22 scientists have published a study they say provides clear evidence about the effectiveness of Non-pharmacological Therapies in Alzheimer's disease and are calling on governments to make these useful treatments readily available.
A cure for Alzheimer's is not in sight and available drugs have worthwhile but limited benefits the study says scientifically developed and rigorously tested Non-pharmacological Therapies can significantly improve the lives of people with dementia and their caregivers.
They say he strongest evidence is for individualized intervention packages for family caregivers which can improve the well-being of caregivers and help delay admissions to care homes. In addition, they say approaches such as cognitive stimulation and physical exercise can improve cognitive function, mood and behavior symptoms of people with dementia.
Professor Clive Ballard, Director of Research at the Alzheimer's Society, commented, "This work shows the difference that can be made to the lives of people with dementia and their carers using therapies that can be readily adapted to individual needs; the Alzheimer's Society calls for these therapies to be made more widely available, so many more can benefit."
36 million people around the world suffer from Alzheimer's. Looking for alternative approaches to drugs, 22 top international scientists embarked on a 5-year project to determine exactly which Non-pharmacological Therapies could significantly improve the lives of patients and caregivers. They screened 1.313 scientific studies on the topic and classified the entire field according to the type of intervention employed (e.g. cognitive stimulation, interventions with music, intervention packages for the caregiver etc).
They say the study has now definitively confirmed what previous, less exhaustive, research has pointed out: by applying rigorous criteria, one Non-pharmacological Therapy had the highest possible level of supporting evidence (grade A): this approach consisted of an individualized package, combining several approaches based on a comprehensive assessment of the caregiver, the patient, the family and the social environment. Components within this intervention may include training and education, use of resources (day care, support groups, respite services, etc.) and organizing additional family support. The evidence was strong that this inexpensive, flexible intervention improves psychological well-being of the caregiver, and prevents or delays costly care home placement. No medication can, to date, show such an outstanding cost/benefit ratio.
They say there was also strong evidence that other therapies such as cognitive stimulation, physical exercise (and combinations including other components) could improve cognition, daily living skills, improve mood and reduce behavior problems (which can severely distress caregivers). These interventions are relatively easy to implement in community settings, have a great potential to improve well-being and are generally enjoyed by the participants. Unlike drugs they have the added advantage of a virtual absence of side effects. These benefits appear independent of the patient taking any of the currently available anti-Alzheimer's drugs. Non-pharmacological Therapies may be even more effective when combined with these drugs.
They say these therapies are often effective, and are relatively cheap to develop and research. In the UK they are already recognized as being best practice in official guidelines, such as those published by NICE and that governments need to develop infrastructures such as partnerships between health and social care and the voluntary sector to enable effective Non-pharmacological Therapies to be made widely available for people with dementia and their caregivers.
The study was published in Dementia and Geriatric Cognitive Disorders.