Beyond Physical Fitness: How Exercise Can Safeguard Against Dementia
Exercise is a powerful tool against dementia prevention.
Living with dementia can be a challenging experience, not only for the affected individuals but also for their loved ones. As the number of people diagnosed with dementia continues to rise, finding effective treatments becomes increasingly vital. In this comprehensive guide, we delve into the world of dementia treatments, providing you with valuable insights and resources.
We have researched and compiled information on evidence-based dementia treatments, delving into their effectiveness, potential side effects, and impact on quality of life. We also shed light on promising new research and emerging therapies that might unlock new avenues of hope for those living with dementia.
Dementia can manifest in various ways, with different types of dementia exhibiting distinct symptoms and progression patterns. Understanding the different types of dementia and their associated symptoms is crucial in tailoring appropriate treatment plans.
Alzheimer’s disease is the most prevalent form of dementia, accounting for approximately 60-80% of cases. It is characterized by progressive memory loss, confusion, and difficulties with language and problem-solving. As the disease advances, individuals may also experience changes in behavior and personality.
Vascular dementia, on the other hand, is caused by reduced blood flow to the brain, leading to cognitive decline. Symptoms may include difficulties with planning, organizing, and focusing, as well as problems with balance and walking.
Lewy body dementia is characterized by the presence of abnormal protein deposits, known as Lewy bodies, in the brain. Individuals with this form of dementia often experience visual hallucinations, fluctuations in alertness, and motor symptoms similar to Parkinson’s disease.
Frontotemporal dementia primarily affects the frontal and temporal lobes of the brain, leading to changes in behavior, personality, and language abilities. It often manifests in younger individuals, typically between the ages of 40 and 65.
These are just a few examples of the different types of dementia, each with its own unique set of symptoms and challenges.
There are fewer than 10 commonly used medications for cognitive impairment. Most FDA-approved drugs work best for people in the early or middle stages of dementia. There are currently no known interventions that will cure dementia. Some medications are not recommended for use in frontotemporal dementia (FTD).
| Drug Name (Brand Name) | Action | Uses |
| Donepezil (Aricept®) | Cholinesterase inhibitor | Treats symptoms of mild, moderate, and severe Alzheimer’s by preventing the breakdown of acetylcholine in the brain. Not recommended in FTD. Possible side effects include nausea, vomiting, diarrhea, loss of appetite/weight loss, dizziness, drowsiness, weakness, trouble sleeping, shakiness (tremor), or muscle cramps may occur as your body adjusts to the drug. |
| Rivastigmine (Exelon®) | Cholinesterase inhibitor | All stages of dementia (not recommended in FTD). Treats symptoms of mild, moderate, and severe Alzheimer’s by preventing the breakdown of acetylcholine and butyrylcholine (a chemical similar to acetylcholine) in the brain. Possible side effects include nausea, vomiting, diarrhea, weight loss, indigestion, decreased appetite, anorexia, and muscle weakness. Delivered through a capsule twice a day or through a skin patch that is replaced once a day. |
| Galantamine (Razadyne®) | Cholinesterase inhibitor | All stages of dementia (not recommended in FTD). Treats symptoms of mild to moderate Alzheimer’s. Possible side effects include nausea, vomiting, diarrhea, decreased appetite, weight loss, dizziness, and headache. Delivered through an extended-release capsule taken once a day or through a tablet or liquid taken twice a day. |
Memantine (Namenda®) (also known as Ebixa, Marixino or Valios) | NMDA antagonist | Moderate to severe stages of dementia; often used in combination with one of the drugs above (not recommended in FTD). Treats symptoms of moderate to severe Alzheimer’s by blocking the toxic effects associated with excess glutamate and regulates glutamate activation. Possible side effects include dizziness, headache, diarrhea, constipation, and confusion. Delivered once or twice a day through a tablet, liquid, or an extended-release capsule. |
| Lecanemab (also known as Leqembi) | Disease-modifying immunotherapy | Treats mild cognitive impairment or mild Alzheimer’s by removing abnormal beta-amyloid to help reduce the number of plaques in the brain. Possible side effects include brain swelling and bleeding, headache, cough, diarrhea, nausea, vomiting, fever, chills, body aches, fatigue, high blood pressure, low blood pressure, and low oxygen. Delivered through IV over one hour every two weeks. |
| Aducanumab (also known as Aduhelm) | Disease-modifying immunotherapy | Treats mild cognitive impairment or mild Alzheimer’s by removing abnormal beta-amyloid to help reduce the number of plaques in the brain. Possible side effects include brain swelling and bleeding, headache, dizziness, falls, diarrhea, and confusion. Delivered through IV over one hour every four weeks. |
| Donanemab | Disease-modifying immunotherapy | Treats mild cognitive impairment or mild Alzheimer’s by removing abnormal beta-amyloid to help reduce the number of plaques in the brain. Possible side effects include brain swelling and bleeding. Delivered through IV. |
While none of these dementia treatments are approved for use in mild cognitive impairment (MCI), some clinicians may prescribe them. Donepezil, galantamine, and rivastigmine are cholinesterase inhibitors that are prescribed for mild to moderate Alzheimer’s symptoms. These drugs may help reduce or control some cognitive and behavioral symptoms. Cholinesterase inhibitors prevent the breakdown of acetylcholine, a brain chemical believed to be important for memory and thinking. As Alzheimer’s progresses, the brain produces less acetylcholine and, over time, these medicines lose their effectiveness. Because cholinesterase inhibitors work in a similar way, switching from one to another may not produce significantly different results, but a person living with Alzheimer’s may respond better to one drug versus another. There is evidence that these medications can also help treat dementia with lewy bodies and Parkinson’s disease dementia, as well as people who have a mixed dementia diagnosis of Alzheimer’s disease with vascular dementia.
