1. Are there any side effects from Alzheimer’s drugs?
There’s no cure for Alzheimer’s, but some drugs can help slow down the disease or manage its symptoms. These medications are usually most helpful for people in the early stages of the disease, although they don’t work for everyone.
Alzheimer’s medications have some common side effects. Usually, they go away after a couple of weeks. But in rare cases, these drugs can cause severe complications.
There are a few types of Alzheimer’s drugs:
Cholinesterase inhibitors. This category includes medications such as donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon). They maintain the levels of a chemical messenger involved in alertness, memory, and rational thought.
Some common side effects include:
- Nausea
- Vomiting
- Diarrhea
- Loss of appetite
- Dizziness
- Difficulty sleeping
You can help prevent these side effects by taking your medications with food.
In rare cases, these drugs could cause seizures, muscle weakness, or fainting. If you have any of these symptoms, call your doctor. You should not take these medications if you have certain types of irregular heartbeat.
Memantine (Namenda). This drug manages levels of a chemical messenger that supports learning and memory.
Side effects include:
- Dizziness
- Headache
- Confusion
- Irritability
- Shortness of breath
- High blood pressure
- Constipation
Taking memantine with food or at certain times can help with these side effects.
Doctors sometimes prescribe this drug with donepezil, which also can cause these symptoms as well as nausea and diarrhea.
Monoclonal antibodies. This is a new type of drug that fights the buildup of plaque proteins in the brain. They include donanemab (Kisunla) and lecanemab (Leqembi).
Monoclonal antibodies are given through an IV. Some people taking lecanemab have bad reactions during the IV infusion, such as:
- Dizziness
- Fever
- Nausea
- Vomiting
- Irregular heart rate
- Difficulty breathing
Tell your doctor if you have any of these symptoms during your IV infusion.
Monoclonal antibodies can cause brain swelling and brain bleeding. Usually, these complications get better on their own. Most of the time, you don’t feel anything. But sometimes, they can cause:
- Headache
- Dizziness
- Confusion
- Changes in vision
- Nausea
- Difficulty walking
- Seizures
Your doctor might recommend regular MRIs to keep an eye out for these side effects. You might be at higher risk for these side effects if you have the APOE e4 gene or take blood thinners.
Some people also experience headaches, falls, or diarrhea.
2. I'm thinking about taking a trip with my father, who has Alzheimer's. How can I make it easier for both of us?
Plan ahead. Think about their needs so you'll be ready for any changes or problems. You can try taking a short trip first to see how they react to traveling.
Some other helpful tips:
- Give them simple, relaxing things to do when you’re traveling. They could, for example, look at a magazine, play with a deck of cards, or listen to music.
- Never leave a person with dementia alone in a car. When moving, keep their seat belt buckled and the doors locked.
- Plan regular rest stops.
- If they get agitated during the trip, stop at the first place you can. Don't try to calm them while you’re driving.
- Think about going on vacation somewhere that’s familiar to them -- such as a lake cabin they have visited in the past.
- If they get flustered easily, it may be wise to avoid places that are crowded. You may also want to skip fast-paced sightseeing trips.
- If they have never been on a plane, it may be a good idea to drive instead.
- Alert the airlines and hotel staff that you’re traveling with a relative who is memory-impaired. Make sure they carry or wear some sort of identification.
- Enjoy your time with your dad, but try to find time to relax, too. It may help to bring someone along who can help you with caregiving tasks.
3. I'm having trouble getting my loved one to eat. What can I do?
Their Alzheimer’s symptoms can make it harder for them to get enough to eat. They might have trouble knowing when they are hungry or thirsty, have problems swallowing, have a hard time using silverware, or feel depressed. Try some of these tips:
- Talk to your loved one's doctor. They may be able to help if your loved one is not eating because of a treatable problem, such as depression.
- Don't force them to eat. If they are not interested in food, try to find out why.
- Focus on serving more nutritious choices, such as protein, fruits, vegetables, and healthy fats, and less salt and sugar.
- Try giving them shakes with nutrition added to maximize the calories they get.
- Offer smaller meals more often instead of three large ones.
- Encourage them to walk, garden, or do other things that get them moving to boost their appetite.
- Serve finger foods that are easier for them to handle and eat.
- Prepare meals that offer different textures, colors, and temperatures.
- Make eating fun, not a chore. For example, liven up your meals with colorful place settings, or play background music.
- Try not to let your loved one eat alone. If you can’t eat with them, invite a guest.
4. My mother has Alzheimer's, and I've noticed she’s getting more confused. How can I help her?
- Keep her surroundings and routine the same. If you have to make changes, do it gradually.
- Make things simple, and avoid situations where she has to make decisions.
- Describe the events of the day to her. Remind her of the date, day, time, place, etc. And repeat the names of the people she sees often.
- Put large labels (with words or pictures) on drawers and shelves so she’ll know what’s in or on them.
- If she doesn't seem to understand something you’ve said, use simpler words or sentences.
- Make sure she takes her medicines on schedule.
- Be patient and supportive.
5. Is there anything I can do to help my mother preserve what memory she has left?
Losing cherished memories is one of the hardest parts of Alzheimer's disease. Some medicines may help slow down symptoms. There are also some ways to help your loved one hold on to the things they do remember.
- Use notes, lists, and memos to remind your mother of her daily tasks.
- Keep photos of family members and friends where she can see them. Label them with names if you need to. Get her to talk about the people or the hobbies she used to enjoy.
- Make sure she gets enough sleep.
- Encourage her to read, do puzzles, write, or do other things that keep her mind active. But if she gets frustrated, don’t push her to keep going.
