Slowing Alzheimer's Progress

How to Slow the Progression of Alzheimer's Disease
senior woman at the game table

Quick summary

The memory loss and other cognitive changes characteristic of Alzheimer's disease and most other forms of dementia can't be reversed. But there are some proven ways to delay further decline, at least over the short term.

The Rush Memory and Aging Project is a large ongoing longitudinal study looking at common chronic conditions of aging with an emphasis on decline in cognitive and motor function and risk of Alzheimer's. A continuously updated list of scholarly publications featuring research conducted by study investigators can be found on the Rush University Medical Center website.

Mental Activity

A growing body of research indicates that stimulating the brain has the power to slow the progress of Alzheimer's, particularly in the early stages. More-frequent cognitive activity across the life span is linked to slower cognitive decline later in life, according to the Rush Memory and Aging Project.

What you can do:

SEE ALSO: Find Memory Care Near You

Encourage the person in your care to participate in activities she finds pleasurable, especially those that engage the mind: reading, writing, playing the piano, working crosswords or puzzle books, playing games such as chess, or even learning a language. Present her with fresh materials or plenty of opportunities.

Local senior centers and adult daycare programs are more than just a way to "pass the time." They excel at providing stimulating activities, including group storytelling, music, art, and games.

Some research suggests that activities are especially protective when they involve interacting with others. Healthy people who are socially active tend to have fewer memory problems than those who are more reclusive.

Arrange for help around the home, if possible, but avoid relieving her of all her customary responsibilities. Participating in daily chores can be a form of mental workout, too.

The catch with mental stimulation:

SEE ALSO: Find Memory Care Near You

It's important that someone with dementia find the activity pleasurable. If she finds studying Spanish or learning to use a computer frustrating because of existing cognitive declines, don't push it.

Also avoid formal mental "exercises" or memory drills. They may stress her, causing symptoms to worsen.

Too much social activity can also be stressful. Outings are best when low-key (small dinners as opposed to, say, big parties) and when they last under two hours.

 

Daily Life Modifications

Simplifying the living environment and providing the tools to assist her existing memory can help her maintain independence longer. This has the benefit of reducing stress and slowing further decline.

SEE ALSO: Find Memory Care Near You

What you can do:

Find ways to minimize any tasks she may worry about. For example, you could arrange electronic bill paying, hire a lawn service, enlist a young neighbor to handle her laundry, or cancel subscriptions to magazines she never reads. Help her keep her home free of piled-up newspapers, old mail, and other clutter. Look into electronic reminder systems, note-keeping systems, or commercially available tools that can help to prop up a faulty memory.

The catch with daily life modifications:

Be sure to make changes gradually. Too many abrupt changes -- removing all the clutter from a messy home in one sweep, for example -- can be disorienting and stressful to someone with Alzheimer's or other forms of dementia and hasten her decline rather than slowing it.

Routine and Familiarity

The stimulation of fresh ideas can have positive effects, but too much change in her life can be confusing and disorienting. Familiarity is very important to someone with Alzheimer's disease or other forms of dementia. The stress of having to cope with sudden or significant change can make symptoms worse. (Note: Stress doesn't cause Alzheimer's, but it has been shown to worsen symptoms in those already affected.)

SEE ALSO: Find Memory Care Near You

What you can do:

Try to give her day a regular rhythm, with meals, sleep, outings, and bathing happening at about the same times each day. Schedule all doctors' appointments at roughly the same time if you can, such as first thing in the morning or right after lunch. It's not unlike the way a new parent organizes the day around a baby's sleep-wake cycle.

The catch with routines:

A good routine is one that's healthy to begin with. Examples of negative routines worth trying to change: If she's staying awake later and later and rising later, or if she's dropped all former social connections and rarely sees anyone.

Vitamins and Herbs

Scientists are investigating several different dietary additions for people with dementia. Two of the most promising areas:

  • Antioxidants

A clinical trial showed that vitamin E helps slow down mental impairment in people with Alzheimer's. Vitamin E is an antioxidant, which helps protect cells against damage. It's now being researched in conjunction with B vitamins.

A large 2005 study found that healthy people who consumed more than 400 micrograms (the recommended daily amount for adults) of folate, a B vitamin that occurs naturally in many foods, cut their risk of developing Alzheimer's in half. This slowing of cognitive decline is being looked at to see if it's also true once decline has started.

