TREATMENT STRATEGIES OF ALZHEIMER’S DISEASE

Apr
02
2009

Posted by: admin in Categories: General health.
Using Tags: General health

In general, treatment strategies fall into three main groups. The first of these is particularly aimed at supporting those who are looking after a person with dementia and in this chapter we will consider the role of support groups, and how to set one up from scratch if necessary. The other two strategies cover behavioural approaches and the use of medication.

Over the years there have been many behavioural approaches to treating people with dementia. The best known of these is probably reality orientation (RO), but there have been others such as reminiscence therapy and music therapy that are gaining popularity at the moment. It must be said that their main purpose is to try to maximize whatever intellectual ability remains, rather than improve the situation by resurrecting brain cells or preventing further decline. Many of the common-sense approaches that carers adopt to overcome difficulties are actually reality orientation techniques although not specifically called this. Reality orientation is the application of common sense to provide stimulation and exercise to the failing mental capabilities of a person with Alzheimer’s disease or a similar condition.

Reminiscence therapy, music therapy, and similar approaches are, in my opinion, effective methods of improving the quality of life for short periods for many people with dementia. Making the most of long-term memories can bring back pleasurable thoughts and associations, and may sometimes have a calming effect upon the sufferer. Music, particularly that relating to the past, can have a similar effect. When these activities are carried out in a group, it is sometimes possible to stimulate interaction between group members, even when the individuals appear to be quite severely demented. It is, however, often worth trying these or similar approaches in a one-to-one situation if attendance at a group session is not practical. Behavioural approaches to improving the quality of life of people with dementia are very important, but it often seems as if more is made of their scientific validity than is realistic and this can lead carers and relatives to expect to see an improvement in the intellectual ability of the person they are caring for, after the session or activity is over. This rarely happens; when it does it is usually short-lived and consists most commonly of an elevation of mood.

The therapeutic strategies involving the use of medicines fall into two groups. On the one hand there is the use of existing, well-tried, medical approaches to treatment of difficult behaviour in people with dementia. These involve drugs that are well-known to most of those looking after a person with dementia, especially professional carers. On the other hand new medicines are being developed and evaluated in the hope that they may slow down, or even reverse, a sufferer’s intellectual decline. Much of our hope for the future lies in the development of the latter group and there are many exciting new compounds on the way, although their effectiveness can only be tested in clinical trials, which may not be for a few years.