Alzheimer’s Disease Medications for Memory

Blog, Dementias, Progressive Neurological Diseases

Dementia Treatments

Alzheimer’s Disease Medication

Introduction

People are increasingly interested in the latest advancements in Alzheimer’s disease medications as they seek to safeguard their brain health through the most cutting-edge scientific developments. Alzheimer’s disease, a progressive neurodegenerative disorder characterized by memory loss, cognitive decline, and behavioral changes, poses significant challenges for both patients and their loved ones. As awareness of Alzheimer’s grows and its prevalence rises, there is a growing sense of urgency to explore all available options for prevention, treatment, and management.

Dementia Medications

Leqembi

+ Leqembi is an IV medication for early-stage Alzheimer’s, targeting and removing beta-amyloid from the brain.

+ While not a cure, it’s the first FDA-approved treatment addressing Alzheimer’s biology, aiming to slow down cognitive decline and maintain independence.

+ It’s only for those with confirmed elevated beta-amyloid levels and hasn’t been tested for advanced stages or those without symptoms.

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Aduhelm

Aducanumab

+ Aducanumab (Aduhelm®) has gained accelerated FDA approval for treating early Alzheimer’s and Mild Cognitive Impairment (MCI) due to Alzheimer’s Disease.

+ It’s the first therapy to demonstrate that reducing beta-amyloid in the brain can slow cognitive and functional decline in early-stage Alzheimer’s by targeting and removing specific forms of beta-amyloid plaques.

+ Administered via intravenous infusion every 4 weeks, Aducanumab aims to reduce beta-amyloid accumulation, potentially aiding other brain functions in memory, thinking, learning, and behaviors.

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Aricept

Donepezil

Donepezil (Aricept) : Approved to treat all stages of Alzheimer’s Disease. Its primary mechanism of action involves inhibiting an enzyme called acetylcholinesterase. This enzyme normally breaks down acetylcholine, a neurotransmitter involved in memory and learning. By inhibiting acetylcholinesterase, Aricept increases the levels of acetylcholine in the brain, temporarily improving communication between nerve cells.

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Exelon

Rivastigmine

Rivastigmine (Exelon): Approved for mild-to-moderate Alzheimer’s disease and mild-to-moderate dementia associated with Parkinson’s disease. This is another medication used to treat Alzheimer’s disease. Its mechanism of action is similar to Aricept but extends to inhibiting both acetylcholinesterase and butyrylcholinesterase enzymes. By doing so, Rivastigmine increases the levels of acetylcholine in the brain, supporting improved communication between nerve cells. This helps alleviate cognitive symptoms in individuals with Alzheimer’s, providing symptomatic relief without modifying the underlying progression of the disease.

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Razadyne

Galantamine

Galantamine (Razadyne): Approved for mild-to-moderate stages of Alzheimer’s disease. Its mechanism of action involves acting as a reversible acetylcholinesterase inhibitor, similar to Aricept and Rivastigmine. By inhibiting the breakdown of acetylcholine, a neurotransmitter crucial for memory and learning, Galantamine temporarily increases its levels in the brain. This enhancement of acetylcholine communication between nerve cells aims to alleviate cognitive symptoms associated with Alzheimer’s disease.

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Namenda

Memantine

Memantine (Namenda): Approved for moderate-to-severe Alzheimer’s disease. Unlike acetylcholinesterase inhibitors, Memantine works by modulating the activity of glutamate, an excitatory neurotransmitter in the brain. It acts as an NMDA receptor antagonist, helping regulate the activity of glutamate and preventing excessive stimulation. This mechanism aims to protect nerve cells from damage caused by overstimulation, which is implicated in the progression of Alzheimer’s. Memantine provides symptomatic relief by addressing a different aspect of neurotransmission compared to acetylcholinesterase inhibitors, offering a complementary approach in the treatment of Alzheimer’s disease.

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Namzaric

Donepezil and memantine (Namzaric): Approved for moderate-to-severe Alzheimer’s disease. Namzaric is a combination medication that includes both donepezil and memantine. Each component targets different aspects of Alzheimer’s disease to provide a comprehensive treatment approach. Together, the combination of donepezil and memantine in Namzaric aims to enhance cognitive function and provide symptomatic relief in individuals with moderate to severe Alzheimer’s disease. It represents a synergistic strategy by targeting both acetylcholine and glutamate to address different aspects of the disease’s underlying pathology.

