Alzheimer's disease damages the brain. It causes a steady loss of memory and of how well you can speak, think, and carry on daily activities.
Alzheimer's disease always gets worse over time, but how quickly this happens varies. Some people lose the ability to do daily activities early on. Others may still do fairly well until much later in the disease.
Mild memory loss is common in people older than 60. It may not mean that you have Alzheimer’s disease. But if your memory is getting worse, see your doctor. If it is Alzheimer’s, treatment may help.
Alzheimer’s disease happens because of changes in the brain. These include lower levels of chemical messengers (neurotransmitters) that help brain cells work properly. What causes these changes is not clear.
The risk of getting Alzheimer’s disease increases as you get older. But this does not mean that everyone will get it. By age 85, about 35 out of 100 people have some form of dementia.1 That means that 65 out of 100 don't have it. Dementia is rare before age 60.
Having a relative with Alzheimer’s raises your risk of getting it, but most people with Alzheimer's disease do not have a family history of it.
For most people, the first symptom of Alzheimer's disease is memory loss. Often the person who has a memory problem does not notice it, but family and friends do. But the person with the disease may also know that something is wrong.
As the disease gets worse, the person may:
The symptoms of Alzheimer’s get worse slowly over time. A person who gets these symptoms over a few hours or days or whose symptoms suddenly get worse needs to see a doctor right away, because there may be another problem.
As people with Alzheimer’s get worse, they may get restless and wander, especially in late afternoon and at night. This is called sundowning. Over time, they may also start to act very different. They may withdraw from family and friends. They may see or hear things that are not really there. They may falsely believe that others are lying, cheating, using them, or trying to harm them. They may strike out at others.
Later, they may not be able to take care of themselves. They may not know their loved ones when they see them. They may forget how to eat, dress, bathe, use the toilet, or get up from a bed or a chair and walk.
To check for the disease, your doctor will ask about your past health and do a physical examination. He or she may ask you to do some simple things that test your memory and other mental skills. Your doctor may also check how well you can do daily tasks.
The examination usually includes blood tests to look for another cause of your problems. You may have tests such as CT and MRI scans, which look at your brain. By themselves, these tests can't show for sure whether you have Alzheimer's.
There is no cure for Alzheimer's disease, but there are medicines that may slow symptoms down for a while and make the disease easier to live with. Drugs that may be prescribed include donepezil (Aricept) and memantine (Ebixa). These medicines may not work for everyone or have a big effect. But most experts think they are worth a try.
As the disease gets worse, the person may get depressed or angry and upset. The doctor may also prescribe medicines to help with these problems.
If you are or will be taking care of a loved one with Alzheimer’s, start learning what you can expect. This can help you make the most of the person's abilities as they change. And it can help you deal with new problems as they arise.
Work with your loved one to make decisions about the future before the disease gets worse. It is important that your loved one has an advance care plan. An advance care plan states the types of medical care the person wants. It is also important to have a representation agreement. In this legal document your loved one gives a substitute decision-maker the authority to make medical decisions if he or she cannot.
Your loved one will need more and more care as the disease gets worse. In time, he or she may need help to eat, get dressed, or use the bathroom. You may be able to give this care at home, or you may want to think about using a nursing home. A nursing home can give this kind of care 24 hours a day. The time may come when a nursing home is the best choice.
Because people are living longer than they used to, Alzheimer's disease is becoming a more common problem. Ask your doctor about local resources such as support groups or other groups that can help as you care for your loved one. You can also search the Internet for online support groups. Help is available.
Learning about Alzheimer's disease:
Living with Alzheimer's disease:
Health Tools help you make wise health decisions or take action to improve your health.
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The cause of Alzheimer's disease is not clear, and it is likely there are several causes of this condition. Alzheimer's disease causes changes or deterioration in certain areas of the brain that control thinking, communication, and behaviour. Some of the deterioration may be related to a loss of chemical messengers in the brain (neurotransmitters)—acetylcholine, in particular—that allow nerve cells in the brain to communicate properly.
