Alzheimer's disease

Alzheimer’s is a disease that causes dementia. It is the most common cause of dementia, accounting for about two-thirds of cases in older people.

The treatments available for Alzheimer’s do not slow or stop the progression of the disease, but they may help with the symptoms for a time. It’s important to discuss your treatment options with the staff involved in your care.

Drug treatments

If you are prescribed a drug for dementia, treatment is usually started by a specialist doctor. Specialist doctors who see people with dementia include psychiatrists, geriatricians and neurologists. Once treatment has been started, it may be continued and monitored either by a specialist or by your GP.

Cholinesterase inhibitors

People with mild to moderate Alzheimer’s disease could benefit from taking a cholinesterase inhibitor. These drugs work by increasing the amount of a chemical called acetylcholine that helps messages to travel around the brain. Cholinesterase inhibitors do not prevent the disease from progressing, but may help people to function at a slightly higher level than they would do without the drug.

There are three cholinesterase inhibitors to treat Alzheimer’s:

  • donepezil
  • rivastigmine
  • galantamine

These are available on NHS prescription for people with mild and moderate Alzheimer’s but doctors may continue to prescribe one of these drugs for longer if they believe it is still having a beneficial effect.

Some people with Alzheimer’s find their condition improves by taking a cholinesterase inhibitor. They may see an improvement in thinking, memory, communication or day-to-day activities. Others may not notice an effect.

The drugs may have side-effects in some people. The most common are feeling or being sick, being unable to sleep, having diarrhoea, muscle cramps or tiredness. These effects are often mild and usually don’t last long. Not everyone will have side-effects.

Memantine

Memantine is recommended for people with more severe Alzheimer’s disease and for people with moderate Alzheimer’s if cholinesterase inhibitors don’t help or are not suitable. Memantine does not stop the disease from progressing but can help with some symptoms.

Some people taking memantine may not notice any effect at all. Others may find that their condition stays the same when they would have expected it to decline.

People may experience side-effects when taking memantine. The most common side-effects are headaches, dizziness, drowsiness and constipation. These are usually short-term effects.

Your doctor will advise on the best treatment and may prescribe both a cholinesterase inhibitor and memantine. This is sometimes called combination therapy.

Non-drug treatments

Cognitive stimulation activities are designed to stimulate thinking skills and engage people who have Alzheimer’s. They are often group-based, with an emphasis on enjoyment. The activities might include games, group discussions or practical tasks such as baking.

The benefits of cognitive stimulation for people with Alzheimer’s may include improvement in memory, thinking skills and quality of life.

People with mild to moderate dementia, including Alzheimer’s, should be given the opportunity to participate in cognitive stimulation programmes, if available. You can discuss your options with your doctor.

Treatment options for mood and behaviour changes

Depression and anxiety

People with depression or anxiety in Alzheimer’s may be offered social support or different types of talking therapies, depending on their needs and personal situation.

Talking therapies, such as cognitive behavioural therapy (CBT) and counselling, can help with symptoms. They provide an opportunity for people to talk about their concerns with a specialist and develop different ways of coping, thinking and behaving.

Some people may also benefit from an antidepressant drug, although these are not always suitable for someone with Alzheimer’s.  A doctor should carefully consider what may be appropriate.

Agitation and aggression

To help relieve symptoms of agitation and aggression, a doctor should review someone’s physical and mental health, and their environment. This helps to identify any causes or triggers, such as pain, another health problem, or something in their surroundings that distresses or angers them.  Addressing these issues might reduce the person’s agitation or aggression.

Complementary therapies, such as aromatherapy, dance or music therapy, may also be considered. This will depend on a person’s preference as well as the availability of treatments.

In some cases, antipsychotic drugs such as risperidone (Risperdal) may be used to relieve symptoms, especially if someone is very distressed or at risk of hurting themselves or others. These drugs are not suitable for everyone and may have serious side-effects.

For more information on treatments, visit our treatments page.

This information was updated in May 2018 and is due for review in May 2020. It does not replace any advice that doctors, pharmacists or nurses may give you. Please contact us if you would like a version with references.