Dementia Treatment
- Treatment is generally community focused; the goal of treatment is to maintain the quality of life as long as possible despite the progressive nature of the disease. Effective treatment is based on:
- Diagnosis of primary illness and concurrent psychiatric disorders
- Assessment of auditory and visual impairment
- Measurement of the degree, nature, and progression of cognitive deficits
- Assessment of functional capacity and ability for self-care
- Family and social system assessment
- Environmental strategies in order to assist in maintaining the safety and functional abilities of the patient as long as possible.
- Pharmacologic therapy used for the person with DAT is directed toward the use of anticholinesterase drugs to slow the progression of the disorder by increasing the relative amount of acetylcholine. Available drugs include donepezil (Aricept), galantamine (Reminyl), rivastigmine (Exelon) and tacrine (Cognex). An NMDA-receptor antagonist memantine (Namenda) may be provided in an attempt to improve cognition. Other drugs may be used for behavioral control and symptom reduction.
- Agitation management: neuroleptic drugs
- Psychosis: neuroleptic drugs
- Depression: antidepressants, ECT
- Hypertension management in vascular dementia is important in reducing the severity of symptoms.
- Family education is a treatment strategy because statistics indicate that family caregivers provide care for patients with DAT in 7 out of 10 cases. The family and the treatment team collaborate in the delivery of care.
Complications for dementia
- Without accurate diagnosis and treatment, secondary dementias may become permanent.
- Falls with serious orthopedic or cerebral injuries.
- Self-inflicted injuries.
- Aggression or violence toward self, others, or property.
- Wandering events, in which the person can get lost and potentially suffer exposure, hypothermia, injury, and even death.
- Serious depression is demonstrated in caregivers who receive inadequate support.
- Caregiver stress and burden may result in patient neglect or abuse.
