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Movement with Meaning: A Multisensory Program for Individuals in Early-Stage Alzheimer's Disease

Those of us in the field of dementia care are reexamining our philosophical beliefs and exploring practical, hands-on approaches in our relationships with individuals living with Alzheimer's disease. We are creating innovative programs and developing a new framework for preserving the emotional health, autonomy, and dignity of those who need us to walk hand in hand with them, witnessing the process of their experiences with empathy and respect.

One of the points I mention in my book on notetaking is that the very act of taking notes helps us remember — it’s not simply about providing yourself with a record. There are a number of reasons for this, but a recent study bears on one of them. The researchers were interested in whether physically writing by hand has a different effect than typing on a keyboard.

What do we mean by word-finding problems?

Here are some examples:

• increasing use of circumlocutions rather than specific terms (e.g., "I wonder where the thing that goes here is")
• use of empty phrases, indefinite terms, and pronouns without antecedents (i.e., referring to something or someone as "it" or "him / her" without first identifying them by name)
• increased frequency of pauses

These problems are all characteristic of Alzheimer's, but also, to a much lesser extent, of normal aging.

We don’t deliberately practice our memories of events — not as a rule, anyway. But we don’t need to — because just living our life is sufficient to bring about the practice. We remember happy, or unpleasant, events to ourselves, and we recount our memories to other people. Some will become familiar stories that we re-tell again and again. But facts, the sort of information we learn in formal settings such as school and university, these are not something we tend to repeatedly recount to ourselves or others — not for pleasure anyway!

Does photographic memory exist?

"Photographic" or eidetic memory is said to occur in some 8% of children, but almost all of these grow out of it. The phenomenon is extremely rare in adults, and indeed the very existence of photographic memory is still somewhat contentious. However, it may be that particular brain abnormalities can lead to ways of processing information that are dramatically different from the normal (see the case of Kim Peek).

There hasn't been a lot of research into the effects of herbs and spices on cognition and the brain, unfortunately. But on the positive side, the risk of side-effects is very low, so we don't need a lot of evidence for it to be worth trying.

Stimulating activities

A 5-year study¹ involving 488 people age 75 to 85 found that, for the 101 people who developed dementia, the greater the number of stimulating activities (reading, writing, doing crossword puzzles, playing board or card games, having group discussions, and playing music) they engaged in, the longer rapid memory loss was delayed. Similarly, a study² involving 1321 randomly selected people aged 70 to 89, of whom 197 had mild cognitive impairment, has found that reading books, playing games, participating in compute

A very common situation today, which is probably responsible for a great deal of modern anxiety about failing memory, is that where we're required to “multitask”, that trendy modern word for trying to do more than one thing at a time. It is a situation for which both the normal consequences of aging and low working memory capacity has serious implications.

Intelligence in a cultural context

One theory of intelligence sees intelligence in terms of adaptiveness. Thus: "What constitutes intelligence depends upon what the situation demands" (Tuddenham 1963). Intelligence in these terms cannot be understood outside of its cultural context. Naturally to us it may seem self-evident that intelligence has to do with analytical and reasoning abilities, but we are perceiving with the sight our culture taught us.

Although I’m a cognitive psychologist and consequently think that memory and cognition is mostly about your mastery of effective strategies, when it comes to age-related cognitive decline, I’m a big believer in the importance of diet and exercise. But while we know these things can play an important role in why some people develop cognitive impairment and even dementia as they age, and others don’t, we don’t yet know with any great certainty exactly what exercise programs would be the best use of our time, and what diet would have the most benefit.