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alzheimer's disease

health canada-approved treatments: alzheimer’s disease

this complete guide outlines all the treatments available for alzheimer's disease in canada.

by angelica bottaro

published oct 15, 2024

24 minute read

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24 minute read

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alzheimer's treatment continues to make progress with research and dedication to finding new ways to slow disease progression and improve symptoms. getty images

this article is for informational purposes only and is not intended to provide medical advice, diagnosis or treatment. always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. alzheimer’s disease is a form of dementia, a group of progressive brain disorders that lead to a gradual decline in various cognitive areas, including memory, thinking, social skills, and behaviour. it is believed to be driven by a build-up of proteins in the brain known as beta-amyloid and tau. it accounts for 50 per cent of all dementia-related diseases.

beta-amyloid proteins build up around brain cells in plaques, while tau proteins form tangles within brain cells. both are thought to interfere with communication between brain cells and contribute to cell death. the exact cause of alzheimer’s is unknown, so medical researchers are not yet clear on why these proteins begin to malfunction. it’s thought that a combination of genetics, lifestyle, and environmental factors drive the development of alzheimer’s disease.

that said, for one per cent of cases, specific genetic changes are known to cause the disease, and people with these genetic changes are all but guaranteed to begin to experience symptoms of alzheimer’s disease between the ages of 45 and 64.

even without a specific cause, in most cases, risk factors can determine how likely a person is to develop alzheimer’s disease, which include:

age: the older a person is, the more likely they are to develop alzheimer’s.
family history/genetics: people who have a first-degree relative, such as a parent or sibling, with alzheimer’s are more likely to develop it than those who don’t.
down syndrome: people with down syndrome are more likely to develop alzheimer’s than those who don’t due to having three copies of chromosome 21, which contains a gene involved in the production of beta-amyloid.
sex: biological females are more likely than biological males to develop alzheimer’s because they tend to live longer.
mild cognitive impairment (mci): people with mci have a higher risk of developing dementia-related diseases later on in life.
head trauma: people over the age of 50 who have experienced a traumatic brain injury (tbi) are at an increased risk of alzheimer’s disease.
excessive alcohol consumption or alcoholism: consuming large amounts of alcohol over a long period can cause brain changes that lead to alzheimer’s.
poor sleep patterns: a lack of adequate quality sleep and poor sleep patterns are connected to alzheimer’s risk.
lifestyle: certain unhealthy lifestyle practices, such as a lack of exercise, smoking, or having high blood pressure, can all play a role in the development of alzheimer’s disease.
other health conditions: people with obesity or poorly controlled type 2 diabetes are also at an increased risk.

while some of the risk factors associated with alzheimer’s disease are uncontrollable, many can be modified to decrease an individual’s risk.

the symptoms of alzheimer’s disease tend to come on slowly and worsen over time. they are broken into separate categories: memory, thinking and reasoning and changes in behaviour or personality.

signs and symptoms can include:

repeating questions or phrases over and over again
forgetting dates, conversations, appointments, or events
misplacing items or putting items in places that don’t make sense
getting lost in familiar areas
forgetting the names of everyday objects, friends, or family members
having difficulty expressing thoughts, participating in conversations or finding the right words
finding it difficult to perform more than one task at a time or perform tasks such as paying bills
making poor choices in specific settings, such as wearing a winter jacket in the summertime
forgetting how to handle simple tasks, such as not remembering how to handle hot food burning on the stove
forgetting or having difficulty planning and cooking meals or playing a game they’ve played their whole life
forgetting how to do basic tasks, such as showering or getting dressed
experiencing mood changes, such as developing depression, anger, agitation, or delusions
experiencing behavioural changes, such as social withdrawal, loss of interest in activities, mood swings, distrusting others or paranoia
wandering
loss of inhibitions
sleep changes

over time, these cognitive changes make it difficult for a person to care for themselves or live alone. eventually, people with alzheimer’s disease will require 24-hour care to ensure they do not unintentionally put themselves in dangerous situations.

there is no cure for alzheimer’s disease, so treatment is designed to manage symptoms. people living with alzheimer’s can experience better quality of life for longer if they receive treatment. roughly 750,000 canadians are currently living with alzheimer’s.

this article discusses the pharmaceutical, adjunct, and lifestyle interventions available to canadians living with alzheimer’s.