Lecanemab, aducanumab, and donanemab are immunotherapy dementia treatments to treat early Alzheimer’s. They target the protein beta-amyloid to help reduce amyloid plaques, one of the hallmark brain changes in Alzheimer’s. Clinical studies to determine the effectiveness of lecanemab were conducted only in people with early-stage Alzheimer’s, or mild cognitive impairment. Study results showed lecanemab slowed the rate of cognitive decline among study participants by 27% compared to the control group over the course of 18 months and reduced the levels of amyloid in the brain.
Studies with donanemab showed slowed cognitive decline by 35% compared with placebo. However, the effects were seen only in people with mild cognitive impairment or who were in the early stages of Alzheimer’s. Those with more advanced Alzheimer’s did not benefit from the medication.
Memantine, an N-methyl-D-aspartate (NMDA) antagonist, can be prescribed for moderate to severe Alzheimer’s. This drug is prescribed to decrease symptoms, which could enable some people to maintain certain daily functions a little longer than they would without the medication. For example, memantine may help a person in the later stages of the disease maintain their ability to use the bathroom independently for several more months, a benefit for both people with Alzheimer’s and their caregivers.
Memantine is believed to work by regulating glutamate, an important brain chemical. When produced in excessive amounts, glutamate may lead to brain cell death. Because NMDA antagonists work differently from cholinesterase inhibitors, the two types of drugs can be prescribed in combination.
A combination medication of memantine and donepezil can be prescribed for moderate to severe Alzheimer’s.
Dr. Dale Bredeson’s ReCode program offers a groundbreaking approach to dementia treatment after an initial diagnosis. This program focuses on identifying and addressing the root causes of cognitive decline, paving the way for potential reversal or stabilization of the condition. After discovering what is causing neuronal death (inflammation, heavy metals, mold exposure, pesticide exposure, etc.) damage to the brain can be stopped or slowed down, and rebuilding can begin.
The ReCode program utilizes a personalized approach that combines lifestyle modifications, nutritional interventions, and targeted therapies. By addressing factors such as inflammation, insulin resistance, and hormonal imbalances, the program aims to optimize brain health and function.
The ReCode program emphasizes the importance of comprehensive testing to uncover underlying contributors to cognitive decline. Through a thorough evaluation of genetics, blood markers, and cognitive assessments, a treatment plan is created to each individual’s unique needs.
While the ReCode program is still considered a newer approach to dementia treatment, it holds promise as a potential game-changer in the field. Ongoing research and advancements in personalized medicine continue to refine and expand the effectiveness of this program.
In addition to medications, lifestyle changes can play a significant role in managing and slowing down the progression of dementia. Adopting a healthy lifestyle can improve overall well-being and enhance cognitive function.
Regular physical exercise has been shown to be one of the most powerful dementia treatments and a dementia-preventative activity. Exercise increases blood flow to the brain, promotes the growth of new neurons, and enhances cognitive function. Engaging in activities such as walking, swimming, or yoga can have a positive impact on memory, mood, and overall quality of life.
Maintaining a nutritious diet is also essential in supporting brain health. Reducing inflammatory foods such as grain and sugar is key. A diet rich in fruits, vegetables, lean proteins, and healthy fats provides essential nutrients that support cognitive function. Omega-3 fatty acids, found in fish, walnuts, and flaxseeds, have been particularly associated with brain health.
Stimulating the brain through cognitive activities is another important aspect of dementia management. Engaging in puzzles, reading, learning new skills, and participating in social activities can help maintain cognitive function and prevent cognitive decline.
Lastly, ensuring a supportive and stimulating environment is crucial for individuals with dementia. Creating a safe and familiar space, minimizing distractions, and providing opportunities for engagement and socialization can enhance overall well-being and quality of life.
Cognitive stimulation and brain training exercises can be valuable tools in managing dementia symptoms and improving cognitive function. These activities aim to keep the brain active, stimulate neural connections, and slow down cognitive decline.
There are various types of cognitive stimulation techniques that individuals with dementia can engage in. Memory games, puzzles, and word exercises can help improve memory and concentration. Art therapy, such as painting or drawing, can provide a creative outlet and promote self-expression.
While cognitive stimulation and brain training exercises cannot reverse dementia, they can help individuals maintain cognitive abilities and improve overall well-being. These activities also provide opportunities for social interaction and engagement, reducing feelings of isolation and depression. Cognitive stimulation therapy is offered by forBetterMinds online, in individual or group format.
Supportive therapies are essential for both individuals with dementia and their caregivers. These therapies aim to address the emotional, psychological, and practical challenges that arise throughout the dementia journey.
Counseling and psychotherapy can provide individuals with dementia and their caregivers with a supportive space to express their feelings, discuss concerns, and learn coping strategies. Therapists can help individuals navigate the emotional impact of dementia, manage stress, and develop effective communication skills.
Support groups are another valuable resource for individuals with dementia and their caregivers. These groups provide a platform for sharing experiences, exchanging advice, and finding emotional support from others who understand the challenges of living with dementia. Support groups can be in-person or online, allowing for flexibility and accessibility. Online and in-person support groups can be found through the Alzheimer’s Association here.
Respite care and day programs offer caregivers a much-needed break while ensuring the individual with dementia receives appropriate care and engagement. These programs provide a safe and stimulating environment for individuals with dementia, allowing caregivers to recharge and attend to their own self-care.
Lastly, assistive technologies, such as reminders and monitoring devices, can help individuals with dementia maintain independence and safety. These devices can assist with medication management, fall detection, and emergency response, providing peace of mind for caregivers.
Dementia is a challenging condition that affects millions of individuals worldwide. However, through early diagnosis, personalized treatment approaches, and a comprehensive support system, there is hope for individuals living with dementia and their loved ones.
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