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Fostering social bonds with friends and family or even having a pet can be therapeutic , as can finding ways to stimulate the brain with mental activities or new interests .
New drug treatments are in the pipeline
experience brain swelling and blood loss , requiring them to be monitored with magnetic resonance imaging ( MRI ) brain scans .
“ Aducanumab stands out as a remarkably unique case of poor decision making using very complicated and noisy data ,” stressed Dr Karlawish .
Currently , the medication can only be administered in clinical trials and isn ’ t covered by insurers , which restricts its wider use , while the US is the only country that has approved it .
Though Dr Karlawish believes Aducanumab will “ fade into history ,” other drugs that clear amyloid plaques from the brain are being tested and could still prove to be beneficial to patients with Al�heimer ’ s .
“ There are three drugs in clinical trials that will soon end . All three target amyloid but have different mechanisms in how they do it . The conclusions of those three studies , I think , will give us probably not the last chapter but probably the last few chapters to answer the question which still remains unanswered : does targeting amyloid as a treatment effectively treat Alzheimer ’ s ? That remains , I think , an open question ,” he said .
The crucial role of caregiving and drug-free intervention Despite all the limitations of drug treatment , there ’ s still a lot that can be done to help people with Alzheimer ’ s improve their health and quality of life .
One important step is to engage in activities that have been proven to maintain brain health , whether you have cognitive impairment or not . Fostering social bonds with friends and family or even having a pet can be therapeutic , as can finding ways to stimulate the brain with mental activities or new interests . Exercise , managing stress , and having good sleep habits can also strengthen cognitive skills .
The EXERT trial , for instance , showed that sedentary people with mild cognitive impairment who exercised four times a week for about 30 to 40 minutes saw no mental decline 12 months after starting the intervention , while a control group of similar patients who remained sedentary experienced the expected worsening of cognitive functions .
In a similar vein , a 20�� study published in P��S Medicine suggests that patients in nursing homes who are involved in social activities could see a reduction in agitation , which is a common Alzheimer ’ s symptom .
It ’ s also paramount to equip caregivers with the necessary skills to manage the physical and mental demands of caring for patients with Alzheimer ’ s — taxing work that can put them at risk for anxiety and a poor quality of life .
“ We do know that if you train and support a family member or another person to help someone with dementia live their life , that person we call caregiver will take better care of the patient and the patient will also be healthier ,” Dr Karlawish said .
Types of training that can help caregivers include programmes to manage behavioural changes related to dementia , psychological support to prevent stress and other health problems , and respite services that offer short breaks for them to look after their own needs .
Similar programmes are especially needed in �MICs where their availability is limited despite logging the largest number of patients worldwide who are mostly taken care of by family members or other unpaid carers without any additional support , according to the WHO report .
The role of caregiving in dementia is particularly crucial because not only does it provide for the material needs of patients ( e . g ., help with bathing , getting dressed , and eating ), but it also supports them mentally .
“ They are another mind that helps someone feel and express their intention , live autonomously , and preserve their identity ,” said Dr Karlawish . “ That ’ s why dementia caregiving is so important and morally challenging .”
Since some patients tend to forget over and over again essential information about their lives — such as why they are living in a nursing home or the death of a spouse — caregivers may face the constant dilemma of either bringing them up to date or lying to avoid upsetting them .
Dr Karlawish suggests letting patients express their desires as much as possible instead of providing painful information straightaway . “ So , when someone says ‘ I want to go back home ’, you could ask ‘ what would you do if you were back home ’, and find what it is they are missing and needing .”
The same approach could be worth trying when patients are asking to see a person whose demise they don ’ t remember and caregivers may have to
30 SEPTEMBER 2022 GlobalHealthAsiaPacific . com