Dementia drugs: Understanding common side effects and how they may affect the heart

What do we mean by ‘dementia drugs’?

Dementia is the broad term used to describe a number of different conditions affecting the brain.

There is currently no cure for the diseases that cause dementia.

However, some drugs can help to relieve or control symptoms for people living with Alzheimer’s disease, dementia with Lewy bodies or Parkinson’s disease dementia.

Unfortunately, there are currently no drugs that can improve the cognitive symptoms of vascular dementia or frontotemporal dementia.

What drugs are available to treat the cognitive symptoms of dementia?

The main drugs used to treat cognitive symptoms of dementia are called ‘cholinesterase inhibitors’.

Cholinesterase inhibitors include donepezil, rivastigmine and galantamine. There is also a drug called memantine, which works slightly differently.

These drugs don’t work for everyone, and the average effect is fairly small. But, for most people, they’re still well worth trying.

What are the common side effects of dementia drugs?

While many people can take dementia drugs without any problems, some may experience unpleasant side effects. The most common side effects include:

• nausea, vomiting, diarrhoea
• loss of appetite
• muscle pain
• sleep problems
• feeling tired
• headaches
• itching or a rash
• dizziness or feeling faint
• hallucinations
• agitation or aggression

If you experience any of these symptoms while you are taking drugs for dementia, you should contact your GP as soon as possible. Your GP may be able to offer an alternative treatment that is easier for you to take.

Dementia drugs and heart problems: what does the latest research say?

The effect of dementia drugs on the health of a person’s heart and blood vessels appears to be generally quite positive.

A recent review of studies found that people who took cholinesterase inhibitors had a 37 per cent lower risk of having a heart attack or stroke.

The research study found that these people were also less likely to die from a heart-related problem.

However, the review also found an increased risk of a relatively rare problem called ‘bradycardia’.

What is bradycardia?

Bradycardia is when the heart beats too slowly. This can prevent enough blood from being pumped up to the brain, leaving the person feeling dizzy and breathless. This increases the risk of falling and sustaining a hip fracture, which is a really serious problem for older people in particular.

Because of the risks of falling, doctors often recommend that people with a very slow heart beat have a pacemaker fitted. This keeps the heart beating fast and regular enough to get a good supply of blood to the brain.

These issues are why your doctor is likely to check whether you have a pre-existing heart problem before prescribing these drugs.

So, the good news is that bradycardia is generally quite rare. Even though dementia drugs may increase the risk of having a slow heartbeat, the overall chances of developing this problem are still very low.

By contrast, heart attacks and strokes are quite common in older people, and dementia drugs like donepezil seem to reduce the risk of these happening.

It is very important to discuss any side effects you may be experiencing with your GP – particularly if these include feeling dizzy or faint. Your GP will be able to check your heart beat and assess the potential risks and benefits of continuing with your current medication. Keep taking your medication in the meantime, unless advised by a clinician to stop.

Dementia medication side effects | Alzheimer’s Society

1. Medication for dementia symptoms
2. You are here: Dementia medication side effects
3. Getting medication for dementia
4. Taking dementia medications
5. Stopping dementia medication

Side effects are common for people taking medications for dementia symptoms. For most people, these get better after a few weeks of taking the medication. However, not everyone has the same side effects, or has them for the same length of time.  

Occasionally, these medications can also cause more severe side effects – particularly when taking higher doses. If the medication is not helping, or the side effects are not worth the benefits, it’s important to talk to the doctor or pharmacist straightaway.

These medications are not essential or life-extending. It may be possible to try another medication that has similar benefits but causes fewer side effects.  

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Some people with dementia may find that the benefits of taking medication are not worth the side effects. The decision to continue with them is therefore very much a personal choice.

Side effects of donepezil, rivastigmine and galantamine  

The most common side effects of donepezil, rivastigmine and galantamine are: 

• loss of appetite 
• feeling sick (nausea) 
• diarrhoea or vomiting 
• headaches 
• feeling tired or dizzy 
• difficulty sleeping well.  

