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personal health history and a family health history, ask for a description of the person’s symptoms, and evaluate the person’s emotional status and living environment. Because Alzheimer’s disease may be mistaken for depression, a doctor will want to rule out depression. Testing the person’s mathematical ability, language skills, and ability to complete tasks that require memory can also provide helpful information in diagnosing Alzheimer’s disease. A thorough physical examination, laboratory tests, and a CT scan (see page 112) or MRI (see page 113) can help identify or rule out other possible causes of the dementia such as a stroke or tumor. If the problem turns out to result from another disorder, early diagnosis makes successful treatment more likely.

Treatment

Alzheimer’s disease has no cure, but several drugs—including donepezil, rivastigmine, and galanthamine—are available for treatment. These drugs can help improve the early symptoms of Alzheimer’s disease in some people, but they do not stop the disease from progressing. They work by slowing the breakdown of the neurotransmitter acetylcholine in the brain, one of the processes that lead to loss of memory and other mental functions. A newer drug called memantine is available for treating people with moderate to severe Alzheimer’s disease. The drug slows down the decline of their thinking skills and ability to perform daily activities such as dressing and bathing. Memantine appears to work by regulating the activity of glutamate, a chemical messenger in the brain that plays an essential role in learning and memory. Some doctors also prescribe antianxiety medications to help relieve the sleeplessness and agitation common in people with the disorder.

Treatment focuses primarily on managing the symptoms and supporting the person’s ability to function independently for as long as possible. If you are a caregiver, your doctor will help you learn how to provide the best possible care for your loved one. For example, keeping routines and surroundings familiar can be comforting and stabilizing for people with Alzheimer’s disease, who have difficulty learning and organizing new information. Explaining each step in a daily task such as dressing can help the person perform the task more easily. Do as much as you can to simplify the tasks by, for example, laying out the person’s clothes in the order in which he or she should put them on. Show the person what to do by performing each task so he or she can copy your actions. Use calendars, clocks, and lists to help the person maintain some sense of time and purpose.

Care for the Caregiver

The job of caring for a person with Alzheimer’s disease can be overwhelming and exhausting. If you are a caregiver, the stress you are experiencing may make you feel depressed, frustrated, angry, guilty, or isolated. But for you to be able to help your loved one, you need to protect your own health. The most significant step you can take to keep yourself healthy is to share your caregiving responsibilities. Don’t be afraid to ask for help or to accept it when it is offered. Seek assistance from siblings and other family members, and take advantage of the time to yourself to get some needed rest and relaxation. Find resources such as home health aides, hired caregivers, or day care centers in your community. You may also be able to arrange for your loved one to be admitted to a nursing care facility for a brief period to allow you to take a break from your responsibilities. Use this time to go on a trip or find things that you enjoy doing.

Preventing Alzheimer’s Disease

Researchers are studying some promising strategies for preventing Alzheimer’s disease and improving the quality of life of people with the disease. For example, studies have found a link between Alzheimer’s disease and mental stimulation, education levels, and other social and behavioral factors. People who continue to engage in intellectually challenging activities as they grow older seem to be less likely to develop symptoms of Alzheimer’s disease than people who