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Alzheimer's Disease

While there is no cure for Alzheimer's disease and no way to reverse the deterioration it causes, care is available at NewYork-Presbyterian to treat symptoms of the disease and to provide guidance, education, rehabilitation, and support to patients and their families. Our doctors may prescribe medications to specifically treat the cognitive symptoms of Alzheimer's disease.

In the early stage of the disease, drugs called cholinesterase inhibitors (Aricept®, Exelon patch®, and Razadyne®) may be used, which cause modest relief of symptoms for most patients. In patients with the moderate to severe stages of Alzheimer's disease, doctors may prescribe memantine (Namenda®), a drug that affects the neurotransmitter glutamate in the brain and provides some modest benefits in patients. In addition, a number of other medications can help manage symptoms of the disease, such as depression, agitation, hallucinations, delusions, and insomnia.

Rehabilitation involving structured activities can also be an important aspect of treatment for Alzheimer's patients. Regular physical exercise and social activities can provide patients with structure, meaning, and a sense of accomplishment, and help manage some behavioral symptoms of the disease.

Other Causes of Dementia

In addition to Alzheimer's disease, NewYork-Presbyterian provides care for patients with other causes of dementia, such as:

  • Lewy body dementia, a progressive dementia linked to the abnormal protein present in Parkinson's disease.
  • Frontotemporal dementia, in which nerve cells in the frontal and temporal lobes of the brain deteriorate. Its prevalence among people with a family history of dementia suggests a strong genetic basis for the disease.
  • Vascular dementia, which is caused by brain damage from cerebrovascular or cardiovascular problems such as strokes, heart problems, and genetic diseases.
  • HIV-associated dementia. The drugs used to treat HIV infection can delay onset of this disease and reduce symptoms.
  • Huntington's disease, a hereditary disorder which causes degeneration in many regions of the brain and spinal cord.
  • Chronic traumatic encephalopathy (formerly called dementia pugilistica), which results from repeated head trauma. Dementia symptoms can appear many years after the trauma ends.
  • Corticobasal degeneration and progressive supranuclear palsy, progressive disorders linked to the accumulation of an abnormal protein in the brain (called "tau").
  • Dementias that occur in patients with disorders that primarily affect movement, such as Parkinson's disease, multiple sclerosis, motor neuron diseases such as amyotrophic lateral sclerosis (Lou Gehrig's disease), olivopontocerebellar atrophy, Wilson's disease, and normal pressure hydrocephalus.

At NewYork-Presbyterian, our doctors first determine if the dementia is caused by a medical condition that can be treated, resulting in relief of symptoms and restoring mental function. Most dementias cannot be reversed, however, and in these cases our goal is to improve symptoms. Symptoms are sometimes alleviated by medications such as:

  • Antidepressants for patients whose dementia is accompanied by depressive symptoms.
  • Cholinesterase inhibitors.
  • Parkinson's disease medications, which can help reduce Parkinson's-like symptoms in some patients with Lewy body dementia.
  • Antipsychotic medications, which can alleviate delusions and hallucinations in some dementia patients.

NewYork-Presbyterian Hospital is known for our expertise in caring for patients with normal pressure hydrocephalus, a reversible disorder that can often be resolved with surgery. Our physicians are also working to develop new medications to treat this cause of dementia.

In the early stages of dementia, patients may benefit from a form of rehabilitation called cognitive training. Using memory aids such as mnemonics, computerized recall devices, or note-taking, for example, patients with dementia can sometimes improve their cognitive function.

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