  • Ginkgo biloba

    This herb, traditionally used in Chinese medicine, comes from the dried leaves of the gingko (maidenhair) tree. It's sometimes called the "memory herb," after findings that it appears to help slow down cognitive decline for some people in the early stages of Alzheimer's disease. To date, research studies making this claim have been criticized, however, and a randomized clinical trial sponsored in part by the National Institute on Aging and the National Center for Complementary and Alternative Medicine found the herb to be ineffective in reducing the development of dementia and Alzheimer’s disease in older people.

What you can do:

Encourage the person in your care to inform her primary-care doctor about any supplements and herbs she's been taking, and their dosages, and do so yourself if she doesn't. Bring the bottle, so the doctor can see exactly what's being taken. Too much vitamin E, for example, can cause gastrointestinal problems and other side effects, and can be fatal to people with heart disease.

In general, the best way to get important vitamins and minerals is to consume them from their natural food sources. One study found that Alzheimer's patients who most closely followed a Mediterranean-style diet (high in vegetables, legumes, cereals, fruit, fish, poultry, dairy, and monounstaturated fats -- and low in saturated fats) lived an average of 1.3 years longer than those who consumed a Western diet (higher in saturated fats and meats, lower in vegetables).

Try to make sure that she's eating a diet low in saturated fats and rich in vitamins E, C, and B. Older people's diets often lack fresh fruits and vegetables (such as citrus, berries, and leafy green vegetables), legumes (beans), whole-wheat or fortified bread, and nuts and seeds.

Take a close look at her eating habits. People with memory problems often slack off on cooking because even the familiar steps, as well as managing cutlery, become too challenging.

The catch with vitamins and herbs:

The one thing scientists agree on concerning memory loss and supplements is that more research is needed. No single "magic bullet" has been found to stop memory decline in its tracks, and no supplements should be taken by people with Alzheimer's or other forms of dementia without medical supervision.

Medications

Five FDA-approved drugs are used to delay the symptoms of Alzheimer's disease or prevent them from becoming worse for a limited time.

What you can do:

Talk to your loved one's doctor about which drugs might be appropriate. For mild to moderate Alzheimer's, cholinesterase inhibitors -- such as Aricept (donepezil), Exelon (rivastigmine), and Razadyne (galantamine), formerly called Reminyl -- may be prescribed. These medications help keep the enzyme acetylcholinesterase from reducing acetylcholine, which affects mental capabilities and muscle control. The drug Cognex (tacrine hydrochloride) was prescribed in the past, but is no longer recommended.

For moderate to severe stages, the drug Namenda (memantine) is also used. This drug is an N-methyl-D-aspartate (NMDA) receptor antagonist, which regulates glutamate (a chemical messenger in the brain that's associated with learning and memory).

The catch with medications:

Not every drug works for all patients. And each involves possible side effects and interactions with other drugs the person in your care may be taking. Talk to her doctor about whether any of these medications is a good fit.


over 2 years ago, said...

The article mentions a study with expected completion in 2009 as if 2009 was still in the future. Would be good to update the article with study results. Thanks for mentioning catches associated with the recommendations.


over 2 years ago, said...

My wife has been diagnosed with early stage dementia and on Aricept. I don't know that it is doing any good. She has become more withdrawn, and not socialising any more. She is not reading much these days. She always was an avid reader. So the tips in the article have been helpful for me.


over 2 years ago, said...

While I know that in my case, sleep apnea (undiagnosed for probably 20 years) was causing trouble with high blood pressure, rapid resting heart rate, and possibly thyroid related problems, I'm unsure that it's linked to AD. Besides - my father is 92 years old, the pulmonologist mentioned sleep apnea with my Dad once about 2 years ago, and I asked him how he suggested I get him to comply with the CPAP, when he won't wear his oxygen. That ended that discussion.


over 2 years ago, said...

I do not believe there is a way to slow the progression of the disease. However, I do believe understanding the best coping mechanisms for behaviors attributable to Alziheimer's does promote a better quality of life for the patient and his/her caregiver, especially a spouse.


over 2 years ago, said...

"how to slow the progression" is not informative in this article. The article just tells me how to live with it and make it more manageable for the person with dementia. That I already know.


almost 3 years ago, said...

