Behavioral Treatment of Alzheimer's Disease

Author:

Ferris Steven H.,Mittelman Mary S.

Abstract

In examining the current status and future potential of behavioral treatments for Alzheimer's disease (AD), it is important to begin by defining the scope and goals of such treatments. The category of behavioral treatments includes not only nonpharmacologic techniques to modify or enhance patient behavior, but also psychosocial interventions applied to family members and paid care providers. Caregiver interventions are important because they can reduce the negative impact of AD on those directly and indirectly affected by the disease. Based on current knowledge about the pathophysiology of AD, it is not considered likely that behavioral treatments can have a direct impact on the disease itself by affecting its clinical onset, rate of progression, or prognosis. Although it is conceivable that certain long-term behavioral interventions might delay onset of symptoms (e.g., mental “exercise” to enhance dendritic growth and increase “cognitive reserve,” or long-term stress reduction methods to minimize possible degenerative central nervous system effects of chronic stress), such approaches remain speculative, and their effectiveness would be difficult and expensive to demonstrate. Thus, the current goal of behavioral treatments is to reduce the negative effects of AD on the patient, on the patient's primary caregiver and immediate family, on the healthcare system, and on society as a whole. Such a goal is far from trivial because (a) successful treatment of primary pathophysiology is not on the immediate horizon, and (b) the impact of AD on the family and society represents a major cost of this tragic disease.

Publisher

Cambridge University Press (CUP)

Subject

Psychiatry and Mental health,Geriatrics and Gerontology,Gerontology,Clinical Psychology

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