What is currently considered to be the best therapy for Alzheimers disease ?
I was also wondering what is the most promising therapy that has yet to reach people suffering from this disease ?
MAYO CLINIC (I think it is good information)
Drugs
Current Alzheimer's medications can help for a time with memory symptoms and other cognitive changes. Two types of drugs are currently used to treat cognitive symptoms:
Cholinesterase inhibitors. These drugs work by boosting levels of a cell-to-cell communication by providing a neurotransmitter (acetylcholine) that is depleted in the brain by Alzheimer's disease. The improvement is modest. Cholinesterase inhibitors can improve neuropsychiatric symptoms, such as agitation or depression, as well.
Commonly prescribed cholinesterase inhibitors include donepezil (Aricept), galantamine (Razadyne) and rivastigmine (Exelon). The main side effects of these drugs include diarrhea, nausea, loss of appetite and sleep disturbances. In people with cardiac conduction disorders, serious side effects may include a slow heart rate and heart block.
Memantine (Namenda). This drug works in another brain cell communication network and slows the progression of symptoms with moderate to severe Alzheimer's disease. It's sometimes used in combination with a cholinesterase inhibitor. Side effects may include constipation, dizziness and headache.
Sometimes other medications such as antidepressants are used to help control the behavioral symptoms associated with Alzheimer's disease. But some medications should only be used with great caution. For example, some common sleep medications — zolpidem (Ambien), eszopiclone (Lunesta) and others — may increase confusion and the risk of falls.
Anti-anxiety medications — clonazepam (Klonopin) and lorazepam (Ativan) — increase the risk of falls, confusion and dizziness. Always check with your doctor before taking any new medications.
Creating a safe and supportive environment
Adapting the living situation to the needs of a person with Alzheimer's is an important part of any treatment plan. For someone with Alzheimer's, establishing and strengthening routine habits and minimizing memory-demanding tasks can make life much easier.
You can take these steps to support a person's sense of well-being and continued ability to function:
Always keep keys, wallets, mobile phones and other valuables in the same place at home, so they don't become lost.
See if your doctor can simplify your medication regimen to once-daily dosing, and arrange for your finances to be on automatic payment and automatic deposit.
Develop the habit of carrying a mobile phone with location capability so that you can call in case you are lost or confused and people can track your location via the phone. Also, program important phone numbers into your phone, so you don't have to try to recall them.
Make sure regular appointments are on the same day at the same time as much as possible.
Use a calendar or whiteboard in the home to track daily schedules. Build the habit of checking off completed items so that you can be sure they were completed.
Remove excess furniture, clutter and throw rugs.
Install sturdy handrails on stairways and in bathrooms.
Ensure that shoes and slippers are comfortable and provide good traction.
Reduce the number of mirrors. People with Alzheimer's may find images in mirrors confusing or frightening.
Keep photographs and other meaningful objects around the house.
Exercise
Regular exercise is an important part of everybody's wellness plan — and those with Alzheimer's are no exception. Activities such as a daily walk can help improve mood and maintain the health of joints, muscles and the heart.
Exercise can also promote restful sleep and prevent constipation. Make sure that the person with Alzheimer's carries identification or wears a medical alert bracelet if she or he walks unaccompanied.
People with Alzheimer's who develop trouble walking may still be able to use a stationary bike or participate in chair exercises. You may be able to find exercise programs geared to older adults on TV or on DVDs.
Nutrition
People with Alzheimer's may forget to eat, lose interest in preparing meals or not eat a healthy combination of foods. They may also forget to drink enough, leading to dehydration and constipation.
Offer:
High-calorie, healthy shakes and smoothies. You can supplement milkshakes with protein powders (available at grocery stores, drugstores and discount retailers) or use your blender to make smoothies featuring your favorite ingredients.
Water, juice and other healthy beverages. Try to ensure that a person with Alzheimer's drinks at least several full glasses of liquids every day. Avoid beverages with caffeine, which can increase restlessness, interfere with sleep and trigger a frequent need to urinate.
