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It is nice when science proves what healthcare workers have known intuitively for years. Recreation and activities depts. work hard to provide residents with activities that stimulate their minds.  While someone walking into an assisted living facility or nursing home for the first time might not think this is the case, as this study shows, basic activities can have a positive effect on slowing down the disease process.  While the report of the study doesn’t indicate the role of spiritual support, the inclusion of religious services in facilities, with familiar tunes and liturgy, I am sure would also be included under the category of cognitive stimulation.  The most important thing to consider is that slowing down the process of mental decline in people with degenerative neurological diseases is a battle all families would like to “win,” thus allowing the family members to have longer periods when they are still recognized.

There are many different causes of dementia and, although its progression can be fast or slow, it is always degenerative. Symptoms of dementia include confusion, loss of memory, and problems with speech and understanding. It can be upsetting for both the affected person and their relatives and carers. New research published in BioMed Central’s open access journal BMC Medicineshows that a regime of behavioral and mental exercises was able to halt the progression of dementia.

Researchers led by Prof. Graessel, from Friedrich-Alexander-Universität Erlangen, included in their study patients with dementia from five nursing homes in Bavaria. After random selection, half the patients were included on the year-long MAKS ‘intervention’ consisting of two hours of group therapy, six days a week. In addition all patients maintained their normal treatment and regular activities provided by the nursing home.

The MAKS system consists of motor stimulation(M), including games such as bowling, croquet, and balancing exercises; cognitive stimulation (K), in the form of individual and group puzzles; and practicing ‘daily living’ activities (A), including preparing snacks, gardening and crafts. The therapy session began with a ten minute introduction, which the researchers termed a ‘spiritual element’ (S), where the participants discussed topics like ‘happiness’, or sang a song or hymn.

After 12 months of therapy the MAKS group maintained their level on the Alzheimer’s Disease Assessment Scale (ADAS) and, even more importantly maintained their ability to carry out activities of daily living, while the control group all showed a decrease in cognitive and functional ability.

Prof. Graessel explained, “While we observed a better result for patients with mild to moderate dementia, the result of MAKS therapy on ADAS (cognitive function) was at least as good as treatment with cholinesterase inhibitors. Additionally we found that the effect on the patients’ ability to perform daily living tasks (as measured by the Erlanger Test of Daily Living (E-ADL)) was twice as high as achieved by medication. This means that MAKS therapy is able to extend the quality of, and participation in, life for people with dementia within a nursing home environment. We are currently in the process of extending these preliminary results to see if this prevention of dementia decline can be maintained over a longer time period.”

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