EMU's therapeutic recreation expert trains Kazakhstan professionals in early detection of Alzheimers

YPSILANTI, Mich. - Aug. 11, 2015 - PRLog -- Experts estimate that by the year 2050, more than 2 billion people, age 65 and older, will have some form of dementia, ranging from mild cognitive problems to Alzheimer’s disease.

Promising research, however, now shows that early detection of dementia and proper intervention can improve cognition functioning involved in learning, remembering and using knowledge.

“The Cognitive assessment is the key element for detecting changes that occur in the prodromal (early) period before clinical symptoms appear,” said David Thomas, professor of therapeutic recreation at Eastern Michigan University. “Early intervention, which includes a multitude of approaches, is critical to optimizing cognitive abilities, thus allowing the person to remain as independent as possible.”

Eastern Michigan University’s expertise in therapeutic recreation and gerontology is helping healthcare professionals in other countries

Thomas recently returned from Almaty, Kazakhstan, where he, in collaboration with professors from Eastern Michigan’s gerontology program, helped with the initial efforts to establish the country’s first memory center. The center will be located in Almaty’s Veterans Hospital, a 289-bed facility offering free healthcare for qualifying veterans in the region.

The center, scheduled to open in December 2015, is a joint collaboration by the Innovative Research School in Gerontology within the SD Asfendiyarov Kazakh National Medical University and Eastern Michigan University.

“The goal of a memory center is to provide a community resource for assessment and intervention depending upon the needs of the individual,” Thomas said. “For example, in late stage dementia, the goal may be to bring out a person’s remaining strengths, such as procedural (long-term) memory-related skills that remain relatively intact deep into the progression of the disease.

“This center will offer the elderly an opportunity for cognitive testing, education, support and both non-pharmaceutical and pharmaceutical interventions. Non-pharmaceutical interventions focus on increasing healthy behaviors such as diet, exercise, mental stimulation and social interaction.”

The center is a new approach for Kazakhstan, which broke away from the Soviet Union in 1991, as it implements healthcare reforms and strategies to deal with its aging population.

A primary feature of the Kazakhstan center will be the use of non-pharmaceutical interventions that focus on increasing healthy lifestyle behaviors. Such lifestyle changes are low in cost and less intrusive, according to Thomas.

“Promoting non-pharmaceutical interventions is new, because these professionals have relied almost exclusively on drug therapy for healthcare, so education of healthy behaviors is an important tool for the staff,” Thomas said.

“This includes increasing knowledge about appropriate foods associated with cognitive health, exercise techniques and resources. We also take into account an assessment of meaningful recreational interests and mentally stimulating activities, and increase the awareness of community resources for social interaction.”

Thomas said, “We know that food that is low in fat and high in Omega-3 fatty acids, such as the Mediterranean diet, can improve cognition. The Kazakhstan veterans’ diet is heavy in meat, such as horsemeat and chicken. This will be a more radical shift that will require educating families, because they bring food for their family members.”

Extensive evidence has shown that exercise, and in particular high intensity exercise, promotes cognitive health, so the center’s patients will use state-of-the-art exercise equipment under the direction of a professional. Recreational activities and computer games will also be available to challenge their mental functions.

Research has also demonstrated that music, art and other activities can make a difference in the elderly with dementia, Thomas said. These activities, however, have to be meaningful for the person.

“You wouldn’t want to play hip-hop or rap for someone who loved a different type of music like classical music,” Thomas said. “If a person has a hard time maintaining focus, they lose track of what they are doing. The staff or their families can choose activities that work on that function.”

Unsupervised wandering is a common problem in elderly persons with dementia. Thomas’ research has discovered that supervised walking programs and physical activity in general may be effective for some persons in the early to middle stages of dementia. During those stages, the person still has the capacity to associate feelings of physical expenditure, which meets their inner needs often met through the more dangerous activity of wandering.

“Physical activity, along with the physiological benefits, also offers release, along with social and emotional benefits,” Thomas said. “It’s hard to extract the specific contributor that leads to positive outcomes.”

Recreational programs have provided some surprising and positive results in unresponsive patients.

Thomas cites an example of an elderly man in a nursing home, who was totally unresponsive. When the staff learned that he loved playing pool, they brought him to a part of the building where there was a pool table. They initiated his movement with a pool stick and, to their surprise, the man responded by independently playing pool for an extended period of time.

“He was smiling, he stayed focused on the task and followed the ball,” Thomas said. “He felt a connection with the game. If we had challenged him in the wrong way, it would have been overwhelming, which could have resulted in frustration and negative outcomes. The activity demonstrated that, while short-term memory may be affected with dementia, there are types of long-term memory that remains relatively functional even in severe forms of the disease.”

More information is available at  Eastern Michigan University's therapeutic recreation website (https://www.emich.edu/chhs/hs/programs/therapeutic_recrea...).