A diagnosis of dementia may seem devastating for you or in reference to a loved one, but 
there are a number of treatments for dementia, depending on what type it is and how far it has progressed.
There are several different kinds of dementia; not all dementia is Alzheimer’s. Four of the most common are:
* Vascular dementia
* Dementia with Lewy bodies (DLB)
* Parkinson’s
* Alzheimer’s
Let’s look at each type in more detail.
1. Vascular Dementia
Vascular dementia is caused by problems with the blood vessels which supply the brain. It often develops after the person has had a stroke. Stroke can trigger a range of symptoms, from mild impairment to paralysis down one side of the body. Treatment includes medications to:
* Lower blood pressure
* Reduce cholesterol
* Prevent blood from clotting, to keep arteries clear
* Tight blood sugar in the case of diabetes
* Exercise
* A healthy diet
* A healthy weight
* Checking to see that the carotid arteries which supply blood to the brain are clear
2. Dementia with Lewy Bodies (DLB)
Lewy bodies are clumps of a particular protein that can clog the cerebral cortex and affect memory and thinking problems. Sufferers often have trouble sleeping and visual hallucinations.
A number of treatments can help.
* Alzheimer’s medications – Medications for Alzheimer’s (known as cholinesterase inhibitors) such as rivastigmine (Exelon), work by increasing the levels of neurotransmitters in the brain. This can help improve alertness and cognition, and may help reduce hallucinations and other behavioral problems.
* Parkinson’s disease medications – Medications such as carbidopa-levodopa (Sinemet) may help reduce Parkinsonian symptoms, including as rigid muscles and slow movement.
* Medications to treat other symptoms – Sleeping pills are often prescribed. People with DLB should not be given anti-psychotic medications, as these can worsen behavior and hallucinations.
3. Parkinson’s Disease
With Parkinson’s the cells that produce dopamine, an essential neurotransmitter, are damaged. As Parkinson’s disease progresses, it often results in dementia similar to dementia with Lewy bodies, or Alzheimer’s. The main symptoms are problems with movement, such as slowness, rigidity, and changes in gait and tremor (the shakes).
There are many medications which may be used to treat the various symptoms of the condition:
* Carbidopa-levodopa – This is the most effective Parkinson’s disease medication. It is a natural chemical that passes into your brain and is converted to dopamine. However, the effects can vary over time and the patient may eventually develop resistance to it. It can also make them have more tremors.
* Dopamine agonists – These mimic dopamine effects in your brain. They include pramipexole (Mirapex), ropinirole (Requip) and rotigotine (given as a patch, Neupro).
* A short-acting, injectable apomorphine (Apokyn), can be used for quick relief of troublesome symptoms.
* MAO-B inhibitors – These help prevent the breakdown of brain dopamine by inhibiting the brain enzyme monoamine oxidase B (MAO-B). This enzyme metabolizes brain dopamine. Medications include selegiline (Eldepryl, Zelapar) and rasagiline (Azilect).
* Catechol-O-methyltransferase (COMT) inhibitors – Entacapone (Comtan) mildly prolongs the effect of levodopa therapy by blocking an enzyme that breaks down dopamine.
* Anticholinergics – These are used to control tremor, include benztropine (Cogentin) and trihexyphenidyl.
* Amantadine – This is used in cases of mild, early-stage Parkinson’s disease and can be used to control tremor.
4. Alzheimer’s
Alzheimer’s is the most severe form of dementia, but new treatments are emerging all the time as a result of patients enrolling in clinical trials and new drugs and strategies being used. For example, a growing body of research has shown that exercise can actually slow the progression of Alzheimer’s and help even those with severe disease so their symptoms don’t worsen.
There are also a number of strategies for dealing with “sundowning”, a typical symptom of Alzheimer’s that happens towards the end of each day, usually around dinner time or when the person with Alzheimer’s is supposed to be going to bed. Experts believe it is the result of overtiredness similar to a child having a temper tantrum, and have a number of effective ways to deal with it.
Medications include cholinesterase inhibitors and memantine (Namenda). It can slow the progression of symptoms with moderate to severe Alzheimer’s disease.