sources:

mayo clinic: alzheimer’s disease.

health canada: dementia overview.

health canada: dementia symptoms and treatment.

statistique canada. alzheimer’s awareness month

canadian psychological association. “psychology works” fact sheet: cognitive disorders and dementia

prescription medications

medications approved for alzheimer’s in canada are used to address cognitive changes and, in some cases, behavioural and mood changes. that said, drugs used for behaviour and mood are typically a last resort after other interventions have failed.

the cognitive changes addressed through medication include memory, communication, ability to perform daily activities, and awareness.

donepezil (aricept)

donepezil is a cholinesterase inhibitor. these drugs work by preventing the breakdown of the neurotransmitters acetylcholine and butyrylcholine. these neurotransmitters play a role in cognitive ability, such as memory, learning, attention and arousal, and increase communication between nerve cells. the drug is used in alzheimer’s to help slow cognitive decline.

donepezil is available as oral tablets and should be taken daily. depending on the type prescribed, the tablets can be swallowed whole or placed under the tongue to dissolve.

the dosage will depend on the person, but people typically start off at a low dosage of 5 mg per day, with increases happening after four to six weeks and then again in three or more months.

the drug can be increased in increments starting at 5 mg per day, then 10 mg per day, and then again to a maximum dosage of 23 mg per day. those with mild to moderate alzheimer’s disease will likely be kept at the lower dosage of 10 mg per day, whereas those with severe alzheimer’s disease will be given the higher dosage of 23 mg per day. donepezil should be taken at night before bedtime, with or without food.

many side effects are associated with donepezil, although people may not experience them all. they include:

gastrointestinal distress, such as nausea, vomiting, diarrhea, and loss of appetite
weight loss
urinary issues, including difficulty controlling urination and frequent urination
muscle and joint issues, including muscle cramps, joint pain, swelling or stiffness, and general pain
sleep disturbances, such as excessive tiredness due to difficulty falling or staying asleep and abnormal dreams
headaches
dizziness
mental health and brain changes, such as depression, confusion, changes in behaviour or mood, nervousness, and hallucinations
red, scaling, or itchy skin

these side effects are generally considered mild. serious side effects can also occur that require emergency medical treatment. they can include:

heart-related issues, such as fainting, a slow heartbeat, and chest pain
gastrointestinal issues, including black, tarry stools, red blood in stools, bloody vomit, and vomit that looks like coffee grounds, and new or worsening stomach pain or heartburn
urinary issues, including finding it difficult to urinate or experiencing pain during urination
lung issues, including new or worsening breathing problems
pain in the lower pack
fever
seizures
bruising or discolouration of the skin

people under the age of 18 should not take donepezil, as the safety of the drug has not yet been established in children. others who should avoid the drug include:

those who are allergic to donepezil or its ingredients
people with liver, kidney, or heart disease
those with ulcers in the gut, stomach, or intestines
people with irregular or slow heartbeats
those with lung diseases, such as asthma or chronic obstructive pulmonary disease (copd)
people who have ever had a seizure
people with any health condition that makes urination difficult
people who weigh less than 120 lbs
people who are pregnant or planning to become pregnant

people taking certain drugs, such as antihistamines, non-steroidal anti-inflammatories (nsaids), bethanechol, carbamazepine, dexamethasone, ipratropium, and ketoconazole, should speak to their doctor about these medications prior to starting donepezil. other medications that may not be able to be taken with donepezil include:

phenobarbital
phenytoin
quinidine
rifampin

certain medications taken for glaucoma, irritable bowel disease (ibd), motion sickness, myasthenia gravis, parkinson’s disease, ulcers, or urinary problems can also negatively interact with donepezil, so people should tell their healthcare provider about those medications before starting the drug as well.

sources:

health canada: dementia symptoms and treatment.

drugs.com. donepezil dosage.

medline plus. donepezil.

uk national health service. who can and cannot take donepezil.

rivastigmine (exelon)

rivastigmine is another cholinesterase inhibitor and functions in the same way as donepezil. it is used to improve cognitive symptoms in people with alzheimer’s disease, but it is also used in the treatment of dementia-related symptoms in parkinson’s disease. there are three administration methods for rivastigmine: oral capsule, liquid oral solution, and a transdermal patch applied to the skin.