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The Neurological Therapist – Interview your therapist

Blog, Neurological Rehabilitation

The Neurological Therapist – Interview your therapist

Neurological therapy is a specialized area requiring devoted time and training.

When looking for a neurological therapist, whether for hiring or collaborating, it’s crucial to consider several factors to ensure they possess the necessary knowledge and skills in neurological rehabilitation.

Qualifications and Credentials

Do they hold any additional certifications relevant to neurological rehabilitation, such as Certified Stroke Rehabilitation Specialist (CSRS), Certified Brain Injury Specialist (CBIS), or Neuro-Developmental Treatment (NDT) certification?
Have they pursued advanced training or completed post-professional education programs focused specifically on neurological rehabilitation?
Are they members of professional organizations related to neurological rehabilitation, such as the American Occupational Therapy Association (AOTA) or the American Physical Therapy Association (APTA)?
Have they participated in continuing education courses or workshops related to specific neurological conditions, assessment tools, or treatment approaches?
Can they provide evidence of ongoing professional development and commitment to staying abreast of advancements in neurological rehabilitation practice?

Experience

What is the extent of their experience specifically in neurological rehabilitation, including the number of years dedicated to this specialty area?
Have they worked with a diverse range of neurological conditions, including stroke, traumatic brain injury, spinal cord injury, multiple sclerosis, Parkinson’s disease, etc.?
In what settings have they practiced neurological rehabilitation, such as acute care hospitals, inpatient rehabilitation facilities, outpatient clinics, community-based settings, or specialized neurological rehabilitation centers?
Can they demonstrate versatility in adapting their skills and expertise to different practice environments and patient populations?
Can they provide specific examples or case studies of patients they’ve treated for neurological conditions, highlighting successful outcomes achieved through their interventions?
Are they able to articulate their approach to managing complex neurological cases, including the development of individualized treatment plans, goal-setting strategies, and ongoing assessment and modification of interventions based on patient progress?
Have they encountered challenging cases or situations in neurological rehabilitation, and how did they approach and overcome these challenges to achieve positive results for their patients?

Knowledge of Neurological Conditions

Do they have a comprehensive understanding of different neurological conditions, such as stroke, traumatic brain injury, spinal cord injury, multiple sclerosis, Parkinson’s disease, Alzheimer’s Disease, Dementia, etc.?
Are they familiar with the specific impairments and challenges associated with each condition?
Can they tailor treatment plans to address the unique needs of individual patients with neurological disorders?
Can they integrate the principles of neuroplasticity, motor learning, and task-specific training into their treatment approaches to promote recovery, maximize functional independence, and enhance quality of life for individuals with neurological disorders?

Evidence-Based Practice (EBP)

Evidence Based Practice - Neurological Therapist

Do they stay updated on the latest research and evidence-based practices in neurological rehabilitation?
Are they able to integrate evidence-based interventions into their treatment plans?
Can they critically evaluate the effectiveness of different treatment approaches based on research findings?

Assessment and Evaluation Skills

How do they assess and evaluate the functional abilities and limitations of patients with neurological conditions?
Are they proficient in using standardized assessment tools commonly used in neurological rehabilitation?
Can they conduct comprehensive evaluations to identify specific impairments and set realistic goals for therapy?

Treatment Techniques and Modalities

What treatment techniques and modalities do they utilize in neurological rehabilitation?
Are they skilled in neurorehabilitation approaches such as neuroplasticity-based therapy, constraint-induced movement therapy, task-specific training, etc.?
Do they have experience with assistive devices, adaptive equipment, and technology used in neurological rehabilitation?

Interdisciplinary Collaboration

Are they accustomed to working collaboratively with other healthcare professionals, such as neurologists, physiatrists, speech therapists, etc.?
Do they ask you about your experience and your team at the time of your evaluation?
Do they seek to offer referrals and recommendations for other professionals at the time of your evaluation?
Can they effectively communicate and coordinate care plans with other team members to optimize patient outcomes?

