Today, Alzheimer’s has no cure. The pharmacological treatment that exists improves the symptoms of the neurodegenerative process, but does not stop it. For this reason, work has been going on for years to find a drug that can modify the course of the disease or cure it. However, there are some habits improve the quality of life in Alzheimer patients, such as physical activity and a healthy diet. A neuropsychological therapy called cognitive intervention can relieve some of the symptoms. This therapy is based on stimulating the patient's mental abilities; working on language, memory, calculation, perception, imagination and the senses. Some of the resources used are jigsaws, games, crossword puzzles, spreadsheets and written cards. They need to be rewarding and motivating activities.
One method that promotes adaptation to daily life for Alzheimer's patients, and lessens the discomfort caused by the difficulty of retaining information, is keeping a diary. "A diary is a way for patients to share their daily life and memories, where they can organise notes, past, present and future that they consider essential in their lives," says the author of the book, Dr Lorena Rami, a neuropsychologist and member of the Alzheimer's Disease and other Cognitive Disorders Research Group at Hospital Clínic-IDIBAPS.
The diary focuses only on recording all the events related to recent memory (the last few days or weeks) and can also be used prospectively, to plan future events; as remote memory, that of the first years of life, is not altered. It is a useful tool that can be part of the therapy of these patients to help them improve their quality of life.
Alzheimer's and its progression
Alzheimer's is a neurodegenerative disease, and is the most common form of dementia, affecting 50 million people worldwide. In fact, every 3 seconds a new case is diagnosed. It is characterised by the patient being forgetful and becoming disorientated. They finally stop communicating and become increasingly dependent for carrying out daily activities. Before symptoms occur, there are two proteins that are deposited in the brain, amyloid beta protein and hyperphosphorylated tau protein, which spread throughout the cerebral cortex and interfere with communication between neurons and their normal functioning.
There are two phases, the cognitive impairment phase, in which the patients have memory problems, but this does not prevent them from carrying out their daily activities, and the dementia phase when they are no longer fully autonomous. The most frequent symptoms are memory loss, difficulty in planning and carrying out tasks, temporal-spatial disorientation (difficulty in knowing the day, month or season of the year), changes in behaviour (in mood), disturbed sleep rhythm and difficulties with movement such as walking. It usually appears in people over 65 years of age, but it can also occur before that age, even starting between 20-50 years of age if the cause is genetic. In this case, the disease is autosomal dominant and is transmitted from parents to children.
Apart from advanced age and family history, there are other risk factors, such as feminine sex (2 out of 3 cases are women), poor cardiovascular health (high blood pressure, obesity and diabetes), social isolation and depression. A diagnosis is made by cognitive tests, which assess the patient's cognitive alteration; brain neuroimaging, for images of the brain to evaluate whether there is significant loss of neurons; and cerebrospinal fluid analysis, to measure whether there is β-amyloid protein or tau proteins. Genetic testing is done only when it is believed there is a genetic basis for the disease.
