The major new dementia medication in 2023 was Lecanemab (marketed as Leqembi), an anti-amyloid antibody that received U.S. FDA traditional approval that year, slowing cognitive decline in early Alzheimer's by targeting amyloid plaques in the brain, though it's not a cure and comes with potential side effects like brain swelling or bleeding (ARIA). It's given as an IV infusion every two weeks.
Donanemab, like lecanemab, is a type of drug called a monoclonal antibody. Antibodies form part of our immune system and bind to harmful proteins to destroy them. Donanemab contains antibodies that bind to a protein called amyloid, which builds up in the brain in the early stages of Alzheimer's disease.
Reports indicate donanemab could cost anywhere between A$40,000 and $80,000 each year in Australia.
Cholinesterase Inhibitors are the most commonly prescribed medications for dementia. There are 3 cholinisterase inhibitors, which include, Donepezil, Galantamine and Rivastigmine. Important to note: There are no significant differences in effectiveness between the three drugs.
A major step forward is the FDA approval of anti-amyloid immunotherapies like lecanemab and donanemab. These drugs are used for early-stage AD, including mild cognitive impairment (MCI) and mild dementia, by targeting and reducing amyloid plaques in the brain.
Vitamin D supplements are linked to a significant reduction in dementia risk, with a major study showing users had a 40% lower incidence of developing dementia compared to non-users, particularly benefiting older adults, with even greater effects seen in women and those without existing cognitive issues. This reduction highlights Vitamin D's role in brain health, possibly by clearing amyloid plaques associated with Alzheimer's.
Seroquel is the brand name for quetiapine, an atypical antipsychotic that is used off-label to treat severe behavioral signs of dementia. It can help with bad symptoms, including agitation, aggressiveness, and hallucinations, that other drugs don't help with.
Life expectancy after a diagnosis of dementia decreases with increasing age. For example, an average person diagnosed with Alzheimer's disease between ages 70-79 can expect to survive seven more years, while a diagnosis after age 90 is associated with an expected survival of only 2.8 additional years.
The "2-finger test" for dementia involves an examiner showing a hand gesture (like interlocking index and middle fingers) and asking the patient to copy it, testing motor skills, visual memory, and coordination, as difficulties can signal early cognitive decline, but it's a screening tool, not a definitive diagnosis, prompting further medical evaluation. Other related tests include finger-tapping and finger-to-nose, looking for hesitation or misjudgment in movement.
Common Drugs to Avoid
Benzodiazepine antianxiety drugs such as diazepam (Valium®); lorazepam (Ativan®); alprazolam (Xanax®); clonazepam (Klonopin®); temazepam (Restoril®); chlordiazepoxide (Librium®) and anticholinergic medications such as hydroxyzine (Atarax®).
Diagnosis: Requires confirmation of Alzheimer's with elevated beta-amyloid plaques through diagnostic tests like PET scans or cerebrospinal fluid (CSF) tests. Insurance coverage: Medicare covers Donanemab if prescribed by physicians participating in a registry.
4 participants died during the trial, with their deaths thought to be related to the drug's side effects. Lilly's trial, known as TRAILBLAZER ALZ-2, included nearly 1,800 people with early-stage Alzheimer's disease. Participants received a monthly infusion of either donanemab or a dummy drug (placebo) over 18 months.
Donanemab treatment should not be initiated in patients with moderate-to-severe dementia (i.e., those requiring assistance in basic activities of daily living, Clinical Stage ≥ 5), as the safety and efficacy of the drug have not been established in this more advanced disease stage.
Smoking, low physical activity, and a poor diet are all lifestyle and environmental influences that have been linked to rapid dementia decline. Physical activity promotes cardiovascular health, which in turn improves brain function. Those who lead a sedentary lifestyle may experience faster cognitive decline.
These foods include:
Blueberries, the well-known 'super fruit,' could help fight Alzheimer's - YouTube.
You Miss Out on Sleep
You do a few things you know you shouldn't -- we all do. But some of those bad habits can take a toll on your brain. For example, lack of sleep may be a cause of dementia, including Alzheimer's disease. It's best to have regular sleeping hours.
The SAGE test is a short, self-administered evaluation that screens for early signs of memory or thinking problems like dementia. You take it on your own, at home or at your provider's office. It's simple and there's no studying needed. It can catch issues early.
Although the early signs vary, common early symptoms of dementia include: memory problems, particularly remembering recent events. increasing confusion.
Remaining at home but with extra support can be a good option for some people with dementia. It allows them to stay in a place that feels familiar and safe to them. It is important to make sure that the person can remain safe and well and get the support they need at home.
Signs of late-stage dementia
While family caregivers often provide the primary daily support for individuals with dementia, legal responsibility for decision-making and financial management can fall to spouses, adult children (depending on filial responsibility laws), or court-appointed guardians or conservators, especially in the absence of a ...
Vitamin D supplements are linked to a significant reduction in dementia risk, with a major study showing users had a 40% lower incidence of developing dementia compared to non-users, particularly benefiting older adults, with even greater effects seen in women and those without existing cognitive issues. This reduction highlights Vitamin D's role in brain health, possibly by clearing amyloid plaques associated with Alzheimer's.
Use calming phrases such as: "You're safe here;" "I'm sorry that you are upset;" and "I will stay until you feel better." Let the person know you are there. Involve the person in activities. Try using art, music or other activities to help engage the person and divert attention away from the anxiety.
When someone gets the diagnosis of dementia, a cure is only very rarely possible (see p2 About Reversible Dementias). In the current issue of Neurology, Sacks and Shulman1 report one of these rare cases of a reversal of dementia involving a patient on steroid medication.