Antidepressants. Antidepressants such as sertraline, citalopram, mirtazapine and trazodone are widely prescribed for people with dementia who develop changes in mood and behaviour. There is some evidence that they may help to reduce agitation – particularly citalopram.
Try gentle touching, soothing music, reading, or walks. Reduce noise, clutter, or the number of people in the room. Try to distract the person with a favorite snack, object, or activity. Limit the amount of caffeine the person drinks and eats.
Haloperidol (Haldol®) Olanzapine (Zyprexa®) Quetiapine (Seroquel®) Risperidone (Risperdal®)
Acetylcholinesterase inhibitors
Donepezil (also known as Aricept), rivastigmine (Exelon) and galantamine (Reminyl) are used to treat the symptoms of mild to moderate Alzheimer's disease. Donepezil is also used to treat more severe Alzheimer's disease.
It can occur at any stage of the disease but it tends to peak in the middle stages of dementia and lessens as the disease progresses.
Many people with dementia become restless and may fidget or pace up and down. They may constantly wring their hands, pull at their clothes or touch themselves inappropriately in public. This could be because of pain or discomfort, needing the toilet, a need for more physical activity or problems with their environment.
Possible Causes
One possibility is that Alzheimer's-related brain changes can affect a person's “biological clock,” leading to confused sleep-wake cycles. This may result in agitation and other sundowning behaviors. Other possible causes of sundowning include: Being overly tired.
Monitoring caffeine and alcohol consumption in the evenings, as well as avoiding daytime napping can reduce restlessness and pacing. Constant pacing may also reveal that your loved one is not getting enough physical activity.
Several medications, including lorazepam and oxazepam, can help treat anxiety in people with dementia. These drugs are examples of benzodiazepines. A person should take the medications as a doctor prescribes and speak with a healthcare professional if they experience any adverse effects.
The primary cause of sleepless nights for those with dementia seems to be the changes that take place in the brain. Leading experts believe that as dementia changes brain cells, it also affects a person's circadian rhythms. When circadian rhythms get disrupted, the individual often confuses morning and evening.
Going outside in the daytime, ideally in the morning, can help to set the person's body clock. They are more likely to feel sleepy during the evening. During the late evening you can dim lighting to encourage sleep at bedtime (unless they are getting sleepy too early).
Melatonin might help improve sleep and reduce sundowning in people with dementia. Provide proper light. Bright light therapy in the evening can lessen sleep-wake cycle disturbances in people with dementia.
Set a quiet, peaceful mood in the evening to help the person relax. Keep the lights low, try to reduce the noise levels, and play soothing music if he or she enjoys it. Try to have the person go to bed at the same time each night. A bedtime routine, such as reading out loud, also may help.
Administration: The examiner reads a list of 5 words at a rate of one per second, giving the following instructions: “This is a memory test. I am going to read a list of words that you will have to remember now and later on. Listen carefully. When I am through, tell me as many words as you can remember.
The average life expectancy figures for the most common types of dementia are as follows: Alzheimer's disease – around eight to 10 years. Life expectancy is less if the person is diagnosed in their 80s or 90s. A few people with Alzheimer's live for longer, sometimes for 15 or even 20 years.
Melatonin secretion decreases in Alzheimer´s disease (AD) and this decrease has been postulated as responsible for the circadian disorganization, decrease in sleep efficiency and impaired cognitive function seen in those patients.
One of the most common causes of death for people with dementia is pneumonia caused by an infection. A person in the later stages of dementia may have symptoms that suggest that they are close to death, but can sometimes live with these symptoms for many months.
Providing the person doesn't appear to be uncomfortable or distressed, then sleeping more during the day isn't normally a reason to be worried. However, if a person is lying down in bed and asleep for most of the time they will need to be looked after to make sure they don't develop any physical health problems.
In the elderly, should prescription medication be necessary, the first-line treatment is nonbenzodiazepines (e.g., zolpidem, eszopiclone, zaleplon, and ramelteon) as they have been found to be safer and better tolerated than tricyclic antidepressants, antihistamines, and benzodiazepines.
Often when a person with dementia asks to go home it refers to the sense of 'home' rather than home itself. 'Home' may represent memories of a time or place that was comfortable and secure and where they felt relaxed and happier. It could also be an indefinable place that may not physically exist.
other long-term health problems – dementia tends to progress more quickly if the person is living with other conditions, such as heart disease, diabetes or high blood pressure, particularly if these are not well-managed.
The Mini-Cog test.
A third test, known as the Mini-Cog, takes 2 to 4 minutes to administer and involves asking patients to recall three words after drawing a picture of a clock. If a patient shows no difficulties recalling the words, it is inferred that he or she does not have dementia.
If you aren't sure which stage of dementia you or your loved one are in right now, take an online Alzheimer's test. This can help pinpoint an individual's symptoms and stage.
Dementia stage 5: Moderately severe cognitive decline
At this point, a person may no longer be able to carry out normal activities of daily living (ADLs), such as dressing or bathing, or Instrumental activities of daily living (IADLs) without some caregiver assistance.