It is not clear why these changes in the brain occur, but they are a major focus of Alzheimer's research. Although most people who have Alzheimer's disease do not have a family history of the condition, you are at increased risk for the condition if a member of your family has it.
Some theories have suggested that metals, such as zinc or aluminum, play a role in Alzheimer's disease. But research has not found much evidence to support these theories. Experts agree that there is no reason to leave zinc out of your diet or to avoid items that contain aluminum, such as cooking utensils or soda pop cans.
Memory loss is usually the first sign of Alzheimer's disease. Many older people may worry about Alzheimer's disease if they start to have memory problems. Having some short-term memory loss in your 60s and 70s is common, and some people with mild memory problems will go on to develop Alzheimer's disease. If you start having memory problems, share your concerns with your family and your doctor.
Examples of normal forgetfulness include forgetting:
Examples of memory loss caused by Alzheimer's disease include forgetting:
Alzheimer's disease also causes changes in thinking, behaviour, and personality. Early in the disease, the person may still behave appropriately in social situations, leading others to believe that the person is not ill. Close family members and friends may first notice the symptoms of Alzheimer's disease, although the person may also realize that something is wrong. Learn the warning signs of dementia—such as having difficulty thinking or remembering, or having trouble balancing a checkbook—and talk to a doctor if a friend or family member has any of the signs. Symptoms vary as the disease progresses.
Experts have identified 10 warning signs for Alzheimer's disease. These signs are:2
Symptoms that may be but are not always present include:
Early in the disease, Alzheimer's usually does not affect a person's fine motor skills (such as the ability to button or unbutton clothes or use utensils) or sense of touch. A person who develops motor symptoms (such as weakness or shaking hands) or sensory symptoms (such as numbness) probably has a condition other than Alzheimer's disease. Conditions such as Parkinson's disease, for instance, may cause motor symptoms along with dementia.
Other conditions with symptoms similar to those of Alzheimer's disease may include:
Researchers have discovered changes that take place in the brains of people who have Alzheimer's disease. These brain changes may cause the memory loss and decline in other mental abilities that occur with Alzheimer's disease. It is not fully understood why these brain changes occur in some people but not in others.
Alzheimer's disease always gets worse over time, but the course of the disease varies from person to person. Some people may still be able to function relatively well until late in the course of the disease. Others may lose the ability to do everyday activities very early on.
Usually, a person with mild dementia:
These symptoms often are more obvious when the person is in a new and unfamiliar place or situation.
Some people have memory loss called mild cognitive impairment. People with this condition are at risk for developing dementia. But not all people with mild cognitive impairment progress to dementia.
With moderate dementia, a person typically:
With severe dementia, a person usually:
A person with severe dementia becomes more vulnerable to other illnesses. Death often results from complications of being confined to bed, such as pneumonia.
The main factor that raises your risk for Alzheimer's disease is getting older. About 6 out of 100 people over 65 years and 35 out of 100 people over 85 years have some form of dementia.1 People rarely have dementia before age 60. Other factors that increase your risk of developing Alzheimer's disease include:
Alzheimer's disease tends to develop slowly over time. If confusion and other changes in mental abilities come on suddenly, within hours or days, the problem may be delirium, a condition that needs immediate treatment.
Seek care immediately if:
Call your doctor to schedule an appointment if:
If memory loss is not rapidly becoming worse or interfering with your work, social life, or ability to function, it may be normal age-related memory loss. Talk to your doctor if you are concerned about new memory loss or memory loss that is getting worse or other signs of dementia, such as having trouble finding your way around familiar places.
A family member or friend will need to go with the person who needs to be evaluated.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Alzheimer's disease is diagnosed after other conditions are ruled out. If you are suffering from a decline in mental abilities (dementia), your doctor will try to find out if another treatable condition may be causing those symptoms.
Alzheimer's disease is diagnosed with a medical history and a physical examination. A physical examination is used to help find out if a physical problem may be causing a person's dementia symptoms. It may be possible to correct some of these problems. For example, sometimes a simple hearing or vision problem can cause confusion, social withdrawal, or a change in behaviour, such as hostility or unresponsiveness. The person may have an undiagnosed illness or infection that is causing the symptoms.
