Alzheimer's disease is a progressive neurological disorder that gradually destroys memory and thinking skills, eventually affecting a person's ability to carry out simple tasks. This condition occurs when abnormal protein deposits form plaques and tangles in the brain, leading to the death of brain cells and the breakdown of connections between them.
Recognising early warning signs is crucial for timely intervention. Common symptoms include difficulty remembering recent conversations or events, challenges in planning or solving problems, confusion with time or place, and changes in mood or personality. As the disease progresses through mild, moderate, and severe stages, individuals may experience increased memory loss, difficulty with language, and eventual loss of independence.
Several risk factors contribute to Alzheimer's development:
It's important to distinguish between normal ageing and Alzheimer's symptoms. While occasional forgetfulness is normal, persistent memory problems that interfere with daily life warrant professional evaluation. Early diagnosis allows for better planning and access to treatments that may slow progression.
Parkinson's disease is a progressive neurological condition that primarily affects movement, caused by the gradual loss of dopamine-producing cells in the brain. This reduction in dopamine leads to the characteristic movement difficulties that define the condition, though symptoms extend far beyond motor function.
The four primary motor symptoms of Parkinson's include tremors (often starting in one hand), muscle rigidity or stiffness, bradykinesia (slowness of movement), and postural instability leading to balance problems. These symptoms typically begin on one side of the body and gradually affect both sides as the disease progresses.
Parkinson's also presents numerous non-motor symptoms that can significantly impact quality of life:
Early signs may be subtle, including reduced arm swing when walking, smaller handwriting, or a softer speaking voice. The disease progresses differently for each individual, with symptoms gradually worsening over years. Understanding these patterns helps patients and families prepare for the journey ahead while maintaining the best possible quality of life.
Three cholinesterase inhibitors are currently approved and available in Australia for treating mild to moderate Alzheimer's disease. These medications work by preventing the breakdown of acetylcholine, a neurotransmitter essential for memory and learning functions.
Memantine (Ebixa) is approved for moderate to severe Alzheimer's disease in Australia. This medication works differently from cholinesterase inhibitors by regulating glutamate activity in the brain, which can help protect nerve cells from damage caused by excessive calcium influx.
Alzheimer's medications currently available in Australia work to slow cognitive decline rather than cure the disease. Cholinesterase inhibitors help maintain cognitive function by preserving acetylcholine levels, whilst memantine protects against glutamate toxicity. These treatments may help maintain daily functioning and independence for longer periods, though individual responses vary considerably.
Patients and families should have realistic expectations about Alzheimer's treatments. These medications may help slow the progression of symptoms for 6-12 months on average, potentially improving or stabilising memory, thinking, and daily activities. However, they do not stop or reverse the underlying disease process. Benefits are generally modest, and not all patients will experience noticeable improvement.
Most Alzheimer's medications are listed on the Pharmaceutical Benefits Scheme (PBS), making them more affordable for Australian patients. PBS subsidies typically require initial prescription by a specialist such as a geriatrician, neurologist, or psychiatrist. Regular reviews and authority approvals may be necessary to continue treatment. Patients should discuss PBS eligibility and any out-of-pocket costs with their healthcare provider and pharmacist.
Common side effects of cholinesterase inhibitors include nausea, vomiting, diarrhoea, loss of appetite, and dizziness. These medications should be used cautiously in patients with heart conditions, asthma, or peptic ulcers. Memantine is generally well-tolerated but may cause dizziness, headache, or constipation. Always inform your doctor about all current medications and medical conditions, as drug interactions and contraindications can affect treatment safety and effectiveness.
Australia offers a comprehensive range of Parkinson's medications through the Pharmaceutical Benefits Scheme (PBS), making treatments more accessible and affordable for patients. Understanding these medication options helps patients and families make informed decisions about treatment plans.
Levodopa remains the gold standard treatment for Parkinson's disease. In Australia, the most commonly prescribed combinations include Sinemet (levodopa/carbidopa), Madopar (levodopa/benserazide), and Stalevo (levodopa/carbidopa/entacapone). These medications work by replacing the depleted dopamine in the brain, significantly improving motor symptoms like tremor, rigidity, and bradykinesia.
Dopamine agonists such as Pramipexole (Sifrol) and Ropinirole (Repreve) mimic dopamine's action in the brain. MAO-B inhibitors like Selegiline (Eldepryl) and Rasagiline (Azilect) help preserve existing dopamine, whilst COMT inhibitors such as Entacapone (Comtan) extend levodopa's effectiveness.
Timing and dosage are crucial for optimal effectiveness. Most medications require precise scheduling around meals and daily activities. Your neurologist will work closely with you to find the right combination and timing that minimises side effects whilst maximising symptom control throughout the day.
Creating a supportive environment is essential for individuals living with Alzheimer's and Parkinson's diseases. Proper planning and support systems can significantly improve quality of life for both patients and their families.
Home modifications play a crucial role in maintaining independence and safety. Remove trip hazards, install grab rails in bathrooms, ensure adequate lighting throughout the home, and consider non-slip surfaces. For Parkinson's patients, wider doorways and ramps can accommodate mobility aids, whilst those with Alzheimer's benefit from clear signage and simplified room layouts.
Establishing consistent routines helps manage symptoms and reduces confusion. Family members should learn about the conditions to provide appropriate support whilst encouraging independence where possible. Consider these support options:
Australia's healthcare system provides extensive support for individuals with Alzheimer's and Parkinson's diseases through various government programs and specialist services.
Neurologists and geriatricians specialising in movement disorders and dementia are available through public and private healthcare systems. Your GP can provide referrals to appropriate specialists, with Medicare covering a significant portion of consultation costs. Many specialists operate within major hospitals and dedicated clinics across metropolitan and regional areas.
The National Disability Insurance Scheme (NDIS) may provide support packages for eligible individuals under 65 with Parkinson's disease. Aged care services, including home care packages and residential care, are available through My Aged Care for those over 65 or younger people with dementia.
Dementia Australia and Parkinson's Australia offer invaluable resources including:
Many Australians also participate in clinical trials, contributing to research whilst potentially accessing new treatments. Contact these organisations or speak with your specialist about current research opportunities.