for mild or moderate alzheimer’s disease, rivastigmine is given in an initial 1.5 mg dosage twice per day if taken orally and 4.6 mg per 24 hours if the patch is used. the dosage will be increased to 3 mg per day after two weeks if the drug is well-tolerated, and then again to 4.5 mg and 6 mg per day every two weeks until the maximum oral dosage (6 mg) is reached.

if the patch is used, the dosage increases take place four weeks after treatment starts. the dosage can be increased to 9.5 mg per 24 hours up to a maximum dosage of 13.3 mg per 24 hours.

the side effects that can develop in people taking both oral or transdermal rivastigmine include:

gastrointestinal distress, such as nausea, vomiting, diarrhea, loss of appetite, heartburn or indigestion, stomach pain, constipation, and increased gas
weight loss
weakness
dizziness
extreme tiredness and lack of energy
tremors or the worsening or existing tremors
increased sweating
confusion

these symptoms can be mild, but if they are severe or don’t go away, people taking rivastigmine should contact their doctor. other more severe side effects that require emergency medical care include:

skin issues, such as a rash or hives
mental changes, such as anxiety, an increase in aggression, auditory or visual hallucinations, anxiety, and depression
gastrointestinal issues, including black, tarry stools, red blood in stools, blood vomit, or vomit that looks like coffee grounds
urinary issues, such as painful or difficult urination
seizures
uncontrollable movements or muscle contractions

the use of rivastigmine should be avoided in people with asthma, enlarged prostate or other conditions that block urine flow, ulcers, abnormal heartbeats, seizures, uncontrollable shaking of body parts, and heart, lung, kidney, or liver disease unless otherwise directed by a doctor. those under 110 lbs and people who are pregnant or planning to become pregnant should also avoid the drug unless otherwise directed by their doctor.

certain medications can interact with rivastigmine, so people should tell their doctor if they’re taking any of the following medicines if prescribed this drug:

antihistamines
bethanechol
ipratropium
medications used to treat other health disorders, including ibd, motion sickness, myasthenia gravis, parkinson’s disease, ulcers, or urinary problems

sources:

health canada: dementia symptoms and treatment.

drugs.com. rivastigmine.

medline plus. rivastigmine.

medline plus. rivastigmine transdermal patch.

galantamine (remnyl er)

galantamine is another cholinesterase inhibitor that treats mild-to-moderate alzheimer’s symptoms. it is available in a tablet, an extended-release capsule, and a liquid solution. the tablets and liquid versions of the drug can be taken twice a day, with morning and evening meals, and the extended-release capsule can be taken once daily in the morning.

people taking galantamine should stick to a specific schedule where they take the drug at roughly the same times each day to get the most benefit.

the extended-release capsule dosage starts at 8 mg once daily for a minimum of four weeks. after those four weeks, they can be increased to 16 mg per day. following another four weeks on a dosage of 16 mg per day, another increase to 24 mg per day may occur.

the immediate-release tablets and liquid solution have different dosing schedules because they are taken twice daily. people given these tablets or oral solutions will take 4 mg twice daily with meals, which will then be increased to 8 mg twice daily after a minimum of four weeks. after another four weeks have lapsed, the dosage may be increased again to 12 mg twice daily to a maximum of 24 mg per day.

there are various side effects associated with galantamine, including:

gastrointestinal issues, including nausea, vomiting, diarrhea, loss of appetite, stomach pain, heartburn, and weight loss
extreme tiredness
dizziness
headaches
pale skin
uncontrollable shaking in one part of the body
depression
sleep disturbances, such as difficulty falling asleep or staying asleep
runny nose

these side effects are typically mild and go away over time. however, a doctor should be seen if they become severe or do not lessen.

other more severe side effects requiring emergency medical care include:

urinary issues, such as difficulty urinating, feeling pain or burning while urinating, or seeing blood in the urine
experiencing seizures
fainting
slow heartbeat
shortness of breath
bowel issues, such as black and tarry stools or red blood in the stools
bloody vomit or vomit that looks like coffee grounds

people with various chronic health conditions, including asthma or other lung diseases, an enlarged prostate, ulcers, seizures, an irregular heartbeat, or heart, kidney, or liver disease, should avoid the use of galantamine unless otherwise given the go-ahead from a doctor.

