Alzheimer's disease is a progressive neurological disorder that gradually destroys memory and cognitive function, representing the most common form of dementia affecting over 400,000 Australians. This degenerative condition occurs when abnormal protein deposits accumulate in the brain, causing nerve cells to deteriorate and die, ultimately impacting daily functioning and quality of life.
Recognising early warning signs is crucial for timely intervention and treatment planning. Common symptoms include:
Alzheimer's typically progresses through mild, moderate, and severe stages over 8-10 years. While age remains the greatest risk factor, with most Australian patients diagnosed after 65, genetics, lifestyle factors, and cardiovascular health also contribute. It's important to distinguish between normal age-related memory changes—like occasionally forgetting names—and concerning symptoms that significantly impact daily functioning and require professional evaluation.
Australian healthcare providers have access to several evidence-based medications through the Pharmaceutical Benefits Scheme (PBS) to help manage Alzheimer's symptoms and potentially slow cognitive decline. These treatments work by addressing chemical imbalances in the brain that occur as the disease progresses.
The primary medications available include donepezil (Aricept), rivastigmine (Exelon), and galantamine (Reminyl). These drugs work by preventing the breakdown of acetylcholine, a brain chemical essential for memory and learning. They're typically prescribed for mild to moderate Alzheimer's and may help maintain cognitive function and daily living skills for several months to years.
Memantine (Ebixa) represents another treatment approach, regulating glutamate activity in the brain and is often prescribed for moderate to severe stages. This medication may help with daily functioning and can be used alongside cholinesterase inhibitors.
PBS subsidies make these medications more accessible to Australian patients, with specific criteria determining eligibility. Treatment benefits vary among individuals, and while these medications cannot cure Alzheimer's, they may help maintain independence longer and improve quality of life when combined with comprehensive care strategies.
Parkinson's disease is a progressive neurological disorder that affects the nervous system and parts of the body controlled by nerves. It occurs when nerve cells in the brain that produce dopamine become damaged or die, leading to reduced dopamine levels that affect movement and coordination.
The primary motor symptoms of Parkinson's disease include tremors (involuntary shaking, often starting in the hands), rigidity (muscle stiffness that limits range of motion), and bradykinesia (slowness of movement). These symptoms typically begin on one side of the body and gradually affect both sides as the condition progresses.
Parkinson's also presents various non-motor symptoms that significantly impact quality of life. Sleep disorders, including insomnia and REM sleep behaviour disorder, are common. Depression and anxiety frequently occur, along with cognitive changes that may include difficulty with concentration and memory.
Parkinson's progresses through five stages, from mild symptoms on one side of the body to severe mobility limitations requiring full-time care. The condition gradually affects daily activities such as walking, writing, speaking, and maintaining balance, often requiring adaptive strategies and assistive devices to maintain independence.
Several effective medications are available through Australian pharmacies to help manage Parkinson's symptoms. The choice of medication depends on individual symptoms, disease stage, and patient response to treatment.
Each medication works differently to address dopamine deficiency or enhance existing dopamine function. Timing is crucial, with many medications requiring precise scheduling around meals and daily activities. Dosages are typically started low and gradually increased under medical supervision to minimise side effects whilst achieving optimal symptom control. Regular monitoring ensures treatment remains effective as the condition progresses.
Medications used to treat Alzheimer's disease can cause several side effects that patients and carers should be aware of. Cholinesterase inhibitors such as donepezil, rivastigmine, and galantamine commonly cause gastrointestinal symptoms including nausea, vomiting, and diarrhoea. Other frequent side effects include sleep disturbances, muscle cramps, and bradycardia (slow heart rate). Memantine, another Alzheimer's medication, may cause dizziness, headache, and constipation. These side effects are often manageable and may improve as your body adjusts to the medication.
Parkinson's medications can also produce various side effects that require careful monitoring. Common initial side effects include nausea, lightheadedness, and orthostatic hypotension (drop in blood pressure when standing). More concerning side effects can include hallucinations and impulse-control problems such as gambling, shopping, or eating disorders. Long-term use of levodopa may lead to wearing-off fluctuations where symptoms return before the next dose, and dyskinesias, which are involuntary movements that can be quite distressing.
Several significant drug interactions can affect the safety and effectiveness of neurological medications. Cholinesterase inhibitors should not be combined with strong anticholinergic medications as this reduces their effectiveness. MAO-B inhibitors used in Parkinson's treatment can interact dangerously with certain antidepressants or sympathomimetics, potentially causing serotonin syndrome or dangerous increases in blood pressure. Levodopa absorption can be significantly reduced by iron supplements and high-protein meals, so timing of doses with meals is important. Dopamine antagonists such as metoclopramide or some antipsychotic medications can worsen Parkinsonian symptoms and should generally be avoided.
Always inform your prescriber and pharmacist about all medicines, supplements, and over-the-counter products you are taking. Contact your doctor or pharmacist immediately if you experience severe side effects such as fainting, chest pain, severe confusion, or suicidal thoughts. Any sudden worsening of neurological symptoms should also be reported promptly to your healthcare team.
Maintaining consistent medication routines is crucial for managing these conditions effectively. Consider these helpful strategies:
Dementia Australia is the peak national organisation providing comprehensive support for people living with dementia and their carers. They offer extensive information resources, professional counselling services, a 24/7 national helpline (1800 100 500), and local services across all states and territories. Similarly, Parkinson's Australia and state-based Parkinson's organisations provide specialised education programs, physiotherapy and exercise classes specifically designed for people with Parkinson's, peer support groups, and referrals to specialist neurological services.
Caring for someone with Alzheimer's or Parkinson's can be physically and emotionally demanding. Carer Gateway provides free services including practical advice, counselling, emergency respite referrals, and connections to local support services. Local respite services offer temporary care relief, while carer support groups through community health centres provide peer support and practical advice from others in similar situations.
Several government programs can help reduce the financial burden of managing these conditions. The Pharmaceutical Benefits Scheme (PBS) provides subsidised medications, significantly reducing prescription costs. Home Care Packages offer coordinated support services to help people remain in their homes longer. The Commonwealth Home Support Programme provides entry-level support services, while aged care assessments through My Aged Care help determine eligibility for various services. Younger people with disability may be eligible for support through the National Disability Insurance Scheme (NDIS). Additionally, eligible carers may access financial support through carer payments and various concessions for utilities and transport.
Maintaining mobility and communication skills is vital for quality of life. Allied health professionals including physiotherapists, occupational therapists, and speech pathologists can provide specialised interventions. Community centres often run support groups and social activities, while local health districts may offer specialised neurological clinics and community nursing services.
Early planning can help ensure preferences are respected as conditions progress. Important considerations include advance care planning discussions, arranging enduring power of attorney, and establishing regular medication and care reviews with your GP. Ask your doctor about developing a GP Management Plan and Team Care Arrangements for access to subsidised allied health services. Regular reviews help ensure treatments remain appropriate as conditions change.
To find services in your area, contact your GP, local health district, or the national organisations mentioned above. Most services can be accessed through referral from your general practitioner or by contacting the organisations directly through their websites or helplines.
