Nonpharmacological Interventions for Alzheimer's Disease

Although acetylcholinesterase inhibitors (e.g., tacrine, donepezil, rivastigmine, and galantamine) and NMDA receptor antagonists (e.g., memantin) have demonstrated efficacy in the temporal symptomatic control of cognitive decline and daily function in Alzheimer's disease (AD) patients, their effect is not good enough to restore premorbid function, nor is it maintained in the later stages. Therefore, nonpharmacological interventions are being increasingly advocated in order to optimize the cognition, affect and global functioning of AD patients. We reviewed the current nonpharmacological interventions for AD. Nonpharmacological interventions can be divided into two groups. One is cognitive interventions (e.g., Memory rehabilitations, Reality orientation, Reminiscence therapy and so on) and the other is behavioral interventions (e.g., unmet needs interventions, learning and behavioral interventions, environmental vulnerability and reduced stress-threshold interventions). Cognitive interventions are aimed to slow and compensate cognitive decline of AD patients. On the other hand, behavioral interventions are aimed to reduce neuropsychiatric symptoms (depression, anxiety, agitation, wandering, aggression and so on) of AD patients. Although many of the nonpharmacological interventions have proven beneficial for AD patients, their efficacy was still ambiguous. Randomized and controlled study with a larger sample size is needed to confirm efficacy of non pharmacological interventions.