J Korean Med Assoc.  2009 Nov;52(11):1069-1076. 10.5124/jkma.2009.52.11.1069.

Nonpharmacological Interventions for Alzheimer's Disease

• Lee SB
• Kim KW

• KMID: 2188089
• DOI: http://doi.org/10.5124/jkma.2009.52.11.1069

Abstract

Although acetylcholinesterase inhibitors (e.g., tacrine, donepezil, rivastigmine, and galantamine) and NMDA receptor antagonists (e.g., memantin) have demonstrated efficacy in the temporal symptomatic control of cognitive decline and daily function in Alzheimer's disease (AD) patients, their effect is not good enough to restore premorbid function, nor is it maintained in the later stages. Therefore, nonpharmacological interventions are being increasingly advocated in order to optimize the cognition, affect and global functioning of AD patients. We reviewed the current nonpharmacological interventions for AD. Nonpharmacological interventions can be divided into two groups. One is cognitive interventions (e.g., Memory rehabilitations, Reality orientation, Reminiscence therapy and so on) and the other is behavioral interventions (e.g., unmet needs interventions, learning and behavioral interventions, environmental vulnerability and reduced stress-threshold interventions). Cognitive interventions are aimed to slow and compensate cognitive decline of AD patients. On the other hand, behavioral interventions are aimed to reduce neuropsychiatric symptoms (depression, anxiety, agitation, wandering, aggression and so on) of AD patients. Although many of the nonpharmacological interventions have proven beneficial for AD patients, their efficacy was still ambiguous. Randomized and controlled study with a larger sample size is needed to confirm efficacy of nonpharmacological interventions.

Keyword

Alzheimer's disease; Nonpharmacological intervention; Cognitive intervention; Behavioral interventions

MeSH Terms

Aggression
Alzheimer Disease
Anxiety
Cholinesterase Inhibitors
Cognition
Dihydroergotamine
Hand
Humans
Indans
Learning
Memory
N-Methylaspartate
Orientation
Phenylcarbamates
Piperidines
Rivastigmine
Sample Size
Tacrine
Cholinesterase Inhibitors
Dihydroergotamine
Indans
N-Methylaspartate
Phenylcarbamates
Piperidines
Tacrine