Non-pharmacological therapies as effective as drugs for Alzheimer's
23 Sept 2010
An international study has for the first time produced strong
evidence for the effectiveness of non-pharmacological therapies in
improving the lives of Alzheimer's sufferers. The study was published in
Dementia and Geriatric Cognitive Disorders .
The strongest evidence is for individualised intervention
packages for family caregivers which can improve the well-being of
caregivers and help delay admissions to care homes. In addition,
approaches such as cognitive stimulation and physical exercise can
improve cognitive function, mood and behaviour symptoms of people
Professor Clive Ballard, Director of Research at the Alzheimer's
Society, commented: "This work shows the difference that can be made
to the lives of people with dementia and their carers using
therapies that can be readily adapted to individual needs; the
Alzheimer's Society calls for these therapies to be made more widely
available, so many more can benefit."
36 million people around the world suffer from Alzheimer's.
Looking for alternative approaches to drugs, 22 top international
scientists embarked on a 5-year project to determine exactly which
Non-pharmacological Therapies could significantly improve the lives
of patients and caregivers. They screened 1.313 scientific studies
on the topic and classified the entire field according to the type
of intervention employed (eg cognitive stimulation, interventions
with music, intervention packages for the caregiver etc).
This study has now definitively confirmed what previous, less
exhaustive, research has pointed out: by applying rigorous criteria,
one non-pharmacological therapy had the highest possible level of
supporting evidence (grade A): this approach consisted of an
individualised package, combining several approaches based on a
comprehensive assessment of the caregiver, the patient, the family
and the social environment.
Components within this intervention may include training and
education, use of resources (day care, support groups, respite
services, etc.) and organizing additional family support. The
evidence was strong that this inexpensive, flexible intervention
improves psychological well-being of the caregiver, and prevents or
delays costly care home placement. No medication can, to date, show
such an outstanding cost/benefit ratio.
There was also strong evidence that other therapies such as
cognitive stimulation, physical exercise (and combinations including
other components) could improve cognition, daily living skills,
improve mood and reduce behaviour problems (which can severely
These interventions are relatively easy to implement in community
settings, have a great potential to improve well-being and are
generally enjoyed by the participants. Unlike drugs they have the
added advantage of a virtual absence of side effects. These benefits
appear independent of the patient taking any of the currently
available anti-Alzheimer's drugs. Non-pharmacological Therapies may
be even more effective when combined with these drugs.
These therapies are often effective, and are relatively cheap to
develop and research. In the UK they are already recognised as being
best practice in official guidelines, such as those published by
Governments need to develop infrastructures such as partnerships
between health and social care and the voluntary sector to enable
effective non-pharmacological therapies to be made widely available
for people with dementia and their caregivers.
1. Olazarán J et al. Nonpharmacological Therapies in Alzheimer’s
Disease: A Systematic Review of Efficacy. Dement Geriatr Cogn
Disord 2010;30:161-178 (DOI: 10.1159/000316119).