Dementia is a degenerative process in the brain that causes dementia. In most cases, dementia occurs in old age. The cause of dementia can be Alzheimer's disease, metabolic disorders in the brain, traumatic brain injury and other diseases. Dementia cannot be cured, however, there are methods that can significantly improve the patient's condition. Specialists at the Yusupov Hospital have extensive experience in treating dementia and related diseases. The hospital also provides training and consultations for loved ones caring for a person with dementia at home.
Principles of treatment
Treatment for people with dementia depends on the cause and stage of the disease process. Therapy cannot be delayed, because modern drugs are most effective at the initial stages of the process. In the vast majority of cases, dementia cannot be cured, but a properly selected treatment regimen can extend the period when the patient is capable of independence and self-care.
Important! Drug therapy is prescribed only by the attending physician after weighing the indications and contraindications.
Compliance with the necessary recommendations allows you to increase the effectiveness of the therapy:
- regularity of intake;
- positive changes develop some time after the start of treatment;
- the effectiveness of medications may decrease as the pathological process progresses;
- the attending physician must be informed in a timely manner about the development of adverse reactions;
- The dosage of medications will need to be adjusted at different stages of the disease.
Patients with dementia suffer from memory impairment, so medication intake must be monitored to avoid skipping or overdosing.
Reviews
In reviews, people write that dealing with relatives suffering from dementia is always very difficult, even if you follow all medical recommendations.
According to relatives of patients, treatment of this disease with the help of medications really helps to stop the progression of personality degradation.
The use of folk remedies is reported to be effective only as part of complex treatment. Separately, certain medicinal herbs and decoctions serve more as a source of vitamins, and the immediate result is observed thanks to special medications.
Thus, dementia is a disease that gradually turns an energetic person into a sick patient who is unable to react and think abstractly. Elementary things constantly disappear directly from the memory of such people. Relatives must understand the condition of such a patient; they need to learn to adapt to it and be patient.
Drug treatment for dementia
After selecting medications, you should be prepared to take them on a regular basis, since dementia takes a long time to be treated. Before starting therapy, it is necessary to diagnose the disease that caused dementia. Dementia can be cured completely only if it is the result of reversible changes in the endocrine system or internal organs. The consequences of strokes should be treated with vascular drugs and agents affecting the blood coagulation system. Degenerative changes in brain tissue are difficult to correct, but the death of neurons can be stopped if specific drugs are prescribed.
Important! The combination of different groups of drugs ensures an enhanced effect of treatment, since the effect is on different aspects of pathogenesis.
Treating dementia with medications
| Group of drugs according to degree of importance | Pharmacological group | Drug name |
| First | Inhibitors of cholinesterase (an enzyme that breaks down the important neurotransmitter acetylcholine) | Donepezil Rivostigmine Galantamine |
| Second | Drugs that interact with specific receptors and reduce the toxic effect of the neurotransmitter glutamate | Memantine (Akatinol) |
| Third | Vascular agents and nootropic drugs | Pentoxifylline (Trental), Cavinton (Vinpocetine), Piracetam, Nootropil, Cortexin, Cerebrolysin |
| Blood cholesterol stabilizers - statins | Atorvastatin, Rosuvastatin, Simvastatin, Lovastatin | |
| Estrogen hormones | Estrodiol | |
| Unsaturated fatty Acids Anti-inflammatory drugs | Omega-3, Arcoxia fish oil, Ibuprofen, Diclofenac, Meloxicam | |
| Vitamin preparations | Tocopherol, Cyanocobalamin, Pyridoxine |
Basic therapy for neurodegenerative dementia
Modern treatment of dementia, accompanied by progressive destruction of nerve cells, requires the mandatory prescription of cholinesterase inhibitors and memantine. These funds are necessary for the following types of senile dementia:
- Alzheimer's disease;
- Pick's disease;
- Parkinson's disease;
- dementia after a stroke.
The protocol for the treatment of dementia involves the administration of Donesepil or Rivostigmine, often the drugs are combined with Memantine. Cholinesterase inhibitors promote increased synthesis of acetylcholine, which facilitates the conduction of nerve impulses between surviving neurons.