Patient-Centered Care

Do they prioritize patient-centered care and actively involve patients in goal-setting and treatment planning?
Are they empathetic, compassionate, and able to establish rapport with patients and their families?

Bottom Line:

For anyone seeking neurological physical therapy or occupational therapy, it’s essential to do some research and be ready to ask questions when meeting with your therapist. Since health insurance often limits the number of sessions and out-of-pocket costs for neurological rehabilitation can be high, it’s crucial not to waste time with the wrong therapist. Take the time to research your provider before committing to treatment.

Questions to ask your Neurological Therapist

Download our FREE 'Interview Questionnaire' resource to help make informed decisions for yourself or your loved ones who may be looking for a neurological therapist. This is a checklist of the questions you should ask your Neuro Physical Therapist, Occupational Therapist, and Speech Therapist.

Understanding the Difference: Therapeutic Exercise, Therapeutic Activity, and Neuromuscular Re-education in Occupational Therapy

OT Practitioners

Understanding the Difference between Therapeutic Exercise and Neuromuscular Re-Education in Occupational Therapy

As dedicated professionals in the field of occupational therapy, we are constantly striving to provide the best possible care for our clients. One crucial aspect of our practice is understanding the nuances between different treatment modalities and knowing when to apply each one effectively. It is important to know the distinctions between three commonly used billing codes: Therapeutic Exercise (97110), Therapeutic Activity (97530), and Neuromuscular Re-education (97112), with a focus on their relevance in adult populations.

Therapeutic Exercise (97110)

Therapeutic Exercise (97110): This billing code is utilized when engaging in interventions aimed at addressing specific joints, structures, or muscles. In alignment with the Biomechanical model of practice, therapeutic exercises are designed to remediate, restore, or maintain the integrity of these elements. Examples of treatments may include:

Strengthening exercises for individuals recovering from orthopedic surgeries such as total knee replacements.
Range of motion exercises for patients with rheumatoid arthritis to maintain joint mobility and prevent contractures.
Endurance training for individuals with chronic obstructive pulmonary disease (COPD) to improve tolerance for daily activities.

Neuromuscular Re-Education (97112)

Functional Ambulation Asymmetrical Stance and Gait

Neuromuscular Re-education (97112): Contrary to common belief, Neuromuscular Re-education (NMRE) does not exclusively pertain to neurological-based diagnoses. Instead, it encompasses various neurological models of practice within the occupational therapy scope. NMRE interventions target balance, coordination, kinesthetic sense, posture, and proprioception for sitting and/or standing activities. Examples may include:

Core stabilization exercises for individuals with low back pain to improve posture and prevent further injury.
Dual-tasking exercises for older adults at risk of falls to improve cognitive-motor integration and balance control.

Therapeutic Activities (97530)

Functional Ambulation-Carry, Modulation, Balance

Therapeutic Activity (97530): Therapeutic activities are movement-based interventions that occur outside of the personal context of the client but often simulate real-life tasks. These activities are designed to improve functional performance and are billed under the therapeutic activity code (97530). Examples include:

Simulated work tasks such as sorting objects or assembly tasks for individuals undergoing vocational rehabilitation.
Community mobility exercises such as navigating public transportation or crossing streets safely for clients with mobility impairments.
Environmental adaptations tasks such as practicing using adaptive equipment or modifying home environments for individuals with physical disabilities.

Core stabilization exercises for individuals with low back pain to improve posture and prevent further injury.
Dual-tasking exercises for older adults at risk of falls to improve cognitive-motor integration and balance control.

Bottom Line:

Understanding the distinctions between Therapeutic Exercise, Therapeutic Activity, and Neuromuscular Re-education is essential for providing comprehensive and effective care in occupational therapy practice. By selecting the appropriate billing code and tailoring interventions to the individual needs and goals of our clients, we can maximize outcomes and promote optimal function and participation in daily life.

Stages of Alzheimer’s Disease

Dementias

“Memories are the threads that weave the fabric of our lives, shaping who we are and who we become.” – Elizabeth Loftus

Stages of Alzheimer’s Disease

Alzheimer’s disease is a complex condition that affects millions of individuals worldwide, impacting not only those diagnosed but also their families and caregivers. Understanding the progression of Alzheimer’s is crucial for providing appropriate care and support at each stage of the disease. In this article, we’ll explore the seven stages of Alzheimer’s Disease, highlighting the areas of the brain affected, common symptoms experienced, and available treatments for each stage.

