Motor stimulation exercises, such as playing croquet, are shown to help patients living with Alzheimer's
While there is, as yet, no medical treatment that can cure dementia, a new study has shown that it is possible to stop its progress without using drugs. The German research team worked with 98 patients with dementia, in five nursing homes in Bavaria. 50 of these patients took part in the group therapy programme of regular behavioural and mental exercises, which happened six days a week for 12 months. The remaining 48 patients continued with their normal treatment. All 98 carried on taking their normal medication, and were able to take part in the usual nursing home activities.
The group therapy, known as MAKS, involved a variety of regular activities. The researchers started each session off with a 10-minute introduction where they talked about topics like happiness, or sang songs or hymns. They then went on to motor stimulation, playing games like bowling and croquet, or doing balancing exercises. Individual and group puzzles made up the cognitive stimulation element of the session, and they also practised ‘daily living’ activities, such as gardening, doing crafts and preparing snacks.
After a year, the researchers assessed members of both groups, using the Alzheimer’s Disease Assessment Scale (ADAS). Those in the MAKS group had kept the same level as they’d achieved a year before, and their ability to carry out daily living activities had stayed the same over those 12 months.
Professor Graessel, from Friedrich-Alexander-Universität Erlangen, who led the research, said “While we observed a better result for patients with mild to moderate dementia, the result of MAKS therapy on ADAS (cognitive function) was at least as good as treatment with cholinesterase inhibitors. Additionally we found that the effect on the patients’ ability to perform daily living tasks was twice as high as achieved by medication. This means that MAKS therapy is able to extend the quality of, and participation in, life for people with dementia within a nursing home environment.”
“Really what this is tapping into, is enabling most people with dementia, and particularly those in care homes, to do activities that they enjoy,” said Dr Anne Corbett, Research Communications Manager for the Alzheimer’s Society. “This is what we call person-centred care, which means that care is tailored and personalised to the person, and means they will have enjoyable moments throughout their day.
“There’s a lot of evidence that this is a really important aspect of caring for people with dementia. Although it’s a very difficult condition to treat and to care for, these people are still the same people they always were, their interests don’t tend to change and by working with them and their family, and developing a care package that works for them, it makes sense that their condition and their quality of life improves.
“In particular we can see the effects with people in a care home setting who have experienced behavioural symptoms, such as aggression and agitation, which are particularly difficult to deal with. We see that this personalisation of care is very effective in reducing the chance of someone having behavioural symptoms, and in managing those behavioural symptoms when they emerge.
“By improving care, we’ve seen that it can actually reduce the use of anti-psychotic drugs, which is absolutely a good thing.” But of course it’s up to the GP to decide when and if, it would be a good idea to reduce the amount of medication prescribed.
If you are looking after someone with dementia at home, it’s worth thinking about how you might adapt the study’s findings to your daily lives. You may well already be making an effort to talk about topics you know once interested the person you care for, but you could encourage visitors to do the same. Old photos can be a focus for conversation, as can other mementoes of the past, such as holiday souvenirs or sports trophies. “Physical activity can be really valuable to people with dementia,” said Dr Corbett. “It could be as simple as a walk in the garden, or if they’re able, they might enjoy dancing. It’s really about remembering who that person is, and keeping them interested.”
The study is published in the journal BMS Medicine.
Alzheimer’s Research UK