The Multidisciplinary Approach to Alzheimer's Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment

Zucchella, Chiara; Sinforiani, Elena; Tamburin, Stefano; Federico, Angela; Mantovani, Elisa; Bernini, Sara; Casale, Roberto; Bartolo, Michelangelo

doi:10.3389/fneur.2018.01058

Cited by 187 publications

(166 citation statements)

References 357 publications

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“…We recommend exercise (group or individual physical exercise) for people living with dementia. [98][99][100][101] We cannot recommend any specific exercise duration or intensity at this time. 1B (93%)…”

Section: Ta B L E 7 Psychosocial Interventionsmentioning

confidence: 99%

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Recommendations of the 5th Canadian Consensus Conference on the diagnosis and treatment of dementia

Ismail

Black

Camicioli

et al. 2020

Alzheimer's & Dementia

132

160

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Since 1989, four Canadian Consensus Conferences on the Diagnosis and Treatment of Dementia (CCCDTD) have provided evidence‐based dementia guidelines for Canadian clinicians and researchers. We present the results of the 5th CCCDTD, which convened in October 2019, to address topics chosen by the steering committee to reflect advances in the field, and build on previous guidelines. Topics included: (1) utility of the National Institute on Aging research framework for clinical Alzheimer's disease (AD) diagnosis; (2) updating diagnostic criteria for vascular cognitive impairment, and its management; (3) dementia case finding and detection; (4) neuroimaging and fluid biomarkers in diagnosis; (5) use of non‐cognitive markers of dementia for better dementia detection; (6) risk reduction/prevention; (7) psychosocial and non‐pharmacological interventions; and (8) deprescription of medications used to treat dementia. We hope the guidelines are useful for clinicians, researchers, policy makers, and the lay public, to inform a current and evidence‐based approach to dementia.

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Section: Ta B L E 7 Psychosocial Interventionsmentioning

confidence: 99%

“…We recommend considering group cognitive stimulation therapy for people living with mild to moderate dementia. [101][102][103][104] 2B (96%)…”

Section: Ta B L E 7 Psychosocial Interventionsmentioning

confidence: 99%

Recommendations of the 5th Canadian Consensus Conference on the diagnosis and treatment of dementia

Ismail

Black

Camicioli

et al. 2020

Alzheimer's & Dementia

132

160

View full text Add to dashboard Cite

show abstract

“…In this test, a lower score indicates a more severe cognitive impairment 56 , and dementia is suspected when the score is below 23. The DBD-13 is a 52-point behavioural rating scale and consists of 13 items (item #1, 2,3,4,5,15,16,17,21,24,26,27, and 28 of the original version of the Dementia Behaviour Disturbance Scale 57 ) and a lower score indicates a less problematic behaviour (such as agitation, aggression, anxiety, or apathy). There is no reference value for the DBD-13.…”

