Lorazepam (Ativan) Lorazepam is a type of benzodiazepine. Doctors prescribe it for its positive effect on anxiety and its sedative effects.
The FDA has approved Belsomra® to address insomnia in people living with mild-to-moderate Alzheimer's disease. Belsomra is thought to inhibit the activity of orexin, a type of neurotransmitter involved in the sleep-wake cycle.
Acetylcholinesterase inhibitors
Donepezil (also known as Aricept), rivastigmine (Exelon) and galantamine (Reminyl) are used to treat the symptoms of mild to moderate Alzheimer's disease. Donepezil is also used to treat more severe Alzheimer's disease.
Set a quiet, peaceful mood in the evening to help the person relax. Keep the lights low, try to reduce the noise levels, and play soothing music if he or she enjoys it. Try to have the person go to bed at the same time each night. A bedtime routine, such as reading out loud, also may help.
The melatonin secretion decreases with age. While the duration of the circadian rhythm stays consistent in older adults, further alterations in the circadian rhythm can occur in those with dementia and lead to more sleep difficulties.
Factors that may contribute to trouble sleeping and sundowning. Mental and physical exhaustion from a full day of activities. Navigating a new or confusing environment. A mixed-up "internal body clock." The person living with Alzheimer's may feel tired during the day and awake at night.
Full results about the Alzheimer's disease drug donanemab have been released today, supporting earlier trial results that suggested the breakthrough drug may slow down the progression of the disease.
Donepezil and rivastigmine
Donepezil tablets are by far the most common medication used to treat dementia. Rivastigmine tends only to be used when donepezil causes side effects, or if the person can't take it for medical reasons.
Introduction: The five-word test (5WT) is a serial verbal memory test with semantic cuing. It is proposed to rapidly evaluate memory of aging people and has previously shown its sensitivity and its specificity in identifying patients with AD.
Provide proper light. Bright light therapy in the evening can lessen sleep-wake cycle disturbances in people with dementia. Adequate lighting at night also can reduce agitation that can happen when surroundings are dark. Regular daylight exposure might address day and night reversal problems.
Daridorexant is FDA approved in doses of 25 mg and 50 mg. In the pivotal trials, doses of 25 mg and 50 mg showed a statistically significant improvement in sleep parameters compared to placebo at both months 1 and 3.
The Mini-Cog test.
A third test, known as the Mini-Cog, takes 2 to 4 minutes to administer and involves asking patients to recall three words after drawing a picture of a clock. If a patient shows no difficulties recalling the words, it is inferred that he or she does not have dementia.
Lecanemab was fully approved by the US Food and Drug Administration (FDA) as a treatment for early Alzheimer's disease in July 2023. This means that it can now be given to patients with early Alzheimer's disease in the USA. The drug is being marketed under the name Leqembi.
Lilly's Donanemab Significantly Slowed Cognitive and Functional Decline in Phase 3 Study of Early Alzheimer's Disease.
One of the most common causes of death for people with dementia is pneumonia caused by an infection. A person in the later stages of dementia may have symptoms that suggest that they are close to death, but can sometimes live with these symptoms for many months.
Stage 6: Severe Mental Decline/Moderately Severe Dementia Quality of life: Severe impact. Your loved one will not remember much or any of the past and may not recognize you and other family and friends.
The average life expectancy figures for the most common types of dementia are as follows: Alzheimer's disease – around eight to 10 years. Life expectancy is less if the person is diagnosed in their 80s or 90s. A few people with Alzheimer's live for longer, sometimes for 15 or even 20 years.
Don't correct, contradict, blame or insist. Reminders are rarely kind. They tell a person how disabled they are – over and over again. People living with dementia say and do normal things for someone with memory impairment.
There is some evidence that this treatment does improve sleep quality in people with Alzheimer's disease and Parkinson's disease but so far evidence suggests melatonin does not affect risk of dementia or cognitive function. Please consult your GP before making any decisions about taking sleep medication.
Suvorexant is the first orexin receptor antagonist to be marketed in Australia. The drug is taken within 30 minutes of bedtime. This should be at least seven hours before the patient plans to get up again. The maximum drug concentration is reached in two hours.
Remimazolam (CNS7056) is a novel benzodiazepine for intravenous sedation; it has an ultra-short duration of action and was recently approved for use in procedural sedation and general anaesthesia.