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Dementia

Dementia

Reviewed by the Faculty of Harvard Medical School

Improving Memory And Treating Memory Loss


Improving Memory

Age-related memory loss is normal, and there is, unfortunately, no miracle cure. You can, however, use specific techniques to sharpen existing memory and make new information more easily retainable. Try making new information more meaningful and relevant to you by personalizing it somehow. By doing this, you'll find it easier to recall things.

In addition, there are certain organizational habits that you can perform to better prepare your brain for new information. Performing these behaviors reduces anxiety and pressure, freeing you from your stress and allowing you to focus more readily. The more organized you are, the better you'll be able to concentrate on what you need to remember. Try the following techniques:

  • Belongings — Always keep important, frequently used belongings (keys, glasses, handbag, etc.) in the same place.


  • Meetings and appointments — Use a calendar or electronic organizer to keep appointments and other important dates. You should have this with you all the time for easy reference.


  • Daily planner — As with your calendar, keep lists of things that you have to do each day in a daily planner. Be sure to write down the names of people to call, any bills you need to pay and any errands you need to run.


  • Names and phone numbers — Keep your address book updated and easily accessible.


Treating Memory Loss

The treatment of memory loss depends on its cause. Sometimes it is as simple as treating the underlying illness that is causing it. For example, treating depression, thyroid disease or a sleep disorder should resolve any associated memory loss.

At present, there is no drug that can prevent age-related memory loss or reverse it. Nor is there a pill for people who want to sharpen their memories, although experts believe that one day this might be possible.

However, self-help techniques and practical exercises, as described above, can be effective.

Using Drugs To Manage Dementia And Its Complications

Drugs have a role in the management of dementia and its complications. Treatment will not reverse the disease but may prevent its progression, perhaps for up to a year. The choice of treatment depends on the cause of the dementia. Alzheimer's disease affects a system of signal transmissions in the brain that is known as the cholinergic system. Medications have been developed to restore cholinergic function. There are four medications approved by the U.S. Food and Drug Administration (FDA) for the treatment of Alzheimer's disease that act on the cholinergic system. These are:

Drug
Brand name
Donepezil
Aricept
Galantamine
Reminyl
Rivastigmine
Exelon
Tacrine
Cognex

Although these medications do not offer a cure, they can improve the symptoms of mild to moderate dementia.

In October 2003, a new medication was approved by the FDA for the treatment of Alzheimer's disease. This is memantine (Namenda).

Namenda works in an entirely different way than the previously available medications. It has been approved for the treatment of moderate to severe Alzheimer's disease. In studies of patients with moderate to severe Alzheimer's disease, those who took Namenda by itself showed a slower decline in mental function when compared with those who took placebo (a sugar pill). In a separate study, those who took Namenda in combination with donepezil (Aricept) vs. donepezil alone, also showed a slower decline in mental function.

New medications are being developed, and initial research results appear promising. Studies are now being conducted to test the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs), vitamin E, estrogen and the Chinese herb Ginkgo biloba. Studies show that arthritis patients who take NSAIDs and women who take replacment estrogen have a lower incidence of Alzheimer's disease than does the general population. Ginkgo biloba mildly improves short-term memory loss, headache and depression. There are other medications that target the buildup of plaque on the brain. These medications are being studied, and researchers hope to develop a vaccine. Treatment of the complications of Alzheimer's disease, including behavioral disorders, depression and sleep disturbance, requires careful assessment of social and environmental issues and exclusion of other medical causes. Treatment should initially involve lifestyle changes. Should this fail, medications can then be considered.

The treatment of multi-infarct dementia is the same as the treatment of stroke. Drugs are used in the management of stroke patients to modify risk factors such as high blood pressure, high cholesterol and diabetes and to treat complications such as stiffness and urinary incontinence. Treatment for Lewy body disease remains focused on symptoms. Drug use is more problematic in this illness, with more side effects involving behavior and balance.



Last updated August 24, 2004



Approximately 15 percent of people older than 65 are thought to have dementia.
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