Certain nutritional supplements are marketed as "medical foods" specifically to treat Alzheimer's disease. The Food and Drug Administration (FDA) does not approve products marketed as medical foods. Despite marketing claims, there's no definitive data showing that any of these supplements is beneficial or safe.
Alternative medicine
Various herbal mixtures, vitamins and other supplements are widely promoted as preparations that may support cognitive health or prevent or delay Alzheimer's. Currently, there's no strong evidence that any of these therapies slow the progression of cognitive decline.
Some of the treatments that have been studied recently include:
Omega-3 fatty acids. Omega-3 fatty acids in fish may help prevent cognitive decline. Studies done on fish oil supplements haven't shown any benefit, however.
Curcumin. This herb comes from turmeric and has anti-inflammatory and antioxidant properties that might affect chemical processes in the brain. So far, clinical trials have found no benefit for treating Alzheimer's disease.
Ginkgo. Ginkgo is a plant extract containing several substances. A large study funded by the NIH found no effect in preventing or delaying Alzheimer's disease.
Vitamin E. Although vitamin E isn't effective for preventing Alzheimer's, taking 2,000 international units daily may help delay the progression in people who already have the disease. However, study results have been mixed, with only some showing this benefit. Further research into the safety of 2,000 international units daily of Vitamin E in a dementia population will be needed before it can be routinely recommended.
Supplements promoted for cognitive health can interact with medications you're taking for Alzheimer's disease or other health conditions. Work closely with your health care team to create a treatment plan that's right for you. Make sure you understand the risks and benefits of everything it includes.
Dear Gerry,
Most literature talks about a combination of drug and non-drug treatments for Alzheimers disease. The following resources may interest you:
http://www.mayoclinic.org/diseases-conditions/alzheimers-disease/diagnosis-treatment/treatment/txc-20167132
http://www.alz.org/alzheimers_disease_treatments.asp
http://www.nhs.uk/Conditions/Alzheimers-disease/Pages/Treatment.aspx
There are no drug treatments that can cure Alzheimer's disease or any other common type of dementia. However, medicines have been developed for Alzheimer's disease that can temporarily alleviate symptoms, or slow down their progression, in some people. This factsheet explains how the main drug treatments for Alzheimer's disease work, how to access them, and when they can be prescribed and used effectively.
Please check out the following sites.
Regards
http://www.webmd.com/alzheimers/guide/treatment-overview
https://www.alzheimers.org.uk/treatments
https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=147
MAYO CLINIC (I think it is good information)
Drugs
Current Alzheimer's medications can help for a time with memory symptoms and other cognitive changes. Two types of drugs are currently used to treat cognitive symptoms:
Cholinesterase inhibitors. These drugs work by boosting levels of a cell-to-cell communication by providing a neurotransmitter (acetylcholine) that is depleted in the brain by Alzheimer's disease. The improvement is modest. Cholinesterase inhibitors can improve neuropsychiatric symptoms, such as agitation or depression, as well.
Commonly prescribed cholinesterase inhibitors include donepezil (Aricept), galantamine (Razadyne) and rivastigmine (Exelon). The main side effects of these drugs include diarrhea, nausea, loss of appetite and sleep disturbances. In people with cardiac conduction disorders, serious side effects may include a slow heart rate and heart block.
Memantine (Namenda). This drug works in another brain cell communication network and slows the progression of symptoms with moderate to severe Alzheimer's disease. It's sometimes used in combination with a cholinesterase inhibitor. Side effects may include constipation, dizziness and headache.
Sometimes other medications such as antidepressants are used to help control the behavioral symptoms associated with Alzheimer's disease. But some medications should only be used with great caution. For example, some common sleep medications — zolpidem (Ambien), eszopiclone (Lunesta) and others — may increase confusion and the risk of falls.
Anti-anxiety medications — clonazepam (Klonopin) and lorazepam (Ativan) — increase the risk of falls, confusion and dizziness. Always check with your doctor before taking any new medications.
Creating a safe and supportive environment
Adapting the living situation to the needs of a person with Alzheimer's is an important part of any treatment plan. For someone with Alzheimer's, establishing and strengthening routine habits and minimizing memory-demanding tasks can make life much easier.
