Early-onset Alzheimer’s Disease: Early detection and treatment with cognitive training

What is Early-onset Alzheimer’s?

Early-onset Alzheimer’s is a form of dementia that occurs in people younger than age 65. Of 44 million people who have Alzheimer’s disease around the world, about 5 percent develop symptoms before the age 65.  Most people with early-onset Alzheimer’s develop symptoms of the disease in their 40s and 50s. One of the strongest risk factors for developing early-onset Alzheimer’s disease is when someone is from a family with a history of Alzheimer’s disease. This is related to genetic causes and its transmission to family members.

Scientific evidence shows that early detection of Alzheimer’s disease can help slow down the progression of the disease through medication and cognitive training. 

10 alarming symptoms of early-onset Alzheimer’s disease

 

  1. Memory loss that obstructs daily activities

  2. Difficulty completing familiar tasks

  3. Problem-solving or planning difficulties

  4. Confusion about time and place

  5. Problems with vision

  6. Misplacing items often

  7. Difficulty finding the right words in writing or speaking

  8. Difficulty making decisions.

  9. Mood and personality changes

  10. Withdrawing from social or work activities

These alarming signs are important for early detection. Early detection results in early prevention of disease progression.. 

How Can Cognitive Training with Occupational Therapist Help?

Cognitive training is the process of training brain parts using scientific methods to boost each part of the brain. This helps neuron cells to relearn things that the particular brain region has lost the ability to do. To enable this, an occupational therapist trained in cognitive therapy will follow a procedure that includes evaluation, planning, treatment and follow-up assessment of progress. Training brain functions also involves training in daily activities, modifying the home environment and encouraging family and social participation by offering suggestions for activities involving  the family or caregiver.

Cognitive Evaluation

The first step of brain evaluation is to evaluate the level of impairment in brain function. The evaluation process needs well-trained occupational therapists and international standardized tool including the Montreal Cognitive Assessment (MOCA) and its special cognitive subtest for deeper and more accurate assessment. Once each part of the brain has been fully evaluated, then the program will be individualized.

Start Training Program

The training program will be set up according to individualized needs. The program includes advising techniques for everyday activities such as dressing or meal preparation as the condition progresses, and routine planning to help structure the day and provide stability. Occupational therapy will play a specific role in memory training to help manage recent or short term memory loss. It will also train cognitive function in areas such as orientation, attention, awareness, planning and problem solving including emotional control through techniques that could be called executive functions. The training program will be adjusted according to problems encountered in cognitive and memory assessment according to the individual patient. 

Enhance activities daily living

The activities training in daily living is one of the key factors to successful cognitive therapy. The activities of daily living in AD involve the occupational therapist educating caregivers (or patients directly) to give patients the opportunity to follow daily routines by themselves as much as they can. Procedures can be reduced in some activities by having caregivers supervise and offer help as necessary. It involves helping patients to join in activities that anyone can do, such as letting patients participate in the cooking process by encouraging them to do certain risk-free steps such as preparing ingredients or setting the dinner table.

Maintaining the capability of patients requires activities that directly promote brain function. Such activities may involve getting the patient to speak a set of words and sentences through the use of picture cards. Various exercises like solving mathematical problems or games like Odd One Out can help. Board games, wooden games, bingo, dominoes, chess or puzzles can all be used. Another technique is to show patients photos from their past and get them to describe who is in it and where it was taken. 

Adjust Environmental Factors

The environmental adjustment also has a significant impact on cognitive improvement. Successful completion of activities also requires having a suitable environment. For example, adding warm lighting may help create an environment that is more relaxing, clean and comfortable. Providing a home environment that facilitates daily life and is beneficial to the mind and the understanding of the elderly is fairly easy to do. 

Place symbols or signs at important points such as light switches, gas stoves, and electrical appliances. Install more lamps and use auto-illumination at night. Modify furniture and its location for ease of use. Remove bolts from doors that do not need to be locked. Use sticky notes as reminders or write down short steps in activities to encourage an elderly person to remember. Arrange for a safer home environment by installing alarms to reduce the chance of accidents.

Play with Smart Device

Smart devices can play a useful role. Tablets are an appropriate size for the elderly. Caregivers can provide websites and applications that have cognitive and memory training games. Speaking and activity in daily life help improve brain function. Let the elderly recognize what they have for breakfast and then ask them at noon what they had for breakfast in the morning. Activities that involve more than one step, such as making instant beverages, can also be helpful.

Importance of Family and Social Integration

The family or caregiver is an important element in rehabilitation. The stimulation of patients must be based on their previous experience. Creating continuous memory data by doing familiar activities in an environment that reduces risk factors will prevent a patient’s abilities from fading away. Caregivers can reduce anxiety by persuading patients to put their attention into performing activities the patient is skilled or familiar with. Communicate using straight and short text that doesn’t need to be re-translated. Give the elderly time to talk and a sense of mental importance. Perform activities together. Paying attention to the elderly while caring for them will help them see the value in themselves so that they can continue to live happily.

References 
https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers/art-20048356
https://otcmu.wordpress.com/การบำบัด-รักษา-ส่งเสริม/กิจกรรมบำบัดสำหรับผู้ป/
https://www.theotpractice.co.uk/how-we-help/conditions/dementia-and-altzheimers