Psychosocial Intervention For Alzheimer’s Disease Patients
Psychosocial interventions can be beneficial to patients suffering from AD. Such treatments generally fall under four categories:
- Behaviour-oriented therapies are used most often with patients who exhibit behaviours that are difficult to manage. The therapies consist of changing environmental factors thought to affect the patients and to reduce the patients’ behavioural problems. There is some evidence for the benefits of such therapies, but additional clinical trials are necessary.
- Emotion-oriented therapies include options like psychotherapy. They are often used to address issues of memory loss and to improve mood and behaviour.
- Cognition-oriented therapies include reality orientation, cognitive retraining and skills focusing on cognitive deficits. This type of treatment provides some improvements, but they are generally short-term.
- Stimulation-oriented therapy includes therapies related to pleasurable activities, such as art, music or exercise. Some data demonstrates its relative effectiveness in reducing behavioural problems.
How To Slow Down Dementia: Treatment Options Therapies And Supportive Care
Many people are confused about whether Alzheimers disease and other forms of dementia are treatable. The short answer?
There is currently no cure for dementia, says Ardeshir Hashmi, MD, section chief of the Center for Geriatric Medicine at Cleveland Clinic.
But, he says, a variety of treatment options can help manage symptoms, improve quality of life, and slow the progression of disease. Read on for Hashmis roundup of current dementia treatment options, along with his main takeaways for caregivers.
The Effects Of Alzheimers On The Brain
Damage to the brain begins years before symptoms appear. Abnormal protein deposits form plaques and tangles in the brain of someone with Alzheimers disease. Connections between cells are lost, and they begin to die. In advanced cases, the brain shows significant shrinkage.
Its impossible to diagnose Alzheimers with complete accuracy while a person is alive. The diagnosis can only be confirmed when the brain is examined under a microscope during an autopsy. However, specialists are able to make the correct diagnosis up to 90 percent of the time.
The symptoms of Alzheimers and dementia can overlap, but there can be some differences.
Both conditions can cause:
- behavioral changes
- difficulty speaking, swallowing, or walking in advanced stages of the disease
Some types of dementia will share some of these symptoms, but they include or exclude other symptoms that can help make a differential diagnosis. Lewy body dementia , for example, has many of the same later symptoms as Alzheimers. However, people with LBD but are more likely to experience initial symptoms such as visual hallucinations, difficulties with balance, and sleep disturbances.
People with dementia due to Parkinsons or Huntingtons disease are more likely to experience involuntary movement in the early stages of the disease.
Treatment for dementia will depend on the exact cause and type of dementia, but many treatments for dementia and Alzheimers will overlap.
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Can Alcohol Intoxication Cause Dementia
Alcohol dementia can appear to people of all ages, regardless of gender, height or body type. It can result from consuming alcoholic beverages in great quantities, including beer, wine, liquor, spirits, and more. Drinking small amounts of alcohol doesnt lead to this dangerous medical condition, so having a few drinks per week is considered to be safe.
Alcohol-induced dementia can be acquired if one gets intoxicated with alcohol regularly. This type of intoxication depletes the nutrients in the body, causes brain damage and seriously affects the function of major organs such as liver, kidneys, pancreas, and more. Each persons body can handle alcohol intoxication differently, but ultimately too much alcohol can lead to serious health conditions.
How To Use Coconut Oil For Dementia And Alzheimers
There are few people in the world who know more about how to use coconut oil for dementia and Alzheimers than Dr. Newport.
She recommends starting by taking one teaspoon of coconut oil 2-3 times a day with food, and working up to 4-6 tablespoons a day of coconut oil and MCT oil combined.
The onset of diarrhea or;an upset stomach means that youve taken too much, too soon.
Its easy to get the impression that you must take coconut oil by the spoonful, like medicine, to get its benefits.
But the best way to use coconut oil is as a food since its a versatile culinary oil.
Swap it out for any unhealthy oils you may be using like canola, sunflower, or safflower oil.
You can use coconut oil anywhere you normally use butter, margarine, or nut butters.
You can bake, saute, fry, and roast with;it, or add;it to smoothies.
The results will be delicious!
Coconut oil is unusual in that its melting point is room temperature 76° F/24° C.
When using it, youll find that it alternates between being solid and liquid.
Therefore, dont drizzle coconut oil on foods that are cool or cold, like salads .
Use olive oil, another brain-healthy oil, for that.
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Final Thoughts On Cannabis For Dementia
As things stand, none of the traditional dementia treatments come close to offering a cure and do little other than provide temporary relief with a great number of risks attached.
Research into marijuanas effects on dementia is still in its embryonic stages but early signs are good.
There is a possibility, albeit a small one, that cannabis could actually reverse the onset of dementia; what an extraordinary discovery that would be.
What Are The Most Common Types Of Dementia
- Alzheimers disease.;This is the most common cause of dementia, accounting for 60 to 80 percent of cases. It is caused by specific changes in the brain. The trademark symptom is trouble remembering recent events, such as a conversation that occurred minutes or hours ago, while difficulty remembering more distant memories occurs later in the disease. Other concerns like difficulty with walking or talking or personality changes also come later. Family history is the most important risk factor. Having a first-degree relative with Alzheimers disease increases the risk of developing it by 10 to 30 percent.