Also, the doctor will do a functional status examination and a mental health assessment. During these examinations, the person will be asked to perform simple tasks that check orientation. It usually is helpful to have a family member or someone in close contact with the person present at the appointment. A family member may be able to provide the best information about how a person's day-to-day functioning, memory, and personality have changed.
Brain imaging tests such as CT scans and magnetic resonance imaging (MRI) may also be done to make sure another problem is not causing the symptoms. Your doctor may also test for certain proteins in your spinal fluid to rule out other causes. Positron emission tomography (PET) or single photon emission tomography (SPECT), two other imaging tests, are not routinely done but may be useful in some cases.
A small number of people with dementia have a condition that proper treatment can reverse (unlike Alzheimer's disease). Lab tests may be done to rule out other possible causes of a person's symptoms, such as levels of certain minerals or chemicals in the blood that are too high or too low, liver disease, abnormal thyroid levels, or nutritional problems, such as folate or vitamin B12 deficiencies. Treatment for these conditions may slow or reverse mental decline.
Blood tests often done to check for these conditions include:
In some cases, examining the brain after death (autopsy) is done to look for changes in the brain that may show Alzheimer's disease. An autopsy is the only definite way to diagnose Alzheimer's disease, but the illness may not be clearly identified if the autopsy is performed when someone dies during the early stages of the illness. An autopsy is rarely needed, but one may be done if the family wants to confirm that the person had Alzheimer's disease.
At this time, there is no routine screening for Alzheimer's disease. It is difficult to diagnose Alzheimer's disease in its early stages. This does not mean that you should ignore symptoms of mental decline (dementia) or assume that they are a normal part of aging. Talk to your doctor if you are concerned about memory loss or other symptoms of dementia, such as having difficulty finding your way around familiar places.
While there is not yet a cure for Alzheimer's disease, there is much that can be done to maintain quality of life and help the person stay active.
Medicines called cholinesterase inhibitors may be started as soon as Alzheimer's disease is diagnosed. These medicines—which include donepezil hydrochloride (Aricept), galantamine (Reminyl), and rivastigmine (Exelon)—may temporarily help with memory and thinking problems caused by the disease. The effect of these medicines usually is not dramatic, and they may not work for everyone who has the disease. Even though cholinesterase inhibitors may slow the progression of symptoms, they do not prevent the disease from getting worse. But most experts agree that cholinesterase inhibitors are worth trying for most people who have Alzheimer's disease.
Another medicine, called memantine (Ebixa), may be used alone or with cholinesterase inhibitors to treat moderate to severe symptoms of confusion and memory loss caused by Alzheimer's disease.
For more information on when or whether to take medicines, see:
Another important aspect of initial treatment is detecting and treating any other medical problems the person may have. For instance, depression occurs in nearly half of people with Alzheimer's disease, especially those in the early stage of the disease who are aware of what the future holds for them. Detecting and treating problems such as depression can minimize disability and maximize the person's remaining abilities.
Newly diagnosed individuals and their families face important questions during initial treatment:
Education of the family and other caregivers is critical to successful care for a person with Alzheimer's. If you are or will be the caregiver, start learning what you can expect and what you can do to manage problems as they arise.
If treatment with a cholinesterase inhibitor medicine seems to be helping the person with Alzheimer's disease, it can be continued until it is no longer helpful. The medicine may remain effective longer in some people than in others. Treatment may be stopped at any time if the person is not able to tolerate side effects from the medicine.
Regular assessment by a doctor helps evaluate the person's response to medicine, detect new problems, monitor changing symptoms, and provide continuing education to the family. Decisions about treatment for behaviour problems or other issues often need to be revisited as the disease progresses. A general guideline is that a person with Alzheimer's should see the doctor every 6 months, or sooner if a problem arises.
It is important to continue watching for and treating other conditions. Hearing and vision loss, arthritis, thyroid problems, kidney problems, and other conditions are common in older adults and may aggravate symptoms of Alzheimer's. Arthritis may make it harder to move around without help. A hearing or vision problem may make the person more agitated, anxious, or unresponsive. Treating these problems can improve quality of life and ease the burden on the caregiver.