before taking galantamine, people should also inform their doctors if they:

are allergic to any of the ingredients
take certain medications, including nsaids, drugs for hiv or aids, other alzheimer’s disease medications, medications for high blood pressure, anticholinergic medications
are pregnant or are planning on becoming pregnant

other drugs that people should inform their doctors about before starting galantamine include:

ambenonium chloride
amitriptyline
benztropine
biperiden
clidinium
dicyclomine
glycopyrrolate
hyoscyamine
ipratropium
oxybutynin
procyclidine
propantheline
scopolamine
tiotropium
tolterodine
trihexyphenidyl
antifungals, including fluconazole, itraconazole, ketoconazole and voriconazole
bethanechol
cevimeline
cimetidine
clarithromycin
digoxin
fluoxetine
fluvoxamine
heart medications
nefazodone
neostigmine
paroxetine
pyridostigmine
quinidine

the dosages of these medications may be adjusted if taking galantamine, and the side effects of the drugs will need to be closely monitored.

sources:

health canada: dementia symptoms and treatment.

rexall canada. reminyl er.

medline plus. galantamine.

drugs.com. galantamine dosage.

memantine (ebixa)

memantine belongs to a class of medications known as nmda receptor antagonists. these medications work by decreasing irregular or abnormal activity in the brain to reduce symptoms such as issues with thinking and memory.

this drug is available in tablets, a liquid solution, and extended-release capsules. they are all taken orally. the solution and tablets are taken once or twice per day, while the extended-release tablet is taken once per day.

for the liquid solution and tablet form, people will start with a small dosage and increase over four weeks. week one begins at 5 mg once per day, with the dosage increasing to 10 mg at week two, split up into two 5 mg dosages daily. at week three, the dosage increases again to 15 mg, split up into one 5 mg dosage and one 10 mg dosage taken at separate times. the week four maintenance dosage is 20 mg per day, split up into two 10 mg dosages.

the extended-release capsule dosage starts at 7 mg per day and increases in increments of 7 mg per day that occur once per week up to a maximum dosage of 28 mg per day. the dosages of these capsules should only be increased if the medication is well-tolerated.

memantine comes with the risk of side effects, some of which are mild and typically go away over time, with others being more severe.

the mild side effects include:

mood changes, such as depression or aggression
dizziness
confusion
headaches
sleepiness
gastrointestinal issues such as diarrhea, constipation, nausea, vomiting and weight gain
pain in the body
cough

serious side effects that require prompt medical care include shortness of breath and hallucinations.

people who should avoid this medication unless otherwise directed are those with preexisting health conditions such as seizures, urinary issues, and kidney or liver disease.

sources:

health canada: dementia symptoms and treatment.

drugs.com. memantine dosage.

medline plus. memantine.

brexpiprazole (rexulti)

brexipiprazole is a newer drug that health canada approved in january of 2024 to help treat agitation in people with alzheimer’s disease. if someone has alzheimer’s without agitation, they are not a candidate for treatment with brexpiprazole.

brexpiprazole has also been used to treat the symptoms of schizophrenia in adults and children over the age of 13 or as an additional therapy for depression prescribed alongside antidepressants if the antidepressants do not make enough of a difference in symptoms on their own.

this drug belongs to a class of medications known as atypical antipsychotics. they change the activity of the brain by modulating certain neurotransmitters, including serotonin, norepinephrine, and histamines.

brexpiprazole is an oral tablet that can be taken once daily, with or without food. for the best possible efficacy, it should be taken at the same time every day.

for alzheimer’s, the dosing schedule will begin with a small dosage of 0.5 mg per day for one week. on week two, the dosage is increased to 1 mg per day and then to 2 mg per day on week three. the maximum dosage is 3 mg per day, but that dosage is only reached if it is clinically warranted to calm symptoms of agitation.

this drug can cause several side effects, which range between mild and severe. the mild side effects can include:

headaches
gastrointestinal changes, such as constipation, diarrhea, heartburn and an increased appetite
tiredness
uncontrollable shakes
dizziness, a lack of balance, or feeling unsteady

the severe side effects, or those that require emergency medical care, include:

skin changes, such as a rash, hives, itching
swelling of the eyes, face, mouth, lips, tongue, throat, hands, feet, ankles or lower legs
lung issues, such as difficulty breathing or shortness of breath
seizures
difficulty swallowing, sore throat or cough
fever and chills
painful urination
increased sweating
confusion
irregular heartbeat
severe muscle stiffness or tightening of the neck or throat muscles
falling
unusual and uncontrollable body or face movements

while this drug has been recently approved, research has shown that antipsychotics given to older adults with alzheimer’s and other forms of dementia can increase the risk of death. these patients are also at an increased risk of having a stroke or ministroke while taking antipsychotics.