- Vascular dementia.;About 10 percent of dementia cases are linked to strokes or other issues with blood flow to the brain. Diabetes, high blood pressure and high cholesterol are also risk factors. Symptoms vary depending on the area and size of the brain impacted. The disease progresses in a step-wise fashion, meaning symptoms will suddenly get worse as the individual gets more strokes or mini-strokes.
- Lewy body dementia. In addition to more typical symptoms like memory loss, people with this form of dementia may have movement or balance problems like stiffness or trembling. Many people also experience changes in alertness including daytime sleepiness, confusion or staring spells. They may also have trouble sleeping at night or may experience visual hallucinations .
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The Rise Of Treatable Neurology
In October 2019, another patient was admitted to the John Radcliffe hospital.Pippa Carter, aged 19, had just begun an English literature degree at the University of Leeds when she noticed that her vision seemed to be strangely distorted.
I would be in lectures and I was really struggling to focus with my eyesight and with concentration in general, she says. I was trying to audition for a university play, and I had to stop because I couldnt really read at all. Initially, I thought it was just nerves because I was starting a new chapter in life.
Within weeks, she found herself unable to get her words out properly, before she was taken to hospital after suffering a large seizure. Just like Abraham, it was the speed of her decline which alerted doctors to a potential autoimmune cause. Within a week she was hallucinating, shouting things, remembers Irani. In her hospital room, which she was in for several weeks, she drew these bizarre childlike pictures on the wall, like the sorts of things a four-year-old would draw. It was like something was causing her to regress in her behaviour.
Carter was suffering from a neuropsychiatric syndrome caused by an autoantibody binding to the brains NMDA receptors, proteins which play a key role in learning and memory formation. Soon after she began treatment, first with steroids, and then an immunotherapy called rituximab, she began to improve. Now more than a year on, she is hoping to resume her university studies soon.
Treatment For Moderate To Severe Alzheimers
A medication known as memantine, an N-methyl D-aspartate antagonist, is prescribed to treat moderate to severe Alzheimers disease. This drugs main effect is to decrease symptoms, which could enable some people to maintain certain daily functions a little longer than they would without the medication. For example, memantine may help a person in the later stages of the disease maintain his or her ability to use the bathroom independently for several more months, a benefit for both the person with Alzheimer’s and caregivers.
Memantine is believed to work by regulating glutamate, an important brain chemical. When produced in excessive amounts, glutamate may lead to brain cell death. Because NMDA antagonists work differently from cholinesterase inhibitors, the two types of drugs can be prescribed in combination.
The FDA has also approved donepezil, the rivastigmine patch, and a combination medication of memantine and donepezil for the treatment of moderate to severe Alzheimers.
|Drug Name||For More Information|
Fdas Accelerated Approval Program
Aducanumab was approved through the FDAs Accelerated Approval Program, which provides a path for earlier approval of drugs that treat certain serious conditions. This helps people living with the disease gain earlier access to the treatment. The approval of aducanumab was based on the ability of the drug to reduce amyloid in the brain. When using the accelerated approval pathway, drug companies are required to conduct additional studies to determine whether there is in fact clinical benefit after the drug is approved. If the follow-up trial fails to verify clinical benefit, the FDA may withdraw approval of the drug. Results of the phase 4 clinical trial for aducanumab are expected to be available by early 2030.
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Weve had success in mice, finding ultrasound can clear toxic tau protein clumps, and that combining ultrasound with an antibody fragment treatment is more effective than either treatment alone in removing tau and reducing Alzheimers symptoms. The next challenge will be translating this success into human clinical trials.
The task of dementia drug development is no easy feat, and requires collaboration across government, industry and academia. In Australia, the National Dementia Network serves this purpose well. Its only through perseverance and continued investment in research that well one day have a treatment for dementia.
Jürgen Götz is director of the Clem Jones Centre for Ageing Dementia Research at the University of Queensland.
Republished under a Creative Commons license from The Conversation.
Q: If Drugs Against Amyloid Arent The Answer What Is
Back in the 80s and 90s, genetic tools weren’t quite developed enough to address the real question we had: What genes are involved in most cases of Alzheimers disease?
Techniques have advanced and we can now answer this question. New studiesmany led by Richard Mayeux, MD;have been pointing to other processes in the brain. We also have better biological tools that can reveal the basic problem inside neurons.;
Based on this research, the new consensus in the field is that there are two other pathways that cause the disease.
One involves protein trafficking, which is how proteins are shipped to different sites within a single cell. The health of neurons, more so than other cells, depends on protein trafficking in and out of one particular site: the endosome.;
In Alzheimers, the flow of proteins out of the endosome is blocked, and we think that causes the other problems we see in the disease: the amyloid, the tau tangles also common in the Alzheimers brain, and the neurodegeneration. Essentially it’s a plumbing problem.