When to see a doctor

If these side effects are concerning or do not go away after a few weeks, it’s important to talk to the doctor or pharmacist. It’s essential to ask for advice first before stopping a medication because of the side effects.

More serious side effects of these medication are less common. These include: 

• severe stomach pain or persistent vomiting 
• having very dark, black poos (caused by bleeding in the gut) 
• seizures or convulsions 
• muscle weakness or pain along with a high body temperature or sweating (fever).  

They can also cause unsteadiness or fainting, which increases the risk of falling. Occasionally, a person may become confused, agitated or restless. Always read the label inside the box, which contains a full list of possible side effects.  

If any of these happen, talk to a doctor straightaway.  

Side effects of memantine 

Memantine can cause different sides effects to the other medications. These include: 

• headaches 
• dizziness or problems with balance 
• tiredness or shortness of breath 
• raised blood pressure 
• constipation. 

Always read the label inside the box, which contains a full list of possible side effects. 

How to reduce side effects 

Side effects can be less likely when people: 

• take the medication with or after food 
• take the lower prescribed dose for at least a month first. 

The following tips may also help with certain side effects: 

• dizziness or nausea – take the medication in the evening 
• being unable to sleep – take the medication in the morning 
• feeling sick or vomiting – take the medication with some food 
• diarrhoea – drink more to avoid dehydration. 

Talk to a GP or pharmacist before taking medications for diarrhoea.

Using skin patches 

When using skin patches, it’s vital to remember to take the old patch off, so the person doesn’t get too much of the medication. It’s also important to change the place on the body that it sticks to. This prevents the skin from becoming irritated.

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Dementia what kind of disease symptoms and causes in item 2

With every year of life, the risk of getting dementia increases in older people. Dementia is a group of diseases characterized by impairment of memory, thinking, related communication and management of daily life.

Dementia is a very common condition among the elderly. A detailed study of the mechanisms of the occurrence of this disease can help create effective methods of treatment and prevention of its development.

This article will tell you about the main causes and symptoms of dementia in older people, as well as suggest treatments that will help improve their lives and maintain as much independence as possible.

Dementia: Symptoms, Causes and Treatment in the Elderly

Symptoms of Dementia in the Elderly

Dementia is a decline in mental ability and cognitive function that manifests itself as severe difficulties with memory, spatial orientation, thinking, attention and communication. Older people with dementia may also experience symptoms of depression, anxiety, aggression, and restlessness.

Causes of dementia in the elderly

Dementia can be caused by a variety of causes such as Alzheimer’s, Parkinson’s, head trauma, vascular dementia and other cognitive impairments. Also, the risk of developing dementia in older people may be increased due to bad habits (such as smoking), diseases of the cardiovascular system and other medical problems.

Treating dementia in the elderly

Currently, there is no cure for dementia, but there are some methods and interventions to improve the condition of older people with dementia. These can be psychological support courses, music therapy, physical exercises and communication with others. It is also important to maintain a healthy lifestyle and monitor your health.

In some cases where dementia is associated with a medical problem, the problem may need to be treated. In any case, it is important to see a medical professional for expert care and advice on how to treat dementia.

Dementia in the elderly

What is dementia?

Dementia is a syndrome that encompasses several brain dysfunctions such as memory, thinking, orientation and self-care. Dementia is an age-related disease that is associated with deteriorating brain health and often results in a loss of independence in an older person.

Dementia can be caused by a variety of causes, including Alzheimer’s disease, stroke, Parkinson’s disease, Gant’s disease, Creutzfeldt-Jakob disease, and others. Older people are at a higher risk of developing dementia than younger people, except for heredity and genetic factors.

Treatment of dementia can be complex and depends on the cause and extent of the disease. However, in most cases, treatment includes drug therapy, psychotherapy and rehabilitation using special exercises to develop the brain and improve the patient’s quality of life.

What are the signs of dementia?

