Treating the Aggression of Alzheimer’s Without Medication

Dementia has no cure, and no effective treatment, which makes for a bleak outlook when receiving a diagnosis. While it’s a devastating disease for the patient, it also affects those who care for them. Sometimes dementia patients seem to become a different person, and outbursts and aggressive behavior are not unusual.

That’s why researchers are exploring non-drug treatments that may help to manage the symptoms of late-stage Alzheimer’s. One group of researchers has tried an approach they dubbed the Tailored Activity Program (TAP), which matches activities to the interests of the person with dementia.

Scientists enrolled 160 dementia patients who were veterans with an average age of 80 in the program. They also studied the patients’ caregivers, who were largely women and were around 72 years old. They sent occupational therapists into their homes to evaluate them for fall risk, and look for things in the home environment that might heighten discomfort for dementia patients—things like lighting, seating, clutter and noise. Based on those visits, the patients were provided with an assessment of risk and “activity prescriptions”—which might include leisure activities like creating art, or activities that focus on daily living, like getting dressed.

Four months into the activity prescriptions, almost 70 percent of the veterans in the TAP group either eliminated or reduced the frequency and severity of their dementia-related behaviors. In the control group that did not receive TAP, 46 percent of the veterans experienced eliminations or reductions of dementia-related behaviors. Caregivers in the TAP group reported less distress and said that their loved one had less trouble with daily activities like getting dressed.

Researchers concluded that the TAP intervention had “positive immediate effects.” In the study, they wrote, “Because TAP reduces behavioral symptoms, slows functional dependence, and alleviates pain and caregiver distress, it is a viable treatment option for families.” This is especially helpful for families whose loved one is experiencing intense behavioral symptoms, they said, because there are no pharmacological treatments approved by the Food and Drug Administration for dementia. Those that are used are off-label, and “have risks, including stroke and mortality, that often outweigh their modest benefits,” said the researchers.

This study was published in the Journal of the American Geriatrics Society.