Neuro-forward Care for Alzheimer’s Disease Patients
Alzheimer’s disease continues to have a significant impact on public health worldwide. While a cure is yet to be discovered, there are a number of drugs that have been shown to treat the symptoms of Alzheimer’s. Recent research has shed more light on how these drugs work and how they can improve quality of life for Alzheimer’s patients.
The Current Impact of Alzheimer’s Disease
A recent study in Communications medicine states that “Alzheimer’s disease (AD) is the most common neurodegenerative disease.” (Yaghmaei E, et al.) The World Health Organization lists Alzheimer’s disease as one of the top five causes of mortality worldwide.
The disease has especially taken its toll in the United States. McKnight’s Long-term Care News reports that “Alzheimer’s deaths have more than doubled between 2000 and 2024,” going on to explain that “about 1 in 9 people (11%) age 65 and older have clinical Alzheimer’s dementia.”
This rapidly increasing population of Alzheimer’s disease patients represents a major challenge for public health and long-term care. McKnight’s puts the projected costs for people living with dementia for 2026 at $409 billion. If current trends continue, that cost will reach $1 trillion by 2050. Finding effective treatment for these patients will continue to occupy long-term care providers in the decades to come.
Donepezil and Memantine — a Winning Combination for Treating Alzheimer’s Disease
The Communications medicine article cited above, Combined use of Donepezil and Memantine increases the probability of five-year survival of Alzheimer’s disease patients, published the results of a comprehensive causal inference study of the survival rates of Alzheimer’s disease patients who had undergone different drug treatments.
The study authors acknowledge that “despite major advances in our understanding of genetic and environmental risk factors, pathological features, and diagnostic methods, the currently available treatments are largely limited to alleviating AD symptoms.” However, their research did identify an increased survival probability for one particular group of Alzheimer’s disease patients. (Yaghmaei E, et al.)
The study found that two particular drugs, Donepezil and Memantine, when taken together, led to increased survival probability over five years versus taking only one of the drugs or no drug treatment at all.
Those drugs have been part of Alzheimer’s disease treatment for some time, but the way they work in tandem has only recently been explored in detail.
What Is Donepezil?
Donepezil is a Cholinesterase inhibitor, often known by its commercial name, Aricept. It is commonly prescribed to treat mild to severe dementia symptoms in Alzheimer’s patients.
Donepezil helps the brain retain acetylcholine, which can promote improvement of the patient’s mental health in the following areas.
- Memory
- Attention
- Other cognitive functions
What is Memantine?
Memantine works as an NMDA receptor antagonist. It helps protect the brain from overstimulation due to excess glutamate. This drug is prescribed for Alzheimer’s patients to improve memory, attention, reason, and language, but can also be used to treat symptoms such as—
- Delusions
- Agitation
- Aggression
Better Quality of Life for Alzheimer’s Patients
Other new studies have found additional benefits to the Donepezil and Memantine combination. The journal PLOS One published a separate causal inference study which concludes that “the combined use of Donepezil and Memantine treatment significantly reduces the average number of hospital or emergency department visits per year.” The study also revealed what the authors call a “significant beneficial additive drug-drug interaction effect between Donepezil and Memantine.” (Yaghmaei E, et al.)
These positive interactions have hopeful implications for long-term care. The Communications medicine research cites not only improved five-year survival probability, but also that Donepezil and Memantine together “reduced the need for caregiver assistance and delayed nursing home placement.” (Yaghmaei E, et al.)
Treat the Whole Patient
At GuideStar Eldercare, our clinicians have already embraced these two drugs in providing long-term care for dementia patients, as outlined in our blog post Dementia Medications: A Guide for Families and Staff.
Our work has found that Donepezil and Memantine can treat many of the behavioral and psychological symptoms of dementia known collectively as BPSD. These two drugs have shown to improve BPSD not only for Alzheimer’s patients, but for patients with other types of dementia as well—including vascular, mixed, and Lewy body dementia, as well as Parkinson’s disease. Refer to our blog post Practical Research – Managing BPSDs for more information.
At GuideStar Eldercare, we seek to deliver comprehensive clinical care for all our patients in long-term care facilities. This involves employing the latest methods at our disposal, including neurology-based drug treatments like these.
Treating the underlying neurology of residents living with dementia has the additional benefit of potentially reducing your facility’s rate of antipsychotic use. Helping to improve cognitive function and emotional regulation without resorting to antipsychotics is just one of the ways GuideStar Eldercare can help your facility improve on key metrics. Get in touch today to learn more about partnering with us.