Health A-Z

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Treatment

Sometimes the cause of dementia can be reversed, such as vitamin B12 deficiency or an underactive thyroid. Treating these conditions may improve the dementia. Other reversible factors that can contribute to symptoms include overuse of alcohol and depression.

People with vascular dementia may show less mental decline if their blood pressure is controlled, they stop smoking, lower LDL ("bad" cholesterol), exercise regularly and maintain a healthy weight.

In some people, medications for Alzheimer's may help with behavioral symptoms and perhaps slow down the mental decline. They may delay the need for placement into a nursing home. Acetylcholinesterase inhibitors, such as donepezil (Aricept), galantamine (Razadyne) and rivastigmine (Exelon), can be prescribed for mild to moderate Alzheimer's dementia. Memantine (Namenda) is approved for moderately severe Alzheimer's dementia.

These same medications are sometimes used to treat the dementia associated with Lewy body disease.

However, many people do not improve at all with medication or improve only a little.

People with dementia that cannot be reversed need medical care. This care can take place anywhere, including in a hospital, at home, in an assisted-living center or in other types of facilities. Depending on the cause of the dementia, several specialists may be involved in care, including neurologists, psychologists, psychiatrists or geriatric doctors. Nurses and social workers play a very important role in care. Important aspects of care include:

  • Familiar surroundings, people and routines, because too much change can cause confusion and agitation

  • Bright, active environments to help focus the person's attention and keep him or her oriented to the environment

  • Safe environments so that the person cannot be hurt or get lost if he or she wanders away

  • Physical exercise to improve balance and general good health

  • Appropriate therapies, including music, art and occupational therapy, to provide stimulation and improve control of muscles

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From Health A-Z, Harvard Health Publications. Copyright 2007 by the President and Fellows of Harvard College. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.

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