” He advises caregivers to take a structured break with time off from the family member. This practice is good for caregivers, but it also improves care when we returned to our loved one feeling refreshed. Respite care and adult daycare programs can help caregivers get needed breaks.

Dr. Hamilton doesn’t feel that it’s imperative for family members of dementia patients to get tested for genetic markers of the disease since most cases are “polygenetic” and you can’t predict your odds of getting the disease by determining that you have just one genetic marker. He also thinks that the cost of genetic testing would be unjustified since it’s not clear what you could do to modify your disease if you discovered that you were susceptible. Finally, Dr. Hamilton reminded me that since about 40% of all people over the age of 80 have the dementia profile – everybody should make a long-term care plan!

4 Responses to The Latest on Drugs, Treatments, and Scientific Views of Dementia

    • I am a nurse & care for the elderly in a Nursing Home caleld Harmonee House. There is a very unique reason for the name but, I won’t go into detail as it is very lengthy. My husband was a victim of the dreaded Alzheimer’s Disease along with vascular dementia. He was a very strong, determined man, very set in his ways. He was just a little this side of brilliant as a building contractor in the construction of any kind of medical facilities IE; Hospitals, clinics, etc. Also built chemical laboratories. He loved traveling in RV’s after retiring. He was diagnosed with this disease quite awhile after I had suspected his problem because I could not get him to see his Doctor even though he had always been one for regular check ups, he was always told he was as healthy as anyone could be at his age. This was stamped in his mind & one thing he never forgot as long as he any bit of memory left . Over two years his doctor & I came up with every reason we could think of to get him into the clinic for tests. He had a traffic accident which warranted the need to be hospitalized (after walking away from many other traffic mishaps, driving without a DL, since it had been taken away from him, another huge fine, but fortunately, out of all the accidents (apprx. 20) no one else was hurt or, more importantly, killed) he was diagnosed & put on medication. He was so far advanced in the disease, the medication used for onset of the disease, did not help him. He had no hospital insurance, only medicare. At that time alot of procedures that were required, were not covered my medicare & our savings were depleted very rapidly. This is not the end of a very tragic story but, I will stop here. I have written this so people will be aware of the costs, mentally & financially, associated with this disease, that they maybe prepared should it ever, suddenly, pop up in their family. Make yourself aware of the signs & symptoms & get checked as quickly as possible if & when a sign is suspected. The medication for Alzheimer will help if it is started in early stages. It will make life so much easier for the unfortunate one & the care giver. Believe me, you will need all the help you can receive. I am a nurse & have taken care of patients with dementia & it is heartbreaking but, when it becomes a family member & you have to watch a mind deteriorate of a loved one, I can’t express enough how terrible this can be. Alzheimer’s Associations need all the help they can get, especially,financial.

      • I appreciate your input on this quiet giant of loss to meantl health. I do not suffer from this but I have known some who did and a few who presently deal with this silent killer. For me, the statement of conditions of Alzheimer’s has limited direct family impact for me but this disease floats like a haze that can settle on anyone. I quietly consider this for me, if for any other reason, the direct and indirect impact of this disease would have on me and those I care for. Thanks for your effort, Tom Harrison

        • The Dementia Plan holds great promise. Glad to see emsaphis on increasing community/home based resources. If we are not proactive in the Commonwealth, we stand to be devastated by the cost of dementia care cost in dollars and resources but especially cost in quality of life for our vulnerable adults and our communities, as well as the cost of compromise to the integrity of our families.

Leave a Reply