Stage 1 – No Impairment

Stages of Alzheimer's Disease Health Brain

Area of the Brain: No noticeable changes.

Symptoms: No memory problems or cognitive decline.

Treatments: Focus on maintaining a healthy lifestyle, including regular exercise, a balanced diet, and mental stimulation.

Stage 2 – Very Mild Decline

Working Memory

Do you find it challenging to remember things you just learned or heard? This could be a sign of dementia.

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Area of the Brain: Minimal changes, primarily in the hippocampus.

Symptoms: Occasional forgetfulness, such as misplacing keys or forgetting names.

Treatments: Continued emphasis on lifestyle factors, along with memory aids and cognitive exercises.

Stage 3 – Mild Decline

Slower Retrieval and Rapid Forgetting

Finding it takes longer to recall information, and forgetting things more quickly.

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Immediate Recall Difficulty

Struggling to remember information right after learning it.

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Area of the Brain: Further deterioration in the hippocampus and other regions involved in memory and learning.

Symptoms: Noticeable memory lapses, difficulty finding the right words, and challenges with planning and organization.

Treatments: Introduction of medications such as cholinesterase inhibitors to help manage cognitive symptoms, along with support from caregivers and memory care programs.

Stage 4 – Moderate Decline

Prospective Memory Challenges

Difficulty remembering to perform tasks in the future without external reminders.

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Episodic Memory

Trouble remembering specific events or experiences from your past.

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Area of the Brain: Significant damage in multiple brain regions, including the frontal and temporal lobes.

Symptoms: Increased memory loss, difficulty performing tasks independently, mood swings, and confusion about time and place.

Treatments: Additional medications, such as memantine, may be prescribed to manage cognitive symptoms. Occupational therapy and support services become more important for daily functioning.

Stage 5 – Moderately Severe Decline

Autobiographical Memory Changes

Memories across your lifespan become less detailed and more vague.

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Area of the Brain: Extensive damage throughout the brain, affecting communication between neurons.

Symptoms: Severe memory impairment, inability to recall personal details, challenges with basic activities of daily living, and behavioral changes.

Treatments: Intensive support from caregivers, including assistance with personal care and supervision. Behavioral interventions and communication strategies are crucial.

Stage 7 – Very Severe Decline

Stages of Alzheimer's Disease Alzheimer Disease Heart

Area of the Brain: Severe neuronal loss and widespread brain damage, resulting in complete dependence on others for care.

Symptoms: Loss of verbal communication, minimal responsiveness, and severe physical impairment.

Treatments: End-of-life care focuses on comfort and dignity, with a focus on pain management and emotional support for both the individual and their loved ones.

Stage 6 – Severe Decline

Stages of Alzheimer's Disease Dementia Brain

Area of the Brain: Severe atrophy and damage in all brain regions, leading to profound cognitive and physical decline.

Symptoms: Loss of awareness of surroundings, difficulty recognizing familiar faces, incontinence, and limited mobility.

Treatments: Palliative care focuses on maximizing comfort and quality of life. Supportive therapies, such as music and art therapy, can provide comfort and stimulation.

Bottom Line:

Understanding the stages of Alzheimer’s disease is essential for navigating the challenges and providing appropriate care and support throughout the journey. While there is currently no cure for Alzheimer’s, early diagnosis and intervention can help manage symptoms and improve quality of life for individuals and their families. With ongoing research and advancements in treatment, there is hope for a future where Alzheimer’s is more effectively managed and ultimately cured.

Warning Signs of Dementia

Dementias

“Memory is the diary that we all carry about with us.” – Oscar Wilde

Warning Signs of Dementia

Memory changes as we age can be unsettling, leaving many of us wondering if what we’re experiencing is just a normal part of getting older or something more serious, like dementia. It’s important to recognize that there’s a subtle overlap between age-related memory changes and the warning signs of dementia. In this article, we’ll explore these warning signs in a way that’s easy to understand.