6. Can ginkgo biloba cure Alzheimer's?
Some people think ginkgo, an herb used in some traditional medicines, can help with Alzheimer’s. Although it cannot cure the disease, some studies suggest that it can improve cognitive function in older adults with early-stage dementia. It might do this by improving blood flow to the brain, fighting inflammation, helping prevent the buildup of plaque, and regulating neurotransmitters such as dopamine. However, more research is needed to be sure.
Talk with your doctor before starting any herbal supplement. This can help prevent unwanted side effects and interactions with medications.
7. Is exercise good for someone with Alzheimer's disease?
Yes. Exercise improves strength and endurance and keeps their heart healthy. It can also give your loved one more energy and improve their mood and sleep. Physical activity also helps people with Alzheimer's keep up their motor skills and balance, which can help them avoid serious injuries from falls. It can make their brain work better, too.
The type of exercise that’s right for your loved one depends on how much the disease affects them. Someone in the early stages of the disease may enjoy walking, bowling, dancing, golf, and swimming. As the disease gets worse, they may need easier activities and more supervision. Talk to their doctor before they start any exercise program.
8. Do the symptoms of Alzheimer’s disease vary by the time of day?
Many people with the disease get confused, anxious, and agitated at dusk and into the evening hours. It’s called sundown syndrome, or sundowning. The problems may last a few hours or throughout the night.
Doctors don’t know exactly what causes sundowning, but they think a lot of different things play a role. Those could include physical and mental exhaustion (after a long day) and a shift in the body’s internal clock that happens with the change from daylight to dark. Some people with Alzheimer's have trouble sleeping at night, which may also make confusion worse. Some medication side effects can add to the problem, too.
Here are some ways for you and your loved one to handle sundowning:
- Schedule harder tasks early in the day when they are less likely to get agitated.
- Watch their diet and eating habits. Offer sweets and drinks with caffeine only in the morning hours. Serve them a late afternoon snack or early dinner.
- Offer them decaffeinated herbal tea or warm milk. It might help them relax.
- Keep the house or room well-lit. Close the drapes before the sun goes down so they don't watch it get dark outside.
- If they fall asleep on the sofa or in a chair, let them stay there. Don't wake them to go to bed.
- Distract them with things they enjoy. Soothing music or a favorite video may help.
- Encourage them to be physically active during the day. It may help them to feel more relaxed and sleep better at night.
9. Are people in the early stages of the disease still interested in sex?
It is normal for sexual desires to change as you age. These changes are especially common in people who have Alzheimer’s. They can be symptoms of the disease itself, an emotional response to feelings of depression or low self-esteem, or side effects of medication.
Some people with dementia lose interest in sex. Others become very interested. A heightened interest, or hypersexuality, might take the form of a lot of masturbation or flirting.
In the later stages of dementia, people might show out-of-character or inappropriate sexual behavior, such as getting undressed in public. This is because Alzheimer’s can lower impulse control. These behaviors are symptoms of the disease and not the person’s fault.
It’s important to have an honest conversation with your partner about these changes. Sometimes, treating depression or adjusting medications can help. The most important thing is to make sure your partner feels loved and accepted. You also can find new ways to express affection, such as hugging, massaging each other, dancing, or trying new hobbies.
Myths About Alzheimer’s Disease
Myth No. 1: Alzheimer’s happens only to older people.
Most people with Alzheimer’s are 65 and older. But it can happen when you’re younger, too. About 5% of people with the disease get symptoms in their 30s, 40s, or 50s. It’s called early-onset Alzheimer’s.
People who have it often go a long time before getting an accurate diagnosis. That’s because doctors don’t usually consider it a possibility during midlife. They often think symptoms such as memory loss are from stress.
Early-onset Alzheimer's can be genetic. Scientists think it involves changes in one of three rare genes passed down from a parent.
Myth No. 2: Alzheimer’s symptoms are a normal part of aging.
Some memory loss is a normal part of aging. But Alzheimer’s symptoms, such as forgetfulness that interferes with your daily life, and disorientation, are not.
It’s normal to forget where your keys are from time to time. But forgetting how to drive to a place you’ve been many times, or losing track of what season it is, points to a more serious problem.
Unlike the mild memory loss that can happen with aging, Alzheimer's disease takes a growing toll on the brain. As the disease gradually worsens, it takes away someone's ability to think, eat, talk, and more.
Myth No. 3: Alzheimer’s doesn't lead to death.
Sadly, it's the sixth leading cause of death in the U.S. Most people live 8-10 years after they’re diagnosed.
They can forget to drink or eat, or they might have trouble swallowing, which can lead to severely low levels of important nutrients. They can also have breathing problems, and that can lead to pneumonia, which is often deadly.
Also, the high-risk behaviors that sometimes happen with Alzheimer's, such as wandering into dangerous situations, can be fatal.
Myth No. 4: There are treatments that stop the disease from getting worse.
While certain treatments can help Alzheimer's symptoms and some treatments slow decline in memory for people in the early stages of the disease, there’s no way to stop the disease from progressing or reverse it.
You should not believe supplements, diets, or regimens that claim to cure it. No evidence shows they're useful treatments for the disease.
Myth No. 5: Alzheimer’s is caused by aluminum, flu shots, silver fillings, or aspartame.
You may have heard that cooking with aluminum pans or drinking from aluminum cans may cause Alzheimer’s. But there’s no scientific evidence to back that claim.
Some people think the artificial sweetener aspartame causes it. No evidence supports that theory either.
Others think silver dental fillings raise your risk. Again, there’s not much to go on.
Another false belief is that flu shots cause Alzheimer’s. Research suggests the opposite is true: Vaccinations can lower your risk and boost your overall health.