You can take these steps to support a person's sense of well-being and continued ability to function:
Always keep keys, wallets, mobile phones and other valuables in the same place at home, so they don't become lost.
See if your doctor can simplify your medication regimen to once-daily dosing, and arrange for your finances to be on automatic payment and automatic deposit.
Develop the habit of carrying a mobile phone with location capability so that you can call in case you are lost or confused and people can track your location via the phone. Also, program important phone numbers into your phone, so you don't have to try to recall them.
Make sure regular appointments are on the same day at the same time as much as possible.
Use a calendar or whiteboard in the home to track daily schedules. Build the habit of checking off completed items so that you can be sure they were completed.
Remove excess furniture, clutter and throw rugs.
Install sturdy handrails on stairways and in bathrooms.
Ensure that shoes and slippers are comfortable and provide good traction.
Reduce the number of mirrors. People with Alzheimer's may find images in mirrors confusing or frightening.
Keep photographs and other meaningful objects around the house.
Exercise
Regular exercise is an important part of everybody's wellness plan — and those with Alzheimer's are no exception. Activities such as a daily walk can help improve mood and maintain the health of joints, muscles and the heart.
Exercise can also promote restful sleep and prevent constipation. Make sure that the person with Alzheimer's carries identification or wears a medical alert bracelet if she or he walks unaccompanied.
People with Alzheimer's who develop trouble walking may still be able to use a stationary bike or participate in chair exercises. You may be able to find exercise programs geared to older adults on TV or on DVDs.
Nutrition
People with Alzheimer's may forget to eat, lose interest in preparing meals or not eat a healthy combination of foods. They may also forget to drink enough, leading to dehydration and constipation.
Offer:
High-calorie, healthy shakes and smoothies. You can supplement milkshakes with protein powders (available at grocery stores, drugstores and discount retailers) or use your blender to make smoothies featuring your favorite ingredients.
Water, juice and other healthy beverages. Try to ensure that a person with Alzheimer's drinks at least several full glasses of liquids every day. Avoid beverages with caffeine, which can increase restlessness, interfere with sleep and trigger a frequent need to urinate.
Certain nutritional supplements are marketed as "medical foods" specifically to treat Alzheimer's disease. The Food and Drug Administration (FDA) does not approve products marketed as medical foods. Despite marketing claims, there's no definitive data showing that any of these supplements is beneficial or safe.
Alternative medicine
Various herbal mixtures, vitamins and other supplements are widely promoted as preparations that may support cognitive health or prevent or delay Alzheimer's. Currently, there's no strong evidence that any of these therapies slow the progression of cognitive decline.
Some of the treatments that have been studied recently include:
Omega-3 fatty acids. Omega-3 fatty acids in fish may help prevent cognitive decline. Studies done on fish oil supplements haven't shown any benefit, however.
Curcumin. This herb comes from turmeric and has anti-inflammatory and antioxidant properties that might affect chemical processes in the brain. So far, clinical trials have found no benefit for treating Alzheimer's disease.
Ginkgo. Ginkgo is a plant extract containing several substances. A large study funded by the NIH found no effect in preventing or delaying Alzheimer's disease.
Vitamin E. Although vitamin E isn't effective for preventing Alzheimer's, taking 2,000 international units daily may help delay the progression in people who already have the disease. However, study results have been mixed, with only some showing this benefit. Further research into the safety of 2,000 international units daily of Vitamin E in a dementia population will be needed before it can be routinely recommended.
Supplements promoted for cognitive health can interact with medications you're taking for Alzheimer's disease or other health conditions. Work closely with your health care team to create a treatment plan that's right for you. Make sure you understand the risks and benefits of everything it includes.
A multicenter phase 2 study showed that some patients with mild Alzheimer's disease (AD) who received deep brain stimulation of the fornix (DBS-f) experienced an increase in cerebral glucose metabolism, and some patients experienced a slowing of cognitive decline.
These positive effects were seen only in patients aged 65 years and older, not in younger patients.