An excess of glutamate, which is formed during the destruction of neurons, leads to overexcitation of the nerve cell. As a result, the necessary signals are not recognized and new information is not absorbed. Memantine removes excess neurotransmitter, causing the neuron to become more receptive to signals.
Therapy with anticholinesterase drugs and Memantine should be carried out without interruption; it is possible to prescribe only one drug. Such methods of treating dementia can slow down the rate of degeneration of nerve cells and slow down the loss of mental functions.
Drugs to improve cerebral circulation
Treatment of vascular dementia in older people is accompanied by the prescription of medications to improve cerebral circulation and metabolic processes in the brain.
After a stroke, some neurons die; the goal of therapy is to stimulate the activity of neighboring areas that can restore functional deficits. Drugs to improve cerebral circulation
| Drug group | Drug name | Feature of the action |
| Antiplatelet agents | Pentoxifylline, Trental, Dipyridamole, Curantil, Agapurin | Helps improve blood flow, prevents the formation of microthrombi |
| Means for improving blood microcirculation | Cavinton, Vinpocetine, Nicotinic acid, Xanthinol nicotinate | Eliminate vascular spasms, activate blood circulation |
| Nootropics | Piracetam, Nootropil, Pyramiracetam | Improves metabolism in brain tissue, stimulates the formation of interneuron connections |
| Extracts from animal brain matter | Cortexin, Cerebrolysin, Ceregin | Stabilizes the nerve cell membrane, facilitates the conduction of nerve impulses |
| Antihypoxants | Improves oxygen supply to cells, reduces the effects of oxygen starvation | Mexidol, Mexiprim, Mildronate |
A vascular treatment for dementia is indicated for patients with dementia of any origin, as stimulation of blood circulation inhibits the death of neurons and helps preserve mental functions.
Treatments for emotional and obsessive disorders
Drug treatment of dementia involves influencing low mood levels, aggressiveness, anxiety, and emotional arousal. To reduce negative manifestations, the following groups of drugs are prescribed:
- neuroleptics (Tizercin, Rispolept);
- tranquilizers (Nitrosepam, Sonapax, Elenium);
- antidepressants (Fluoxetine, Mianserin);
- amino acids that stimulate the inhibition process (Glycine, Glycised);
- sedatives of plant origin (tablets of valerian, motherwort, mint, lemon balm).
Important! It is necessary to take into account the fact that an overdose of drugs that affect the psyche can cause breathing and cardiac problems.
Neuroleptics, tranquilizers or antidepressants are prescribed in long courses with mandatory breaks. Effective treatment of senile dementia at home allows you to prolong the initial period of the disease.
Sleeping pills
Sleep disturbances worsen the course of dementia, so the standard of care for dementia involves the use of sleeping pills. Drugs that improve sleep should not cause dependence or drug withdrawal syndrome. Melatonin and Ramelteon meet these requirements. These drugs are taken in the dark, when the patient is already in bed. Antidepressants with a sedative effect (Trazodone) help you fall asleep.
It is important that the bedroom is well ventilated before going to bed, and that the patient takes walks in the fresh air whenever possible. Aromatic oils (mint, lemon balm, lavender) that can be inhaled or added to a warm bath help to relax.
Aids
The following groups of medications help to activate brain activity:
- estrogenic hormones;
- vitamins (tocopherol, cyanocobalamin, pyridoxine);
- unsaturated fatty acids (omega-3);
- amino acids (taurine, glycine, lecithin);
- tonics (tincture of ginseng, eleutherococcus);
- gingko biloba.
The treatment regimen for dementia should include a set of methods that affect various parts of the pathogenesis of the pathological process.
Traditional methods of treating dementia
Herbal treatments for dementia can be used as an adjunct to drug therapy. This method is characterized by the absence of side effects and good tolerability at any stage of the pathological process. To stimulate mental activity, decoctions and infusions of periwinkle, barberry, fruits and flowers of hawthorn are used, which treat dementia. Gingko biloba extract helps to activate memory and thinking. Medicines are produced based on this plant, but you can make decoctions or infusions from the leaves.
To increase the overall tone of the body, alcohol tinctures of Leuzea, Rhodiola, and Chinese lemongrass are used. Dandelion, chicory, elecampane, calamus and wormwood activate the pituitary gland and hypothalamus. To stabilize the emotional background, infusions from the rhizomes of valerian and hogweed are used; St. John's wort and oregano reduce the manifestation of depression.
