Memory cafes offer a path to cognitive improvement for Alzheimer’s patients

In the quiet suburbs of Khar, the Kothare family is grappling with a harrowing illness. Every morning, Damini (74) believes that a man dressed in white is trying to enter her home with a packet of milk in hand. A resilient woman, Damini has been diagnosed with a neurological condition - Alzheimer's. Her journey is marked by daily challenges, but one aspect of her life remains consistent: She feels anxious whenever the milkman drops by in the mornings.

Her daughter, Daksha, opens up about this traumatic ailment that affects millions of families worldwide. "Aai, began to show subtle signs of forgetfulness some five years back. It started with misplacing keys, forgetting dates and sometimes losing her way in familiar places. When this became too rampant, we sought medical advice, which led to a diagnosis of Alzheimer's disease."

Daksha recalls the profound impact on their lives as they navigated the challenges of watching a beloved family member slowly slip away. As Damini's memory continues to fade, their story serves as a poignant reminder of the urgent need for research and support for those affected by Alzheimer's - a condition that touches countless lives and demands greater awareness and understanding.

New-age medical treatments for Alzheimer's disease:

Memory café

Memory cafes, also known as cognitive stimulation programs, are supportive and social group activities designed to enhance the cognitive function of individuals with Alzheimer's and related dementias. These clubs provide a safe and engaging environment where participants partake in memory-enhancing exercises, cognitive games, and reminiscence activities.

By promoting mental stimulation, social interaction and emotional support, memory clubs aim to slow cognitive decline, improve quality of life, and foster a sense of belonging for individuals living with Alzheimer's disease, while also providing respite and support for their caregivers, shares Dr. Aman Priya Khanna, co-founder and Medical Director HexaHealth, General Laser Bariatric and Minimal Access Surgeon.

Virtual Reality (VR) Therapy

Medical experts are exploring the use of virtual reality as a therapeutic tool for Alzheimer's patients. VR technology allows individuals to immerse themselves in interactive and engaging environments, which aims to stimulate cognitive functions and memory recall.

Alzheimer's patients are given VR devices to relive past experiences, visit familiar places, or engage in mentally stimulating activities, potentially improving memory and overall cognitive well-being. This innovative approach not only enhances quality of life but also provides a non-pharmacological method for managing the disease's symptoms.

Art and Music Therapy

Creative therapies, such as painted art and exposure to rhythms have gained prominence as non-pharmacological interventions for Alzheimer's patients. These therapies harness the power of creative expression to enhance emotional well-being, reduce anxiety and stimulate memory.

Patients can engage in painting, sculpting, or playing musical instruments, allowing them to express themselves and connect with memories and emotions that they felt once. Such therapies promote a sense of accomplishment and joy contributing to a better quality of life for those living with Alzheimer's.

Gut Microbiome Interventions

Emerging research suggests a connection between gut health and brain function. Medical experts are investigating interventions that aim to improve the gut microbiome of Alzheimer's patients. These interventions may include dietary changes, probiotics, or fecal microbiota transplantation. By promoting a healthier gut environment, researchers hope to positively impact brain health and potentially slow the progression of Alzheimer's disease, offering a unique and holistic approach to treatment.

Tau-Targeted Therapies

The growth of abnormal tau protein is another key component of Alzheimer's pathology. Innovative therapies are being developed to target tau and prevent its aggregation which poses the risk of nerve cell damage. These treatments aim to slow or halt the progression of the disease by addressing tau-related neurodegeneration. Several approaches, including small molecules and immunotherapies, are under investigation to target tau in different ways.

Other scientific innovations to tackle forgetfulness in older adults

In May 2019, the Alzheimer's Association's Research Roundtable delved into alternative therapeutic approaches, including active immunotherapy for neurological disorders.

This approach involves stimulating the patient's immune system to produce antibodies against the very elements that trigger Alzheimer's disease. With this treatment, doctors aim to reduce the buildup of ‘beta-amyloid plaques' in the brain to potentially slow down the progression of the disease.

Recent progress in measuring Alzheimer's indicators like amyloid, tau, and neurodegeneration in blood enables tracking drug effects during clinical trials. This offers a less invasive and cost-effective alternative to cerebrospinal fluid or neuroimaging markers.

Role of technology to monitor and support Alzheimer's patients

Technology is vital in supporting Alzheimer's patients and their caregivers.

