Evaluating Alternative Treatments for Alzheimer's and Dementia
Until medical science cures dementia, there is broad range of alternative therapy for Alzheimer's disease and dementia and ways to improve the lives of people afflicted
Interest in alternative treatments for Alzheimer’s disease (AD) and other forms of dementia is growing almost as fast as the epidemic itself. Unfortunately, the search for a cure moves at a snail’s pace, leaving families desperate for measures that can help their loved one now.
As a registered nurse and a Certified Alzheimer’s Educator (CAEd), family members and caregivers often ask me what else they can do help their loved ones and possibly slow the progression of their cognitive decline. Of course, most people living with some form of dementia are under the care of a doctor, but the tools, treatments and therapies that the medical field currently has at their disposal are very limited. Spouses, adult children and grandchildren, siblings and friends are often shocked by the limited options that are available to help manage symptoms of this devastating condition. Many people turn to alternative medicine and complementary techniques for hope and improvement.
When someone you love is struggling with an incurable disease, there is little you wouldn’t do to try to ease or cure their burden. Unfortunately, times of desperation will always give rise to opportunists who are only interested in making a buck. While many alternative treatments are touted as natural and safe, it is possible for some to cause harm and interact negatively with conventional medical practices. Because of this, it is crucial for family members and caregivers to understand the risks and benefits of and evidence (or lack thereof) behind any treatments they may be considering.
In this piece, we’ll explore some of the most popular alternative treatments on the market right now, and I will offer suggestions on how consumers can distinguish truly helpful options from the hype.
Look for Treatments Backed By Legitimate Studies and Research
If you consult Dr. Google for “alternative treatments for Alzheimer’s disease,” you will get millions of results. Add the qualifier “scholarly articles,” and that number is considerably reduced, but you’ll still get a list that will take more than an afternoon to review! A few simple steps can whittle this sequoia of information down to the toothpick we need to make an informed decision.
Government web sites and national advocacy organizations are excellent sources of information. Think the National Institute on Aging or the Alzheimer’s Association. If you are interested in a specific treatment, search for “[name of the treatment] associations” and look for nonprofit groups who are not trying to sell related products.
When studies of a treatment are mentioned, look for the answers to three key questions:
When was the study done?
Peer-reviewed circles consider five years old to be the cut-off age for work that is current.
Where was the study done?
Professionals affiliated with a university are one of the top sources for reliable studies. You want to avoid sources that you can’t verify as legitimate.
Was the treatment tested on people? If so, how many people?
A study done on 1,000 people is more trustworthy than one done on 27 people. We also know that treating Alzheimer’s disease and its symptoms is often a matter of trial and error. You can line up twenty people and give the exact same treatment to each one. Some will get better, some will get worse and some won’t change at all.
How to Decide if a Treatment Is Worth Trying
Studies look at “averages,” not individual cases. Each individual brain is unique and responds to its environment in a unique way. So, the fact that a treatment did not help most of the people in a trial doesn’t necessarily mean it will not help your loved one. So how do we know when is it reasonable to try a treatment?
There are four criteria you can use in weighing an alternative treatment for AD:
The likelihood of negative side effects.
If a treatment causes diarrhea, for example, and your loved one is already underweight and easily dehydrated, it presents a high risk to their health. If this treatment causes them to become increasingly frail and they end up falling, Alzheimer’s will only be one of your many concerns.
The chance of interfering with other treatments in use.
Ask your physician or licensed pharmacist if the treatment you are considering will counteract, decrease the absorption of or magnify the effect of other prescribed treatments your loved one is receiving. There is no limit to the way that prescription drugs, over-the-counter medications, supplements, vitamins and foods can interact with each other.
Before you shell out hundreds of dollars for any alternative treatment, know this: if it was great enough to carry such a significant price tag, the world would already know about it.
When it comes to alternative and complementary therapies, like supplements, medical foods and essential oils, it is important to know what exactly each pill or vial contains. For many of these treatments, there is no definitive regulatory body that manufacturers must answer to. Carefully examine the ingredients and manufacturing processes and locations of potential treatments to avoid any issues.
Applying the Guidelines
Let’s look at a popular example: the use of coconut oil (CO) for AD and other forms of dementia. There have been many claims about coconut oil, but there is no concrete scientific evidence for its effectiveness against Alzheimer’s. On the other hand, studies on CO do not show major negative side effects. It is worth noting that coconut oil can cause diarrhea, though, so it is best to start out with just a tablespoon each day and watch for this issue. You can gradually increase the dose if diarrhea doesn’t arise or is minimal. CO may interfere with the absorption of some medications, so ask a doctor or a licensed pharmacist before trying it.
Lastly, the cost of CO is a tiny fraction of many other treatments. Our four criteria did not give us any strong reasons not to try this treatment, so it may be worth experimenting with if your loved one’s health is a good fit and their physician approves it.
A Closer Look at Other Alternative Treatments
Now that we have a framework to use when considering alternative treatments, let’s look carefully at eight other popular and/or promising options. If something sounds reasonable to you, learn more about it using the criteria above to guide your research.
