My mother has been diagnosed with mild dementia. Is this the same thing as Alzheimer’s disease?
Dementia is a blanket term used to describe a decline in cognitive function which affects normal social or occupational activities.
Dementia can develop gradually over time, and may be the result of another condition such as multiple sclerosis, Parkinson’s disease, vascular problems in the brain or Alzheimer’s disease. Alzheimer’s disease is thought to be the most common cause of dementia.
Dementia can also develop suddenly as a result of an acquired brain injury – for example following a stroke or head injury.
She has been started on a medication called an acetylcholinesterase inhibitor. What does this do?
Some, but not all, forms of dementia may respond to medications called acetylcholinesterase inhibitors. There are several different types of drugs on the market aimed at treating dementia and while symptoms of the disease may improve with treatment, no drug has yet been developed to prevent the long-term progression of the disease.
The type of drug you describe works by blocking the action of a brain enzyme called acetylcholinesterase. Levels of acetylcholine are often found to be very low in people with dementia and Alzheimer’s disease.
Blocking the action of this enzyme can lead to an increase in the levels of acetylcholinesterase in the brain. This in turn may increase levels of alertness and may help slow down the rate of progression of the disease.
Prior to commencement of treatment with these types of drugs, a comprehensive assessment of cognitive, behavioural and functional abilities should be carried out.
She has been taking the drug for about two weeks but I haven’t noticed any significant improvements. Are there any side effects associated with these types of medications?
If treatment with an acetylcholineesterase inhibitor is considered appropriate for the individual patient, it is usually given in a very low dose at first.
This is increased gradually until improvements are noticed – these are usually evident after about three weeks of treatment. The dosage is kept as low as possible to minimise any potential side effects which can include urinary difficulties, nausea, diarrhoea and vomiting.
Repeat assessment is usually carried out about three to six months after treatment begins to evaluate and quantify any improvement of cognitive function. About 50 per cent of people treated will show some improvement. However, once the medication is stopped there is typically a gradual loss of improvement.
