As a cure for Alzheimer’s disease continues to elude scientists, non-drug treatments—including mental and physical exercise and even caregiver support—are emerging as the best proven medicine for the disease, according to many of the latest studies presented at the 25th Conference of the Alzheimer’s Disease International, which opened Wednesday in Thessaloniki, Greece.
Although the impact of these approaches has been understood anecdotally for years, the arc of Alzheimer’s disease research has finally reached a point where non-drug treatment studies have continued long enough to constitute evidence-based research. That means these approaches are proven tools for those working to help people with the debilitating illness, which affects 26 million people worldwide, 5.3 million in the United States alone. An irreversible brain disorder, Alzheimer’s robs people of their memory and eventually impairs most of their mental and physical functions.
The proof that these therapies really work may also be good economic news: Non-drug therapies can save money, for individual families as well as state and local governments, by delaying entrance into nursing homes for those suffering from dementia, experts say.
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“Psychological therapies have been used with people with dementia for at least 50 years,” says Robert Woods, a professor at Bangor University in Wales, whose presentation highlighted the fact that behavioral approaches have fewer side effects than drug therapies.
Two of the common therapies are known as “cognitive stimulation” and “reminiscence therapy.” Cognitive stimulation involves a small group of people with dementia meeting a couple of times a week with a care worker, to take part in a range of activities—from word games to a group baking session. The sessions are intended to involve those with Alzheimer’s in activities that are mentally stimulating and enjoyable.
Woods cites studies that found cognitive stimulation groups can actually improve a person’s scores on tests of memory, language and thinking—similar to the changes seen with the currently available medications for Alzheimer’s disease. “More importantly,” Woods says, “participants also reported improved quality of life. Behavioral approaches have been shown to be effective in a number of domains including improved mood.”
Reminiscence therapy groups are similar, but focus on activities and discussions of personal events and experiences. Carefully selected pictures, objects, sound and video recordings, are used to evoke old memories. Caregivers reported improved behavior in those with Alzheimer’s, without the use of drugs. And the patients reported a better quality of life. Both these results help keep men and women at home with their families, rather than in a nursing home.
“Dementia is a complex set of conditions,” he adds. “Building on the person’s life history is always a good starting point, as a guide to their values, interests and preferences. Engaging the person in a positive, constructive approach may be more effective than tackling problem behavior head-on.”