Most people with Alzheimer's disease can be cared for at home by family or friends, at least until the disease becomes severe. Ongoing treatment focuses on making the most of the person's abilities as they change and dealing with new problems as they arise. Caregiving tasks range from keeping the environment safe and helping the person get dressed every day to finding ways to manage or minimize disruptive behaviours such as wandering and sleep problems. No single strategy works for everyone. Successful care also depends on making sure the caregiver is involved in making decisions about treatment. These decisions will affect both the person with the disease and the caregivers.
If you are a caregiver for someone with Alzheimer's, finding help and support is crucial to the person with Alzheimer's and your own well-being. Take advantage of respite services, home care nurses or aides, or adult day care. Seek help from family and friends. And take care of yourself. All of this is key to providing ongoing care. Seek support as soon as you need it. Contact the Alzheimer Society at 1-800-616-8816 or visit its website (www.alzheimer.ca) for help and advice on being a caregiver for someone with Alzheimer's disease.
As Alzheimer's disease progresses, providing care at home usually becomes more and more challenging. Being a caregiver for someone with Alzheimer's is not easy, no matter how much you know about the disease and how committed you are to taking care of the person. The decision to place a family member in a nursing home or other facility can be a very difficult one, but sometimes nursing home placement is the best choice. For more information, see:
Hospice palliative care
As Alzheimer's disease gets worse, you may want to think about hospice palliative care. Hospice palliative care is a kind of care for people who have illnesses that do not go away and often get worse over time. It is different from care to cure a disease, which is called curative treatment. Hospice palliative care focuses on improving quality of life—not only in the body but also in the mind and spirit. Some people combine hospice palliative care with curative care.
Hospice palliative care may help with symptoms or side effects from treatment. It may also help your family make future plans for medical care. It could even help the person living with the disease or his or her caregivers understand Alzheimer's disease or better cope with feelings about living with the disease.
If you are interested in hospice palliative care, talk to your doctor. He or she may be able to manage your care or refer you to a doctor who specializes in this type of care.
For more information, see the topic Hospice Palliative Care.
Because Alzheimer's disease gets worse over time, people may want to think about discussing health care and other legal issues that may arise near the end of life. Many people find it helpful and comforting to state their health care choices in writing with an advance care plan while they are still able to make and communicate these decisions. Some people want every possible medical treatment to sustain life, while others prefer measures to maintain their comfort without prolonging life. It may be helpful to think about what kind of medical treatment you want. For more information, see the topics Advance Care Planning and Care at the End of Life.
At this time, there is no known way to prevent Alzheimer's disease.
Adults who are physically active may be less likely to get Alzheimer's disease or dementia than adults who are not physically active.3 Moderate activity is safe for most people, but it's always a good idea to talk to your doctor before starting an exercise program.
Older adults who stay mentally active may be at lower risk for developing Alzheimer's disease.4 Regularly reading newspapers, books, and magazines, playing cards and other games, working crossword puzzles, going to museums, and doing other social activities, and even actively watching television or listening to the radio may help you avoid symptoms of Alzheimer's disease. Although this "use it or lose it" approach has not been proved, no harm can come from regularly putting your brain to work.
People who eat more fruits and vegetables, high-fibre foods, fish, and omega-3 rich oils (sometimes known as the Mediterranean diet) and who eat less red meat and dairy may have some protection against dementia.5, 6
As we learn more about the causes of Alzheimer's disease, we also may learn more about how to prevent the disease. Drugs now being developed to prevent damage the nerve cells in the brain may someday be used in people who are at risk for Alzheimer's.
If you have just been diagnosed with early Alzheimer's disease, you may feel angry, frightened, depressed, anxious, and worried about the future. Although the disease does get worse over time, some people are able to continue their usual activities for many years, even if at a reduced level or in different ways.
