Nonpharmacological Therapies in Alzheimer’s Disease: A Systematic Review of Efficacy

October 27, 2010

Therapies for Persons with Alzheimer’s Disease and Their Caregivers
Dementia and Geriatric Cognitive Disorders
September 10, 2010
Full PDF here

A systematic review of previous worldwide studies, researchers led by Barry Reisberg, MD, the clinical director of the Fisher Alzheimer’s Disease Education and Resources Program at New York University’s Langone School of Medicine, and some colleagues in Spain and the UK, have found that that nonpharmacological therapies (NPTs) can improve relevant outcomes, such as improved thinking, behavior and delay of institutionalization of patients with Alzheimer’s. Research published in Dementia and Geriatric Cognitive Disorders on September 10, 2010 reveals that therapies such as physical activities, behavioral interventions and cognitive training are useful, and potentially cost effective.

“Patients with Alzheimer’s can’t live without care, especially in the later stages,” says Dr. Reisberg who is the clinical director of the NYU Silberstein Aging and Dementia Research Center and a member of the Center of Excellence on Brain Aging and at NYU Langone Medical Center. “If we don’t intervene with cognitive behavioral and physical therapies, patients will develop physical problems, and ultimately, deformities as well as agitation. We must help patients through the various stages of Alzheimer’s so that their needs are managed.”

In this meta-analysis, the nonpharmaceutical therapy determined to be most effective in this study was a multi-component intervention developed by Mary Mittelman, DPH, research professor in the Department of Psychiatry at NYU Langone Medical Center, also a study co-author. Her multi-component interventions include improving dementia care giving skills, mobilizing the support of family networks, and caregiver counseling. In 2009, Dr. Mittleman received the first global award for psychosocial research in Alzheimer’s and dementia from Alzheimer’s Disease International (ADI) and the Fondation Mederic Alzheimer, in recognition of the best evidence-based intervention for patients with dementia and their caregivers.

The interventions described in the meta-analysis can be tailored based on the patient’s “stages” of cognition and functioning from “very mild decline” to “very severe decline.” In fact, Dr. Reisberg developed the Global Deterioration Scale and the Functional Assessment Staging scale which allow professionals and caregivers to chart the decline of people with Alzheimer’s disease.

Comparatively little has been done to investigate non pharmaceutical resources and care strategies,” says Dr. Reisberg. “But it is the care giving that patients with Alzheimer’s disease rely on as the disease progresses. For the first time, we have comprehensively and systematically looked at these types of interventions and find them to point to efficacy for both patient and caregiver. Although current research is promising, much more research needs to be done which should result in very large payoffs in reduced societal burden and improved patient well being.

About NYU Langone Medical Center
NYU Langone Medical Center is one of the nation’s premier centers of excellence in healthcare, biomedical research, and medical education. For over 168 years, NYU physicians and researchers have made countless contributions to the practice and science of health care. Today the Medical Center consists of NYU School of Medicine, including the Smilow Research Center, the Skirball Institute of Biomolecular Medicine, and the Sackler Institute of Graduate Biomedical Sciences; the three hospitals of NYU Hospitals Center, Tisch Hospital, a 705-bed acute-care general hospital, Rusk Institute of Rehabilitation Medicine, the first and largest facility of its kind, and NYU Hospital for Joint Diseases, a leader in musculoskeletal care; and such major programs as the NYU Cancer Institute, the NYU Child Study Center, and the Hassenfeld Children’s Center for Cancer and Blood Disorders.

About the Fisher Center for Alzheimer’s Research Foundation
The Fisher Center for Alzheimer’s Research Foundation is a leading source of funding for Alzheimer’s research. It serves Alzheimer’s patients and their families by seeking to understand the causes of, discover a cure for, and improve the lives of people with Alzheimer’s disease. The foundation primarily funds Nobel laureate Dr. Paul Greengard, Dr. Barry Reisberg, and Alzheimer’s information programs such as Preserving Your Memory magazine and www.ALZinfo.org.


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