if a person has an existing medical issue, taking brexpiprazole may not be an option, or they may need to be closely monitored for adverse events. conditions that could stop a person from being prescribed brexpiprazole include:

heart and circulatory diseases, including blood vessel disease, heart failure, heart rhythm problems, hypovolemia, low blood pressure, ischemic heart disease or stroke
diabetes or high blood sugar
trouble swallowing
dyslipidemia
neuroleptic malignant syndrome
seizures
kidney or liver disease

people taking metoclopramide, a drug used to address nausea and vomiting in people with gastrointestinal diseases, should not take brexpiprazole.

other medications may also negatively interact with brexpiprazole, so they should be avoided or the dosages adjusted and monitored by a physician. those drugs include:

aprepitant
atazanavir
avacopan
boceprevir
bupropion
carbamazepine
cinacalcet
clarithromycin
conivaptan
diltiazem
dronedarone
duloxetine
erythromycin
fluconazole
fluoxetine
fosaprepitant
fosphenytoin
imatinib
indinavir
itraconazole
ketoconazole
letermovir
lopinavir
mavacamten
nefazodone
nelfinavir
paroxetine
phenytoin
posaconazole
quinidine
rifampin
ritonavir
saquinavir
st john’s wort
telaprevir
telithromycin
terbinafine
verapamil
voriconazole

according to health canada, other antidepressants or antipsychotic medications may also be prescribed to treat various symptoms of alzheimer’s disease. however, that will be under the discretion of the care provider.

sources:

newswire. health canada approves otsuka and lundbeck’s rexulti®️ (brexpiprazole) for the symptomatic management of agitation associated with alzheimer’s dementia.

medline plus. brexiprazole.

mayo clinic. brexpiprazole (oral route).

rexulti. rexulti®️ (brexpiprazole): low starting dosage and 2- to 4-week titration schedule.

the centre for addiction and mental health.dementia: medications for treating behavioural and psychological symptoms.

non-drug therapies

non-drug therapies are utilized as alzheimer’s symptoms progress as a way to manage cognitive issues and behaviour and mood changes. these are often used before medication and can help to maintain and improve certain functions, such as memory or thinking ability.

cognitive stimulation therapy

cognitive stimulation therapy (cst) is a group exercise performed under the supervision of psychologists, occupational therapists or social workers. it combines an adequate learning environment and social activity to improve thinking and behaviours.

these sessions are conducted in groups with themed activities twice weekly for 14 or more sessions. activities participated in during cst include:

discussions about past and present events
discussions about topics of interest, such as pop culture, music, news or more
word games, puzzles, and listening to music
practical activities, such as gardening, baking or cooking
physical exercises
faith-based activities, such as singing hymns and reading scripture

to create consistency for people with alzheimer’s, these group sessions always begin with the same warm-up activity alongside a reality orientation, which involves reiterating information about the group on a board. a theme song may also be used.

research has found these sessions to be beneficial in many ways. people with alzheimer’s who participate in these groups can experience improvements in:

cognitive functioning
language skills
quality of life
mood
confidence
concentration

while these sessions are typically done in groups, one-on-one cst sessions are also beneficial in some cases.

sources:

health canada: dementia symptoms and treatment.

st. louis university school of medicine. cognitive stimulation therapy (cst) and icst

wiley open access collection. the promise of music therapy for alzheimer’s disease: a review.

music therapy

music therapy can be highly beneficial for people with alzheimer’s because music is omnipresent in most people’s lives. this type of therapy involves listening to music that can evoke memories and emotions by choosing music that is familiar or enjoyable to the individual.

this type of therapy works so well because of the way the brain stores memory when accompanied by music. if a person experiences happiness while at a concert, that music will be stored within the brain and associated with feelings of happiness.

listening to that music again when a person develops alzheimer’s may then evoke that emotion of happiness, reducing feelings of anger, agitation, or confusion. it can also:

reduce feelings of depression or anxiety
enhance autobiographical recall of memories from a person’s past
increase verbal fluency
enhance cognitive function
manage behavioural and psychological symptoms

according to research, passively listening to music has helped people with alzheimer’s disease remember events from their lives with more detail, even in instances when the music was not present or associated with that specific memory.

