Enabling Alzheimer's Disease patients and families to cope

August 11, 2010, University of Wales

Providing people with early-stage Alzheimer's Disease with rehabilitation directed towards helping them with everyday activities is an effective means of enabling them and their families to manage the effects of the condition, research at Bangor University has shown.

With increasing numbers among an ageing population expected to develop Alzheimer's and age related and the consequent increased pressure on caring and health related services, it's vital that research establishes the most effective and cost effective methods of providing support to these individuals and their carers.

This particular three year trial at Bangor University's School of Psychology, funded by the Alzheimer's Society, compared a treatment called cognitive rehabilitation against relaxation therapy and no treatment. In the cognitive rehabilitation treatment, participants identified and worked towards goals that they wanted to achieve, with the support of a therapist, so as to manage their everyday activities better.

The results showed that participants rated their performance of activities significantly better after the course of rehabilitation and were significantly more satisfied with how they performed activities. Almost all the selected goals were either fully or partially achieved. Goals were tailored to specific individual needs and preferences, and included things like remembering details of jobs to be done around the house, learning to use a mobile phone, maintaining concentration when cooking, or remembering the names of people at a 'keep fit' class. The focus was always on things that were important to the individual.

"Improving performance of everyday activities can help the person to gain enjoyment and satisfaction, and to feel more in control or more independent. This is good for family carers too, and carers also seemed to benefit from the therapist's visits, rating their quality of life more highly," explained Professor Linda Clare, who led the research.

"We also used fMRI imaging technology to investigate whether the changes observed in the participants who received cognitive rehabilitation were reflected in changes in how the brain responds to a memory task. We found that the brains of participants who received cognitive rehabilitation did show different responses after the intervention. This suggests that the treatment stimulated greater activity in certain brain areas and networks, reactivating some areas that were under-functioning due to the effects of the disease."

Staff in the Betsi Cadwaladr University Health Board attended a one-day training course to learn about the cognitive rehabilitation approach.

"It is vital that we find more effective ways of supporting people with Alzheimer's and other degenerative diseases, and their families. The results of this study show for the first time that cognitive rehabilitation addressing individually-tailored goals can help to maintain or improve aspects of everyday functioning, and may have an effect on how the brain is working too. This is a promising new approach that offers some help to people living with early-stage dementia and their families," commented Dr Bobby Kurian, Consultant Psychiatrist in Old Age Mental at the Betsi Cadwaladr University Health Board.

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