Mnemonic strategies as dyadic interventions to increase well-being in Alzheimer's disease

Abstract

BACKGROUND: Dementia is a growing problem with 50 million patients worldwide expecting to triple by 2050. The most common form of dementia is Alzheimer's Disease, characterized by a long process of deterioration for the patient and negative impact on the close environment ('caregiver burden'). Dementia is not only memory-loss, there is also communication-loss. More than 70% of the dementia patients are still living at home, taken care for by a family member. Dementia thus affects three times as many persons involved than there are patients. The primary objective is to examine how the accumulation of (augmented) reality to mnemonic strategies can strengthen the relation between Alzheimer patients and their caregivers. The secondary objective is to elaborate a dyadic intervention to transform the 'hidden victims of dementia' into 'hidden resources'. METHOD: We developed a mobile application ('MemoryHome') based on the ancient mnemonic strategy 'the method of loci'. The digital tool allows caregivers to construct personalized memory walks throughout the known environment of dementia patients. These memory palaces link photos of significant others to the architectural surroundings. Previous research mainly focused on the method of loci as a solitary activity for Alzheimer patients to delay their memory problems. The novelty of our study is to use the mnemonic strategy for the first time as a dyadic intervention to increase well-being by introducing the concept of a 'co-walker'. The visual-audio-guide encourages conversation between the patient and the caregiver. RESULT: We evaluated the impact of our psychosocial intervention (week 0-4-8) in homecare (n=19 dyads) and in the residential setting (n=22 dyads) on quality of life (QOL-AD), feelings of depression (GDS-15) and connectedness of subjects in the early phase of AD and their significant others (QCPR). Results suggested a modest but positive association with quality of life, connectedness between dyads and the absence of feelings of depression. Participants reported to feel more cheerful, more physically active and socially connected. CONCLUSION: The mobile application MemoryHome is a convenient instrument to reinforce the dialogue between patients and their environment. Translating mnemonic strategies into dyadic interventions can turn 'hidden victims' in 'hidden resources' in future Alzheimer research.