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Dec 13, 2022

Mental Health

Alzheimer's vs Dementia

Alzheimer's dementia affects approximately 6.2 million Americans aged 65 and older.

What is Dementia?

Dementia is characterized as a progressive decline in intellectual and social abilities, and impaired functioning. The most noticeable initial symptoms include memory loss.

As dementia worsens, issues develop with judgment, attention, planning, and personal grooming. Agitation, aggression, and depression can be present and are difficult challenges for individuals and caregivers.

There are various types of dementia, including Alzheimer's disease, vascular dementia, and Lewy body dementia.

What is Alzheimer's Disease?

The most frequent cause of dementia, which is characterized by a steady deterioration in mental, behavioral, and social abilities and impairs an individual’s capacity for independent functioning, is Alzheimer's disease.

Alzheimer’s dementia is characterized by neuritic plaques and tangles in the brain tissue, which interrupts neuron signaling, and/or alteration of neurotransmitters (chemical messengers), such as reduced acetylcholine (ACh).

In other words, Alzheimer’s disease is a degenerative neurological condition that results in brain shrinkage and the death of brain cells.

What are the symptoms of Alzheimer’s disease?

Being that Alzheimer's disease normally affects the portion of your brain linked to learning, difficulty remembering new knowledge is the most frequent early sign of Alzheimer’s.

Symptoms of this medical condition, which include confusion, disorientation, and behavioral abnormalities, worsen as the disease progresses. Speaking, swallowing, and walking eventually become challenging.

Common symptoms of Alzheimer's disease include:

  • Difficulty communicating, repeating words, and information
  • Inability to learn and/or remember new information
  • Memory loss and/or getting lost
  • Poor coordination and/or motor function
  • Inappropriate demeanor
  • Personality/mood changes
  • Paranoia, agitation, and/or hallucinations

What are the risk factors for Alzheimer's disease?

Family history

Your risk of developing Alzheimer’s disease rises if family members, particularly parents or siblings, have or have had this disease.

Age

The risk of developing Alzheimer’s disease increases with age (after the age of 65 years). Every 5 years after age 65, the chance of developing Alzheimer's doubles. The risk increases to roughly one-third after the age of 85.

Gender

More women than males develop Alzheimer’s disease.

Genetics

Risk genes and deterministic genes are 2 types of genes that affect whether individuals develop this disease.

How is Alzheimer's Disease Treated?

The U.S. Food and Drug Administration (FDA) has authorized several prescription medications to help individuals with Alzheimer's disease manage their symptoms.

Medications used for Alzheimer's disease are Acetylcholine Inhibitors and Memantine

1. Acetylcholine Inhibitors

This drug class of medications is the mainstay of treatment. They are used alone or with memantine in more advanced stages of Alzheimer's disease.

Clinical improvement with these mediations is modest, but individuals generally have a slower clinical progression than with no treatment at all. Some individuals may have no noticeable improvements and can experience side effects, such as nausea, diarrhea, and/or dizziness.

Donepezil (brand: Aricept)

Start at 5 mg taken every night (to help decrease nausea), can increase to 10 mg every night after 4-6 weeks

  • For moderate-to-severe disease: can increase to 23 mg every night after greater than 3 months of taking 10 mg every night.
  • This medication comes as a tablet, as well as an ODT (orally disintegrating tablet)
Order Donepezil HCL

Rivastigmine (Exelon)

Start at 1.5 mg twice a day, taken with breakfast and dinner

  • Rivastigmine comes as a patch: start with 4.6 mg/24 hours. Can increase every 4 weeks to 9.5, then 13.3 mg/24 hours (max dose).
    • Apply the first patch the day after the last oral dose; apply daily at the same time each day; rotate application sites and avoid using the same site for 14 days.
    • This patch can be applied to your upper or lower back, upper arm, or chest.
Galantamine (Razadyne, Razadyne ER)
  • IR (immediate-release): start 4 mg twice a day, taken with breakfast and dinner
  • ER (extended-release): start 8 mg taken daily, taken with breakfast

Common side effects of these medications:

  • Slow heart beats
  • Insomnia
  • Nausea
  • Vomiting
  • Diarrhea
  • Tremors
  • Weight loss

2. Memantine (brand: Namenda, Namenda XR)

  • IR: start with 5 mg daily. This formulation can be titrated weekly by 5 mg to a max dose of 10 mg twice a day.
  • ER: tart with 7 mg daily. This formulation can be titrated weekly by 7 mg to a max dose of 28 mg daily.
Order Memantine ER

This medication is approved for use alone or with donepezil for moderate-to-severe disease.

Common side effects found with Memantine

  • Dizziness
  • Headache
  • Diarrhea or constipation
  • High or low blood pressure

Speak With Your Doctor

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