Common issues faced by people in the early stages of Alzheimer's disease and by their families include:
The following tips may be helpful in the early stages of dementia:
Most people who have Alzheimer's disease are cared for at home by family members and friends. Taking care of someone with Alzheimer's disease can be physically and emotionally draining, but there are ways to make it easier. One of the keys to successful home care is educating yourself. You can do a lot to make the most of the person's remaining abilities, manage the problems that develop, and improve the quality of his or her life as well as your own. Also remember that caregiving can be a positive experience for you and the person you are caring for.
If you are taking care of someone with Alzheimer's, one of the goals is to keep the person as healthy and safe as possible. A safe environment, good nutrition, regular sleep habits, good hygiene, and prompt care of other medical problems are important to the person's overall well-being.
Dealing with behaviour problems and failing mental abilities often is the biggest challenge for caregivers. Strategies for dealing with these problems may not eliminate all the problems but may make the problems easier to deal with.
It also is critical that you take good care of yourself. Finding and relying on sources of caregiver support can be extremely helpful. Try to find a support group in your area and an adult day care for some respite care. Remember to take care of your own health and not to shoulder all the responsibility of caring for your loved one who has Alzheimer's disease. Groups such as the Alzheimer Society can provide not only educational materials but also information on support groups and services.
Taking care of a person with Alzheimer's disease at home is not always possible. Even when it is possible, it often becomes more difficult with time as the person develops new behaviours or medical problems that are hard to manage. The caregiver may have or develop medical problems of his or her own. Or the stress of caring for the person at home may become too overwhelming. There are many assisted-living arrangements that you may consider, though many people with Alzheimer's will need full-time care at some point. Making the decision about nursing home placement is often very difficult, because there are no guidelines that fit every situation. Every family has different needs, preferences, and situations to think about. For more information, see:
At this time, there are no medicines that can prevent or cure Alzheimer's disease or that will restore normal mental abilities. Medicine may help some people function better by temporarily reducing memory loss and thinking problems. Other medicines may be needed to treat associated conditions, such as depression.
Medicines include donepezil (Aricept), galantamine (Reminyl), and rivastigmine (Exelon). These medicines, called cholinesterase inhibitors, have been approved specifically for treatment of Alzheimer's disease. Research suggested that people with moderate to severe Alzheimer's disease who took cholinesterase inhibitors experienced improvement in thinking and daily functioning when they added memantine (Ebixa) to their treatment.7
All these medicines may temporarily help improve memory and daily functioning in some people who have Alzheimer's disease. The improvement varies from person to person. These medicines do not prevent the disease from getting worse, although they may slow down symptoms of mental decline.
The main decision about using medicines to treat failing mental function usually is not whether to try a medicine but when to begin and, later, when to stop treatment. Medicine treatment can be started as soon as Alzheimer's disease is diagnosed. But the person may or may not significantly improve when taking medicines, because they do not work for everyone. If the medicines are effective, they are continued until the side effects outweigh the benefits or until the person no longer responds to the medicines. For more information, see:
Sometimes, medicine may be used to manage behaviours or symptoms that are causing strain for the person who has Alzheimer's disease and/or for his or her caregivers. Medicines generally are used only when other treatments have failed. For example, if the person still has trouble sleeping after trying regular exercise and avoiding naps, a medicine may be needed.
When it comes to disruptive behaviours, caregivers are encouraged to try to understand the reasons for the behaviours and to find other ways to manage them whenever possible. Distracting the person, avoiding situations that seem to cause the behaviour, and using good communication often can help limit these behaviours.
Although other approaches to managing behaviours should always be tried first, medicines such as tranquilizers may be needed if:
Depression occurs in close to half of people who have Alzheimer's disease. It is especially common during the early stages of the disease when a person may be aware of losing his or her ability to think and function independently. Antidepressants can relieve symptoms of depression and may improve quality of life, although they will not slow down the progression of Alzheimer's disease. Counselling, such as cognitive-behavioural therapy, is also used to treat depression.
For more information , see the topic Depression.
Conditions such as high blood pressure (which can lead to multi-infarct dementia), thyroid problems, or Parkinson's disease, also can contribute to dementia in an older person who has Alzheimer's disease. Some of these conditions may respond well to treatment with medicines.
