The first step in dementia treatment is a thorough evaluation of all medications, and other possible causes of the disorder, with a comprehensive history and physical examination. This will help uncover clues as to the antecedents, mediators, and triggers of dementia.
The second step in treatment, particularly effective in the early stages (mild memory loss) is evaluating and actively reducing inflammation (through diet, supplements, treatment of chronic infection, correction of respiratory allergies and biotoxin exposures, correction of gastrointestinal dysbiosis), treating nutritional and hormonal deficiencies, supporting detoxification, reduction of stress, reducing oxidative stress, improving lifestyle (exercise, developing an enriched environment, learning a language, doing crossword puzzles, increasing social activities). The use of supplements is an important part of this approach, and useful in the very early stages of dementia. These include anti-inflammatory supplements (e.g., curcumin); supplements which increase the natural anti-oxidant and detoxification agent glutathione; supplements which may increase acetylcholine (helps memory) in the brain; supplements which increase blood flow; supplements which allow neurons to take up more nutrients; supplements which slow neurodegeneration.
The third step in dementia treatment often involves the use of medication. These medications are geared to slow the downward course of the disease and include medications which affect such as acetyl-choline breakdown (tacrine, donepezil, rivastigmine, galantamine) or NMDA antagonism (memantine). These medications have a modest effect. Memory-enhancing medications such as aniracetam and piracetam seem to have a different effect (perhaps working through ion channels, AMPA receptors, or NMDA receptors) and may be beneficial. Some claim that the use of lecithin is helpful, however, there is little clear data to support this.
Finally, if the dementia is progressive despite the above measures, the patient will need increasing support, as will the family members. Caregivers are at increased risk of mortality if they experience increased emotional strain.