Treatment of dementia with traditional methods until recovery is possible with mental changes against the background of reversible diseases of internal organs and blood vessels (hypofunction of the thyroid gland, diseases of the heart and cerebral vessels in the initial stages).
Neuroleptics and vascular drugs
Neuroleptics include: Aminazine, Tizercin, Melleril, Etaperazine, Moditene and others. We’ll write more about some of them.
Propazine
Eliminates depressive effects, anxiety, phobias. Has a sedative, hypnotic effect. Does not cause tremors and shuffling gait, does not eliminate delirium and visions.
Prices for Propazine tablets 25 mg 50 pcs.
Prices for Propazine solution 2.5% ampoule 2 ml 5
Tisercin (Levomepromazine)
Relieves anxiety better than Aminazine. Used to get rid of delirium. In small quantities it acts as a sleeping pill.
To improve the patency of the arteries of the brain, drugs have been developed that reduce atherosclerotic plaques and expand the lumen in the vessels, reducing spasm.
Prices for Tizercin tablets 50 pcs.
Medicines have also been created, calcium antagonists, which reduce spasm in the arteries, but almost do not reduce the tension in the veins. Under their influence, blood supply is normalized, oxygenated blood washes the gyri unhindered. Such drugs are successfully used and their 3rd generation will soon be released.
The second generation includes:
- Isradipin (Lomir);
- Anipamin, Gallopamil, Falipamin;
- Felodipine (Plendil), Amlodipine (Norvax);
- Clentiazem.
These drugs have positive effects:
- prolonged action;
- exhibit selective influence;
- have fewer side effects.
To strengthen blood vessels, take vitamins B and P. Also herbal-based medications: Periwinkle, Ginkgo Biloba, and nicotinic acid derivatives.
Even though the tablets are herbal, they should not be taken without consulting a doctor. Although they have virtually no contraindications. The doctor prescribes the optimal regimen, taking into account the person’s condition and the type of pathology.
Psychotherapeutic influence
Maintenance therapy plays a significant role in the patient’s adaptation to changed living conditions. Psychotherapeutic sessions have the following therapeutic effects:
- self-esteem increases;
- the patient’s attention is drawn to the positive qualities of his personality;
- an elderly person gets an idea of the essence of his disease and the possibility of treatment methods;
- activation of the patient, maximum prevention of addiction.
Psychotherapeutic treatment contributes to the rehabilitation of the patient, its importance is especially great in the initial stages of the process.
Watch out for the first signs of dementia
If you pay attention to the first symptoms of a developing disease in time, you can immediately take action and slow down its progression, or even stop it altogether at a mild stage. The main symptoms include:
- the appearance of absent-mindedness, memory disorders;
- problems with speech arise, the patient’s vocabulary becomes significantly poorer, and thinking is impaired;
- in the behavior of an elderly person, deviations from the norm are formed, negative character traits are aggravated, egocentrism appears, manifestations of aggression, or suspicion, increased anxiety are possible;
- An elderly person is poorly oriented in time, may confuse important dates and events, and depending on the area of brain damage, the senses of perception of the surrounding world suffer.
Exercises for rehabilitation
Rehabilitation activities include physical exercises and training aimed at maintaining mental functions, household and professional skills. Individual and group classes at the initial stage of the disease allow the patient to adapt to new conditions and delay the period of complete dependence on others. Classes in rehabilitation centers are especially effective; in such conditions, the patient does not feel loneliness and does not suffer from social isolation.
Aerobic exercise
Physical activity helps saturate brain cells with oxygen and activate mental functions. The following aerobic exercises are especially effective:
- walks in the open air;
- exercise on an exercise bike;
- dancing;
- jogging or standing still.
Classes, which are conducted in a favorable psychological environment, help to increase motor and mental activity. Such treatment of dementia at home helps improve memory and thinking.
Stimulation of mental functions
The following ways to treat dementia by enhancing memory, thinking and attention improve mood and promote adaptation to changing conditions:
- keeping a diary of current events;
- joint recall of biographical facts;
- viewing old photographs with a discussion of past events;
- watching old movies;
- listening to retro melodies.
