Is There A Drug For Memory Loss? Evidence-Based Alzheimer's Treatment

According to the Alzheimer’s Association, more than six million people are living with Alzheimer’s disease in the United States. Alzheimer’s disease is a condition that typically affects an individual’s cognition, memory, and ability to care for themselves. Whether you’re a caregiver for someone with Alzheimer’s or have the condition yourself, treatment options are available. Exploring evidence-based treatments that have shown promise in assisting those living with Alzheimer’s can be a step toward finding support and hope. 

What is Alzheimer's disease? 

Alzheimer's disease is a common cause of dementia (a non-specific term for memory loss and degradation of cognitive function). This condition is most common among older adults. According to the Alzheimer’s Association, Alzheimer’s is most common in those over 65, though early-onset Alzheimer’s can occur in younger adults.  

Alzheimer's disease is a progressive brain disorder, which means it tends to worsen over time. The disease typically interferes with memory formation, thinking, and behaviors, as collections of proteins (called amyloid plaques) and tangled fiber bundles (called tau tangles) develop in the brain, causing the death of neurons (brain cells). During the early stages of the disease, amyloid plaques and tau tangles occur in areas of the brain associated with memory formation, and later, Alzheimer’s disease typically affects the frontal areas of the brain that are responsible for reasoning, social behaviors, and language processing. As Alzheimer’s develops, other areas of the brain become affected as well.  

Symptoms of Alzheimer's disease

Since Alzheimer's disease is a progressive disorder, symptoms change and become more severe over time. Additionally, symptoms can vary from person to person, particularly depending on what stage of the disease they’re in. Alzheimer's disease is classified into four stages: preclinical, mild, moderate, and severe. The following are common symptoms at each of these stages.

Preclinical Alzheimer’s disease:

Preclinical Alzheimer’s disease is typically defined by early tau bundle and amyloid deposit development. During this stage, individuals may begin to experience mild behavioral changes, such as increased apathy and irritability. 

Mild Alzheimer’s disease: 

During the mild stage of Alzheimer’s disease, people are often able to complete daily activities, such as driving, working, and completing chores. However, symptoms of memory problems and repetitiveness may become noticeable, as well as the following symptoms: 

• Poor judgment and decision-making 
• Reduced initiative
• Memory loss that interrupts daily functioning 
• Confusion about dates, new information, or physical location
• Difficulty handling money, solving problems, and completing tasks 
• Increased irritability, aggression, and anxiety
• Personality changes 
• A tendency to misplace items
• Repetition of questions

Moderate Alzheimer’s disease: 

Middle-stage or moderate Alzheimer’s disease is often characterized by symptoms that become increasingly apparent. While symptoms can vary, they may include the following: 

• Increasing memory loss, such as difficulty remembering events, personal history, and occasionally, loved ones 
• Language challenges, such as difficulty reading or writing 
• Increasing social withdrawal
• Difficulty learning new information
• Inability to learn new things
• Reduced attention span or ability to cope with change 
• Changes in the wake-sleep cycle, such as sleeping during the day and experiencing sleep disruption at night 
• Difficulty with tasks with multiple steps, such as getting dressed
• Delusions and impulsivity 
• Increased irritability, anxiety, fear, wandering behaviors, and agitation
• Repetitiveness in movement or conversation

Severe Alzheimer's disease: 

Late-stage Alzheimer’s disease is the last stage of the disease. People with severe Alzheimer’s disease typically require intensive caregiving and may display the following symptoms:   

• Unawareness of surroundings 
• Little interest in food with accompanying weight loss
• Lack of communication
• Physical health problems, such as becoming prone to skin infections or pneumonia
• Seizures 
• Difficulty swallowing
• Lack of bladder and bowel control 

Alzheimer’s disease treatment options

Clinical trials are currently underway to find new ways to treat Alzheimer's disease. While there is currently no cure for the condition, there are treatment options available that may improve individuals’ quality of life.

Pharmaceuticals: To slow cognitive decline

Pharmaceutical treatments are often broken down into those that target behavioral symptoms, cognitive symptoms, and disease progression. Medications often prescribed to slow the progression of the disease include the following. 