Dementia is a condition that can lead to memory loss, decreased thinking ability, and changes in the patient’s mood and behaviour. The main symptoms that are characteristic of patients with dementia are the following:

• loss of memory, especially short and long-term;
• difficulty in replacing words, forgetfulness;
• decreased ability to analyze and make decisions;
• mood changes, emotional instability;
• loss of orientation in space and time;
• changes in behavior, for example, may become more aggressive or agitated;
• difficulty performing routine tasks, such as brushing teeth or cooking.

If the patient has any of these symptoms, it may indicate dementia. It is also worth noting that they can be of varying severity and manifest themselves at different stages of the disease.

Causes of dementia in the elderly

Dementia is a condition of loss of cognitive and memory abilities that can occur in a person at any age, but the elderly are most often affected.

The influence of genetic factors may also be the cause of dementia in the elderly. If a person’s parents or close relatives have had cases of dementia, then the likelihood of its occurrence also increases.

In addition, external factors such as poor nutrition, lack of physical activity, bad habits (both smoking and alcohol abuse), stress, etc. can also influence the onset of dementia.

In order to prevent the development of dementia in the elderly, it is necessary to monitor their health and lifestyle, as well as undergo preventive medical examinations and specialist consultations in a timely manner.

Diagnosis of dementia: how does it work?

In order to determine the presence of dementia in the elderly, special studies are needed. As a rule, a specialist prescribes a comprehensive diagnosis, including various research methods.

Additionally, for the diagnosis of dementia, an electroencephalographic study can be prescribed, which allows you to detect the presence of neurodegenerative changes in the patient’s brain. RNA lab tests may also be ordered.

It is important to bear in mind that dementia is a serious disease and its diagnosis must be carried out by a qualified doctor. Seek medical attention promptly if you notice signs of dementia in yourself or your loved ones.

Treatment of dementia: what methods are used?

Dementia is a neurodegenerative disease that affects memory, thinking, orientation and the ability to perform daily tasks in the elderly. While there is currently no fully effective cure for dementia, some treatments can improve a patient’s quality of life and slow the progression of the disease.

Medicines: Many medicines can be used to treat dementia, but they cannot cure the disease, only slow its progression. Some of them increase the concentration of neurotransmitters in the brain used to send signals between neurons, which in turn improves cognitive performance. Drugs are also often prescribed to help control the patient’s behavior and mood.

Therapy: Various therapies, such as music therapy, art therapy, and pet therapy, can help people with dementia take their mind off the illness and improve their mood. In addition, psychotherapy can help patients cope with the emotional and social problems associated with the disease.

Care: A structured daily routine, regular physical activity, and a healthy diet can improve the general condition of a person with dementia. In addition, it is necessary to organize a safe space in the house and help the patient cope with daily tasks such as cooking and cleaning.

What is the best way to care for a patient with dementia?

For people diagnosed with dementia, it is important to provide care and support that will help them maintain some degree of independence and quality of life. Caregivers need to be considerate and patient and know how to deal with difficulties that may arise in the care process.

It is important to remember that people with dementia may have difficulty understanding and performing simple tasks and orienting themselves in space. Therefore, it is necessary to ensure the safety of the house, remove everything that can be dangerous for the patient, and be near him during the performance of tasks.

Another important part of caring for a patient with dementia is proper attention to nutrition. Patients often forget what they need to eat, so assistance with food preparation and provision may be needed. It is also important to provide enough water to avoid dehydration.

Finally, good dementia care includes not only physical care but also concern for their emotional and psychological well-being. From an emotional point of view, it is important to support the patient, give him a sense of security and respect, without offending or criticizing him.

Examples of practical exercises for patients with dementia Activity Description

Art therapy	Finding and developing visual skills and coordination of movements through painting, drawing, modeling
Musical therapy	Listening and creating music, karaoke
Animal Therapy	Working with and interacting with pets to reduce stress. The patient also receives physical benefits from walking dogs and other pets

Dementia drugs

Dementia is a progressive disease and must be treated immediately. Fortunately, there are many medicines that can help improve the patient’s condition.

