Nonpharinacological approaches to Alzheimer’s disease As emphasized by Reichman,147 pharmacological approaches can be combined with behavioral and environmental interventions that assist patients
in maintaining the highest, possible level of function. Patients #click here randurls[1|1|,|CHEM1|]# in the early stages of dementia may benefit from support groups and other constructive environments that provide information and feedback on the cognitive and behavioral symptoms. Attempts to improve cognitive function Inhibitors,research,lifescience,medical in AD patients through reality orientation, reminiscence, and memory retraining have had some limited success.148 Reality orientation was developed primarily to reduce confusion and disorientation in dementia patients in institutionalized settings. A key feature of reality orientation is Inhibitors,research,lifescience,medical to remind patients of who and where they are, provide feedback on time of day, day of week, etc, comment, on and describe what is happening at a given moment in time, and generally reinforce the patient’s awareness of their environment. Recent studies have observed improvements on the MMSE following sustained Inhibitors,research,lifescience,medical treatment, with reality orientation.149,150 However, such changes are often observed on the
orientation components of the MMSE-, and reality orientation does not appear to significantly impact behavioral functioning and, despite improvement, in cognition, improvements in IADL were not observed in several studies.150,151 There are a variety of memory training techniques that have been employed with some success in nondemented older adults, and we discuss these in detail Inhibitors,research,lifescience,medical below. These techniques are typically not effective in patients with dementia since their success relies upon utilization of many of the information-processing systems, which are no longer intact, in dementia. However, prosthetic memory aids such as diaries, memory wallets, and well-placed lists around the house and garden have been found to be helpful, particularly for early-stage patients who
can benefit from the Inhibitors,research,lifescience,medical type of mnemonic cueing such aids provide.152,153 Reminiscence therapy has also been postulated to be a potentially effective therapy for patients with dementia since studies suggest, that memories for remote events remain intact, longer than other forms of memory. Reminiscence Rolziracetam therapy aims to facilitate recall of past experiences with the overall goal of enhancing well-being. Few systematic studies of the effectiveness of reminiscence therapy in dementia patients exist, but the limited data available suggest that this technique may be more beneficial to interpersonal communication than cognitive processing.154-156 Indeed, many of the aforementioned techniques can also frustrate the dementia patient, by underscoring the limitations of their cognitive functioning. Behavioral therapy approaches aimed at, decreasing agitation, negative thoughts, and depression, and improving self-care have been quite successful.