Integrated Treatment Useful for Alzheimer’s Disease
Exercise training combined with teaching caregivers behavioral management techniques may help improve physical functioning and mood in adults suffering from Alzheimer’s disease (AD), according to a new study in the Journal of the American Medical Association (2003;290:2015–22). This integrated approach may help people with AD enjoy a more independent life and be less likely to be institutionalized for behavioral disturbances.
Alzheimer’s disease is a brain disorder that affects mostly elderly individuals and results in progressive memory loss and loss of ability to care for oneself. Symptoms may also include forgetfulness, short attention span, difficulty completing tasks, disorientation, depression, agitation, irritability, or hostility. Some studies suggest that between 17 and 86% of those with dementia (the hallmark of Alzheimer's disease) also suffer from depression.
The cause of AD is unknown, although some scientists speculate it may involve an abnormal breakdown of acetylcholine, an important chemical messenger (neurotransmitter) in the brain. Other scientists believe an accumulation of aluminum in the brain may lead to AD, but research has not been conclusive. There is no cure for AD, but some medications such as tacrine (Cognex®), donepezil (Aricept®), and rivastigmine (Exelon®) may help slow the progression of memory loss.
In the new study, 153 adults between the ages of 55 and 93 years with AD were randomly assigned to participate in an integrated exercise and caregiver training program or to receive standard medical care for three months. Physical health and function and mood were assessed initially and after the three month training program. Additional follow-up visits were scheduled at 6, 12, 18, and 24 months to monitor participants’ progress. Those in the integrated-program group engaged in a minimum of 30 minutes per day of moderate-intensity exercise (aerobic exercise, strength training, balance exercises, and flexibility training) and caregivers were taught to identify and modify behavioral problems that interfered with day-to-day functioning and to reduce participant stress.
After three months of treatment, those in the integrated-treatment group had significantly better physical functioning and mobility and less depression than those receiving standard medical care. The beneficial effects observed in the integrated-treatment group were maintained after two years of follow-up. Those receiving standard medical care actually worsened during the same three-month and two-year time periods, experiencing poorer physical abilities and more depression. These findings are important in that they demonstrate that a home-based treatment program may improve the quality of life in individuals with AD and, presumably, ease some of the burden on their caregivers as well.
Some nutrients may be effective in slowing the progression of AD. Studies suggest acetyl-L-carnitine, vitamin B1 (thiamine), and vitamin E may be useful against AD. Ginkgo (Ginkgo biloba) and huperzine A (a compound derived from huperzia, a type of moss) may also be effective in reducing the symptoms of AD. Please consult your healthcare provider for specific dose information.
Darin Ingels, ND, MT (ASCP), received his bachelor’s degree from Purdue University and his Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. Dr. Ingels is the author of The Natural Pharmacist: Lowering Cholesterol (Prima, 1999) and Natural Treatments for High Cholesterol (Prima, 2000). He currently is in private practice at New England Family Health Associates located in Southport, CT, where he specializes in environmental medicine and allergies. Dr. Ingels is a regular contributor to Healthnotes and Healthnotes Newswire.
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