Although medications can help alleviate and slow the progression of Alzheimer's disease, non-pharmacological interventions are also an essential part of helping a person remain as functional as they can. Interventions revolve around addressing memory, cognitive and behavioral problems and practical issues such as retaining general activities of daily living, or ADLs, which include eating, walking, dressing and toileting.
Cognitive Therapy
Cognitive therapy delivered by trained professionals or caregivers can help Alzheimer's patients. Therapy sessions may last a few minutes to a few hours, and may be on a one-time or ad hoc basis or continual.
Cognitive stimulation includes therapies such as reality orientation, which can involve topical discussion groups; validation therapy, in which a person is encouraged to talk about the problems she is experiencing; and reminiscence therapy, in which people talk about their pasts, prompted by photos or objects. A January 2009 review by Bob Woods in the "Cochrane Database of Systematic Reviews," points out that research has shown that reminiscence therapy has significant effects on clinical measures of memory, mood and behavioral function.
Cognitive rehabilitation involves treatment to improve daily functioning. These therapies can include using memory aids such as diaries and calendars, repetitive teaching of specific tasks, problem solving and memory drills. In his 2006 analysis of several studies published in "Acta Psychiatrica Scandanavica," David Sitzer indicates that these therapies could improve "cognitive functioning, verbal and visual learning and ADLs."
Exercise and Occupational Therapy
Physical therapies not only aid general functioning but also help with cognitive and behavioral problems.
Yves Rolland shows in a 2007 study in the "Journal of the American Geriatric Society" that an exercise program consisting of at least two 1-hour sessions per week led to a slower decline in ADL scores in Alzheimer's patients. Further, in a review of several studies on exercise therapy published in 2006 in "Neuroscience and Biobehavioral Reviews," Laura Eggermont notes that exercise therapy correlated with a positive effect on both physical activity levels and on "attention, memory, communication, executive functions and global mental functioning."
A 2007 report by Maria Valeria Baldelli in the "Archives of Gerontology and Geriatrics" supplement demonstrates that an occupational therapy program that includes gardening, drawing, cooking and physical activities could lead to significant improvements in behavioral problems such as aggression and agitation, enabling a reduction in the need for psychiatric medications and physical restraint.
Protection
People with Alzheimer's disease may need measures to protect them from potential hazards. The Alzheimer's Association recommends having smoke detectors and fire extinguishers in a house, placing locks on cabinets and ovens, safely storing dangerous substances and equipment and installing walk-in showers and baths with a temperature regulator and a nonslip surface.
People with Alzheimer's disease may wander away from where they live and should wear a medical alert bracelet. Caregivers can lessen wandering by actively going out for a walk with the person if he seems restless or by keeping him occupied in other ways. People with early Alzheimer's disease may still be able to drive but only with another person present and if their driving abilities are continually assessed.
References
- "Cochrane Database of Systematic Reviews"; Reminiscence Therapy For Dementia (Review); Bob Woods, et al; January 2009
- "Acta Psychiatrica Scandanavica"; Cognitive Training in Alzheimer's Disease: A Meta-Analysis of the Literature; David I. Sitzer, et al; August 2006
- "Journal of the American Geriatric Society"; Exercise Program for Nursing Home Residents With Alzheimer's Disease: A 1-Year Randomized, Controlled Trial; Yves Rolland, et al; February 2007
- "Archives of Gerontology and Geriatrics"; Occupational therapy and dementia: the experience of an Alzheimer special care unit; Maria Valeria Baldelli et al; 2007 Supplement
- "Neuroscience and Biobehavioral Reviews"; Exercise, Cognition and Alzheimer's Disease: More Is Not Necessarily Better; Laura Eggermont, et al; May 2006