Cannabinoids, like tetrahydrocannabinol (THC) and cannabidiol (CBD), are the chemical components of cannabis or marijuana. Evidence is strong that non-psychoactive doses (low enough to not cause a “high”) may have a neuroprotective effect and reduce amyloid and tau in the brain—the proteins that seem to cause all the trouble in AD patients. But before you whip out the brownie pan, remember that these results came from controlled quantities and qualities of these compounds. Consult a professional or a nonprofit organization for more detailed information on medical marijuana.
Engaging in purposeful, mentally stimulating activity for a set amount of time each day (can be at short intervals spaced throughout the day) shows strong benefits. People with AD experience improved cognition, a greater feeling of well-being, and improved communication and socialization skills. Set routines (with built-in flexibility) are extremely important for Alzheimer’s patients. Incorporating pleasant activities can help to enhance their daily routines and reduce dementia behaviors like agitation.
The Mediterranean diet, with its emphasis on fresh fruits and vegetables, olive oil, and lean proteins like fish and poultry, has a strong preventative effect on heart disease and may reduce a person’s dementia risk. It may also slow the decline of patients with mild cognitive impairment or those in the early stages of AD. As with many treatments, the benefit seen with this diet tapers off in the middle and advanced stages, but this kind of healthy eating is still important throughout the course of the disease.
Stories of positive responses to essential oils and aromatherapy abound. They can either be used topically or inhaled through aromatic methods, like diffusion. Interestingly enough, most patients with Alzheimer’s lose their sense of smell due to changes in the olfactory centers of the brain. There are few objective studies on the use of essential oils for people with AD.
One intriguing study showed that using a morning and evening regimen of these oils increased cooperation with care and decreased excessive motor activity like restless pacing. The morning routine consisted of rosemary and lemon balm, while the evening routine included rosemary and lavender. The oils were rubbed on participants’ faces and arms, which could have a soothing effect in itself. The power of human touch is known to be very calming and therapeutic. Other supposed benefits of essential oils include reduced agitation and wandering and improved sleep quality.
Increased quality of life and decreased stress are proven results of training both people with AD and their caregivers in mindfulness-based stress reduction (MBSR). This is a meditation-based practice developed and made popular by Jon Kabat-Zinn. Places like schools and prisons are now using MBSR, and you can use Google to find a course near you. Again, the benefits of meditation are largely limited to the early stages of the disease. As AD progresses, patients will likely lose the ability to initiate meditation sessions and focus on the task at hand.
Music therapy can produce major improvements in behavior and cognition. The benefits of music were beautifully portrayed in the documentary film “Alive Inside: A Story of Music and Memory.” Following the success of the film, the organization Music & Memory emerged to create personalized playlists for individuals with mental and physical difficulties in long-term care facilities and provide digital equipment for them to listen to their music. Their website offers practical ideas for using music therapy both in facilities and at home.
These include playing sacred music and reading or listening to material that is meaningful to the individual. Spiritual activities can promote calmness and ease distress, even in those who are no longer able to read, verbally participate or respond.
This category of alternative treatments is probably the most studied. We’ve already discussed the potential benefits of coconut oil, but other supplements that show positive effects on brain health are omega-3 fatty acids, lutein, vitamin D and curcumin, which is found in the spice turmeric. Supplements that have not shown benefit for AD in studies include gingko biloba, coral calcium and Coenzyme Q10.
Each supplement or vitamin has its own mechanism of action, dosing instructions, supposed benefits and possible side effects. It’s important to understand these characteristics of a supplement and clear it with a doctor before adding it to a regimen. Just because something is natural or available over the counter doesn’t mean it can’t interact with other medications, foods, medical conditions or lifestyle choices.
The Big Picture
In 2014, a group of scientists at the University of California, Los Angeles (UCLA) published a small study of ten people with varying degrees of memory impairment. While this particular study used a very small sample size, it also tested an intensive 36-point therapeutic program, which incorporated most of the treatments noted above paired with exercise, sleep management, pharmaceutical drugs and a few supplements. The improvements in cognition were jaw-dropping and held strong at two years after the study concluded.
At this point in time, there is no one cure or treatment for AD and this study highlights the importance of leading a healthy lifestyle across the board. Making wise choices about diet, exercise, sleep, hygiene and stress reduction can ensure overall health that will aid in delaying the progression of AD and prevent other medical issues from arising or worsening, which can then exacerbate symptoms of dementia. Comprehensive programs like the one at UCLA potentially hold the key to hope for people suffering with AD now.
Consult a Doctor
While alternative treatments like music therapy and brain exercises pose little, if any, risk to participants, other options like specialized diets, vitamins and supplements can be detrimental to some. If you or a loved one is considering incorporating alternative medicine into their daily life and/or treatment plan, it is best to discuss all changes with a doctor beforehand. A physician will be familiar with the patient’s health status and able to help them understand the risks and benefits associated with alternative treatments and therapies. The lesson is to be smart, do your research and discuss options with a medical professional.
For more information call Memory Matters Utah/Nevada at 435-319-0407. Memory Matters is a 501(C)(3) non-profit organization providing services in southern Utah and Mesquite, Nevada.