Cholinergic drugs

Cholinergic drugs increase the level of acetylcholine in the brain, which leads to improved cognitive functions. Some of them include:

1. Doneglesin
2. Sizeedin
3. Galantamine
4. Rivastigmine

Antipsychotics

Antipsychotics may help reduce aggression and recklessness in patients with dementia. These include:

• Haloperidol
• Clozapine
• Risperidone

Antidepressants

Antidepressants may be useful in patients with dementia who have depression. These include:

• Citalopram
• Escitalopram
• Sertraline

Although the above drugs may help improve the patient’s condition, their use should only be carried out under the supervision of a physician.

Side effects of medications for dementia

Treatment of dementia involves the use of specific medications that may have side effects. One of the most common is nausea. This can be a problem for patients who suffer from gag reflexes. In addition, many medications cause dizziness, which increases the risk of falls.

Some drugs used for dementia may also cause drowsiness and poor coordination. This may affect the patient’s ability to drive vehicles and machines, as well as an increased risk of falls.

• Disorders of the digestive system and appetite.
• Insomnia and other sleep disorders.
• Dry mouth and swallowing problems.
• Constipation and diarrhea.

Before starting treatment for dementia, the patient should discuss possible side effects with their doctor and start treatment at the lowest dose. It is also important to consider that side effects may manifest differently in each patient, and may not occur immediately after the start of treatment, but after a few days or even weeks.

How to make lifestyle changes to prevent dementia in older people?

Remember that a healthy lifestyle is one of the keys to preventing dementia. This alarming symptom progresses faster in people with unhealthy lifestyles, including low physical activity, poor diet, and sleep problems.

• Brain exercise: Reading, playing crossword puzzles, collections and games on the learning platform, maintaining social network connections will help keep the brain in shape.
• Physical activity: Moderate exercise, especially air sports, can increase blood flow to the brain and help minimize cognitive deficits.
• Eat right: Avoid the need to increase blood sugar and blood pressure control with healthy food choices and dietary scenarios.
• Smoking and drinking habits: Refrain from smoking and drinking alcohol to avoid dangerous negative health effects that can cause dementia.
• Monitor health parameters: Maintain a healthy cardiovascular condition, manage diabetes, control blood pressure to minimize the risk of dementia.

General recommendations include more fresh fruits and vegetables, especially those that carry fish oils (such as salmon and tuna), and less saturated and trans fats. If you are concerned about your risk of dementia, please consult with your doctor to develop a personalized action plan with all the necessary monitoring and screening to help you maintain your cognitive abilities.

Prevention of dementia in the elderly

As people age, the brain becomes less efficient, which can lead to various forms of dementia. However, there are steps you can take to reduce your risk of developing this condition.

• Physical exercise. Research shows that exercise can help protect the brain from degeneration and reduce the risk of dementia.
• Proper nutrition. The diet should include plenty of fruits and vegetables, fish, nuts and other foods rich in healthy fats, vitamins and minerals. Avoid eating large amounts of animal fats and salty foods.
• Stress management. Stress can negatively affect brain function, so it’s important to find ways to deal with it, such as yoga, meditation, deep breathing, or other relaxation techniques.
• Maintaining social ties. Research shows that people who have strong social ties have a lower risk of developing dementia.
• Active mind. Mental exercise such as reading, playing games, learning new skills, or doing math problems can help strengthen the brain and reduce the risk of dementia.

It must be remembered that preventing the development of dementia does not guarantee its absence, but increases the chances of maintaining a healthy and active life in old age.

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Q&A:

What is dementia and what are its symptoms?

Dementia is a syndrome of deterioration of cognitive (cognitive) functions, such as memory, thinking, speech. Symptoms may include memory loss, inability to perform simple tasks, communication difficulties, mood and behavior changes.

What factors cause dementia in the elderly?

The causes of dementia in the elderly can be varied, including genetic predispositions, infections, heart and vascular disease, and some bad habits such as smoking and alcohol abuse.

How is dementia diagnosed and what treatments are available?