while listening to music calmly can help during music therapy, other approaches include:

dancing or exercising while listening to music
writing down or discussing song lyrics
singing along with songs
playing or learning musical instruments

there are different variations of music therapy because there is no one-size-fits-all approach. for example, if a person with alzheimer’s disease has difficulties with language, writing down song lyrics may not be a good music therapy approach. however, they could benefit from dancing to their favourite songs.

sources:

health canada: dementia symptoms and treatment.

annals the new york academy of sciences. the promise of music therapy for alzheimer’s disease: a review.

animal-assisted therapy

animal-assisted therapy involves animals, such as dogs or cats, to help increase social engagement in people with alzheimer’s. it has also been shown to decrease loneliness and boredom, improve a person’s quality of life, stimulate physical activity and balance a person’s emotions.

these sessions typically last half an hour to 45 minutes and are done weekly. in some cases, animal-assisted therapy will be conducted with lifelike versions of pets for people who do not respond well to live animals.

anyone with dementia can take part in animal-assisted therapy, and there are no reported adverse side effects. the only contraindication would be if a person is allergic to a particular animal, in which case, a lifelike version or a different animal can be used.

sources:

health canada: dementia symptoms and treatment.

healthcare. effects of animal-assisted therapy (att) in alzheimer’s disease: a case study.

ontario shores centre for mental health sciences. animal assisted therapy.

registered massage therapists’ association of ontario. massage therapy for people with alzheimer’s disease.

massage therapy

massage therapy involves manually manipulating soft tissues, such as connective tissue, tendons, ligaments, joints and muscles, to alleviate discomfort or pain in specific areas. it can be used for muscle stresses, muscle overuse or chronic pain conditions.

massage therapy can be applied to any area of the body, but for alzheimer’s disease, the most notable are the back, shoulders, back of the neck, hands and arms. in some cases, only the hands or the lower legs and feet will be worked on.

different touch styles can also be implemented, ranging from tender to large strokes, kneading or rubbing and slow strokes.

people with alzheimer’s can engage in massage therapy as much or as little as they like, depending on how it affects them and their enjoyment of the activity. there is no set rule for how many sessions a person should have, but typically, one to two per month is a good frequency for most individuals. those living with alzheimer’s may benefit from more or fewer sessions, depending on how they experience it and whether or not it provides benefits.

research has found that massage therapy can address specific symptoms, helping to improve health parameters in people with alzheimer’s, such as:

agitation levels and agitated behaviours, such as wandering
depression or anxiety
aggression
social isolation
quality of life
chronic pain
appetite or willingness to eat

certain types of massage may have side effects, such as sleepiness, lightheadedness, or increased thirst. these are typically mild and can be remedied with rest.

not everyone with alzheimer’s will benefit from massage therapy. those who do not like being touched or having people in their personal space may experience increased feelings of anxiety or agitation, so massage therapy should not be performed on those people.

certain health conditions can also deter people from getting massage therapy, so if a person with alzheimer’s has other illnesses, this type of therapy may not be suitable for them. contraindicated conditions include:

contagious diseases, fever, or cold and flu
blood clots
kidney or liver disease
cancer
uncontrolled high blood pressure
cuts or open wounds
broken bones, burns, bruises, or varicose veins
some skin conditions

it is always best to speak to a healthcare provider before starting massage therapy to ensure that the person can safely have it done.

sources:

health canada: dementia symptoms and treatment.

cochrane database of systemic reviews. massage and touch for dementia.

shelbourne physiotherapy massage therapy clinic. contraindications of massage therapy.

brain healthy lifestyle

living a brain healthy lifestyle will not cure or reverse alzheimer’s symptoms, but it can improve symptoms for those who have the disease.

physical activity

regular physical activity is known to help reduce the risk of developing alzheimer’s disease, but it can also be helpful for people who have already started displaying symptoms. research has shown a direct connection between cognitive function and dementia-related diseases.

for people with alzheimer’s disease, exercise can positively impact the function of hippocampal circuits that play a role in episodic-like memory by improving hippocampal volume. this can improve cognitive scores.

exercise is a viable addition to a person’s treatment plan that they can engage in as little or as much as they like. it also helps to choose a type of physical activity that an individual with alzheimer’s enjoys most.