The BetterHelp platform is not intended for any information regarding which drugs, medication, or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action without consulting a qualified medical professional.

Anti-amyloid medications: To avoid protein build-up

Anti-amyloid treatments target the cause of Alzheimer’s disease itself, instead of specific symptoms. Alzheimer’s disease is believed to be caused by an abnormal build-up of beta-amyloid proteins in the brain, which form harmful plaques and tangles around brain cells and create a loss of connection between vital neurons. Anti-amyloid medications target and destroy the clumps of proteins in the brain. With a reduction in the amount of beta-amyloid accumulation in the brain, the clumps may be less likely to form and disrupt communication between neurons. This may contribute to the healthy functioning of an individual’s brain cells, allowing them to work longer.

Cholinesterase inhibitors: To improve nerve function

People with mild to moderate symptoms of Alzheimer's disease are often prescribed cholinesterase inhibitors by a healthcare provider to address changes in the brain. Cholinesterase inhibitors may temporarily improve nerve function and reduce symptoms. 

Glutamate regulators: To address cognitive impairment and improve memory

Glutamate regulator medications target glutamate, a chemical in the brain that aids in learning and memory. Glutamate regulators may be prescribed for people with moderate to severe Alzheimer’s disease as a treatment for cognitive decline. 

Antipsychotics: To prevent psychosis

Some antipsychotic medications may be prescribed if a person with Alzheimer’s disease is experiencing psychosis, presents a danger to themselves or others, or is experiencing distress or serious difficulty receiving care. However, these medications can increase the risk of serious cardiovascular problems, especially in those with preexisting cardiovascular disease. Sudden cardiac death can be a rare side effect, so, as with any medication.  

Anti-anxiety drugs and antidepressants: To reduce symptoms of anxiety and depression

According to research published in the Journal of Alzheimer’s Disease Reports, anti-anxiety medication is commonly used to treat Alzheimer’s disease. Antidepressants may also be used to reduce the impacts of mood changes, which can be frequently observed in people with this condition. While anti-anxiety medications may increase one’s risk of falls, antidepressants may reduce symptoms of anxiety and depression in some people.

Insomnia medications: To promote high-quality rest

Individuals living with Alzheimer's disease may experience sleep disturbances, changes in sleep-wake cycles, or “sundowning.” Medications may be prescribed to alter biological signals that impact wakefulness and contribute to higher-quality rest. 

Metabolic medications: To prevent Alzheimer’s disease (ongoing clinical trials and drug research)

Increasing amounts of research have made connections between insulin resistance or with type 2 diabetes and Alzheimer’s disease. Because the cellular changes that occur with Alzheimer’s disease are very similar to those that are observed in insulin resistance, Alzheimer’s disease has been called “insulin resistance of the brain” and “type 3 diabetes.” Ongoing research is investigating the potential use of type 2 diabetes insulin-sensitizing medications as effective treatments to prevent (and to possibly treat) Alzheimer’s disease.

Non-medication treatment options

While medications are often prescribed for cognitive and behavioral changes associated with Alzheimer's disease, there are non-pharmacological options that may be effective when used as an alternative to or combined with medications, including but not limited to the following. 

Reality orientation exercises 

Studies support the use of orientation exercises, which may cue individuals with Alzheimer’s into their surroundings, improve cognitive functioning, and improve self-esteem in those with mild to moderate Alzheimer’s disease. However, memory orientation is not shown to improve behavior or mood, and it can cause distress in some people. Orientation exercises can be guided by the way people with Alzheimer’s disease respond to them. The following tips may help caregivers and loved ones concerning orientation exercises, which may only work at certain stages of Alzheimer’s disease:

• Use people’s names frequently
• Mention the time of day, date, day of the week, and season
• Utilize signs and labels on objects
• Ask questions about memorable items or photographs

Validation therapy

Validation therapy may help caregivers and loved ones communicate with people with Alzheimer’s disease and related dementia diagnoses more compassionately. Unlike reality orientation, validation therapy tends to emphasize the emotions behind behaviors rather than factual reality. By providing an opportunity to communicate feelings, validation therapy may reduce emotional distress. 

