Mar 20, 2018

What are the Treatment Options for Dementia?

There is no cure for dementia, and while current treatments manage symptoms, they offer no prospect of recovery. The main therapies available come in the form of medications and social programs.

Drugs for dementia

For Alzheimer’s disease, most medications aim to correct the impact to the brain’s chemical messengers – called neurotransmitters – particularly, the cholinergic and glutamate neurotransmitter systems. Drugs known as acetylcholinesterase inhibitors prevent enzymes from breaking down acetylcholine (which is important for memory), meaning more of it is available at the sites where neurons transmit messages. Cholinergic treatments may be prescribed for people with mild-to-moderate disease. Glutamate blockers prevent excess glutamate destroying neurons and are given to those with moderate-to-severe disease. There’s a window for using these drugs; they can improve symptoms in some people, but because of side effects, their use is closely monitored by doctors.

Immunotherapy: vaccines for dementia

Whereas currently available medicines manage symptoms, new treatments are focused on slowing or reversing the disease process itself by using the body’s own immune defence system. This approach, called immunotherapy, involves creating artificial antibodies that attach to abnormal aggregates (such as amyloid-β or tau), and mark them for destruction by the immune system. Immunotherapy is experiencing a surge of interest and a number of clinical trials – targeting both amyloid-β and tau – are underway.

Ultrasound

A major problem in treating any brain disorder is the difficulty in accessing the brain itself. Not only is the brain protected by a thick skull and a three-layered protective membrane called the meninges, but the blood-brain barrier prevents most things from leaving the bloodstream and entering the brain. While it is beneficial for keeping out foreign substances such as toxins or bacteria from the brain, the blood-brain barrier is a huge impediment to drug development for brain disorders. Not surprisingly, vast resources have been devoted to designing drugs with the right properties to get through this almost impenetrable barrier.

An alternative way to overcome the blood-brain barrier is to temporarily open it. Focusing ultrasound waves at specific locations in the brain can temporarily open the tight junctions of the blood-brain barrier that are usually sealed shut. This allows drugs to enter the brain that, because of their size or chemical properties, are normally prevented from doing so. Higher brain levels of an appropriate therapeutic drug means more of the drug reaches its target, elevating the drug’s effectiveness.

Research from scientists at the Queensland Brain Institute at The University of Queensland have made a breakthrough discovery involving non-invasive ultrasound technology. Led by Professor Jürgen Götz in the Clem Jones Centre for Ageing Dementia Research, they discovered that ultrasound technology can be used to clear amyloid-ß, reverse Alzheimer’s symptoms and restore memory in animal models. Extending this work, he and his team have also shown that scanning ultrasound helps deliver an antibody that works against the toxic tau protein to the brain more efficiently.

When mice were given the tau antibody alone, the amount of toxic tau protein decreased and the animals’ behaviour improved. Multiple treatments of ultrasound on its own also decreased the levels of toxic tau, and had a positive effect on cognition when the number of treatments was increased. Most crucially, when ultrasound was combined with the antibody, the therapeutic effects were even greater. To test the safety of using ultrasound to open the blood-brain barrier, this research is moving into sheep, which have a skull thickness similar to human skulls. If successful, the next stage will be to add additional capabilities and proceed to human clinical trials.

Exercise as a treatment

Exercise may be an effective way of decreasing the risk of cognitive decline. Evidence for its direct benefit as a treatment for dementia, however, is lacking. A 2015 review, which analysed multiple studies into the effects of exercise on people with pre-existing dementia, found some evidence that exercise could help with daily living activities, but no clear cognitive benefits were found. Other studies show that people who exercise regularly are less likely to have dementia.

Professor Perry Bartlett, Founding Director of UQ’s Queensland Brain Institute, successfully used exercise to improve cognition in older mice. He is now leading a human clinical trial, along with researchers from the UQ School of Human Movement and Nutrition Sciences and the Centre for Advanced Imaging, to find the amount, intensity, and type of exercise that might lead to cognitive improvement in elderly people. It’s thought that exercise boosts the production of new neurons in the brain, which might improve cognition.

Social programs

Keeping loved ones active with hobbies and interests they enjoyed in the past can be important after a disease diagnosis. Social programs such as music therapy and visits with animals can help stir memories, foster emotional connections with others, lessen anxiety and irritability and make people feel more engaged with life.

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  1. Its personal – I’ve been on Aricept since 08-2015 and improved cognitively DRAMATICALLY – so different I’m not believed by those who didn’t know the in the past…
    My LBCRS pre 8.5/10 are now 1.5/ 10 Re CODE and micro fasting and ketogenics — Hair analysis has and knowledgeable supplementations to OPITIMAL aka Dr Dale Bredesen protocol with a VAL spin means I’m the healthiestI’ve been in 10 years
    SPECT scan show six lobes and brain stem neuro-genative changes.. PET and MRI are read as ? ‘normal changes’ — ITS DISEASE my MRI has improved from jun 2015 —
    Looks like its ALzheimers 3 the TOXIC one
    A health professional community educator for decades — when I sold my practice acupuncturist/physio after 32 yrs specialising in COMPLEX PAIN in 2005 I had the ear of 30 GP’s and a dozen specialists as pain like dementia is NO respecter of persons..
    I’m the VOICE for the thousands who cant speak — My scientific brain can still read a scientific paper any genre and find six salient points and give it back in PLAIN SPEAK — I’m in a honorary position on the DAI board making use of this intact gift
    Ultra Sound is exciting
    Inflammation needs to be dealt with especially 9n the brain and NOT by adding statins to reduce cholesterol – No brainer to no take out what the brain is 87% ie Cholesterol
    My wellness is lke my Type 1 Diabetic grandma — I’m only 8 hrs ahead of brain fog and being a locked in zombie – Grandma didn’t HAVE eight hours late with her insulin injection
    FIND early — call the changes DISEASE and start treatment — a 2 month trial of Aricept —
    Find the toxic factors reduce/remove them – including people environment – moulds environment
    Protocol EVERY DAY for every day for the rest of my life — cover ALL bases psychologist mindfulness spirituality EXERCISE and SLEEP — I have insomnia issues BUT I’d sooner a clear brain on Aricept than a locked in zombie OFF it… MY path forward I live an EXUBERANT life beyond dementia

  2. The question is after zapping the proteins away – will they come back? Why does the body produce them in the first place. In Dr Dale’s Bredesen’s book “The End of Alzheimers” he believes the beta amyloid protein is a protective mechanism produced by the body to trap and remove toxic pollutants in the brain. However, if the the toxic source is not removed, then they continue to build up in the brain, producing more beta amyloids!
    Dr Bredesen has developed a protocol to prevent and reverse cognitive decline which is showing incredible results. It is called the Bredesen protocol or ReCODE protocol. I highly recommend the book.

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