Setting Back the Clock on Dementia
Glenn Brynes, Ph.D., M.D.

 

Maybe it happened when your wife got lost driving to the neighborhood market. Or when your father received a cut-off notice because a utility bill was not paid for two months. Up to that point you thought the forgetting was “normal aging”—a series of “senior moments”; now you can no longer deny that someone you love has started to have serious problems with daily tasks.

Next comes the doctor’s appointment…a discussion of recent problems with memory, judgment and functioning…some medical tests; then, the terrible moment when the doctor informs you that your loved one is showing signs of dementia.

What is dementia? It is the loss of thinking abilities that were mastered early in childhood. These abilities include memory, the ability to perform multi-step tasks, the use of language as well as higher order functions like judgment, planning and organizing. There are a number of diseases that can cause this impairment. The most common causes include Alzheimer’s disease, multi-infarct dementia and diffuse Lewy body disease. Each of these illnesses shows a different pattern of symptoms and progression.

While most forms of dementia can’t be cured, there are now treatments that can make a significant difference in the course of the illness. A group of medications called "acetylcholinesterase inhibitors" works by boosting the strength of signals that are sent by nerves within the brain using the chemical messenger, acetylcholine. It is surprising that while these medications were developed for treatment of Alzheimer’s disease, there are growing reports that they help other forms of dementia as well.

The three most commonly used medications, donepezil (Aricept®), rivastigmine (Exelon®) and galantamine (Reminyl®) don’t change the course of the illness. However in adequate doses they restore cognitive functioning to where it was about 9 months previously. While that may not seem like much, consider for example the person who has just started to have trouble caring for himself. With such medication, they might enjoy 6-12 more months of independent living.

These medications aren’t generally dangerous. Nausea and diarrhea are common side effects. Because of this, small starting doses are generally increased gradually as tolerated.

For some patients these medications can restore the ability to recognize family members, to socialize or to care for themselves, at a point where these abilities were faltering. Even a modest difference can mean a lot.


Remember: Always consult your health care provider before taking medication.  We do not specifically endorse any particular medication.


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Telephone:410-329-2028
Fax: 410-343-1272
Postal address: We have two locations in Baltimore County
      Monkton Office16829 York Road/PO Box 544/Monkton, MD 21111
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Email: ncpa@qis.net
Please use telephone for appointments or medical questions.

Carol Watkins, M.D.
Glenn Brynes, Ph.D., M.D.
Rita Preller, LCSW-C

Copyright © 2004  Northern County Psychiatric Associates
Last modified: December 14, 2004