Why Repetition is Critical to Treating Alzheimer’s Patients

Care plans that promote an active senior lifestyle, used in conjunction with current pharmaceuticals, can empower skilled nursing providers to make a tremendous impact in managing — and possibly delaying — Alzheimer’s disease.

This is according to Maria Carrillo, chief science officer at the Chicago-based national non-profit Alzheimer’s Association. Carrillo spoke about the pervasiveness of Alzheimer’s disease in a panel discussion at the National Investment Center for Seniors Housing & Care (NIC) 2017 Fall Conference in Chicago.

The disease’s impact on the senior care market is evidenced by its staggering incidence rate over the last few years.

The current landscape

Citing information from NIC’s MAP Data Service, moderator Jack Callison explained that over the last decade, the existing inventory of Alzheimer’s and dementia care units across the country has grown from about 60,000 to roughly 120,000 today.

Callison is CEO of Chicago-based Enlivant, a provider of assisted living, independent living, memory care and short-term stay rehabilitation.

This growing level of inventory coincides with demand for this type of care.

Currently, there are more than 5.4 million people in the U.S. living with Alzheimer’s. This number is expected to grow by 500,000 per decade, reaching upwards of roughly 16 million by 2050, Callison explained during the panel.

Nearly half a trillion dollars is spent every year by pharmaceutical companies on Alzheimer’s treatments and medications at any stage—from pre-clinical trials to phase three studies, according to Carrillo.

This growing population of Alzheimer’s patients is reflected by the growing size of the Baby Boomer population, according to Pinchas Cohen, MD, dean at the University of Southern California’s Leonard Davis School of Gerontology.

“The enormous rise that we’re projecting in cases of Alzheimer’s is a result of the aging of the population, and the fact that there are so many of the Baby Boomers who are going to reach the age where a percentage of them will get Alzheimer’s,” Cohen said.

Despite the increasing prevalence of the disease in the senior population, Cohen explained that society’s health-conscious mindset may slow the growth rate and play a role in preventing or delaying the onset of Alzheimer’s disease.

“That’s a trend that we need to capitalize on,” he said.

The role of repetition

Jean Makesh, CEO of South Russell, Ohio-based The Lantern Group, is one provider capitalizing on the active senior lifestyle trend in combatting Alzheimer’s disease.

The Lantern Group operates three assisted living and memory care residences throughout the northeastern part of Ohio.

Makesh highlighted the concept of neuroplasticity during his discussion. The concept revolves around a person’s ability to mold and shape the cognitive capacity and overall “functional size” of their brain, he explained.

“Research shows that there is significant evidence of neuroplasticity even in a 90-year-old brain — so there is a ray of hope,” Makesh said. “For neuroplasticity to occur, any task or anything that you learn, you have to repeat it at least 400 to 450 times.”

This amount of repetition is central to the treatments Makesh and his team of caregivers administer at The Lantern. In this setting, caregivers act more as teachers who oversee a small group of residents, and model tasks and behaviors that residents need to work on.

“If there’s a task that the client has to learn — let’s say that the client has to learn how to feed himself — then that is something that is practiced over and over. We need to get that 400-to-450 repetition,” Makesh said.

In the five years since Makesh has implemented this program at The Lantern, the group has been able to increase the attention span in some residents from two minutes to almost 28 minutes, he explained.

The organization has further been able to minimize elopement — or patients wandering away from the community — by bringing the outside in. The group has installed a simulated light feature that mimics the sunrise and sunset in the common area of its Chagrin Valley community in South Russell, as well as creating an indoor fountain display at its Madison, Ohio community.

For Carrillo, the strategy of utilizing current medications in conjunction with an active senior lifestyle is critical to managing Alzheimer’s disease.

“[The] combination therapy approach will help us take Alzheimer’s from a killer to a chronically managed disease,” she said.

Written by Carlo Calma