Learning Objectives
- Describe treatment options for neurocognitive disorders.
Treatment options for those with neurocognitive disorders are minimal at best, with most attempting to treat secondary symptoms as opposed to the neurocognitive disorder itself. Furthermore, the degenerative nature of these disorders also makes it difficult to treat, as many diseases will progress regardless of the treatment options.
Pharmacological
Pharmacological interventions, and more specifically medications designed to target acetylcholine and glutamate, have been the most effective treatment options in alleviating symptoms and reducing the speed of cognitive decline within individuals diagnosed with Alzheimer’s disease. Specific medications such as donepezil (Aricept), rivastigmine (Exelon), galantamine (Razadyne), and memantine (Namenda) are among the most commonly prescribed (Alzheimer’s Association, 2017a). Due to possible negative side effects of the medications, these drugs are prescribed to individuals in the early or middle stages of Alzheimer’s as opposed to those with advanced disease. Researchers have also explored treatment options aimed at preventing the build-up of beta-amyloid and neurofibrillary tangles; however, this research is still in its infancy (Alzheimer’s Association, 2017a)
Parkinson’s disease has also found success in pharmacological treatment options. The medication levodopa increases dopamine availability, which provides relief of both physical and cognitive symptoms. Unfortunately, there are also significant side effects such as hallucinations and psychotic symptoms; therefore, the medication is often only used when the benefits outweigh the negatives of the potential risks (Poletti & Bonuccelli, 2013).
Psychological
Among the most effective psychological treatment options for individuals with neurocognitive disorders are the use of cognitive and behavioral strategies. More specifically, engaging in various cognitive activities such as computer-based cognitive stimulation programs, reading books, and following the news, have been identified as effective strategies in preventing or delaying the onset of Alzheimer’s disease (Szalavits, 2013; Wilson, Segawa, Boyle, & Bennett, 2012).
Engaging in social skills and self-care training are additional behavioral strategies used to help improve functioning in individuals with neurocognitive deficits. For example, by breaking down complex tasks into smaller, more attainable goals, as well as simplifying the environment (i.e., labeling location of items, removing clutter), individuals can successfully engage in more independent living activities.
Support for Caregivers
Supporting caregivers is an important treatment option to include as the emotional and physical toll on caring for an individual with a neurocognitive disorder is often underestimated. According to the Alzheimer’s Association (2017b), nearly 90% of all individuals with Alzheimer’s disease are cared for by a relative. The emotional and physical demands on caring for a family member who continues to decline cognitively and physically can lead to increased anger and depression in a caregiver (Kang et al. 2014). It is important that medical providers routinely assess caregivers’ psychosocial functioning, and encourage caregivers to participate in caregiver support groups, or individual psychotherapy to address their own emotional needs.
Key Takeaways
You should have learned the following in this section:
- Pharmacological interventions for Alzheimer’s disease target the neurotransmitters acetylcholine and glutamate and newer research is focused on the build-up of beta-amyloid and neurofibrillary tangles.
- Psychological treatments include cognitive and behavioral strategies such as playing board games, reading books, or social skills training.
- Caregivers need to join support groups to help them manage their own anger and depression, especially since 90% of such caregivers are relatives of the afflicted.
Review Questions
- Review the listed treatment options for neurocognitive disorders. What are the main goals of these treatments?
Module Recap
Our discussion in Module 14 turned to neurocognitive disorders to include the categories of delirium, major neurocognitive disorder, and Mild neurocognitive disorder. We also discussed the subtypes of Alzheimer’s disease, traumatic brain injury (TBI), vascular disorder, substance/medication induced, dementia with Lewy bodies, frontotemporal NCD, Parkinson’s disease, Huntington’s disease, and HIV infection. The clinical description, epidemiology, etiology, and treatment options for neurocognitive disorders were discussed.
