Are Alzheimer’s disease drugs effective for other types of dementia?

We explore the evidence behind the effectiveness of Alzheimer’s disease drugs as treatment for people that are living with other types of dementia.

What does the research say?

The cholinesterase inhibitors were developed specifically to treat Alzheimer’s disease.

There has been relatively little research into whether they, or memantine,  are helpful for people with other types of dementia.

Drugs for dementia with Lewy bodies, and Parkinson’s disease dementia

There is evidence that the cholinesterase inhibitors are effective in people with dementia with Lewy bodies, and dementia due to Parkinson’s disease.

Rivastigmine is licensed for Parkinson’s disease dementia. Acetylcholine levels are often even lower in people with dementia with Lewy bodies than in those with Alzheimer’s disease.

NICE guidelines recommend that a cholinesterase inhibitor is offered to a person with dementia with Lewy bodies or Parkinson’s disease dementia if they have distressing symptoms, such as hallucinations, or challenging behaviours, such as agitation or aggression.

For memantine, one trial showed benefits for people with dementia with Lewy bodies and Parkinson’s disease dementia, but there is not enough evidence to draw any firm conclusions.

Drugs for vascular dementia

Several trials have looked at the treatment of vascular dementia with a cholinesterase inhibitor or memantine.

The benefits for either are very small, if any at all. These benefits are seen mainly for mental abilities of people with a combination of both Alzheimer’s disease and vascular dementia (known as mixed dementia).

NICE guidelines recommend cholinesterase inhibitors for treatment of mixed dementia when Alzheimer’s is the main cause, but not for the treatment of pure vascular dementia.

Drugs for frontotemporal dementia

From the few trials carried out, there is no good evidence that the cholinesterase inhibitors or memantine are of benefit for people with frontotemporal dementia, including Pick’s disease.

In some people they may make symptoms worse. These drugs are not licensed for frontotemporal dementia and will not generally be prescribed for it.