Care and Treatment Options

There are a few specific Alzheimer’s disease medications that are currently FDA-approved. In June 2021, the FDA approved Aducanumab (Aduhelm™) under the accelerated approval pathway. This is the first drug that targets the underlying biology of Alzheimer’s disease. The most up to date information on aducanumab can be found on the FDA’s website. Other medications used to treat the behavioral and psychological symptoms of Alzheimer’s disease and related dementias fall into two classes of drugs: cholinesterase inhibitors and NMDA receptor antagonists. Always talk to your doctor about what treatments may be appropriate for you.

Cholinesterase Inhibitors

The brain uses a neurotransmitter, acetylcholine, to aid in function of learning, memory, and other important functions. Individuals with Alzheimer's disease have decreased levels of acetylcholine. Cholinesterase inhibitors prevent the normal break down of acetylcholine, thereby sustaining some level of learning, memory and other symptoms associated with decreased acetylcholine that are present in individuals with Alzheimer's disease. 

There are currently three drugs in the cholinesterase inhibitor drug class used to treat behavioral and psychological symptoms of Alzheimer's disease: 

• Donepezil
• Rivastigmine
• Galantamine 

NMDA Receptor Antagonists

There is one drug in the NMDA receptor antagonist drug class used to treat the behavioral and psychological symptoms of Alzheimer's Disease: 

• Memantine

Memantine is the most recent FDA approved drug to treat Alzheimer's disease symptoms, with approval date of 10/16/2003. In 2014 a new drug was released that does not include a new drug component but is a combination of the previously FDA approved drugs Donepezil and Memantine. 

Other Common Medications

Other common medications for individuals with dementia include:

• anti-depressants
• anti-psychotic drugs
• others

Always talk to your doctor about what medications you may benefit from and what treatments are appropriate. 

Other care options to maintain and improve quality of life can include therapies or interventions that are not pharmaceutical in nature.

Personalized Music

Individualized music has been shown to increase socialization and recall, as well as decrease behavioral and psychological symptoms associated with dementia including depression and agitation.2 Individualized music is effective because even as short-term memory and physical functions are affected, the parts of the brain associated with emotion and music are affected much later. Someone may still find joy in their wedding song or their favorite hymn long after they forget more recent information.

Currently in Tennessee there are two music programs for persons living with dementia.

The Tennessee Person-Centered Music Program is working with nursing homes across the state of Tennessee to create personalized playlists and provide music players and headphones for thousands of residents. For more information on the Tennessee Person-Centered Music Program, please contact Amanda.boulware@tn.gov.

A similar music program is being implemented for individuals with dementia who still live at home. TN M.I.N.D.S. (Music Intervention Navigating Dementia Symptoms) combines the evidence based Powerful Tools for Caregivers program with individualized music for persons living with dementia. Caregivers will participate in the Powerful Tools for Caregivers program, a 90-minute class once a week for 6 weeks where they learn about topics such as stress management and local resources. The care-receivers with dementia will receive a personalized playlist and music players and headphones. For more information on TN M.I.N.D.S., please contact emily.long.gateley@tn.gov.

Exercise

Physical activity has health benefits for individuals of any age. Exercise is especially beneficial to persons living with dementia by increasing blood flow to the brain, strengthening muscles to limit falls, and providing opportunities for socialization.3 Exercise also decreases depression which individuals with dementia are at increased risk of. Exercise for persons living with dementia can be anything from gardening to attending a local dance class. Other exercise ideas include swimming, walking, seated exercises. Seek out opportunities to engage in social physical activity and make it fun!

Other personal approaches to care may include physical therapy, occupational therapy, or even animal assisted treatment!