Cognitive Stimulation in Alzheimer’s Patients Offers Proven Results (CST)

Cognitive stimulation of the Alzheimer’s patient is an important part of treating the disease. Studies show that this stimulation slows down the progression of the disease. There are many and varied resources on the internet to obtain exercises and to be able to work at home with the Alzheimer’s patient or with anyone with a cognitive impairment. Many times at home you don’t work because you “don’t know what to do” and although many people do basic and very important jobs such as using calendars, writing, doing accounts. There are many other options. The traditional hobbies: crosswords, word searches, finding differences are very good exercises, as long as they are adapted to the abilities of the patient, since we have to try not to cause frustration with exercises that are very difficult. Reading the newspaper and commenting on the news, watching the news, helps the sick to stay connected to the real world.

• Card games, such as cinquillo, dominoes, puzzles, lace are all beneficial, it also encourages us to spend pleasant time with our family members which is therapeutic family time for everyone involved.

• With worksheets you can work on many cognitive areas. On the Internet there is a very interesting page with a large amount of material to stimulate Alzheimer’s patients.

The page in principle is aimed at children, but the material is perfectly valid for Alzheimer’s, in addition there are different degrees of difficulty in the material, making the adaptation to each specific case easier. In addition, the download of the material is completely free and easy to do. Other ideas can be found on the following page, in the memory workshop section, as well as information and links of interest about the disease. With a little time a day we can achieve a better quality of life for our family member suffering from this disease.

Cognitive Stimulation in Alzheimer’s Patients

A study from the year 2000 that is now considered classic showed that London taxi drivers had a more developed part of the brain than other people who were not taxi drivers (specifically the right hippocampus) and that this development was directly related to the hours they worked in the cab. We know that this part of the brain is related to what we call spatial memory, an essential function in the ability to orient oneself in space. In other words, taxi drivers had developed that part of the brain that helped them to be more efficient in their work. Our brain governs our behavior, but our behavior, in turn, produces changes in the brain. The study of taxi drivers is a clear example: the brain is a dynamic organ that changes depending on many factors. Some factors are not modifiable (for example, age or genetics), but others are. In this case, the example shows how our behavior influences not only activity (with a more efficient function), but also brain structure (with a larger hippocampus). In other words, what a person does changes their brain. Our behavior does not include only work activity (as in the example of taxi drivers), but all our experience: the training we have received, social relationships, our diet … In short, our life history. All this makes up our brain and, therefore, our way of being and the way we respond to the demands of day to day.

Cognitive Reserve

Another good example of the relationship between behavior and the brain is the concept of cognitive reserve: we now know that people who have had a very rich life, with good training and a good cultural level, have a brain that is more resistant to injuries. In other words, enriching experiences throughout life make the brain more prepared to recover better in case of injury. In the case of Alzheimer’s disease, the concept of cognitive reserve helps scientists to explain why some people have a more benign course of the disease (to some extent) than others: they take longer to show symptoms because their brain compensates better the bugs.

Keep in mind that a good cognitive reserve does not immunize against Alzheimer’s disease. This means that people with high cognitive reserve have the same risk as anyone else their age and in the same situation of suffering from the disease, but a brain with good reserve will function well for longer. Both the study of London taxi drivers and what we know today about the cognitive reserve show how functional and structural changes in the brain related to our activity can appear throughout life: activity and brain maintain a two-way relationship.

What’s more, today we know that this is true even when the brain is diseased. Fortunately, the most pessimistic views that considered the treatment of people with dementia as absurd due to the inevitable deterioration in the disease have been put aside. While it is true that no treatment to date has managed to stop it, there are therapies that have shown benefits in modifying its course and slowing it down. Cognitive stimulation is one of them.

What is Cognitive Stimulation?

We professionals who are dedicated to the study of Alzheimer’s disease refer to cognitive stimulation as a treatment designed and applied by specialists, interdisciplinary, with its own and specific method, complementary to specific drugs for dementia, which is applied to the patient but that involves both the patient and his family. Through the assessments we carry out, we obtain valuable and accurate information about the state of the person with dementia, both at a cognitive level, as well as at a behavioral, emotional state, in relation to their environment and their family and the main caregiver. All these aspects are they take into account when proposing formal activities of cognitive stimulation to the patient and help us to determine the state and evolution of the deterioration.

In specialized centers, such as some day hospitals, it is a treatment that is usually considered in a group due to the added benefit of social interaction, since many times people with dementia tend to withdraw and abandon activities. It is important to bear in mind that what we seek in the treatment with cognitive stimulation of dementia’s is a global activation of mental functions, with the double objective of maintaining them and slowing down the deterioration. We will not intend to restore the previous level of cognitive functioning, since in most dementia’s (and Alzheimer’s disease is one of them) the functions that have been lost are not recovered. Does this mean that cognitive stimulation can only be performed by a specialized professional? No. It is considered very positive that people with dementia can do activities at home.

In this sense, there is already research that studies the efficacy of specific programs of cognitive stimulation activities carried out by family members at home. There are still no conclusions about the effects of this type of treatment, but there has been a very good acceptance of the idea by family members: the first results are encouraging. In fact, cognitive stimulation in a broad sense can be considered as the activation of brain functions through tasks and activities. Many times we think of more formal activities of paper and pencil, such as word searches or crossings, the search for differences or sudoku, which are perhaps the best known and other hobbies such as board games, but in reality, what homework does not stimulate the brain? Cognitive stimulation should not only be limited to paper and pencil exercises, since activities of daily living, what a person does each day, provide very good opportunities for more informal stimulation at home.

Passive vs. Active Stimulation

Performing any activity stimulates the brain, although it is clear that some activities stimulate more than others because they require more cognitive effort. For example, watching TV stimulates the brain, but it is an activity in which the person’s attitude is completely passive: they are not expected to do anything and generally require little mental effort. In addition, there are many ways of watching TV: sometimes we watch without seeing, or “disconnect”. This does not mean that watching TV is harmful, but, like everything else, you have to do it in moderation and think about how we can take advantage of the fact that the person with dementia watches it. For example, asking about the characters in your favorite series or recent news: this is also stimulation. Cognitive stimulation activities can benefit anyone. In the case of dementia’s, stimulation can be provided at any stage of severity of the disease, although several aspects must be taken into account: the difficulty of the tasks that can be proposed will be different depending on the degree of deterioration. In other words, the more serious, the activities must necessarily be simpler. This should be borne in mind throughout the course of the disease and is important when proposing activities to the person with dementia: you should take into account what you can and cannot do, and you should pay attention to which part of the activity presents more difficulties to be able to help solve it. This will prevent the person with dementia from becoming frustrated or distressed because they cannot do it without help or because they see that they are doing it wrong. In this sense, the environment must adapt to the person with dementia and not the other way around, facilitating, simplifying the activity so that it can be carried out. This precept will be necessary throughout all the phases of the disease, both for activities that we can propose to you and in day-to-day activities.