[More Attention Should be Paid to Alzheimer's Disease Patients' Daily Living Than to Their Cognitive Function: Interventions Offering a Social Role, Including Psychotherapy].

Abstract

Both biological and psychological interventions are important in the treatment of Alzheimer's disease(AD). Although there is no curative therapy for AD, current interventions that focus mainly on their cognitive functions are neither sufficient nor effective. More atten- tion should be paid to their self-efficacy in daily life. When people develop AD, they will lose their self-respect and social role or relationships. The aim of the treatment for AD is simply to regain these, which will not be successful unless their daily lives become the target of sharp focus. Behavioral and psychological symptoms of dementia (BPSD) are also strongly associated with patients'daily life rather than with their cognitive function. Upon medical examinations, psychiatrists should not only listen to patients' caregivers, but also provide psychotherapy for the AD patients themselves, despite their being cognitively more or less impaired. Psychiatrists have to inform caregivers about the loneliness AD patients feel and the importance of respecting their feelings. Regarding pharmacotherapy, discussion concerning the best for each patient's condition among the four kinds of current anti-dementia drugs would not be useful, as each patient's condition, inclusive of BPSD, does not only depend on their neurological impairment. General function of the brain is largely normal in AD patients at early stage, therefore rarely causing BPSD. What may well cause BPSD are the patients' circumstances including social interaction between caregivers and themselves in their daily life. Thus, psychi- atrists need to keep in mind both biological and psychological factors in the treatment of AD.