Non-drug treatments for dementia show promise, experts say
WINSTON-SALEM, N.C. -- Memory training and other non-drug treatments may one day help older adults ward off declines in mental function, according to researchers from Wake Forest University School of Medicine in an editorial in the current issue of the Journal of the American Medical Association.
"The latest research suggests that mental training and physical activity both have promise for preventing declines in cognition," said Sally A. Shumaker, Ph.D., lead author on the editorial. "It's possible to envision a future treatment approach that combines lifestyle and drug treatments to meet the specific needs of each individual."
Shumaker, a professor of public health sciences and associate dean for research at Wake Forest, said the findings suggest opportunities for studying other non-drug treatments, such as meditation, to prevent or slow declines in cognition, which includes concentration, language, memory and abstract reasoning.
"Cognitive decline is a rapidly growing problem because of our aging population," said Shumaker. "It is probably one of the biggest fears that older adults have – the loss of your mind and your competency and independence. It seriously threatens the ability of the aging population to live independently."
In the editorial, Shumaker and co-authors Claudine Legault, Ph.D., and Laura H. Coker, Ph.D., also from Wake Forest, discuss the results of a recent multicenter study involving cognitive training, as well as other advances in the field.
The Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study involved almost 3,000 participants. Half received 10 sessions of cognitive training and half received no special training. Participants who had the training showed immediate improvements in memory, reasoning and speed of processing. When the participants were tested five years later, the improvements had been sustained.
Other recent research showing that sedentary older adults perform less well on measures of memory suggests that physical activity may also be able to improve memory, according to the editorial.
There are an estimated 24 million people in the world with dementia and 4.6 million new cases are diagnosed each year. Declines in certain mental functions, such as memory, predict future inability to perform activities of daily living, such as dressing and feeding themselves.
"These studies illustrate the promise of non-drug treatments," said Shumaker. "The medications available today produce only low to moderate improvements in mental function. And they can have adverse side effects. Showing that cognitive training can protect mental function means that individuals who cannot tolerate existing drugs would have additional treatment options."
"The ACTIVE study is an important step toward demonstrating the feasibility of enrolling older adults in a long-term study of a cognitive training intervention," according to the editorial.
The authors say that matching cognitive training with an individual's risk factor profile is an intriguing possibility. For example, training that focuses on memory may be best for those at risk for Alzheimer's disease.
"Once they are standardized and developed for mass markets, cognitive training programs might be available to seniors through churches, schools and senior centers," said Shumaker.
"Importantly, cognitive training programs may give individuals a greater sense of control over the disturbing prospect of cognitive decline and have a beneficial effect on their quality of life," says the editorial.
As a researcher, Shumaker served as national principal investigator for the Women's Health Initiative Memory Study, which showed that estrogen and progestin doubled the risk of dementia in older women.
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Wake Forest University Baptist Medical Center is an academic health system comprised of North Carolina Baptist Hospital and Wake Forest University Health Sciences, which operates the university's School of Medicine. U.S. News & World Report ranks Wake Forest University School of Medicine 18th in family medicine, 20th in geriatrics, 25th in primary care and 41st in research among the nation's medical schools. It ranks 35th in research funding by the National Institutes of Health. Almost 150 members of the medical school faculty are listed in Best Doctors in America.
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