People with Alzheimer’s disease may take medicines to treat the disease itself, mood or behavior changes, and other medical conditions. Caregivers can ensure that medicines are taken safely and correctly. Here are some tips to help you manage medications for someone with Alzheimer’s disease.

Know each medicine (prescription and over-the-counter) the person with Alzheimer’s disease takes. Ask the doctor or pharmacist:

Why is this medicine being used?
What positive effects should I look for, and when?
How long will the person need to take it?
How much should he or she take each day?
When does the person need to take the medicine?
What if the person misses a dose?
What are the side effects, and what can I do about them?
Can this medicine cause problems if taken with other medicines?
Managing medications is easier if you have a complete list of them. The list should show the name of the medicine, the doctor who prescribed it, how much the person with Alzheimer’s takes, and how often. Visit Tracking Your Medications: Worksheet for a template. Keep the list in a safe place at home, and make a copy to keep in your purse or wallet. Bring it with you when you visit the person’s doctor or pharmacist.

People with Alzheimer’s should be monitored when they start taking a new drug. Follow the doctor’s instructions and report any unusual symptoms right away. Also, let the doctor know before adding or changing any medications.

Use Medicines Safely
People with Alzheimer’s disease often need help taking their medicine. If the person lives alone, you may need to call and remind him or her or leave notes around the home. A pillbox allows you to put pills for each day in one place. Some pillboxes come with alarms that remind a person to take the medicine.

As Alzheimer’s gets worse, you will need to keep track of the person’s medicines. You also will need to make sure the person takes the medicines or give the medicines to him or her.

Some people with Alzheimer’s take medicines to treat behavior problems such as restlessness, anxiety, depression, trouble sleeping, and aggression. Experts agree that medicines to treat behavior problems should be used only after other strategies that don’t use medicine have been tried. Talk with the person’s doctor about which medicines are safest and most effective. With these types of medicines, it is important to:

Use the lowest dose possible
Watch for side effects such as confusion and falls
Allow the medicine a few weeks to take effect
It is recommended that people with Alzheimer’s should not take anticholinergic drugs. These drugs are used to treat many medical problems such as sleeping problems, stomach cramps, incontinence, asthma, motion sickness, and muscle spasms. Side effects, such as confusion, can be serious for a person with Alzheimer’s. These drugs should not be given to a person with Alzheimer’s disease. You might talk with the person’s doctor about other options. Examples of these drugs include:

Keep all medications locked up.
Check that the label on each prescription bottle has the drug name and dose, patient’s name, dosage frequency, and expiration date.
Call the doctor or pharmacist if you have questions about any medicine.
Medicines to Treat Alzheimer’s Disease
There are five medicines available to treat Alzheimer’s disease. It’s important to understand that none of these medicines can cure or stop the disease. What they can do, for some people, is help slow down certain problems, such as memory loss. Slowing down memory loss can allow many people with Alzheimer’s disease to be more comfortable and independent for a longer time.

by Richard J. Hodes, M.D., Director, National Institute on Aging, National Institutes of Health

The FDA’s approval of the Biogen-Eisai drug, aducanumab, marks a milestone achievement in Alzheimer’s disease research. This drug is the first approved treatment shown to slow progression of this disease. It is also a reflection of the years of research and momentum we see in Alzheimer’s research more broadly.

FDA approved aducanumab to treat patients with Alzheimer’s using the Accelerated Approval pathway, under which the agency “approves a drug for a serious or life-threatening illness that may provide meaningful therapeutic benefit over existing treatments when the drug is shown to have an effect on a surrogate endpoint that is reasonably likely to predict a clinical benefit to patients and there remains some uncertainty about the drug’s clinical benefit.” FDA further stated that “at the end of the day, we followed our usual course of action when making regulatory decisions in situations where the data are not straightforward.”

The FDA also stated that “approval is based on a surrogate or intermediate clinical endpoint (in this case reduction of amyloid plaque in the brain).” Additionally, “drug companies are required to conduct post-approval studies to verify the anticipated clinical benefit. These studies are known as phase 4 confirmatory trials. If the confirmatory trial does not verify the drug’s anticipated clinical benefit, FDA has regulatory procedures in place that could lead to removing the drug from the market.”

NIA thanks the many individuals who have participated in the clinical trials that have led us to this point. Advancements like this underscore the enormous importance of participating in clinical trials, today and in the future.

While the NIH provided no direct support for the drug development of aducanumab, our years of funding have been integral to this and other promising therapeutic approaches to treating Alzheimer’s disease. For example, NIA supported basic science investigations behind the discovery of immunotherapies like aducanumab, as well as translational research for next-generation immunotherapies. Additionally, the selection of participants for aducanumab clinical trials hinged on amyloid PET imaging, a technology that would not exist today without the publicly funded research supported by the NIA.

Today’s announcement is indeed significant, yet the work does not end here. Bolstered by significant investments in this research in recent years, NIA will continue to press forward with its robust and diverse research portfolio in the area of therapy development, building on the advancements we have achieved thus far. We will continue to evolve our understanding about Alzheimer’s and to develop more ways to detect, treat, and prevent this disease. We’re closer than ever to living in a world in which this condition may not take the enormous toll it does today.

by Alzheimer’s DiseaseCognitive HealthDementiasHealth Care ResearchMental & Emotional Health

About 14% of older adults with dementia filled prescriptions for multiple medications that target the central nervous system (CNS), or the brain and spinal cord, according to a recent study. The use of multiple medications, called polypharmacy, can increase the risk of serious side effects. Taking combinations of CNS-active drugs can lead to an increased risk of falling, breathing issues, and heart problems. In addition, some CNS-active drugs can affect thinking and memory — a side effect that is especially troubling in people with dementia. The NIA-supported study, led by researchers at the University of Michigan, was published in JAMA on March 9.Nurse giving an older adult medications.