A recent report from the American Academy of Neurology (AAN) revealed evidence from two studies that Sleep Apnea is a cause of the neurodegenerative dementias including Alzheimer's Disease. Patients who were treated with CPAP showed improvement. For details : www.neurotodayonline.com and go to "Obstructive Sleep Apnea Associated with Dementia Risk."


over 3 years ago, said...

what is your source for stating that the drugs mentioned in your article slow the progression of the disease? Many people are arguing that said drugs to not slow progression while other researchers state they can/do slow progression, hence my question as to your source. I started my mom on namenda and exelon patch at the time of diagnosis because there was hope the medications would slow the progression. Mom has not declined since she started the drugs and was diagnosed which was ;07. thank you


over 3 years ago, said...

is in the article to long on Alzheimer's. My Dad pssted away this past 8/24/2012. In our home . My husbsnd snd I took care of him for 3 1/2 years. I have to say it was difficult, but one of the most rewarding times of our lifes.my dad had Lewy Bodies dementia and Parkinson's disease. we tried all kinds of things to get his memory to hold on a little longer, but was never interested in anything we tried,so we were trying new things still no interest, so we would go back and try things that we had already tried. still no interest. Louie bodies dementia is one of the worst. forms of Alzheimer's. there is.we were told by so many family members to put him in a nursing home. We could not do that.I just hope they find a cure for all the patience to come.because to watch my father, to go from this light hearted happy man smart. To what he became. I am just so glad he's out of his misery. I pray for New Hope for all the people still suffering.I just wanted to write and say what a blessing it was to have my father with me and my wonderful husband that help so much. Not many husbands would take the time to help their wife out and love their father in law like they're own father.I am truly am truly blessed.what is 1 of the most memorable experiences we will have her off had I love my dad with all my heart it wasn't always like that. But today I can truly say he's a wonderful man and I wouldn't have changed a thing about him. Except for him getting this awful diseasemay God bless you dad you are with mom nowand I truly love you both with all my heart and soul and for what we went through with dad things will never be the same in my life what an amazing experience thank you God for giving us the chance to take care of my father.


over 3 years ago, said...

Present other ways to slow the progression, especially early stages. My husband has no interest in the ways suggested in this article.


over 3 years ago, said...

Explanation of what the two drugs my husband takes do.


over 3 years ago, said...

The info on a recommended diet and medications.


over 4 years ago, said...

What a positive blog! It can give hope to many caregivers. http://www.lovemyoldfolks.com/when-to-intervene/ "Ž


over 4 years ago, said...

Nice to see simple steps outlined. Printable to share with family


almost 5 years ago, said...

very interesting article. unfortunately i am observing most of the symptoms. i have discovered routine and organization is a very important key to managing symptoms. also true about the caregiver taking time to care for self.


almost 5 years ago, said...

Made me realize how important it is to try to keep the person busy with worthwhile activities that they enjoy.


almost 5 years ago, said...

There is no way I believe that what a person who already has Alzheimer's eats - or what supplements she takes - have any effect on the course of the disease. Gingko is not a proven therapy for anyone; the tested pharmacological drugs help some people show fewer syumptoms for a little longer, but do not halt or delay the disease's progress, not from anything I have read. The time when a healthy diet would have impact on this disease in when people are younger - probably what we eat as children has a more significan impact on the growth - and ultimate resiliency - of the brain than anything that can be done in later decades. While the article gives good suggestions for helping people to best use what they've ( or their relatives have) got - and to reduce unnecessary stress - again - it is best to increase the brain's resources by engaging in many different activities when younger - and to keep up interests - not necessarily because they absolutely prevent AD, but because they give you more to work with as you age. There is a major genetic compoment in all this - but it also looks as if some of the same threats to our health that contribute to heart disease and some cancers - obesity, high blood pressure, poor diet, lack of exercise - also may set up some people for Alzheimer's or other dementias. I am just affraid that people may think that if they make all the recommended changes, the individual with Alzheimer's symptoms will be "normal" ... but this simply will not happen. Expectations that are too high lead to frustration for all involved.


almost 5 years ago, said...

"Ooh, let's stretch out an article over five pages to get more clicks." FAIL! Because I leave petty little websites that resort to creepy click-throughs, Asta la Vista Beyotches!


almost 5 years ago, said...