options for exercise include:

strength training
balance activities
flexibility exercises
walking
swimming
dancing
other aerobic exercises
pilates or yoga

different studies have found variations in the amount of exercise that is beneficial for various health parameters in alzheimer’s disease. for example, some research suggests that doing aerobic exercises twice per week for a year can help improve activities of daily living.

in contrast, another found that an hour of moderate to high-intensity exercise three times weekly for 16 weeks can improve neuropsychiatric symptoms. memory has also been shown to improve after an exercise program is implemented for people with alzheimer’s disease.

exercise and regular physical activity can also help to maintain physical strength and mobility in people with dementia-related diseases, including alzheimer’s.

according to research, prescribed exercise routines monitored by caregivers have the best outcomes and make it easier for people with alzheimer’s to adhere to a new addition to their daily lives.

sources:

health canada: dementia symptoms and treatment.

journal of sport and health science. physical exercise in the prevention and treatment of alzheimer’s disease.

frontiers in neuroscience. relationship between exercise and alzheimer’s disease: a narrative literature review.

social activity

social engagement is a vital component in alzheimer’s treatment and management. people with alzheimer’s have better health scores when maintaining an active and engaging social life.

these types of activities keep loneliness and social isolation feelings at bay, both of which can contribute to increased feelings of depression and anxiety. social isolation has also been shown to hasten cognitive decline.

being separated from friends and family, which can often occur for people with alzheimer’s, has also been shown to cause worsened behaviours, including aggression, hallucinations, and wandering.

according to research conducted during the covid-19 pandemic, symptoms worsened in people with dementia who experienced social isolation. these symptoms and the percentage of study partcipants impacted include:

memory function declined in 53 per cent of participants
feelings of depression increased in 31.2 per cent of participants
feelings of anxiety increased in 37.4 per cent of participants
ability to participate in activities of daily living were impaired for 28.3 per cent of participants
sleep disturbances or changes occurred in 23.1 per cent of participants
appetite changes occurred in 39.2 per cent of participants
feelings of aggression increased in 38 per cent of participants
feelings of agitation increased in 42 per cent of participants

to reduce the risk of a person experiencing declines in these areas, social activity should be prioritized in the care of alzheimer’s disease. some potential options for engaging in social activities include:

support groups for alzheimer’s disease
book clubs
intergenerational clubs
art classes or craft activities with others
engaging in activities around the home, such as cooking or baking together
watching movies or television shows with others
continuing to visit places they enjoyed going to prior to their diagnosis, such as coffee shops, places of worship, or other clubs

the importance of keeping a social life while living with alzheimer’s is indisputable, so finding a way to incorporate social outings or get-togethers is crucial in the management of alzheimer’s symptoms.

sources:

health canada: dementia symptoms and treatment.

journal of alzheimer’s disease. impact of social isolation on people with dementia and their family caregivers.

alzheimer society of canada. finding suitable activities.

treating alzheimer’s disease in canada

alzheimer’s disease is incredibly debilitating, leading to many symptoms that rob a person of their memories of their life as well as their ability to live out their remaining years independently. since there is no cure for the disease, treatments are used to manage symptoms of the disease. they don’t, however, address the underlying cause of alzheimer’s, which is not fully understood.

alongside pharmaceutical options, other interventions can be used to address cognitive decline as well as the behavioural and psychosocial aspects of alzheimer’s disease to maintain the best quality of life for those with the disease for as long as possible.

newer treatments continue to be developed as medical researchers dive into the cause of alzheimer’s disease. drugs such as kisunla (donanemab) and leqembi (lecanemab) have not yet been authorized for use in canada.

these drugs are considered disease-modifying and aim to slow the progression of alzheimer’s, even if only modestly. that said, they are not yet available on the canadian market, and a timeline for availability has not been outlined.

while alzheimer’s disease is not curable, nor entirely preventable, people can address their individual risk factors to reduce their chances of developing the debilitating disease.

sources:

canada drug agency. lecanemab.

u.s. food and drug administration. fda approves treatment for adults with alzheimer’s disease.

angelica bottaro

angelica bottaro is the lead editor at healthing.ca, and has been content writing for over a decade, specializing in all things health. her goal as a health journalist is to bring awareness and information to people that they can use as an additional tool toward their own optimal health.

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