Nevertheless, the findings are encouraging, said lead researcher Andres Lozano, MD, PhD, professor and chairman, Department of Neurosurgery, University of Toronto, Canada.
webmd.ads2.defineAd({id:'ads-pos-520',pos: 520}); "These findings indicate that we are headed in the right direction with our research on DBS as a treatment of Alzheimer's disease. In AD, certain areas of the brain shut down and no longer metabolize glucose to the normal level, and we hope that by stimulating the circuits in the brain that are involved, that we can restore function within the fornix and that that in turn will lead to improvement in the signs and symptoms of Alzheimer's," Dr Lozano told Medscape Medical News.
The study was published online July 18 in the Journal of Alzheimer's Disease.
TORONTO — Researchers have identified a genetic variant linked to reduced risk for Alzheimer's disease (AD), even in individuals with other elevated genetic risks for the disease. This discovery, they believe, could have important implications for a therapeutic intervention.
The research, presented here at the Alzheimer's Association International Conference (AAIC) 2016, suggests that a variant of the RAB10 gene protects against AD.
RAB10 is known to have higher expression in AD cases than in controls and has been previously linked to functional effects on amyloid secretion.
webmd.ads2.defineAd({id:'ads-pos-520',pos: 520}); This specific variant confers loss of function that improves resilience to AD and "provides us with a meaningful therapeutic target," study investigator Keoni Kauwe, PhD, associate professor, Department of Biology and Coordinator of the Bioinformatics Program, Brigham Young University, Utah, told a press briefing.
"This is not just another gene report," he said
TORONTO — A drug that inhibits tau aggregation significantly reduces disease progression in patients with mild to moderate Alzheimer's disease (AD), but only in those not already receiving standard therapy with AD medications, a new phase 3 study shows.
The study is viewed by some experts as disappointing because it failed to meet its primary endpoint of significantly reducing disease progression in all patients but as positive by others because it informs future directions for this drug.
webmd.ads2.defineAd({id:'ads-pos-520',pos: 520}); "What we have here is a potentially completely new approach to treatment that's based on the tau pathology, which is very closely linked to cognitive decline. What we have shown is that if you attack that pathway, you really do impact disease progression," said study investigator Claude M. Wischik, professor, psychiatric gerontology, University of Aberdeen, United Kingdom.
Dr Wischik is chairman of TauRX Pharmaceuticals, the company developing the new agent — leuco-methylthioninium-bis(hydromethanesulfonate) (LMTX) — a stabilized reduced form of methylthioninium.
An earlier form of the molecule was shown to be effective as monotherapy in a phase 2 trial, with the results presented in 2008 at the Alzheimer's Association International Conference and reported by Medscape Medical News at that time.
The latest findings from the phase 3 trial were presented here at the Alzheimer's Association International Conference (AAIC) 2016.
Primary Endpoint Not Met
The multicenter randomized, double-blind, placebo-controlled study included 891 patients (62% female) with probable AD who had a Mini-Mental State Examination (MMSE) score of 14 to 26, had a Clinical Dementia Rating of 1 to 2, and were younger than age 90 years.
webmd.ads2.defineAd({id:'ads-pos-420',pos: 420}); Participants were recruited at 115 sites across 16 countries in Europe, North America, Asia, and Russia and randomly assigned to one of three study groups: oral LMTX 150 mg/day, LMTX 250 mg/day, or control/placebo LMTX 8 mg/day.
Only 15% of study patients were not taking an AD medication, such as a cholinesterase inhibitor or memantine. The proportion of patients who completed the 15-month trial was 69%.
The trial's primary outcome measure was statistically significant change from baseline on standard measures of cognition and function: the Alzheimer's Disease Assessment Scale-Cognition (ADAS-Cog) and Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) scores.
Secondary outcomes included assessment every 3 months by MRI of the lateral ventricular volume (LVV) as a disease-modifying outcome, the ADCS-Clinical Global Impression of Change (ADCS-CGIC) and MMSE.
ADAS-Cog and ADCS-ADL assessments were performed at baseline every 13 weeks thereafter. Cranial and MRI scans were performed at baseline/screening and every 13 weeks.
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