Our research here at Columbia provided some early evidence for an endosomal trafficking problem in Alzheimers. And genetic studiesincluding those led by Dr.;Mayeuxhave now found that some endosomal genes are linked to Alzheimers, which provides more support.
What To Do If A Loved One Is Suspicious Of Having Dementia
- Discuss with loved one.;Talk about seeing a medical provider about the observed changes soon. Talk about the issue of driving and always carrying an ID.
- Medical assessment.;Be with a provider that you are comfortable with. Ask about the Medicare Annual Wellness exam.
- Family Meeting.;Start planning, and gather documents like the Health Care Directive, Durable Power of Attorney for Health Care, Estate Plan.
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Will A Treatment For Alzheimers Ever Be Found
In the 90s, Alzheimers researchers were full of optimism. New genetic studies all pointed to one culprithard clumps of protein, called amyloid, that litter the brains of people with the disease.;
With the emergence of the first tangible target, pharmaceutical companies jumped in to develop drugs to clear amyloid from the brain. In animals, the drugs appeared to improve memory. But the results of human clinical trials that followed were disheartening: One after one, these drugsall designed to target amyloidhave failed to slow the disease.
The onslaught of news about these failures has left the public wondering whether amyloid has anything to do with Alzheimersand whether a new approach is needed.;
The field has already begun to redirect its focus, says Scott Small, MD, director of Columbias Alzheimers Disease Research Center and the;Boris and Rose Katz Professor of Neurology at Columbia University Vagelos College of Physicians and Surgeons.
Theres now reason to be cautiously optimismistic, he says, because we have uncovered new pathways that lead to the disease, and we know that they truly make a difference.
The CUIMC Newsroom spoke with Small about the current state of research into Alzheimers treatments and prevention.
Debate Over Targeting Beta Amyloid Formations
Known among scientists as aducanumab, it works by offering an array of identical antibodies that are cloned from white blood cells. These antibodies are chosen for their targeting abilities, since they can identify specific proteins, called beta amyloids, that have constructed particular formations in the body.
There is extensive evidence suggesting that these beta amyloid formations, also known as “pathological aggregates” or”plaques,” are a major driver of Alzheimer’s disease, though the exact causal mechanisms are still not fully understood, according to Christian Pike of USC’s Leonard Davis School of Gerontology. Nonetheless, he says the antibodies can help prevent these plaques from forming, before directing other particles to break them apart, a process that’s clearly identifiable in before-and-after neural imaging.
For an analogy, it may be helpful to think of the beta amyloid proteins as young people walking around a city over the course of the day, where the city is the human body, and the day is a human lifespan. In certain cities, as afternoon turns into evening, individual young people start to congregate, and some of those congregations can turn toxic, and begin to cause problems. The antibodies delivered by Aduhelm act like law enforcement officers, arriving on the scene, identifying troublesome gatherings, surrounding them, separating them, then ordering bystanders to make the young people disperse.
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Alzheimers Vaccine And Immunotherapy
Researchers have been attempting to develop a vaccine for Alzheimers disease for almost a decade. The strategy behind the immunotherapy approach is to use the bodys own immune system to destroy beta-amyloid plaques.;
The first Alzheimers vaccine was tested in clinical trials in 2001. However, the trial was prematurely halted because six percent of participants developed serious brain inflammation. However, the vaccination did appear to benefit thinking and memory in some unaffected participants who were monitored after the end of the trial. Researchers have now developed a safer vaccine by using antibodies against a smaller fragment of the beta-amyloid protein, which they hope will avoid the complications of the previous trial.
Another approach to developing a vaccine involves using immunoglobulin, a filtered human blood product containing antibodies. Immunoglobulin was shown to be successful in a very small trial of 8 people with mild Alzheimers disease, with most showing improvement on tests of cognitive function after treatment. Although this trial is very small, it suggests the potential for larger trials of immunoglobulin therapy, which may have safety advantages over other vaccination techniques. Although this initial research is promising, much more research needs to be done before we know whether this approach will work.;
Symptoms Of Alcohol Dementia
There are several symptoms which can be easily identified and might indicate that one suffers from this health problem. For example, headaches, frequent anger episodes, mood swings, slurred speech as well as memory gaps are serious signs of alcoholic dementia. Having regular alcohol blackout symptoms while drinking is also dangerous to the human brain and acts as a contributing factor to this condition.
Elderly alcoholic dementia is a closely-related condition which affects elderly people, and the health effects of alcohol are worse when coupled with other neurological illnesses such as Alzheimers disease or Parkinsons disease. This combination of brain issues might be incurable and are known as alcohol-induced psychosis.
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Stem Cells And Dementia
Stem cells are “building block” cells. They can develop into many different cell types, including brain or nerve cells.
Scientists have taken skin cells from people with certain types of dementia, such as Alzheimer’s disease, and “reprogrammed” them into stem cells in the lab. They’ve then triggered these stem cells to become brain cells.
These brain cells can also be used to test potential treatments at a very early stage.