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The future of dementia treatment and care

by Dominic Bayley | 30 Aug 2016

There has never been more research into treatments for dementia. Here we look at some of the exciting new developments and their implications for the future of dementia care.

There are more than 350,000 Australians currently living with dementia. One in 10 Australians over the age of 65 has the condition and it is the second leading cause of death. Dementia can be quite confronting for many Australians as they grapple with symptoms of memory loss, loss of mental functioning and the practical dilemma of finding care when the condition becomes debilitating.

The most common form of dementia is Alzheimer’s disease, which causes 50-75 per cent of all new dementia cases. So far, there is no known cure, but there is now hope for future treatment, thanks to research aimed at discovering new drugs and lifestyle interventions that will change the way we treat and care for those living with dementia.

Dementia treatments

Conventional drug treatment is only successful in combating some of the symptoms at the early stages of Alzheimer’s disease, but now, much of the hope for future treatment is in drugs that target the toxic proteins that cause the plaques and tangles seen in the brains of Alzheimer’s patients. Associate Professor Michael Woodward AM, Chief Medical Officer of Alzheimer’s Australia Victoria, points to one drug in particular, Solanezumab, nearing the final stages of clinical trials this year.

“If the results are positive for this drug and others like it, in the next decade people who have this toxic protein will be able to have a monthly injection or infusion and be able to stop the disease, or at least delay the progression of the disease,” says Woodward.

But he cautions about any drug being a ‘silver bullet’ and suggests that treatment will be similar to cancer, in that a combination of different treatments are likely to be used.

Stem cell therapy, which involves injecting stem cells into the brains of dementia patients to help replace lost cells, is yet to be trialled on humans and this treatment is some way off. But early results show these treatments to be effective in reversing dementia in rodents.

So what other treatments will be available? It’s likely that new pharmacological treatments will be combined with physical and mental training in the early stages of Alzheimer’s disease, like the ones used in a recent study by Associate Professor Michael Valenzuela from the Brain and Mind Centre and Medical School at the University of Sydney.

His study has shown that resistance or strength training can help thicken parts of the brains of people affected with Alzheimer’s disease and improve their mental function, in turn slowing the progression. Participants in the study who did computerised mental training also showed better connectivity

in the parts of the brain responsible for memory, which may mean that future treatment will involve a combination of both of these therapies.

Professor Valenzuela says this research takes advantage of our growing understanding of how the brain can produce new brain cells even in old age – a process called neuroplasticity. “Even until the latest point in life, the brain has a lot of regenerative capacity and all of the stimulation, the mental training and physical training helps to promote those processes,” he says.

Therapies available

In 2008, experts in the US began working with dementia patients to create personalised music playlists, and the results were astounding.

While remembering everyday things can be a problem for patients with Alzheimer’s disease, remembering music isn’t usually a problem. That’s because the parts of the brain that process music aren’t usually affected by the disease.

In one study that examined how well Alzheimer’s patients could remember spoken versus sung lyrics, patients could better recall sung lyrics to music. The therapy began its Australian rollout late last year and the hope is that every person newly diagnosed with dementia will receive a personalised music playlist to help with their treatment. The results in other countries have shown that after listening to music, patients become more aware, less aggressive and much happier.

There are also new technologies being implemented to help Alzheimer’s patients and their families and loved ones. One is an app that gives carers ideas to make homes more accessible for people living with dementia. Based on 10 Dementia Enabling Environmental Principles, the Dementia Friendly Home app advises carers to do things like place labels on cupboard doors, and install motion sensors that turn lights on and off automatically so that dementia patients feel more comfortable at home. The Dementia Friendly Home app is available for iPad on the App Store and for Android tablets from the Google Play Store.

Finally, your home environment matters. For dementia patients, there is a growing interest in care that can better accommodate their special needs, while also allowing them the independence to live the life they want.

Jonathan Gavshon, General Manager of Group Homes Australia, a dementia care provider that provides personalised home-like accommodation for dementia patients, says specialist care is very important to dementia patients’ welfare.

“The main message we like to talk about is driving meaningful and purposeful engagement with our residents. In a Group Homes Australia home, residents can do their own washing, cooking and shopping  and have all their personal choices fulfilled with the help of a homemaker. That contributes to them having purpose and dignity,” he says.

What you can do now

Exercise regularly, Have a positive mindset and Brain boosting activities

Exercise, aerobic and resistance training, improves memory, language and reasoning and should be included in a healthy lifestyle, but within your physical capacity, says Clinical Neuropsychologist Dr Nicola Gates and author of the book A Brain for Life.

“One of the things that often happens in nursing homes is that there’s not a lot of physical activity. But for Alzheimer’s patients, continuing to be active is really important. You’ve got to weigh up your medical needs with your ‘enrichment’ needs and include physical, social and mental elements in your daily life,” says Gates.

Sleep tight

Experts say that the quality of your shut-eye at night might be putting you at risk of developing Alzheimer’s disease. In one study, researchers found that people with early signs of Alzheimer’s disease had a worse sleep quality than those without the early signs of Alzheimer’s disease. If you suffer from sleep apnoea, seeking help from a sleep specialist could be of real benefit to your brain health.

Food, glorious food

Eating a Mediterranean diet reduces your risk of developing Alzheimer’s disease and slows cognitive decline, according to a study in the journal Annals of Neurology. Add more vegetables, legumes, fruits and cereals as well as olive oil to your diet, while keeping fatty foods to a minimum. Also, turmeric has powerful anti-inflammatory properties that helps to reduce inflammation in the brains of Alzheimer’s patients.