Medicines used to treat symptoms of mental decline in people who have moderate Alzheimer's disease include cholinesterase inhibitors such as donepezil (Aricept), galantamine (Reminyl), and rivastigmine (Exelon).
Memantine (Ebixa) is a medicine for treating severe symptoms of confusion and memory loss from Alzheimer's disease. It works differently than cholinesterase inhibitors. But, like cholinesterase inhibitors, it does not prevent Alzheimer's disease from progressing. This medicine may cause dizziness, confusion, headache, and/or constipation in some people.
Other medicines may be tried to treat anxiety, agitated or hostile behaviour, sleep problems, frightening or disruptive false beliefs (delusions), suspicion of others (paranoia), or hallucinations (seeing or hearing things that aren't there).
Close monitoring and regular re-evaluation of the person who has Alzheimer's disease are very important during treatment with medicine. As the disease progresses and symptoms change, the person's medicine needs often change. If you are a caregiver for someone with Alzheimer's disease, be alert for adverse drug reactions or side effects that further impair the person's ability to function.
Before deciding to manage behaviour problems with a medicine, try to figure out what is causing the behaviour. Understanding why a person is behaving in a certain way can point to better ways of dealing with that behaviour. If you are able to find other ways of dealing with behaviour problems, you may be able to avoid treatment with medicine and the side effects and costs that come with it.
Doctors don't know for sure that cholinesterase inhibitors help with behaviour problems in people who have Alzheimer's disease.8 Some studies show that these medicines do help, which can mean less burden on caregivers.9 If that burden is reduced, people who have Alzheimer's may be able to live at home longer.
Rivastigmine (Exelon) can now be given through a skin patch. Skin patches release medicine into the blood at a steady level and may reduce side effects. And when the person uses a skin patch, it’s easier for caregivers to make sure a person is taking the medicine properly.
Some behaviours, such as agitation, wandering, and becoming restless and agitated in the early evening (called sundowning), do not always respond well to treatment with medicine. Figuring out what is causing the behaviour and taking steps to manage or change it can sometimes be helpful. It may be worth trying this approach before using medicine.
As research on the causes and progression of Alzheimer's disease continues, the search for effective medicines continues.
Researchers are studying many medicines, including those used for other conditions, as possible treatments for Alzheimer's disease. Some of the medicines may be available only to people who are enrolled in clinical trials. It may be some time before researchers know whether these medicines are effective in treating Alzheimer's disease. For more information on clinical trials, contact the Alzheimer Society by calling 1-800-616-8816 or visit the website at www.alzheimer.ca/english/treatment/drug-approval.htm#trials.
There is no surgical treatment for Alzheimer's disease at this time.
Treatment with the herbal supplement ginkgo biloba to improve mental functioning is considered experimental.
Other therapies, such as light therapy, aromatherapy, and exercise, may help reduce behaviours such as agitation but should only be done with supervision.
Another way a caregiver can try to reduce agitation is to play soothing music for the person who has Alzheimer's disease, during meals and when the caregiver is helping with bathing.
As with other new drugs in development, other treatments for Alzheimer's disease such as ginkgo biloba need further study. Their effectiveness and possible side effects are not yet fully known. Talk to your doctor before you decide to try any herbal therapies, supplements, or non-prescription treatments.
|Alzheimer Society of Canada|
|20 Eglinton Avenue West|
|Toronto, ON M4R 1K8|
The Alzheimer Society of Canada provides information, education, and support services to individuals with Alzheimer's disease and their caregivers. There are provincial and local affiliates located throughout Canada.
|Fisher Center for Alzheimer's Research Foundation|
|One Intrepid Square, West 46th Street & 12th Avenue|
|New York, NY 10036|
Alzinfo.org was created by the Fisher Center for Alzheimer's Research Foundation to educate people about Alzheimer's disease. The mission of the Web site is to build an online community with 24-hours-a-day/7-days-a-week access to information and support via online chats, message boards, and resource databases.
|Family Caregiver Alliance|
|180 Montgomery Street|
|San Francisco, CA 94104|
This organization supports and assists people who are providing long-term care at home. It also provides education, research, services, and advocacy.
