The scourge of dementia seems to be touching more and more of us these days: patients, families, caregivers, and practitioners. There are now nearly 6 million people in the U.S. with Alzheimer’s disease (AD) and related dementias, and that number is projected to increase substantially in the coming decades.

Though there is still much mystery as to why AD occurs, what is quite clear is that specific regions of the brain are affected. And the vast devastation occurring in those locations often leads to memory loss, cognitive impairment, and unwanted behavior. These behaviors include agitation, aggression, and insomnia. In addition, there are changes involving appetite, motivation, planning, social behavior, language, personality, mood, swallowing, and gait. (1)

Current treatment modalities either attempt to maintain levels of acetylcholine (an important neurotransmitter involved with cognition whose concentrations decrease in AD and other dementias); attempt to modify the underlying disease’s advancement; or calm the agitation and help with sleep. While there is significant research, and new drugs on the market, to try to combat the processes that cause dementia, the disease’s resistance to currently available medications and the nearly inevitable behavioral decline that occurs still present serious challenges.

The issues with current regimens are many: Aricept and drugs like it that attempt to raise acetylcholine levels may not help very much: newly introduced antibody medications are for mild disease, and while they may delay the development of some of the neurodegeneration that occurs, they are not without potentially serious side effects; tranquilizers can mitigate disturbing behavior but can sedate and further isolate the patient, decreasing desired interactions with family and caregivers. Many can further compromise the patient’s ability to function socially........

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