Section: Behavioural Assessments the Levels Of Cognitive Impairmentsmentioning

confidence: 99%

Non-pharmacological treatment changes brain activity in patients with dementia

Shigihara

Hoshi

Shinada

et al. 2020

Sci Rep

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Non-pharmacological treatment (NPT) improves cognitive functions and behavioural disturbances in patients with dementia, but the underlying neural mechanisms are unclear. In this observational study, 21 patients with dementia received NPTs for several months. Patients were scanned using magnetoencephalography twice during the NPT period to evaluate NPT effects on resting-state brain activity. Additionally, cognitive functions and behavioural disturbances were measured using the Mini-Mental State Examination (MMSE-J) and a short version of the Dementia Behaviour Disturbance Scale (DBD-13) at the beginning and the end of the NPT period. In contrast to the average DBD-13 score, the average MMSE-J score improved after the NPT period. Magnetoencephalography data revealed a reduced alpha activity in the right temporal lobe and fusiform gyrus, as well as an increased lowgamma activity in the right angular gyrus. DBD-13 score changes were correlated with beta activity in the sensorimotor area. These findings corroborate previous studies confirming NPT effects on brain activity in healthy participants and people at risk of dementia. Our results provide additional evidence that brains of patients with dementia have the capacity for plasticity, which may be responsible for the observed NPT effects. In dementia, NPT might lead to improvements in the quality of life.Dementia is a chronic and progressive syndrome caused by brain diseases 1 . It is characterised by deterioration in cognitive functions, behaviour, and psychological symptoms. To date, there are only a few pharmacological treatment options available to influence the course of dementia 2-4 . At the time a patient is diagnosed with dementia, the brain damage is considered too severe to be reversible to a healthy state 5 . Thus, early diagnosis and interventions are essential to treat people at risk of dementia, such as those with "cognitive impairment, no dementia" (CIND) or "mild cognitive impairment" (MCI) [6][7][8][9] . Recent studies showed that MCI can be reversed to normal cognitive functions by non-pharmacological treatments (NPTs) [10][11][12][13][14][15] . Neuroimaging studies revealed that NPTs enhance brain plasticity even in older adults 16,17 supporting the importance of early diagnosis and interventions in dementia.The positive effects of NPTs are not limited to people at risk such as those with CIND or MCI. Clinicians and therapists frequently observe that NPTs improve cognitive functions and/or behaviours in patients with dementia 18-23 . However, the neural mechanisms underlying the positive influences of NPTs remain unclear.Geriatric health service facilities are transitional facilities between hospital and home or nursing home where registered physical, occupational, and speech therapists provide NPT and nursing care to reduce the patients' hospital stay. Patients with dementia are often transferred there when their physical conditions are usually not too severe to be treated in hospitals but their cognitive symptoms prevent them from staying at t...

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“…NPT can improve the quality of life (QoL) of patients diagnosed with MCI and / or Alzheimer's type dementia, being noninvasive and having reduced side effects. (8) NPT interventions are numerous, they play a role in reducing patient symptoms, caregiver stress and can be both simple (eg environmental interventions) to more complex approaches (eg, virtual reality, home automation). (7) Non-pharmacological therapies do not act on the etiopathogenic mechanisms of Alzeimer dementia.…”

Section: Discussionmentioning

confidence: 99%

"Alternative therapies and management of dementia in Alzheimer's disease"

Cristina¹,

Făget²,

Chiriță³

et al. 2019

BPI

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Neurocognitive disorders are defined by an "significant cognitive impairment in one or more areas: complex attention, executive function, learning and memory, language, perceptual motor ability and social cognition. These dysfunctions represent a decline from a previous level of functioning, so dementia. does not refer to low or reduced intellectual functioning, or mental retardation, which are developmental and static disorders. "(1) Dementia of the Alzheimer's type is the most common nosological form of dementia, characterized by memory loss and other cognitive skills severe enough to interfere with daily life. Dementia of the Alzheimer's type has a prevalence of 60-80% of dementia cases. (2) The factors that differentiate the dementia subtypes are: "evolution over time, the specific areas affected and the associated symptoms" (5) The therapeutic strategies are based on the increase of the cholinergic transmission and on the modeling of the glutamatergic transmission, validated etiopathogenic hypotheses in dementia Alzheimer's focus on acetylcholine transmission deficiency and NMDA receptor hyperactivity. (19)Patients diagnosed with a neurocognitive disorder such as dementia of the Alzheimer's type, represent a special group, with special needs, in which the concept of quality of life differs from that used for patients diagnosed with conditions that are certainly less disabling. A series of prospective cohort studies have suggested that in addition to anti-dementia psychotropic therapy, regular physical activity associated with standardized herbal oily

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The Multidisciplinary Approach to Alzheimer's Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment

Cited by 187 publications

References 357 publications

Recommendations of the 5th Canadian Consensus Conference on the diagnosis and treatment of dementia

Recommendations of the 5th Canadian Consensus Conference on the diagnosis and treatment of dementia

Non-pharmacological treatment changes brain activity in patients with dementia

"Alternative therapies and management of dementia in Alzheimer's disease"

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