Diagnosis of dementia includes neurological examination, psychological tests, MRI and CT examinations. Treatment includes medication, rehabilitation therapy, and work with a psychologist. It is important to know that dementia cannot be completely cured, but it is possible to slow its progression and improve the patient’s quality of life.

What is the life expectancy of older people with dementia?

Life expectancy for older people with dementia can vary depending on many factors. Typically, patients can live from several years to several decades after being diagnosed with dementia.

What preventive measures can be taken to prevent dementia?

Some of the preventive measures you can take to prevent dementia include a healthy lifestyle, healthy eating, physical activity, mental health care, and prevention of heart and vascular disease.

Can people develop dementia at other ages than the elderly?

Dementia can develop not only in the elderly, but also in people of other ages, including children and young people. However, the most common form of dementia is Alzheimer’s disease, which most often develops in older people.

Medicines for the treatment of sleep problems in dementia

Relevance

People with dementia often have trouble sleeping. These may include reduced sleep at night, waking up frequently, walking at night, and excessive sleepiness during the day.

This behavior is highly stressful for caregivers and may be associated with earlier admission of people with dementia to specialized care. Nursing home staff may also find it difficult to care for such people.

Non-drug treatments should be tried first, but they may not work and medications are often used. Because dementia-induced brain changes can be a source of sleep problems, it is unclear whether conventional sleeping pills are effective in people with dementia, and there are concerns that medications may cause significant side effects (harm).

Purpose of this review

In this updated Cochrane Review, we attempted to determine the benefits and overall harms of any medications used to treat sleep problems in people with dementia.

Results of this survey

Until February 2020, we searched for well-designed trials that compared any drug used to treat sleep problems in people with dementia with a fake drug (placebo). We consulted with a group of caregivers to help us identify the most important outcomes to look out for in trials.

We found nine trials (649 participants) that looked at four types of drugs: melatonin (five trials), trazodone (one trial), ramelteon (one trial), and orexin antagonists (two trials). Participants in all trials suffered from dementia due to Alzheimer’s disease. The ramelteon trial, one melatonin trial, and both trials of the orexin antagonist were funded by commercial sources. Overall, the evidence was of moderate to low quality, meaning that further research is likely to influence the results.

Participants in the trazodone trial and most participants in the melatonin trial had moderate to severe dementia, while participants in the ramelteon and orexin antagonist trials had mild to moderate dementia.

Five trials of melatonin involved 253 people. We found no evidence that melatonin improves sleep in people with Alzheimer’s dementia. The ramelteon trial involved 74 people. The limited information available did not provide evidence that ramelteon was better than placebo. There was no evidence of serious harm associated with the use of these drugs.

Only 30 people participated in the trazodone trial. It showed that a low dose of the sedative antidepressant trazodone (50 mg) taken at night for two weeks could increase total time spent sleeping each night (an average of 43 minutes more during the study) and improve sleep efficiency (percentage sleep time). It may have slightly reduced the amount of time you’re awake at night after you first fall asleep, but we can’t be sure of that effect. This medicine did not affect the frequency of awakenings at night. There was no information on serious harm associated with the use of the drug.

Two trials of orexin antagonists involved 323 people. We found evidence that orexin likely has some beneficial effect on sleep. On average, test participants slept 28 minutes longer at night and spent 15 minutes less time awake after first falling asleep. There was also a slight increase in sleep efficiency, but there was no evidence of an effect on how often the participants woke up. Side effects were no more common in participants who took the medication than in those who took a placebo.

Medications that appeared to have a beneficial effect on sleep did not impair participants’ thinking ability, but these studies did not assess participants’ quality of life or look in detail at caregiver outcomes.

Disadvantages of this review

Although we searched, we were unable to find any studies of other sleep medications commonly prescribed for people with dementia. All participants had dementia due to Alzheimer’s disease, although sleep problems are also common in other forms of dementia. None of the trials assessed the duration of uninterrupted sleep, which is very important for caregivers. Only four trials systematically assessed side effects.

We conclude that there are very many gaps in the evidence needed to make drug decisions to address sleep problems in dementia.