Alzheimer's care: Where do we stand?

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Alzheimer's care: Where do we stand?
Alzheimer's care: Where do we stand?

With more than 225,000 new cases per year, Alzheimer's disease remains a major public health concern. Accompanying patients and families, improving home and facility care, providing information, raising awareness, and experimenting with new treatments are some of the many advancements made in recent years. As we approach World Alzheimer's Day on September 21st, where do science and research stand in this field? What prevention and support tools are available? Do we have a better understanding of the disease and ways to improve the daily lives of patients and families?

Games and activities to preserve Alzheimer's patients' memory

While preventing Alzheimer's disease remains a great hope, advances in research and medicine have allowed us to better understand risk factors and factors that could delay the onset of the disease or slow its progression. Professionals unanimously agree on the importance of games and cognitive exercises in preserving the mental faculties of elderly individuals, delaying the onset of dementia, and slowing the progression of Alzheimer's disease. Games and other playful and physical activities play an integrative, socializing, and therapeutic role.

Activities provided to Alzheimer's patients are typically tailored and designed by specialists to perfectly meet their needs. There is a wide range of recommended exercises that provide both physical and mental contributions, preserving and stimulating listening, attention, comprehension, recognition, and memory abilities. These activities can include simple conversations as well as exercises aimed at stimulating visual memory through recognition games, drawing comparisons, or analyzing photographs. Among the many activities offered, especially in facilities, are reminiscence workshops. During these workshops, residents are presented with evocative themes such as "childhood and the family home," "school years," "neighbors," or "war."

Over about an hour and a half, residents engage in conversations about photo albums, old films, images, and objects from the past, as well as various tastes and scents. It's a moment of intense sensations where sensory memory, both olfactory and gustatory, is stimulated. Ms. Pauline Carpentier, the director of the Alzheimer's Center "Les Parentèles" on Rue Blanche in Paris, explains the importance of therapeutic workshops for residents.

"The numerous workshops for laughter, gymnastics, painting, press reviews, image analysis, and many other workshops organized within the facility not only stimulate and preserve the physical and cognitive abilities of individuals but also combat sadness or anxiety and create a positive and stimulating atmosphere that also has positive effects on health."

Social life and outings as integral parts of Alzheimer's care

There is no doubt about it. Having coffee with a friend or another resident on the terrace, participating in gardening activities, or going for a walk are essential activities for the physical and mental well-being of the elderly.

Social relationships are excellent drivers of interaction, engagement, and enthusiasm. And yet, social life represents much more. Whether one lives at home or in a facility, maintaining active relationships with others is considered preventive regarding the onset of dementia such as Alzheimer's and helps slow its effects. In an interview for Retraite Plus, Dr. Sandra Benizri, a neurologist, emphasized the significant importance of social relationships in preserving cognitive abilities. It is, therefore, essential to prioritize this broad range of non-pharmacological therapy, especially concerning prevention.

Emotions play a key role in triggering memories in individuals with Alzheimer's. Social relationships promote emotional expression and sharing while creating a friendly and reassuring atmosphere for the person. In care facilities, various activities and workshops offered to residents, especially Alzheimer's patients, are not considered supplementary recreational tools but rather essential factors in targeted care that is indispensable for the well-being of the elderly.

More Alzheimer's patients admitted to facilities

According to a survey by the Fondation Médéric Alzheimer reported by the specialized Gerontonews website, the number of Alzheimer's patients admitted to specialized facilities such as nursing homes (EHPADs) or Alzheimer's centers has increased by 35% in eight years.

This increase in numbers has been accompanied by improvements in care, expanded specialized facilities and accommodations, a better understanding of symptom management, and natural therapy methods such as art therapy. "In 2019, 371,000 Alzheimer's or related disease patients resided in a care facility, which is "35% more than in 2011," according to the Fondation Médéric Alzheimer, which also noted that specific accommodation capacity increased by 64% during this period," Gerontonews reported.

Typically equipped with a Snoezelen room and open yet secure outdoor spaces and therapeutic gardens, EHPADs that care for Alzheimer's patients offer them the opportunity for some degree of independence in a closely supervised environment. In Snoezelen rooms, for example, residents, generally accompanied by a professional, allow their emotions to guide them freely, often bringing back long-buried memories through the magic of the senses. Therapeutic gardens, on the other hand, are designed to meet the specific needs of these individuals.

As Ms. Carpentier explains, "Our therapeutic garden is equipped with a large circle so that people who need to stroll can do so without losing their bearings. In general, a specialized center like ours is entirely designed and conceived to facilitate the daily lives of Alzheimer's patients, help them maintain their autonomy, and feel comfortable in secure, purpose-built spaces. Both day and night care are provided without the resident feeling restricted in their freedom."

Promising Non-Pharmacological Therapies for Alzheimer's

Beyond workshops and other non-pharmacological therapy tools that help alleviate the symptoms of the disease, some therapies aim to slow down or even reverse the characteristics associated with the disease itself, such as the abnormal accumulation of amyloid plaques in the brain. Among these, light therapy has already shown some effectiveness in slowing the progression of Alzheimer's disease.

Several studies have demonstrated the beneficial effects of regular exposure to natural or artificial light on the disrupted circadian rhythms of day and night, often seen in Alzheimer's patients. Regulating this disruption can alleviate various disease-related symptoms and daytime drowsiness. Beyond its influence on disease symptoms, controlled light exposure has been found to reduce the burden of amyloid-β protein in the brain, partly responsible for the characteristic cellular degeneration of Alzheimer's disease.

This could partially restore memory and cognition. Additionally, the effects of oxygen therapy have also been highlighted in slowing the progression of the disease. Already known to improve the daily lives of thousands of elderly individuals at home with chronic respiratory insufficiency, oxygen therapy has shown real effects on Alzheimer's disease. Hyperbaric oxygen therapy involves placing the patient in a specially designed chamber to improve cell oxygenation.

According to the medical news site Santé Log, "Hyperbaric oxygen therapy targets several pathological processes involved in Alzheimer's disease by affecting microcirculation, mitochondrial dysfunction, biogenesis, reducing amyloid burden, tau protein phosphorylation; it also helps control oxidative stress and reduce inflammation." In a study conducted by the University of Health Sciences in Louisiana, a 58-year-old patient diagnosed with Alzheimer's underwent a total of 40 sessions of hyperbaric oxygen therapy, lasting 50 minutes each, five times a week for over two months. "After 21 sessions, the patient reported increased energy and activity levels, improved mood, and better ability to perform daily activities.

After 40 sessions, she reported memory and concentration recovery, improved sleep, conversation, appetite, greater computer use, and an improved sense of well-being five days a week, reduced anxiety levels, reduced disorientation and frustration. Her tremors were reduced, and her mobility improved. Finally, brain imaging confirmed an overall improvement in brain metabolism of 6.5 to 38%. This case report also includes video images that clearly illustrate the improvements in brain function."

Whether the person with Alzheimer's continues to live at home with the help of a caregiver or resides in a specialized facility, the care of Alzheimer's disease and its patients has evolved significantly in recent years, and research continues to progress. On the eve of World Alzheimer's Day, we can be hopeful about an improved daily life for patients and caregivers, thanks to very promising medical and non-medical treatment options.

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