Medications affecting the CNS are used to treat depression and other mental health conditions, prevent seizures, and reduce pain. Older adults who have dementia sometimes have behavioral and psychological symptoms, such as agitation or delusions. Health care providers may prescribe CNS-active drugs to treat those symptoms, but evidence of the drugs’ effectiveness for the symptoms is limited.

To better understand how many people with dementia received a combination of these drugs, researchers looked at Medicare claims data on more than 1 million adults ages 77 to 88 who had dementia. The researchers analyzed the number and timing of prescriptions filled to estimate the number of people who likely took combinations of the drugs.

The researchers found that 13.9% of these adults filled prescriptions for three or more CNS-active drugs for more than 30 days in a row. More than half of those adults had the drugs for more than 180 days. The researchers also found that people who were prescribed a combination of CNS-active drugs had higher rates of insomnia, mental health conditions, and pain not associated with cancer and seizure disorders. However, the researchers could not, based on the claims data, determine whether the drugs were prescribed to treat those conditions.

The researchers identified some limitations of their study that could point to areas for further investigation. The study may have overestimated the number of people who actually took the drugs because it counted prescriptions filled. The study did not look at the reasons the drugs were prescribed or their dosages. It also did not determine whether the adults who took a combination of CNS-active drugs had health problems that the drugs could cause, such as falls.

This study is the first to examine the number of adults with dementia who live in the community — not in nursing homes — and take a combination of CNS-active drugs. As the number of adults living with dementia increases, better understanding how these drugs are used, their effects, and associated risks could help health care providers and dementia patients make safer, well-informed care decisions.

This research was supported by NIA grant R01AG056407.

How to Set Fitness Goals

Write a Plan to Add Exercise and Physical Activity to Your Life

Deciding to become physically active can be one of the best things you can do for your health. Exercise and physical activity are not only great for your mental and physical health, but they can help keep you independent as you age. Now, let’s talk about getting started.

How Much Activity Do Older Adults Need?

According to the Physical Activity Guidelines for Americans (PDF, 14.5M) you should do at least 150 minutes (2 ½ hours) a week of moderate-intensity aerobic exercise, like brisk walking or fast dancing. Being active at least 3 days a week is best, but doing anything is better than doing nothing at all. You should also do muscle-strengthening activities, like lifting weights or doing sit-ups, at least 2 days a week. The Physical Activity Guidelines also recommend that as part of your weekly physical activity you combine multiple components of exercises. For example, try balance training as well as aerobic and muscle-strengthening activities. If you prefer vigorous-intensity aerobic activity (like running), aim for at least 75 minutes a week.

How Older Adults Can Get Started with Exercise

Exercise and physical activity are great for your mental and physical health and help keep you independent as you age. Here are a few things you may want to keep in mind when beginning to exercise.

Start Slowly When Beginning Exercise

The key to being successful and safe when beginning a physical activity routine is to build slowly from your current fitness level. Over-exercising can cause injury, which may lead to quitting. A steady rate of progress is the best approach.

To play it safe and reduce your risk of injury:

Begin your exercise program slowly with low-intensity exercises.

Warm up before exercising and cool down afterward.

Pay attention to your surroundings when exercising outdoors.

Drink water before, during, and after your workout session, even if you don’t feel thirsty. Play catch, kickball, basketball, or soccer.

Wear appropriate fitness clothes and shoes for your activity.

If you have specific health conditions, discuss your exercise and physical activity plan with your health care provider.

Don’t forget to test your current fitness level for all 4 types of exercise—endurance, balance, flexibility, and strength. You may be in shape for running, but if you’re not stretching, you’re not getting the maximum benefit from your exercise. Write down your results so you can track your progress as you continue to exercise.

Make notes about how these test exercises feel. If the exercises were hard, do what’s comfortable and slowly build up. If they were easy, you know your level of fitness is higher. You can be more ambitious and challenge yourself.

Many people enjoy warm-weather outdoor activities like walking, gardening, or playing tennis. Make sure to play it safe in hot weather. Too much heat can be risky for older adults and people with health problems. Being hot for too long can cause hyperthermia—a heat-related illness that includes heat stroke and heat exhaustion.

If you want to be active when it’s hot outside:

Check the weather forecast. If it’s very hot or humid, exercise inside with videos online, or walk in an air-conditioned building like a shopping mall.

Drink plenty of liquids. Water and fruit juices are good options. Avoid caffeine and alcohol. If your doctor has told you to limit liquids, ask what to do when it is very hot outside.

Wear light-colored, loose-fitting clothes in natural fabrics.

Dress in layers so you can remove clothing as your body warms up from activity.

Know the signs of heat-related illnesses and get medical help right away if you think someone has one.

Tips for exercising in cold weather

You can exercise outdoors in the winter, but take a few extra steps to stay safe before braving the cold. Exposure to cold can cause health problems such as hypothermia, a dangerous drop in body temperature.

If you want to walk, ski, ice skate, shovel show, or do other outdoor activities when it’s cold outside:

Check the weather forecast. If it’s very windy or cold, exercise inside with videos online and go out another time.

Watch out for snow and icy sidewalks.

Warm up your muscles first. Try walking or light arm pumping before you go out.

Pick the right clothes. Wear several layers of loose clothing. The layers will trap warm air between them. Avoid tight clothing, which can keep your blood from flowing freely and lead to loss of body heat.

Wear a waterproof coat or jacket if it’s snowy or rainy. Wear a hat, scarf, and gloves.

Learn the signs of hypothermia.