Alzheimer's disease is a progressive neurodegenerative disorder that primarily affects memory, thinking, and behaviour. It is the most common form of dementia, accounting for approximately 70% of all dementia cases in Australia. The disease occurs when abnormal protein deposits, including amyloid plaques and tau tangles, accumulate in the brain, leading to the death of nerve cells and the breakdown of connections between them. This process gradually impairs cognitive function, starting with mild memory loss and eventually affecting the ability to carry out daily activities.
Recognising the early signs of Alzheimer's disease is crucial for timely intervention and management. The symptoms typically develop gradually and worsen over time. Key warning signs include:
Several factors can increase the risk of developing Alzheimer's disease. Age is the greatest known risk factor, with most people diagnosed being 65 or older. Family history and genetics also play a significant role, particularly the presence of the APOE-e4 gene variant. Other risk factors include cardiovascular disease, diabetes, high blood pressure, and lifestyle factors such as lack of physical exercise and social isolation.
Alzheimer's disease progresses through three main stages: mild (early-stage), moderate (middle-stage), and severe (late-stage). In the mild stage, individuals may experience memory lapses and difficulty with complex tasks. The moderate stage involves increased confusion, difficulty recognising family and friends, and behavioural changes. The severe stage is characterised by the inability to communicate coherently and requiring full-time care.
Alzheimer's disease affects approximately 250,000 Australians, with this number expected to increase significantly as the population ages. The impact extends far beyond the individual diagnosed, profoundly affecting family members, carers, and the broader community. Families often face emotional, physical, and financial challenges as they navigate the caregiving journey. The Australian government recognises this burden and provides support through various programs, including respite care services, carer support groups, and financial assistance through the Department of Health and Aged Care.
If you notice persistent memory problems or other cognitive changes in yourself or a loved one, it's important to consult a healthcare professional promptly. Early diagnosis allows for better planning, access to treatments that may slow progression, and connection with support services. Your GP can conduct initial assessments and refer you to specialists such as geriatricians, neurologists, or psychiatrists who specialise in dementia care. Memory clinics are also available in major Australian cities, offering comprehensive assessments and ongoing support.
Cholinesterase inhibitors are the primary class of medications used to treat mild to moderate Alzheimer's disease in Australia. These medications work by preventing the breakdown of acetylcholine, a neurotransmitter important for memory and learning. Three cholinesterase inhibitors are available on the Pharmaceutical Benefits Scheme (PBS): donepezil (Aricept), rivastigmine (Exelon), and galantamine (Reminyl). These medications can help maintain cognitive function and daily living skills for a period of time, though they do not cure or stop the progression of the disease.
Memantine (Ebixa) is an NMDA receptor antagonist approved for treating moderate to severe Alzheimer's disease in Australia. It works by regulating glutamate activity in the brain, which can become excessive in Alzheimer's disease and contribute to nerve cell damage. Memantine may help with cognition, daily functioning, and behavioural symptoms. It is also listed on the PBS and can be used alone or in combination with cholinesterase inhibitors.
While these medications cannot cure Alzheimer's disease, they may help slow the decline of cognitive and functional abilities for several months to a few years in some people. Cholinesterase inhibitors help maintain communication between nerve cells by preserving acetylcholine levels, while memantine protects cells from excess glutamate. Benefits may include improved memory, attention, and ability to perform daily activities, though individual responses vary considerably.
All Alzheimer's medications in Australia require a prescription from a medical practitioner and must meet specific PBS criteria for subsidised access. Initial prescriptions typically require specialist approval from a geriatrician, neurologist, or psychiatrist experienced in dementia care. Patients must have a confirmed diagnosis of Alzheimer's disease and meet cognitive assessment criteria. Regular reviews are required to demonstrate continued benefit and maintain PBS eligibility.
Common side effects of cholinesterase inhibitors include nausea, vomiting, diarrhoea, loss of appetite, and dizziness. These effects are usually mild and may improve over time. Memantine is generally well-tolerated, with possible side effects including dizziness, headache, and constipation. Regular monitoring by healthcare professionals is essential to assess treatment response, manage side effects, and adjust dosages as needed. Patients should inform their pharmacist and doctor about all other medications they are taking to avoid potential interactions.
In moderate to severe Alzheimer's disease, combination therapy with both a cholinesterase inhibitor and memantine may be considered. This approach can potentially provide additional cognitive and functional benefits compared to single-drug therapy. Your specialist will determine the most appropriate treatment strategy based on individual circumstances, disease stage, tolerability, and response to treatment. Regular review and adjustment of therapy is important to optimise outcomes and minimise side effects.
Parkinson's disease is a progressive neurological disorder that affects approximately 100,000 Australians, with around 20 new cases diagnosed daily across the country. This condition occurs when nerve cells in the brain that produce dopamine become damaged or die, leading to a significant reduction in this essential neurotransmitter that controls movement and coordination.
Parkinson's disease presents with both visible and less obvious symptoms. Motor symptoms include tremors, rigidity, bradykinesia (slowness of movement), and postural instability. Non-motor symptoms often appear earlier and include depression, anxiety, sleep disturbances, constipation, and cognitive changes that can significantly impact daily functioning.
The condition progresses through five distinct stages, from mild symptoms on one side of the body to requiring full-time care. Unlike essential tremor or other movement disorders, Parkinson's typically begins unilaterally and includes the characteristic resting tremor. For Australian patients, accessing specialist care through public and private healthcare systems, along with support from Parkinson's Australia, plays a crucial role in maintaining quality of life and independence throughout the disease journey.
Treatment of Parkinson's disease in Australia involves several classes of medications available through the Pharmaceutical Benefits Scheme (PBS), making essential treatments more accessible for patients nationwide. The primary goal is to restore dopamine levels or enhance dopamine function in the brain.
Australian patients also have access to advanced therapies including deep brain stimulation (DBS) through major hospitals in capital cities, and newer medications like Duodopa pumps for continuous medication delivery. Recent additions to the PBS include extended-release formulations that provide more consistent symptom control.
Timing is critical with Parkinson's medications, particularly levodopa, which should be taken 30-60 minutes before meals for optimal absorption. Australian patients are advised to avoid high-protein foods around medication times and maintain consistent daily routines to maximise treatment effectiveness while minimising side effects.
Effective management of Alzheimer's and Parkinson's conditions requires a comprehensive approach that extends beyond medication alone. Maintaining strict medication compliance is crucial for optimal symptom control and disease progression management. Your pharmacist plays a vital role in monitoring potential drug interactions and helping manage side effects that may arise from complex medication regimens.
Successful treatment involves multiple therapeutic approaches working together:
Lifestyle modifications such as regular exercise, maintaining social connections, and following a Mediterranean-style diet can significantly impact quality of life. Sleep management is particularly important, as both conditions can disrupt sleep patterns, affecting cognitive function and physical wellbeing.
Australia offers comprehensive support systems for individuals living with Alzheimer's and Parkinson's disease. The Pharmaceutical Benefits Scheme (PBS) provides subsidised access to essential medications, significantly reducing treatment costs for eligible patients and carers.
Dementia Australia and Parkinson's Australia provide invaluable resources, including:
Government services through My Aged Care connect families with local support options, including home care packages and residential care services. Community pharmacies across Australia offer specialised medication management programs, including dose administration aids and comprehensive medication reviews. Planning for advanced care needs, including advance care directives and enduring power of attorney arrangements, ensures patient preferences are respected throughout their care journey.
