Alzheimer’s Disease Treatment: Medications & Lifestyle Changes

There’s so much to process after an Alzheimer’s diagnosis. Whether it’s you or a loved one who has this disease, you’re likely working through piles of complicated information, an avalanche of difficult emotions, and a slew of sensitive conversations about what happens next.

Alzheimer’s disease doesn’t have a cure, meaning no treatment can reverse the damage that’s already occurred in the brain. But that doesn’t mean life has to come to a screeching halt. There are ways to manage symptoms so people with Alzheimer’s can still have fulfilling lives and caregivers can continue to have meaningful experiences with their loved ones, Katherine Ornstein, PhD, MPH, director of the Center for Equity in Aging at the Johns Hopkins School of Nursing, tells SELF.

While Alzheimer’s symptoms progress over time, on average, people live between four and eight years after their diagnosis—sometimes up to 20 years after the fact, depending on factors like when symptoms first manifested, how severe the disease is, and whether it’s responsive to treatment, Dr. Ornstein says. That last factor is particularly significant, so it’s essential to understand the options. Here’s what experts want you to know about treating Alzheimer’s, whether you’re experiencing early symptoms yourself or caring for someone with the disease.

Several medications may ease Alzheimer’s symptoms or temporarily slow the disease’s progression.

The FDA-approved therapies for Alzheimer’s fall into two camps: medications that may temporarily improve symptoms (like impaired memory and thinking) and drugs that aim to slow the rate of cognitive decline. The former targets chemicals that carry messages between the brain’s nerve cells, while the latter goes after the underlying biology of the disease.

To recommend the right drug for you or your loved one, a neurologist will determine whether the disease is in a mild, moderate, or severe stage and evaluate each treatment’s potential efficacy and safety risks based on symptoms and medical history. Ultimately, you should feel empowered to ask about the possible benefits, risks, time commitment, and costs associated with each treatment to ensure you make the decision that’s right for you (or help your loved one choose what’s best for them), says Irina Skylar-Scott, MD, a clinical assistant professor in the Center for Memory Disorders at the Stanford Department of Neurology and Neurological Sciences.

Cholinesterase inhibitors

Alzheimer’s disease hijacks the brain by slowly destroying its nerve cells, which triggers a cascade of cognitive turmoil like gradually escalating forgetfulness, difficulties with planning or organizing, and an uptick in confusion or moodiness. As these nerve cells diminish, so do levels of a chemical messenger called acetylcholine, a key player in memory, language, and thought-processing skills.

That’s where cholinesterase inhibitors can come in. Drugs like donepezil (commonly sold under the brand name Aricept), galantamine (Razadyne), and rivastigmine (Exelon) thwart the breakdown of acetylcholine, upping the amount available to healthy nerve cells. These treatments are typically taken in pill form; rivastigmine can also be applied as a skin patch.

Research suggests cholinesterase inhibitors can drive a modest improvement in cognitive symptoms ranging from mild to severe, but they won’t alter disease progression. Even while a person is taking these medications, Alzheimer’s will continue impacting the brain’s nerve cells and acetylcholine levels, making the drugs less effective over time. The medications also come with a fair share of potential side effects, from nausea and diarrhea to muscle cramps and weight loss, and may not be safe for everyone, particularly those with a history of abnormal heart rhythms.

Anti-amyloid immunotherapies

People with Alzheimer’s tend to have an abnormal buildup of two proteins in their brains: amyloid and tau. These sticky proteins form plaques and tangles that cause severe damage to nerve cells’ vital functions, ultimately triggering dementia symptoms.