Tips for slowing the mental decline of Alzheimer's

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Tips for slowing the mental decline of Alzheimer's

Running Time: 0:07:52

Welcome to Mayo Clinic podcast. Our topic today is tips for slowing mental decline that comes with Alzheimer's disease. I'm your host, Rich Dietman.

In today's podcast, we're talking about some things to do that may slow the mental decline that accompanies Alzheimer's disease. My guest is Dr. Glenn Smith. Dr. Smith is a Mayo Clinic neuropsychologist who specializes in the treatment of Alzheimer's disease. He's also a consultant in the Department of Psychiatry and Psychology at Mayo, and a professor of psychology at Mayo Clinic College of Medicine.

Rich Dietman: Dr. Smith, thanks for joining us.

Dr. Smith: My pleasure.

Rich Dietman: Is it true that doing things like keeping a journal or a personal calendar, even a list of things to do can help someone with Alzheimer's preserve their memory?

Dr. Smith: Just to clarify, Rich, the things we're going to talk about today don't really preserve memory, they constitute a way to maintain maximal independence in the face of the lost memory. So keeping a journal, keeping a calendar, is a way to compensate for that lost memory.

Rich Dietman: What are some ways to go about keeping a journal or managing a personal calendar that can help a person with mental decline?

Dr. Smith: The most important thing is not so much the journal or the calendar itself, but establishing the habit of using it. You know, people early in the course of Alzheimer's disease or other dementing illnesses can still form new habits but they need some help and support in order to be able to do that. So they need family or friends who cue them to start to use the journal, use the calendar, to keep it with them, carry it with them at all times so that they can take advantage of it, to check their journal or calendar to see what they maybe wrote in it recently. That habit will not start on its own, typically, it requires people to help cue the person to begin to use those techniques. But if they do then that journal, that calendar, can be a great help.

Rich Dietman: So, simply giving a journal or a calendar to someone with Alzheimer's and saying "Here, keep this or take care of this" is not going to work for very many people?

Dr. Smith: Right, because if you think about it, what we're really asking them to do is to remember to use the journal and if they could remember, they wouldn't need the journal. So it really requires some sort of structure to be put in place, which we actually studied this in some of our research work and found that only about 10 percent of people whom we give a journal or a calendar to and say go use this, will start to use it all on their own. And those are people who've maybe always kept a diary or who have always used a pocket calendar to organize their life, so most people need some help. It's not sufficient to simply hand them the calendar and ask them to use it.

Rich Dietman: Are there ways in which keeping lists or journals or calendars don't work to ward off decline?

Dr. Smith: You know, just the other day I was talking to a patient of ours who has some memory decline about using these techniques, and she described this very nice calendar that she kept on her refrigerator at home. And so to make the point of the need to carry this on your person, I asked her, "What's on your calendar?" And it drives home the point that for these techniques to serve as your memory, they have to go with you. So having that big calendar at home works as long as you never leave the house. But the minute you do, if that's your habit, that kind of technique fails. So we use a system here at Mayo where we use a combined calendar and journal system that's small enough to fit in a woman's purse or a man's breast pocket so that it's always with them.

Rich Dietman: So that's part of the concept, really, is that what you may have lost in memory you basically compensate for by having it on paper.

Dr. Smith: Yes.

Rich Dietman: So we've talked about lists, journals and calendars. Are there other techniques that a person can use to help ward off mental decline?

Dr. Smith: Well, you know many older persons, including those with dementia, are on many, many medications. And getting the medications straight is a very important part of their continued safety and ability to live at home. So lots of families will do things like get pillboxes, even have help come in to set out the pillboxes, to make sure that that person is safe with their medications. But one thing we encourage families to do to go one step beyond that is to really work with their physician to maximally simplify their medication regimen so that that memory demand is halved or thirded. If there's a medication out there that you can take once a day instead of three times a day to get the same effect, then we've just cut the demand on your memory by a third. So talking to your physician about "Is this the most simple medication regimen we can be on in light of the memory challenges here?" can be another way to maintain independence and retain safety even in the face of memory decline.

Rich Dietman: Speaking of medications, are there medications that are available these days that can help slow or reverse mental decline?

Dr. Smith: Rich, as many people know, there are about five medications that have been approved by the FDA for Alzheimer's disease and related dementias. None of these medications has been shown to actually improve people's memory or even to arrest the memory loss. These medications were approved by the FDA on the basis that they seem to slow the rate at which memory declines. And some recent data really suggests that they only seem to do this for a period of time. So physicians who prescribe these medications are coming to recognize that there's a right time to give these meds and that eventually their effectiveness may wane. So medications are an important part of our interventions here, but they're not the only part and they have their limits.

Rich Dietman: What about computer software or computers in general? What role can they play in aiding memory?

Dr. Smith: You know, I think in the near term, Rich, this is the next big thing in terms of helping people maintain their independence in the face of memory loss. We're familiar with one man, for example, former computer programmer whose mother was developing Alzheimer's disease, so he developed this program that he's now made available commercially, where he uses Internet technology to be able to see his mother, even though he lives several hundred miles away from her. He's trying to keep her in her own home for as long as possible, so each morning he has coffee with her, so to speak, via the Internet where they can see each other and talk to each other. And then the computer program works throughout the day to prompt her when it's time to take her medications, prompt her when it's time for lunch or time for dinner, to keep her on schedule to help her know the time and where she is. And so it's a very fascinating use of technology and there are going to be many other things like this to come on the market. Some folks are talking about how we can use peoples' cell phones to keep track of where they are so that people who might be at risk for wandering can be tracked by their cell phones so that they wouldn't get lost. The largest advocacy group in the country for people with Alzheimer's disease is the Alzheimer's Association, and they have a program called Everyday Technologies in Alzheimer's Care, where they're working to explore all these options in the future to help people maintain their independence through the use of computers, cell phones and other technologies. It's fascinating.

Rich Dietman: So we're likely to hear more about this in the coming years?

Dr. Smith: Yes, we are.

Rich Dietman: Thanks very much, Dr. Smith. We've been talking about techniques for slowing mental decline for someone with Alzheimer's disease with Dr. Glenn Smith. Dr. Smith is a neuropsychologist who specializes in treating Alzheimer's at Mayo Clinic. You've been listening to Mayo Clinic Podcast. I'm Rich Dietman.

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Last Updated: 2010-09-30
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