The progression of dementia may be slowed down by intervention, so getting an early and accurate diagnosis is very important.

Because dementia can take so many forms and has so many causes, the most important first step to understanding what form of dementia you or a loved one may have, and what can be done about it, is to get an accurate diagnosis.  If you notice changes in a loved one's or your own mental abilities, you should seek medical advice.  Speak openly and honestly with your doctor and explain what changes you have noticed.  You or your loved one should also have a thorough medical examination, including a general physical and neurological exam and a neuropsychological evaluation.  A neuropsychological evaluation consists of a number of written and/or oral tests that measure a person's mental functioning.  The results are compared with the normal range of scores and help in the diagnosis of dementia, and its differentiation from depression and other causes of cognitive impairment.

When you have an accurate diagnosis, you can begin to take the appropriate steps to deal with the condition.  These may include medications (discussed below), lifestyle changes, and planning how to handle needs such as safety, transportation, nutrition, social stimulation, physical stimulation, and legal and financial affairs.  You may also want to plan to get extra help (privately or through social service and government agencies, at home or in skilled care facilities) for you or your loved one as the condition progresses.

A class of drugs known as acetylcholinesterase inhibitors, sometimes called cholinesterase inhibitors, has successfully slowed the progression of Alzheimer's disease in a significant number of cases.  They work by preventing the breakdown of acetylcholine, a chemical in the brain that helps memory and other thinking skills. Donepezil is the generic name of a commonly prescribed cholinesterase inhibitor (in the show it is referred to by a brand name, Aricept). Two other generic cholinesterase inhibitors are galantamine and rivastigmine.

A newer drug that has also proven effective, and is also mentioned in the show, is memantine.  Recently, a multi-center study was directed by University of Rochester Medical Center faculty.  The study was led by Dr. Pierre Tariot, who appears on this episode of Second Opinion. It concluded that memantine, when taken with donepezil, helped moderate-to-severe Alzheimer's patients maintain or in some cases improve their memory and other mental activities and their ability to do the tasks of daily life.  Memantine is one of a new class of drugs for treating Alzheimer's and the first approved by the FDA for advanced Alzheimer's patients.

Of course other factors, such as care and personal environment, are also important for people with Alzheimer's disease and their caregivers. Physical, emotional, and mental activities, such as music therapy and brain exercise (doing crossword puzzles), have shown to be helpful.