(Haipo) – On the occasion of World Alzheimer's Day, the Ministry of Health is publishing important highlights from the world of occupational therapy for family members accompanying a loved one living with Alzheimer's disease. The main message is to maintain the person's dignity and independence even as their abilities change, while also providing tools and support to the caregivers themselves.
Dementia is a general term for diseases and conditions that gradually impair cognitive functions, including memory, language, thinking, and orientation. As the disease progresses, the ability to perform daily activities independently may also be impaired. Alzheimer's disease is the most common cause of dementia, but there are other types, including vascular dementia and dementia with Lewy bodies.
Currently, there is no cure for most dementias. However, there are treatments that are designed to relieve symptoms, maintain functional abilities, and in some cases, slow the rate of deterioration. Treatment is tailored to the type of dementia, the stage of the disease, and the patient's individual condition.
The Ministry of Health makes information available... this time on the subject of dementia and Alzheimer's
The Ministry of Health emphasizes three key principles from the world of occupational therapy for families dealing with Alzheimer's disease:
The first principle is safety alongside respect. – Adapting the home to the person's changing needs, while maintaining their dignity and independence.
The second principle is maintaining a clear routine and a fixed agenda. – Even a simple action like changing from pajamas to day clothes helps distinguish between day and night and between activity and rest.
The third principle is to incorporate meaningful activity – Favorite activities that are tailored to the person’s current abilities and interests, such as adult coloring pages at a relaxed and appropriate pace.
Mild cognitive decline: the stage when it is important to act
Mild cognitive impairment (MCI) is an intermediate state in which there are difficulties with memory or other cognitive functions, but there is not yet the significant impairment in daily functioning that characterizes clinical dementia.
At this stage, treatment focuses primarily on dealing with risk factors and maintaining function. Among other things, it is recommended to balance risk factors for cardiovascular disease, be careful with physical activity, and combine cognitive and social activity.
Cognitive training can include memory games, crossword puzzles, Sudoku, writing, creativity, and other activities that engage the mind. The Ministry of Health also notes the importance of physical activity and sensory and cognitive stimulation as part of coping with symptoms.
Early stages of Alzheimer's: Drug treatment
In mild to moderate Alzheimer's disease, in appropriate cases, treatment with drugs from the acetylcholinesterase inhibitor group can be given. These drugs may help stabilize the patient's cognitive, behavioral, and functional functioning.
Among the drugs in this group are donepezil, rivastigmine, and galantamine. According to the Ministry of Health, these drugs are included in the health basket according to the indications.
Treatment does not cure the disease, but may help maintain function and quality of life. Possible side effects include decreased appetite, weight loss, diarrhea, and sleep disturbances.
It is important not to stop medication or change the dosage without consulting your doctor.
In intermediate and advanced stages: treatment that affects the glutamatergic system
In intermediate and advanced stages of Alzheimer's disease, treatment with drugs that affect the glutamatergic system in the brain, including memantine, may be administered, depending on the patient's condition and the treatment indications.
This system is associated with, among other things, learning and memory processes. Treatment may help with cognitive and behavioral functions in some cases. Possible side effects include gastrointestinal disturbances and restlessness, and treatment requires medical monitoring.
And what about the behavioral and mental symptoms?
Dementia is not just about memory loss. Some patients also experience anxiety, depression, sleep disturbances, confusion, behavioral changes, and other symptoms.
Treatment for these symptoms should be individualized. The Ministry of Health emphasizes that challenging behaviors do not always require medication, and when such treatment is considered, side effects should be taken into account and the patient should be monitored. In some cases, it is also important to rule out another medical cause, such as an infection or a side effect of a medication, that may be causing the confusion or change in behavior.
Not just medication: exercise, nutrition, and maintaining independence
Dementia treatment is not limited to medication. Maintaining an active lifestyle and as much functional independence as possible is an important part of coping with the disease.
The Ministry of Health recommends adapting physical activity to the person's abilities, through consultation with a physiotherapist. In addition, it is recommended to receive nutritional advice if necessary and to maintain daily abilities through encouragement, accompaniment, and tailored assistance.
Regular social and intellectual activity can also be integrated into daily life and help maintain function.
Risk factors that can be influenced
Some of the risk factors for dementia are related to lifestyle and medical conditions that can be treated or controlled. Among other things, it is important to keep blood pressure, blood sugar and blood lipids within recommended ranges, avoid smoking, exercise regularly and maintain a balanced diet.
The Ministry of Health notes that, according to expert estimates, a significant portion of dementia cases are related to risk factors that can be influenced.
New Alzheimer's Treatments: A Change in Research Direction
In recent years, new treatments have been developed that target mechanisms associated with Alzheimer's disease, in particular the accumulation of amyloid protein in the brain.
One of the drugs being tested in this field is Lecanemab (Leqembi), which is intended for disease-modifying treatment of Alzheimer's and for initiating treatment in stages of mild cognitive decline or mild dementia.
This means that research in this field is no longer focused solely on relieving symptoms, but also on trying to influence the course of the disease itself. However, these treatments are intended for specific populations, require medical diagnosis and adjustment, and follow-up, and are not suitable for every person with dementia.
Why is early diagnosis important?
Early diagnosis allows you to identify the type of problem and adjust treatment and follow-up. Not all memory loss indicates dementia: Sometimes the source of the symptoms is another medical condition, such as depression, thyroid dysfunction, infection, dehydration, or a side effect of medication.
The Ministry of Health recommends that the initial examination be done with a family doctor, and that later referrals may be made for a geriatric evaluation and consultation with specialists in geriatrics, neurology, or psychiatry, depending on the case.
Dementia treatment is multidisciplinary.
Coping with dementia does not focus only on doctors and medications. Depending on the patient's needs, professionals from various fields can be consulted:
- Speech therapist – To preserve communication capabilities.
- Occupational therapist or clinic – To preserve cognitive abilities and daily functioning.
- Physiotherapist – To improve walking, stability and adapted physical activity.
- Nutritionist – To adjust the diet and monitor the nutritional status.
The Ministry of Health emphasizes that treatment should be tailored to the type of dementia and the stage of the disease, while also taking into account the needs of family members and caregivers.
Professional support for caregiver families
The Ministry of Health notes that accompanying a loved one with Alzheimer's is a process that involves many changes and challenges, and that the companions and caregivers themselves also need tools and support. Clinics and occupational therapists can help adjust the environment and routine, and provide guidance and practical tools for caregivers and their loved ones.
The bottom line
Although there is currently no complete cure for most dementia diseases, the world of their treatment continues to evolve. In addition to treatments aimed at relieving symptoms and preserving function, there are also new treatments designed to influence the course of Alzheimer's disease in the early stages. Therefore, when signs of a decline in memory or function appear, it is important to seek medical attention and not assume that this is necessarily a natural process of aging.
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