What questions should loved ones ask their health-care providers?
Ask the provider about whether the patient has Alzheimer’s-type dementia or some other type. This affects the choice of therapy. Cholinesterase inhibitors (donepezil, galantamine and rivastigmine) have been shown to slow the progression of Alzheimer’s, vascular dementia and dementia with Lewy bodies, but they are not effective for those with Pick’s disease, where there is no cholinergic deficit. Can the progression of dementia be slowed? There is good evidence that cholinesterase inhibitors delay the need for nursing home placement among those with Alzheimer’s. Memantine allows many moderate Alzheimer’s patients to remain in the home for longer periods of time because it reduces agitated behavior. Several studies have shown that aspirin (or other anti-platelet agents) can slow the progression of vascular dementia. What is happening in the brain to cause dementia? Depending on the type of dementia, different degenerative processes are involved. For example, a normal protein (beta-amyloi