- Beers MH, et al., eds. (2004). Merck Manual of Health and Aging. Whitehouse Station, NJ: Merck Research Laboratories.
- Alzheimer's Association (2010). 10 signs of Alzheimer’s. Available online: http://www.alz.org/alzheimers_disease_10_signs_of_alzheimers.asp.
- Wang L, et al. (2006). Performance-based physical function and future dementia in older people. Archives of Internal Medicine, 166(10): 1115–1120.
- Wilson RS, et al. (2007). Relation of cognitive activity to risk of developing Alzheimer disease. Neurology, 69(20): 1911–1920.
- Barberger-Gateau P, et al. (2007). Dietary patterns and risk of dementia: The three-city cohort study. Neurology, 69(20): 1921–1930.
- Sofi F, et al. (2008). Adherence to Mediterranean diet and health status: Meta-analysis. BMJ. Published online September 11, 2008 (doi:10.1136/bmj.a1344).
- Tariot PN, et al. (2004). Memantine treatment in patients with moderate to severe Alzheimer's disease already receiving donepezil. JAMA, 291(3): 317–324.
- Sink KM, et al. (2005). Pharmacological treatment of neuropsychiatric symptoms of dementia: A review of the evidence. JAMA, 293(5): 596–608.
- Trinh NH, et al. (2003). Efficacy of cholinesterase inhibitors in the treatment of neuropsychiatric symptoms and functional impairment in Alzheimer disease: A meta-analysis. JAMA, 289(2): 210–216.
- Raina P, et al. (2008). Effectiveness of cholinesterase inhibitors and memantine for treating dementia: Evidence review for a clinical practice guideline. Annals of Internal Medicine, 148(5): 379–397.
- Howard RJ, et al. (2007). Donepezil for the treatment of agitation in Alzheimer's disease. New England Journal of Medicine, 357(14): 1382–1392.
- Birks J, Grimley Evans J (2009). Ginkgo biloba for cognitive impairment and dementia. Cochrane Database of Systematic Reviews (1).
- Nguyen QA, Paton C (2008). The use of aromatherapy to treat behavioural problems in dementia. International Journal of Geriatric Psychiatry, 23: 337–346.
Other Works Consulted
- American Psychiatric Association (2007). Practice Guideline for the Treatment of Patients With Alzheimer's Disease and Other Dementias. Arlington, VA: American Psychiatric Association. Available online: http://www.psychiatryonline.com/pracGuide/PracticePDFs/AlzPG101007.pdf.
- California Workgroup on Guidelines for Alzheimer’s Disease Management (2008). Guideline for Alzheimer’s Disease Management. Chicago: Alzheimer’s Association. Available online: http://www.alz.org/national/documents/2008_Guidelines_Final_Report.pdf.
- Desai AK, Grossberg GT (2005). Diagnosis and treatment of Alzheimer's disease. Neurology, 64(Suppl 3): S34–S39.
- National Center for Health Statistics (2010). Alzheimer's Disease. Available online: http://www.cdc.gov/nchs/fastats/alzheimr.htm.
- Petersen RC, et al. (2001, reaffirmed 2003). Practice parameter: Early detection of dementia: Mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 56(9): 1133–1142.
- Qaseem A, et al. (2008). Current pharmacologic treatment of dementia: A clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Annals of Internal Medicine, 148: 370–378.
- Small SA, Mayeux R (2010). Alzheimer disease. In LP Rowland, TA Pedley, eds., Merritt's Neurology, 12th ed., pp. 713–718. Philadelphia: Lippincott Williams and Wilkins.
|Primary Medical Reviewer||Anne C. Poinier, MD - Internal Medicine|
|Primary Medical Reviewer||Andrew Swan, MD, CCFP, FCFP - Family Medicine|
|Specialist Medical Reviewer||Peter J. Whitehouse, MD - Neurology|
|Last Revised||January 11, 2011|
Last Revised: January 11, 2012
This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.