EARLY INTERVENTION IN ALZHEIMER’S DISEASE

Guiding patients from first signs and symptoms to intervention

Your patient’s initial cognitive complaint or observed impairment may be your trigger to screen, diagnose, and intervene. You can help your patients navigate this journey today.1-3

Mild Cognitive Impairment (MCI): The Path to Alzheimer's Disease (AD) Intervention

The 4 steps to Alzheimer's disease intervention: Step 1. Monitor cognitive complaints and rule out reversible causes. Step 2. Screen for mild cognitive impairment (MCI) based on individual patient case. Step 3. Diagnose the phase of the mild cognitive impairment. Step 4. Recommend interventions and support based on identification of mild cognitive impairment due to Alzheimer's disease.
The 4 steps to Alzheimer's disease intervention: Step 1. Monitor cognitive complaints and rule out reversible causes. Step 2. Screen for mild cognitive impairment (MCI) based on individual patient case. Step 3. Diagnose the phase of the mild cognitive impairment. Step 4. Recommend interventions and support based on identification of mild cognitive impairment due to Alzheimer's disease.

Diagnosis of MCI due to AD is an opportunity for meaningful interventions

Doctors have access to a range of evidence-based early interventions after diagnosis of MCI due to AD.3 Early diagnosis also provides the opportunity to prepare financial and end-of-life plans while cognitive impairment remains mild.3,4

The current pharmacological landscape for managing patients with Alzheimer’s disease includes symptomatic treatments, clinical trials, and treatments for comorbidities such as depression.5

Nonpharmacological interventions for your patients3,4,6

Implement lifestyle changes

Recommend cognitive and mental health interventions

Plan for a more safe and secure future

Offer support for care partners

Implement lifestyle changes4,6

A focus on overall brain health to reduce cognitive decline may include:

  • Exercise
  • Smoking cessation
  • Cardiovascular health
  • Low-fat/high vegetable and fruit diets
  • Adequate sleep

Recommend cognitive and mental health interventions3,4,6

Provide mental stimulation strategies to enhance cognitive function:

  • Cognitive training and stimulation, reality orientation, and reminiscence therapy may be beneficial for patients with dementia
  • Refer to mental health experts for psychological and behavioral therapies, counseling, and peer support groups

Plan for a more safe and secure future4

Educate patients and care partners on safety and financial planning considerations:

  • Safety considerations include high fall risk, wandering, and driving implications; discuss appropriate living arrangements and ongoing care needs
  • Consider referral to a physical therapist to improve function and protect against slips and falls
  • Help patients understand their coverage and the cost of care

Offer support for care partners4

Help patients assemble a care team and advise care partners about health needs and supportive services:

  • Provide care partner training and resources to help them cope with their increasingly demanding role
  • Refer as needed to other experts for the psychological support and encouragement required to stay healthy

Early Interventions in AD Can Help Patients Along Their Journey

These interventions may be effective in3:

Icon for a human brain

Improving cognitive
function

Icon for a person with depression

Addressing depression
symptoms

Icon for an Alzheimer's disease care facility

Delaying
institutionalization

Nonpharmacological interventions may help change the direction of cognitive decline6

In the 2-year observational FINGER study, elderly patients showed 25 to 150% improvements in cognition due to non-pharmaceutical post-testing interventions.

  • 25% change in overall cognition (as measured through a comprehensive neuropsychological test battery)
  • 83% improvement in executive function
  • 150% improvement in processing speed

Care partner interventions are an important component of overall care

As of 2017, 48% of care partners were unpaid while caring for a spouse, parent, or family member. Dementia care partners tend to provide more extensive assistance as the disease progresses, with an emphasis on self-care and mobility. The care required of family members can result in increased emotional stress and feelings of depression. Tailored interventions can have a positive impact on the well-being of care partners. Continued support for care partners is instrumental in treating Alzheimer’s disease holistically.4,5

What’s Next? Find out what else you can learn about Alzheimer’s disease>>

References

  1. Cordell CB, Borson S, Boustani M, et al; and Medicare Detection of Cognitive Impairment Workgroup. Alzheimer’s Association recommendations for operationalizing the detection of cognitive impairment during the Medicare Annual Wellness Visit in a primary care setting. Alzheimers Dement. 2013;9(2):141-150.
  2. Michels TC, Tiu AY, Graver CJ. Neuropsychological evaluation in primary care. Am Fam Physician. 2010;82(5):495-502.
  3. Alzheimer’s Disease International. World Alzheimer Report 2011: the benefits of early diagnosis and intervention. https://www.alz.co.uk/research/world-report-2011. Accessed February 20, 2020.
  4. Alzheimer's Association. Alzheimer's Association Report: 2018 Alzheimer's disease facts and figures. Alzheimers Dement. 2018;14:367-429.
  5. Alzheimer's Association. Alzheimer's Association Report: 2020 Alzheimer's disease facts and figures. Alzheimers Dement. 2020;16(3):391-460.
  6. Ngandu T, Lehtisalo J, Solomon A, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet. 2015;385(9984):2255-2263.

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