NEUROREHABILITATION IN PATIENTS WITH DEMENTIA
Keywords:
motor neurorehabilitation, dementia, preclinical stageAbstract
Dementia is a widespread neurocirculatory disease that affects a large number of people worldwide, with significant consequences for individual functionality and quality of life. It is characterized by progressive loss of cognitive functions, such as memory, attention, language and ability to think. This affects the daily activities of patients and their general functionality. Hence, neurorehabilitation focuses on improving cognitive, physical and psychosocial functions in patients with dementia. This approach combines different techniques and interventions in order to maintain or improve existing functions and slow down the progress of the disease. Neurorehabilitation contributes to improving the quality of life of patients and their loved ones, and supports them in the special challenges they meet. In order to understand the meaning of neurorehabilitation in patients with dementia, it is important to emphasize the impact of this condition on individuals and their families. Dementia can have a significant emotional and financial burden, and therefore needs effective interventions that will help support patients and their loved ones. The aim of the study is to examine the influence of health therapeutic activities among the patients in preclinical stages of dementia. Material and Methods: For the study, 13 patients in preclinical dementia (7 women and 6 men, average age 77.6±5.3 years) with mild cognitive impairment compared to the Mini-Mental State Examination (MMSE) scale. Their Daily abilities and impairments were assessed with the Barthel index on a scale from 0 to 100 points to assess the 10 most common areas of daily activities and other human abilities and the results were assessed on the 1st day, 1st and 3rd month from the beginning of the therapy. The motor activity affects cerebral circulation and memory functions, normalization of vascular tone and blood pressure, decreasement of oxidative stress and systemic inflammation, improvement of sensitivity of arterial vessels and brain perfusion. It includes moderate intensity aerobic exercises, resistance and balance exercises and coordination exercises. Results: After the applied therapeutic exercises, the highest improvement in motor body was found at 1 month, with a significance level of p<0.001. Conclusion: Therapeutic exercises positively affect physical health by improving balance, speech and motor control and cognitive functions by enhancing attention, memory and visuospatial abilities in dementia.The final conclusion supports the importance of neurorehabilitation and the need for advanced research in this field.
References
American Physical Therapy Association. (2001) Guide to physical therapist practice. Phys Ther, 81,1-768.
Bahar-Fuchs, A., Clare, L., Woods, B. (2013). Cognitive training and cognitive rehabilitation for mild to moderate Alzheimer's disease and vascular dementia. Cochrane Database of Systematic Reviews, 6(6), CD003260.
Caffò, A. O., Lopez, A., Spano, G., Serchisu, L., Galluzzi, S., Rainero, I., ... & Marra, C. (2018). Neuropsychological rehabilitation for Alzheimer's disease: A randomized controlled trial. Journal of Alzheimer's Disease, 61(3), 1189-1201.
Clare, L., Linden, D. E., Woods, R. T., Whitaker, R., Evans, S. J., Parkinson, C. H., ... & Rugg, M. D. (2008). Goal-oriented cognitive rehabilitation for people with early-stage Alzheimer disease: A single-blind randomized controlled trial of clinical efficacy. American Journal of Geriatric Psychiatry, 16(12), 927-935.
Gorelick, P. B., Scuteri, A., Black, S. E., DeCarli, C., Greenberg, S. M., Iadecola, C., ... & Schneider, J. A. (2011). Vascular contributions to cognitive impairment and dementia: A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 42(9), 2672-2713.
Hardy, J., & Higgins, G. (1992). Alzheimer's disease: The amyloid cascade hypothesis. Science, 256(5054), 184-185.
Hébert, R., Bravo, G., & Préville, M. (2000). Reliability, validity and reference values of the Zarit Burden Interview for assessing informal caregivers of community-dwelling older persons with dementia. Canadian Journal on Aging/La Revue Canadienne du Vieillissement, 19(4), 494-507.
Henneghan, A. M., Miller, J. A., Sperber, K. M., Raker, J. M., & Lageman, S. K. (2018). Informed consent in the acute rehabilitation setting: The ethical principle of autonomy. PM&R, 10(2), 160-165.
Holden, M. K. (2005). Virtual environments for motor rehabilitation: Review. CyberPsychology & Behavior, 8(3), 187-211.
Holtzman, D. M., Mandelkow, E., & Selkoe, D. J. (2012). Alzheimer disease in 2020. Cold Spring Harbor perspectives in medicine, 2(11), a011585.
Iso-Markku, P., Kujala, UM., Knittle, K, et al. (2022) Physical activity as a protective factor for dementia and Alzheimer’s disease: systematic review, meta-analysis and quality assessment of cohort and case–control studies. British Journal of Sports Medicine, 56:701-709.
Liu, L., Dong, H., Jin, X., Brooke-Wavell, K. (2022) Tackling Dementia: A Systematic Review of Interventions Based on Physical Activity. Journal of Geriatric Physical Therapy, 45(4), E169-E180(12)
Lubenova, D., Titianova, E. (2021) Neurorehabilitation in dementia. In Titianova, E. Textbook of Clinical neurology. 437-446. KOTI-EOOD
Lubenova, D., Titianova, E. (2012) Principles of Modern Neurorehabilitation. Neurosonology and cerebral hemodynamics, 8(1), 45-55
McDowell, FH (1994). "Neurorehabilitation". Western Journal of Medicine. 161 (3), 323–327.
McKeith, I. G., Boeve, B. F., Dickson, D. W., Halliday, G., Taylor, J. P., Weintraub, D., Aarsland, D., Galvin, J., Attems, J., Ballard, C. G., Bayston, A., Beach, T. G., Blanc, F., Bohnen, N., Bonanni, L., Bras, J., Brundin, P., Burn, D., Chen-Plotkin, A., ... & Wenning, G. K. (2017). Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology, 89(1), 88-100.
Moyle, W., Venturato, L., Griffiths, S., Grimbeek, P., & McAllister, M. (2011). Factors influencing quality of life for people with dementia: A qualitative perspective. Aging & Mental Health, 15(8), 970-977.
Neary, D., Snowden, J. S., Gustafson, L., Passant, U., Stuss, D., Black, S., ... & Benson, D. F. (1998). Frontotemporal lobar degeneration: A consensus on clinical diagnostic criteria. Neurology, 51(6), 1546-1554.
Olazarán, J., Reisberg, B., Clare, L., Cruz, I., Peña-Casanova, J., Del Ser, T., ... & Muñiz, R. (2010). Nonpharmacological therapies in Alzheimer's disease: A systematic review of efficacy. Dementia and Geriatric Cognitive Disorders, 30(2), 161-178.
World Health Organization. (2012). Dementia: A public health priority. https://www.who.int/mental_health/publications/dementia_report_2012/en/
World Health Organization. (2017). Global action plan on the public health response to dementia 2017-2025. https://www.who.int/mental_health/neurology/dementia/action_plan_2017_2025/en/
World Health Organization. (2019). Risk reduction of cognitive decline and dementia: WHO guidelines. https://www.who.int/mental_health/neurology/dementia/guidelines_risk_reduction/en/
World Health Organization. (n.d.). iSupport: A digital training and support tool for caregivers of people with dementia. https://www.who.int/mental_health/neurology/ISupport/en/