It was very informative, with a lot of information given. I learned many things I had not heard before.


about 5 years ago, said...

yes I am going to check into the electronic reminders


about 5 years ago, said...

yes


about 5 years ago, said...

My mom was dx w/ "Dementia of the Alzheimers Type" in Jan of 2008. Honestly her symptoms began in May of 2005 while taking care of my dying dad who passed Dec 2005. The assisted living facility she is in now does not take Medicaid and we are all out of money except for her house, which my son (9) and I are currently living in. Since we cannot pay the assisted living they are expecting me to move her out end of the month. 10 days. I guess I'll just bring her home and take care of her here. (I have a very flexible part-time job). We did everything this article recommends and she remains on Namenda and Excelon patch entering or having entered Stage 3. She seems finally adjusted to the assisted living and I haven't found any openings in places that take Medicaid close to home. I am terrified of the effects her demise will have on my 9 yr old son, who is very self centered and unempathic. (He wants his old grandma back that knows who he is). I am confident my husband will use the same excuse for his 2007-08 business venture failures to take my son away from me; he says" I gave up my family to take care of my mom." He has 5 bros and sisters, I have 1. His mom passed in a nursing home after major complications from heart surgery in Dec. 2008, and his dad already remarried. Am I asking too much of my son and husband to stick with me until the end? I cannot apply for Medicaid until I get the last 2 years taxes done. I haven't even had time to take the christmas tree down. I worry her demise will be hastened by coming home and having only me to depend on again. She is not a wanderer as she has RA and is in pain when trying to walk w/her walker. We have no wheelchair yet. I know I can get PT in here couple times a week and Medicare should pay for some home health aide help, yes? we are in Ohio. There is more to the story as she is newly diabetic as an overdose of prednisolone over 2 mos. caused her to bleed out Nov 2009 at home and she has been from ICU to skilled nursing and back to assisted living since then. She had no history of peptic ulcers. I truly believe the ulcer must have been adjacent to her pancreas as she had never had any symptoms of type II or sugar probs before this 4 month course of prednisones. Thru it all she never complained once and was pleasant and compliant even if confused and now definitely in begining of Stage 3. She is constantly worried what her father is going to do or say when he finds out she is sick and seeing all these doctors! She thinks I'm her mom or twin sister alot, but i don't care. She is often smiling and so happy to see me. I am terrified of handling Stage 3 alone.


over 5 years ago, said...

"Alzheimer's" is the popular generic for all kinds of dementia. However, there are other causes of senility/dementia besides Alzheimer's, and they should not be ignored.


over 5 years ago, said...

Hi obbyscuba, Thank you for your question. If you'd like, you can post your question in our Ask & Answer section, here: ( http://www.caring.com/ask ). I hope that helps. Take care -- Emily | Community Manager


over 5 years ago, said...

What is wrong with rising later and going to bed later? If that is their current pattern it seems better to go with the flow.


over 5 years ago, said...

Rereading the stream of comments it seemed to me and still seems to me that many of us are seeking information on anything that may help us. For me, one of the most helpful things has been the direct experience of others who are caring for an Alzheimer's affected spouse, sometimes referred to as your life partner. My life partner is slipping away. I don't believe there are drug cures for Alzheimer's. It is fair to ask then why I give him Aricept and Namenda. It's not because I am expecting a cure. It is to delay the onset of total cognitive collapse. I don't know if it's helped or not. The things other spouses communicate to me are small things that facilitate my efforts and help me to feel less alone. Feeding tips that help keep the affected spouse eating. Sleeping tips that help keep him sleeping at night rather than in the daytime and roaming at night. Pats on the head from others who have been there. Someone asked why it is mostly females that are considered in these comments. There are a some reasons I can think of: Spouses more often take care of each other. Since women often live longer, they get their Alzheimer's after their spouses have died. Also, in our culture, husbands are often older than their wives. While I see comments from many daughters who take care of their mothers, it also is not uncommon that mom is "placed" in a wonderful facility with lots of activities and stimulation. These comments that we write are an attempt to be helpful. Sometimes a little background puts that help in context so that it is easier to relate to a readers personal situation. We, as readers, are sometimes a little cranky if our questions aren't answered the way we would like them to be. We aren't getting enough sleep and we are exhausted from worry.