Office of the Public Guardian. (2019). Make, register or end a lasting power of attorney. Government Digital Service. [online] Available at: https://www.gov.uk/power-of-attorney [Accessed 4 Jul. 2019]. The World Health Organisation recommends that stopping smoking, reducing alcohol intake, increasing exercise and a healthy, balanced diet (e.g. the Mediterranean-like diet is specifically recommended) can reduce the risk of dementia, especially if these There may come a time when you start to find it hard to make decisions about important parts of your life, such as managing your money, or in taking medical decisions. You can givea trusted relative, friend or solicitor the rightto make such The titles on the booklist are divided into four categories: information and advice; living well with dementia; support for relatives and carers; and personal stories.

Exelon (rivastigmine) - NetDoctor

A unique aspect of dementia treatment is the integral role that care-givers often play in the management of the disease. Considering that the majority of patients (~75%) require assistance with the management and/or administration of medications, 34 compliance to treatment is often care-giver-driven. Given that care-givers of individuals with AD are often older people themselves with their own medical conditions and drugs to manage, this may contribute to difficulties coping. 35 Medication responsibilities – which may include purchasing, scheduling and/or administration – can be a major concern to care-givers, particularly when medications are associated with side effects or time is limited. 36Care-giver preference for, and satisfaction with, rivastigmine patches were investigated in a large clinical trial that showed their efficacy to treat AD patients with good tolerability and formed the basis for the approval of the rivastigmine patch. 37 The important study findings are presented in Figure 1. It should be remembered that all patients received both capsules and patches in this double-blind and double-dummy trial. In total, 72% of care-givers preferred rivastigmine patches to capsules “overall”, while 74 and 64% of care-givers preferred patches to capsules based on “ease of use” and “ease of following the schedule”, respectively (all p<0.0001). 37 Care-givers also expressed greater satisfaction overall, greater satisfaction with administration and less interference with daily life with patches versus capsules (all p<0.01). 37 Subgroup analyses revealed that care-giver preference for patches over capsules were consistent, independent of the disease severity of patients or the age, gender, patient relationship or country of residence of care-givers. 37

Memantine and breastfeeding

Eileen does not feel there is a real problem with her memory. She gets irritable and upset when her daughters tell her that they are worried about her memory. After much persuasion, she agrees to go and see her GP with them. The GP does some simple

Factsheet 407LP Drug treatments April 2018 for Alzheimer’s

the patch should be replaced by a new one after 24 hours, and the previous day’s patch must be removed before application of a new patch to a different skin location This uncertainty can have a big impact on how the person feels and how their carers, family and friends feel. Signs of late-stage dementia He has noticed a shake of his right arm developing over the last few months and yesterday he had a fall in the street. He has found himself shuffling, which has upset him because he has always seen himself as active and athletic. His daughter, Cath, was worried after a he nearly had an accident after he lost attention while driving. He put this down to poor sleep, as his bed is always a mess in the morning and he sometimes has bruises. Aarsland D, Andersen K, Larsen JP, et al., Prevalence and characteristics of dementia in Parkinson disease: an 8-year prospective study, Arch Neurol, 2003;60(3):387–92.Department of Transport. (2019). Dementia and driving. Government Digital Service. [online] Available at: https://www.gov.uk/dementia-and-driving [Accessed 4 Jul. 2019].

Rivastigmine | Drugs | BNF | NICE

One of the features of both Alzheimer's disease and Parkinson's disease appears to be a lower than normal level of acetylcholine in the brain. This is due in part to degeneration of brain cells, in particular those that normally release acetylcholine. If you have an increased appetite, try to eat a healthy balanced diet without increasing your portion sizes. The incidence of dementia syndromes such as Alzheimer’s disease (AD) or Parkinson’s disease dementia (PDD) increases with age: approximately 10% of people over the age of 65 years may develop AD, 5 and dementia has been reported in as many as 80% of older PD patients (mean age 73 years). 6 These dementia syndromes are characterised by a progressive deterioration of cognition and the emergence of behavioural and psychological symptoms and functional decline, which makes conducting everyday tasks increasingly challenging. Cholinesterase inhibitors such as rivastigmine, donepezil and galantamine – which have been widely available in oral formulations – and memantine form the mainstay of treatment for AD. Currently, rivastigmine is the only treatment approved for the treatment of mild to moderate PDD. However, due to the multitude of risk factors that individuals with dementia face, i.e. typically being older, with co-morbidities, high medication burden and memory deficits, this patient population is especially vulnerable to treatment non-compliance. 7 For example, despite AD being a long-term, chronic disease, the average treatment duration for this condition seldom exceeds even one year. 8–10 Many patients continue taking low, non-therapeutic doses due to a misunderstanding of complex titration schedules; however, patients who stay on AD therapies for longer periods at adequate doses have a greater chance of slowing or delaying the progression of cognitive decline, 11 may experience fewer admissions to nursing homes and may have reduced healthcare costs. 12 You find it harder to remember things and develop other problems with your thinking. These make it more difficult to cope with your day to day life. Choose the area where you will apply the patch. Wash the area with soap and warm water. Rinse off all of the soap and dry the area with a clean towel. Be sure the skin is free of powders, oil, and lotions.Transdermal rivastigmine comes as a patch you apply to the skin. It is usually applied once a day. Apply the rivastigmine patch at around the same time each day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use the rivastigmine skin patch exactly as directed. Do not apply it more or less often than prescribed by your doctor. In some families, ‘early onset dementia’ is more common, so here there does seem to be a stronger genetic cause. Also, people with Down’s syndrome are more likely to develop dementia early. 17 If there has been more than one person in These changes are part of the dying process when the person is often unaware of what is happening. How can healthcare professionals help at this stage? Nelson, P. et al. (2019). Limbic-predominant age-related TDP-43 encephalopathy (LATE): consensus working group report . Brain. Vol.142:6. pp 1503-1527. [online] Available at: https://academic.oup.com/brain/article/142/6/1503/5481202 [Accessed 4 Jul. 2019].

Clinical Benefits Associated with a Transdermal Patch for Clinical Benefits Associated with a Transdermal Patch for

A psychological treatment called group cognitive stimulation may help with memory and improve the quality of a person's life, by using group games to stimulate thinking skills. 21 The most common side effects of memantine are feeling sleepy or dizzy, headaches, constipation and shortness of breath. Salzman C, Medication compliance in the elderly, J Clin Psychiatry, 1995;56(Suppl. 1):18–22, discussion 3. Mercier F, Lefevre G, Huang HL, et al., Rivastigmine exposure provided by a transdermal patch versus capsules, Curr Med Res Opin, 2007;23:3199–3204.This service was developed by the National Institute for Health Research (NIHR) in partnership with Alzheimer Scotland, Alzheimer’s Research UK and Alzheimer’s Society to match interested volunteers with researchers. Prince, M et al. (2014). Dementia UK: Update Second Edition. Alzheimer’s Society. [online] Available at: http://eprints.lse.ac.uk/59437/1/Dementia_UK_Second_edition_-_Overview.pdf [Accessed 4 Jul. 2019]. p 16. Like all medicines, risperidone can cause side effects, although not everyone gets them. Common side effects Memantine is available on prescription only. It comes as tablets, including soluble tablets that you dissolve in water and swallow as a drink, tablets that melt in your mouth, and as a liquid that you swallow. Key facts