Health Professional Guide to Memory Loss: Neurodegenerative Dementias

Text Size: Normal / Medium / Large
Printer-friendly versionPrinter-friendly version

Neurodegenerative dementias

Alzheimer’s disease is the most common neurodegenerative dementia. This category also includes frontotemporal and Lewy Body dementias.


Alzheimer’s Disease (AD)

Alzheimer’s Disease is marked by progressive memory impairment, gradually accompanied by cognitive impairment not caused by physical symptoms.

Characteristics of Alzheimer's Disease

  • Memory impairment with 1 or more cognitive deficits:
    • Executive dysfunction
    • apraxia
    • aphasia
    • agnosia
  • Subtle onset with progressive deterioration

Alzheimer’s Disease





MMSE score 15 - 24

MMSE score 10 - 15

MMSE Score below 10


Report diagnosis

Refer to Alzheimer’s Society

Training and support for caregivers

Evaluate driving ability

Medical/legal issues

Refer to Alzheimer’s Society

Training and support for caregivers

Non-RX approach to physiological and behavioural symptoms of dementia


Institute plans for long-term care

Treatment Options

Prevention and treatment of vascular risk factors

ginkgo biloba: insufficient data

cholinergic replacement (donepezil, rivastigmine, galantamine)

Antipsychotics as needed

Warning ! Vitamin E is not recommended – high levels could cause death.

Cholinergic replacement (Donepezil, Rivastigmine, Galantamine)


Antipsychotics as needed



Cholinergic replacement

Limit prescriptions

Stop medications


Lewy Body Dementia and Frontotemporal Dementia


Lewy Body Dementia

Frontotemporal Dementia


Visual hallucinations (detailed/recurrent)

Highly variable cognitive status

Parkinsonian signs (esp. rigidity) / bradykinesia

Executive memory highly affected

Sensitivity to tranquilizers

Falls/unexpected loss of consciousness

Sleep problems

Relatively young onset (50 to 70 years old)

Behavioral changes: disinhibition/apathy/neglecting personal care/social misconduct

Impulsivity / poor judgment / irritability

Talks too much / behavioral perseveration

Executive function altered


Therapeutic trial of Rivastigmine, Galantamine and Donepezil


Behavioural interventions (calm and secure environment)

Treatment Alternatives



Consider a monitored drug trial of one of the three medications in use and check if behaviour improves. BEWARE! anticholinergics can aggravate behavioural problems. Experts recommend a serotoninergic approach: SSRI or Trazodone.


Next: Vascular Dementia and Mixed Dementias


We are pleased to house this series of FAQs for health professionals, supervised by Cara Tannenbaum, from the Centre de recherche de l’Institut universitaire de gériatrie de Montréal.

Browse Contents of the Health Professional Guide to Memory Loss:




Not a health care provider? Click here