THE THERAPY ROOM: Mental Health and Medical Dementia Advances

Posted on 17 May 2018 by LeslieM

(Part 3 in our series on Dementia)

The good news is that there are many advances being made in both the mental health and medical fields when it comes to dementia. Let’s examine some of these new advances.

Dementia and Mental Health advances:

The Dementia-Directive

Dr. Barak Gaster, an internist at the University of Washington School of Medicine, spent three years working with specialists in geriatrics and devised a dementia specific mental health advance directive (https://dementia-directive.org). This directive provides a map for mild, moderate and severe dementia and asks dementia patients to decide what medical interventions they want and do not want at each phase of their dementia.

It is estimated that between 20 to 30 percent of us at some point will develop dementia. As patients turn 65 and qualify for Medicare, which covers a visit to discuss advance care planning, the dementia- directive can be a useful tool that acts as a supplement to other directives.

The dementia-directive has many positive aspects. We know that many patients move into advanced stages of dementia prior to anyone identifying it and, therefore, being able to discuss with the patient what exactly is happening to them and asking them how they would like their dementia managed is beneficial. It is difficult for dementia patients to express their wants and needs as their dementia progresses and the dementia-directive can be a helpful tool for better management as the disease progresses.

Dementia and Medical advances:

Medical Devices

Neural Devices are electrodes that penetrate top layers of the brain and act as mini-microphones to record brain activity. Some neural devices are currently being tested to diagnose Alzheimer’s and Parkinson’s based on what is called a fingerprint or activity patterns recorded directly from the brain. It’s interesting to note that Facebook and Elon Musk’s company Neurolink are currently looking to invest in neural device companies.

Medications

Cholinesterase inhibitors, such Aricept, Exelon, Razadyne and Memantine or Namenda, are used to treat the common cognitive symptoms of Alzheimer’s, such as memory loss, confusion and problems with thinking and reasoning. There is also a Namzaric that combines one of the cholinesterase inhibitors Donepezil with Memantine.

As Alzheimer’s progresses, brain cells die and connections among brain cells are lost causing cognitive symptoms to worsen. Current medications cannot stop the damage Alzheimer’s causes to brain cells, but they may help lessen or stabilize symptoms for a limited time by affecting certain chemicals involved in carrying messages among the brain’s nerve cells.

Exercise

According to Neurology Times, a study of over 1,400 women over age 44 years were observed to determine a correlation between midlife cardiovascular fitness and the risk of developing dementia. It appears there was a 9.5 year delay determined by using an ergometer cycling test and this study supports research that exercise is a reliable strategy to prevent dementia.

Dementia Series summary:

We have explored dementia in our three part series over the past three months. Dementia is a complex condition with many possible causes, but what many people want to know is can dementia be cured? Recent developments and understanding of how the disease progresses have been encouraging. Researchers believe more effective treatments will continue to be realized.

Additional information is available to you online at www.Alz.org. This website will help you find your local Alzheimer’s chapter, direct you to a 24/7 helpline (800-272-3900) and provide you with access to a virtual library with over 5,000 library books, journals and other Alzheimer’s resources.

Dr. Julia Breur is a licensed Marriage and Family Therapist with a private clinical psychotherapy practice in Boca Raton. Further information available at www.drjuliabreur.com.

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