1 Cognitive training apps help preserve cognitive abilities, while medication reminder apps ensure timely doses.
2 Mobile apps provide information and resources, and wearable devices like smartwatches and fitness trackers monitor vital signs and activity levels, offering valuable insights into overall well-being.

3 GPS tracking devices enhance patient safety by preventing wandering and telehealth enables convenient remote consultations, reducing caregiver burden.
4 Fall detection systems promptly alert caregivers to potential accidents, thus improving safety.

Assistive technology, designed to assist individuals in their daily lives, encompasses various tools, from electronic pill reminders to smart home systems controlling heating and lighting. Smartwatches have gained popularity as wearable devices that collect essential health and activity data, benefiting Alzheimer's and dementia care.

Caregivers can track activity levels, monitor heart rates, and evaluate sleep patterns, all crucial aspects of patient health. Some devices also aid in safer mobility. Boundary alarm systems issue alerts if a person strays beyond a predefined boundary, and tracking devices utilise satellite or mobile technology to locate individuals at risk of becoming lost or missing. These technological advancements empower caregivers, enhance patient safety, and improve overall quality of life.

The role of precision medicine

In Western societies, Alzheimer's disease is the predominant form of dementia and ranks sixth in causes of death. Precision medicine, an individualised approach considering a person's genetics, environment, and lifestyle has gained prominence in AD care.

Precision medicine tailors care for enhanced outcomes, utilising advanced diagnostics for early detection and intervention. Genetic profiling identifies risk factors and sheds light on treatment decisions to be made by the expert.

From then on, treatment plans are personalised based on genetics and clinical profiles optimising effectiveness. Regular monitoring allows adjustments for sustained efficacy, while accurate prognosis supports long-term care planning for patients and caregivers.

Personalised strategies address modifiable risk factors, promoting prevention. Tailored support helps patients and families navigate Alzheimer's complexity. Precision medicine individualises care, potentially slowing disease progression and improving patients' and families' quality of life.

Current challenges in treating Alzheimer's disease

Alzheimer's disease (AD), often seen in older individuals, can stir strong emotions like surprise, uncertainty, anger, anxiety, hopelessness, and sadness. However, the medical fraternity faces several challenges in treating AD. These challenges can differ depending on the region.

In India, socioeconomic disparities, cultural stigma, and inadequate recognition of dementia by medical professionals can impede timely diagnosis. The primary hurdle in addressing Alzheimer's is its typical late-stage diagnosis, often after it has significantly progressed. Many link Alzheimer's with the ageing process, leading to limited awareness and understanding of the condition.

We're still searching for precise and dependable early detection methods for the disease. Despite progress in Alzheimer's research over recent decades, even drugs that showed initial promise have failed to demonstrate effectiveness in large-scale clinical trials for slowing or reversing the disease's advancement.

Non-pharmacological interventions for Alzheimer's disease

Non-pharmacological or behavioural interventions are designed to enhance cognitive function, enable daily living activities, and address accompanying behavioural symptoms in Alzheimer's patients, such as depression, wandering, sleep disturbances, agitation, or aggression.

Cognitive training programs, especially when initiated early in the disease's progression, have shown the potential to slow cognitive decline and improve overall quality of life. These programs engage the mind through mental exercises, bolstering cognitive reserves and maintaining cognitive function.

Lifestyle adjustments, encompassing proper nutrition with diets like the Mediterranean or DASH diet, rich in antioxidants and healthy fats, offer neuroprotective advantages. Additionally, weight management plays a role in reducing the risk of cognitive decline related to obesity.

Social support is equally vital, fostering cognitive stimulation through social engagement and emotional support. Stress-reduction techniques and mindfulness practices enhance mental well-being, diminishing the risk of cognitive decline associated with chronic stress.

Incorporating these non-pharmacological interventions into Alzheimer's care plans can complement traditional treatments, ultimately elevating the quality of life for individuals grappling with the disease.

The nomenclature of Alzheimer's disease

Alzheimer's disease is named after Dr Alois Alzheimer, a German psychiatrist and neurologist who first described the condition in 1906. Dr Alzheimer made this groundbreaking discovery while studying the case of a middle-aged woman named Auguste Deter, who exhibited unusual and severe cognitive and memory impairments.

Dr Alzheimer conducted a post-mortem examination of Deter's brain and observed distinct neurological abnormalities, including the presence of abnormal protein deposits (known as amyloid plaques) and tangled nerve fibres (referred to as neurofibrillary tangles). His detailed findings and clinical observations contributed significantly to the understanding of this condition.