Alzheimer's Patients Have Ability to Learn
HealthSCOUT - July 05, 2004
People in the early stages of Alzheimers
disease might have more capacity to learn new things
than previously thought.
The findings may eventually make life easier for patient
and caretaker alike. They are the result of two new
studies supported by the National Institute on Aging
"This is the first time weve shown that
a non-pharmacological intervention can actually augment
a pharmacological intervention," said David Loewenstein,
lead author of the first study and director of research
at the Wien Center for Alzheimers Disease and
Memory Disorders at Mt. Sinai Medical Center in Miami
Beach. "As we develop more effective medications
and hopefully maybe even start stopping the disease
in its tracks, we are still going to have millions
of individuals who are going to have cognitive and
functional deficits because of brain impairment that
has already occurred. This type of intervention may
be able to help."
Alzheimers disease is a progressive deterioration
of brain processes whose early trademark symptom is
the erosion of a persons memory. Currently,
the disease affects about 4.5 million Americans; that
number is expected to rise as the population ages.
The first study, appearing in the July-August issue
of the American Journal of Geriatric Psychiatry, involved
44 people all taking cholinesterase inhibitor drugs
such as Aricept who were randomized into one of two
groups. The first group attended 45-minute "cognitive
rehabilitation" sessions twice a week for 12
The lessons included learning to associate names with
facial features (for example, Smiling Sam), ways to
make change for a purchase, and how to use a calculator
to balance a checkbook after paying three bills. There
were also exercises designed to improve attention
span and cognitive processing speed.
The second group played computer games requiring memory,
concentration and problem-solving skills. They also
did crossword puzzles and word scrambles.
People in the cognitive rehabilitation group showed,
on average, a 170 percent improvement in their ability
to recall faces and names and a 71 percent improvement
in their ability to provide the right change for a
purchase. The study shows the improvements remained
three months later and more recent data shows they
are still intact six months on, Loewenstein said.
"The patients and the caregivers got very excited
because its something theyre doing that
is constructive that is actually dealing with activities
that are relevant to everyday life," Loewenstein
said. "The alternative is to take medicine and
hope for the best. These people are taking charge."
"This study is really the first to combine various
techniques and look for outcomes that are more practical,
and the effect seems to last at least three months,"
said Neil Buckholtz, chief of the NIAs Dementias
of Aging Branch.
The findings are preliminary, however. "It would
be premature to say how what theyre doing would
be quickly translated into some application, although
certainly what theyve found gives us an indication
of promise for intervention," added Molly Wagster,
the NIAs program director for Neuropsychology
of Aging Research.
The second study, which appeared in the June 10 issue
of Neuron, involved 34 young adults, 33 older adults
without any symptoms of Alzheimers, and 24 older
adults with early symptoms of Alzheimers. They
were looking at a type of "implicit" or
subconscious memory, which helps people act faster
on items they are familiar with than on new items.
All of the groups were faster when asked to categorize
repeated words rather than new ones, indicating that
this ability remains intact in people with early Alzheimers.
Functional magnetic resonance imaging (fMRI) indicated
the brain did not have to work as hard when a word
"This kind of memory is automatic, unconscious,"
said study author Cindy Lustig, who did the research
while she was a postdoctoral fellow in psychology
at Washington University in St. Louis. "The brain
areas involved in high-level, complex thought are
affected by aging and Alzheimers disease, but
they can still benefit and show changes related to
learning. Our question now is how to best target those
preserved abilities so that they can be translated
into training and rehabilitation programs to help
older adults, especially those with Alzheimers
To learn about treating Alzheimers, visit the
National Institute on Agings Alzheimers
Disease Education and Referral Center.
150 Muir Road (127A)
Martinez, CA 94553-4612
Telephone: (925) 372-2485
Lawrence J. Ellison Ambulatory Care Center
4860 Y Street, Suite 3900
Sacramento, CA 95817
Telephone: (916) 734-5496