Practical skills can be preserved for as long as possible if you regularly carry out exercises while performing household duties (washing fruits and berries, sorting through cereals, sewing on buttons, repairing small furniture). Entrusting an older person with household responsibilities increases the sense of self-worth and activates the cerebral cortex.
To adapt an elderly person to deteriorating orientation, it is advisable to use an imitation of a guidebook. Special mobile applications help to perform household chores in case of impaired memory and disorder in the algorithm of habitual actions. Reminders to turn off gas, lights, and electrical appliances can increase patient safety and maintain his independence for as long as possible.
Prevention
As you know, the most promising direction in the fight against dementia throughout the world today is prevention, and not the search for a cure for Alzheimer’s disease.
- Physical activity. It is difficult to find another method that would have the same complex effect. Therefore, modern doctors primarily recommend not memorizing poetry or solving crossword puzzles, but physical activity that is appropriate for the patient’s age.
- Diet. In second place, apparently, we should put diet - it both protects from damage and can prevent the development of inflammatory processes. The model diet for the brain is usually the Mediterranean-type diet (little meat, lots of fish, vegetables and fruits).
- Social activity and depression control. Both of these areas increase the cognitive reserves of the brain and prevent its damage.
- Intellectual work. Solving non-trivial problems, mastering new types of activities. Weight control and other forms of prevention/treatment of hypertension, diabetes, high levels of “bad” cholesterol.
- To give up smoking. This is indeed a very important factor.
New in treatment
To date, dementia is incurable; all drugs used can only slow down the progression of symptoms. Scientists persistently continue to search for remedies that can stop the disease and prevent mental dysfunction. New in the treatment of dementia is research to create a vaccine that can affect the patient’s immunity and destroy the pathogenic protein that destroys brain cells.
Important! The development of gene therapy offers hope for the creation of drugs that can prevent deposits of inclusions that interfere with the conduction of nerve impulses and communication between neurons.
To date, no guaranteed cure for senile dementia has been found. But it is unacceptable to give up and remain inactive, since intensive influence with the help of medicines, folk methods and rehabilitation measures can slow down irreversible changes in the psyche. If dementia occurs in older people, drug treatment improves connections between neurons and the conduction of nerve impulses, so early therapy delays the period of complete dependence.
Alternative Methods
As part of the treatment of this pathology, the following methods are used:
- Application of gene therapy. This method is supposed to act on genes that provoke the development of dementia, thereby stopping the death of brain cells. This will also allow you to start the processes of restoring neural connections.
- Use of stem cells. Such cells are endowed with the ability to transform into the tissues into which they are introduced. Scientists hope that stem cells will be able to replace damaged brain tissue.
- Conducting vaccinations. A vaccine is currently being developed to help fight dementia. These developments are based on the fact that the immune system, after receiving vaccination, will be able to recognize amyloid plaques, destroying the pathological protein. True, so far all these methods are not official and recognized. They are still at the stage of their development and testing.
What should you give up?
Categorical refusal of certain foods that negatively affect the state of the brain can slow down the development of dementia. They should be completely banned.
- Margarine. The product is an artificial mixture of fats, which causes a severe blow to the blood vessels of the brain.
- Refined (purified) sugars. The main harm of sugar to the body is its disruption of metabolism and weight gain. The result is low physical activity, a constant feeling of fatigue, high blood pressure, and deterioration of cognitive abilities.
- Gluten (gluten). A complex protein found in grain crops, including wheat. A person consumes it along with bakery products. There is evidence that gluten has a negative effect on the intestinal tract and prevents complete absorption of food.
- Trans fats. WHO recommends avoiding their consumption due to the negative effects on health, mainly on the cardiovascular system.
- Salty, spicy, fatty foods.
Healthy foods
Nutrition for dementia should first of all be balanced. The brain must receive everything it needs for normal functioning.
Foods that lower cholesterol levels must be present - dry red wine, almonds, blueberries, beans, vegetable oils, avocados.
Products with antioxidants are irreplaceable. This is mainly food containing vitamins C and E - citrus fruits, seafood, vegetables, fruits, herbs, seasonings (cinnamon, sage, saffron, lemon balm, etc.).
The need for protein must be met mainly by eating dietary meat.