To practice validation therapy, you might try the following: 

• Take a deep breath before engaging.
• Join the person in their experience by matching their expression. 
• Let them know you see them by rephrasing their feelings. 
• Ask compassionate questions about their memories. 

Research suggests that validation therapy can decrease stress levels and reduce behavioral disturbances in people with Alzheimer’s disease. 

Increased activity during the day

Sleep difficulties can worsen symptoms and accelerate disease progression. However, exercise and activity throughout the day may improve sleep and quality of life. One study found that walking weekly with relatives could improve sleep quality and reduce the occurrence of sundowning in those with Alzheimer’s disease. Another study suggests that exercise can prevent or delay the development of behavioral problems in those with dementia. 

For individuals who may be unable or unwilling to exercise, sitting outside or by a light-facing window may regulate the sleep-wake cycle. Avoiding large meals or naps late in the day may also improve sleep quality. 

Listening to music

Areas of the brain associated with music listening tend to be less affected by Alzheimer’s disease, which can make music a type of interaction people with dementia can more effectively engage in. A 2019 review published in Frontiers in Neuroscience found that music can provide clinical benefits like inducing relaxation, providing social opportunities, and reducing behavioral concerns and symptoms of depression. 

Caregiver training

Caregiver education and training may improve the mental and physical health of individuals with Alzheimer’s disease. Training can also reduce loss of income and burnout among caregivers. UCLA Health created a free Dementia Caregiver Training Video Guide to help caregivers and loved ones develop a safe and healthy environment for people with dementia. Video topics cover common behavioral challenges, such as wandering, aggressive behaviors, harsh language, agitation, refusal to bathe or take medication, repetitive questions, and sleep disturbances.  

Time with animals

A 2019 study found that animal-assisted therapy with dogs may be an effective complementary treatment for the behavioral and psychological symptoms experienced by those with Alzheimer’s. According to the Alzheimer’s Association, pets can provide nonjudgmental companionship, comfort, increased opportunities for physical activity, and calming stimulation. 

For individuals who cannot care for a live animal, robotic pets may be a useful alternative. A 2017 study published in the Journal of Alzheimer's Disease found that robotic pets can decrease stress and anxiety and reduce the need for pharmaceutical interventions.  

Social activities 

Social activities could include art classes, music, volunteer events, exercise groups, or gardening. Research suggests that socializing can improve the quality of life of those with Alzheimer’s disease and reduce their need for care. Social activities can also give individuals with Alzheimer’s disease the chance to form meaningful connections with others.

Support options for caregivers

Various treatment options are available to directly improve the cognitive and behavioral symptoms in individuals with Alzheimer’s disease. However, by addressing the mental health of caregivers, both people with Alzheimer’s disease and caregivers may experience improved mental health. Therapists may help caregivers reframe unhelpful thoughts and develop healthy coping mechanisms. Additionally, they can aid caregivers in providing compassionate care to people with dementia, which may reduce the occurrence of behavioral challenges.

Online therapy for caregivers providing evidence-based Alzheimer’s treatment

For some caregivers, attending in-person therapy can pose a significant burden, especially when they’re providing Alzheimer’s disease care at home. In these cases, online therapy through a platform like BetterHelp may be more useful. With online therapy, caregivers can connect with a therapist from anywhere they have an internet connection and at a time that’s convenient for them. In these cases, they may devote themselves to their caregiving responsibilities while also receiving mental health support in a way that’s convenient for them. Caregivers can connect with a licensed therapist via audio, video, or live chat, in addition to using in-app messaging if they have questions in between therapy sessions.

A review of 12 randomized controlled trials found that cognitive-behavioral therapy (CBT) can effectively reduce emotional burdens, anxiety, and depressive symptoms in caregivers. In addition to the convenience of internet-based therapy, research has found that online CBT can reduce behavioral and psychological symptoms of dementia and the resulting distress of caregivers. CBT is a type of therapy that focuses on changing the thought patterns that are contributing to unwanted behaviors. As individuals shift their thoughts, they may also be able to alter their emotional and behavioral responses.