She is passionate about changing the culture and HOW nurses provide care for patients with dementia. She is a community volunteer with the Alzheimer’s Association and Dementia Friends. She has 2 adult daughters, a son-in-law, and a new granddaughter born December 26. She lives with her husband in Cumberland, Virginia.

1. Is there a pill for Alzheimer’s Disease?

• There is NO pill to cure Alzheimer’s or any other dementia

• Much like many other Chronic Health conditions like diabetes and heart disease, or multiple sclerosis, we treat the symptoms

.2. What about the newer drugs recently approved by the FDA?

• (Leqembi) lacanemab anti-amyloid medications that reduce the amyloid plaque surrounding the nerve.

• Accelerated approval Jan 2023; full approval July 2023, MCI and Mild Alz Dz Study was over 18 months – no info on long term effect or safety Shown to have a moderate effect on slowing decline in memory and thinking on paper tests, only minimal change in functioning IV Infusion every 2 weeks at an infusion center Side Effects: N/V, Chills, body aches, HA, Dizziness, ^ HR, SOB Serious Side effects: brain swelling; small brain bleeding and death Talk to doctor about these risks vs benefits

• Exclusion criteria: genetic testing for APOE gene, stroke or TIA, blood thinners, and other health conditions such as RA or uncontrolled diabetes Imaging tests:– Amyloid PET scan or spinal lumbar puncture measure amyloid Follow up MRI scans to check for swelling and bleeding Cost is close to $27,000/ year, 80% Medicare, ? other insurance Coverage for cost of imaging is uncertain

3. What are the other medications doctors often prescribe for dementia?

• Memory Enhancers – cholinesterase inhibitors & Glutamate Regulators

4. Discuss the Psychiatric Medications that are used, like the new one Rexulti

• Think of Symptoms Depression, Anxiety, and psychosis (hallucinations & delusions) Seizures and Sleep problems 50% patients with dementia are prescribed an antidepressant

Psychiatric medications were approved for disorders of the brain where there is often a chemical imbalance. Sometimes they work and sometimes they don’t, maybe 30% use In dementia, we have brain changes and loss of nerves and chemistry – medications may not work the same as they were intended for psychiatric disorders