Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.

How Can I Help My Wife's Memory?

Thursday, 05 August 2010 09:12 AM

Question: My wife has been taking Aricept and Namenda for several years. Is there anything new on the market that could possible help her memory and thinking? She is 86 but is in fairly good health.

Dr. Hibberd's Answer:

Your best choice is to pay close attention to nutrition and maintain an active schedule of physical and mental activities. There is good evidence that challenging mental and physical activities benefit longevity and maintain function more than we have previously realized.

Alzheimer's disease is a degenerative disease that predominantly affects our brain's memory functions. Advanced cases may show varying degrees of behavior disturbances and other signs of disordered thought and memory that include self-neglect, emotional disorder, isolation, and general physical deterioration.

The medications we use to manage Alzheimer's victims have been universally disappointing to most patients and their caregivers. The "treatments" we have generally available are actually not curative and are not able to reverse losses in function that have already been suffered, contrary to the initial claims of almost all the current Alzheimer's medication marketing. The currently popular medications do, however, produce a variable SLOWING in the decline in function seen when compared with non-treated groups. The negatives are side effects from the medication and high costs.

We have not reached a point where we can pick one medication or combination that is best for all Alzheimer's patients, and we still rely on a skillful combination of neuro-active medications to try to slow the decline seen in Alzheimer's cases.

Your current combination of Aricept and Namenda may be one of the more popular combinations currently being used. These agents work by altering the balance of the micro-hormones called neurotransmitters that work to enable brain tissue to function. I cannot comment further since I am not aware of the doses prescribed, the co-existing medical conditions, or the severity of your wife's Alzheimer's condition. At the same time, I wish to state again that a healthy diet and exercise are necessary components of successful treatment.

I want to emphasize the importance of being very aggressive in the early stages of this disorder, when mild to moderate gains in slowing the disease can be seen. Do not delay therapy and wait until the disorder progresses to a point where the decline has become catastrophic and treatment, as we know it, becomes futile. Aggressive late-treatment of Alzheimer's is akin to waiting until you have had a stroke before trying to prevent damage to your brain tissue.

Look at the current treatment options as a modified prevention strategy designed to prevent or slow further deterioration. No cure for Alzheimer's disease is currently available. Beware of false claims and aggressive regimens when there is little to gain, or when the improvements are seen over a short period of time.

Be aware that some treatment options may actually be counterproductive in selected patient groups. Also be aware that we may be able to offer preventive strategies in the near future. Some of these strategies will relate to toxins we were exposed to many years ago or toxins that accumulated over many years.

Simple strategies such as not using plastics to store and cook food and avoiding food contacting aluminum when cooking may yield great gains later in life. We should strive to minimize the use of pesticides and chemical additives. We need to try to minimize antibiotic use in livestock and food products. All of these are used for a short-term economic gain in terms of yield, expense, and waste, yet this gain may be more than offset by costs to our health and the health of our children.

We live in a toxic environment, and we need to address this aggressively if we want to reduce the effect of premature onset of degenerative ailments such as Alzheimer's disease.

A discussion of available choices in treating Alzheimer's is outside the limited scope of my column, but I do recommend you periodically review the available choices with your wife's treating physician. I encourage her to see her primary physician and/or neurologist frequently to be sure you stay abreast of treatment options and choices, as well as to monitor her response and advise you of new issues that may affect the choice of medication and doses.

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