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World Alzheimer’s Day
Sharing information about Alzheimer

September is World Alzheimer’s Awareness month and our last post about Alzheimer’s disease will be to raise awareness about the disease. Firstly, it would be best explaining what Alzheimer’s disease is and its origin. The disease is named after Alois Alzheimer – a German psychiatrist – who discovered it for the first time in 1901 in a 50-year-old German lady. As the disease spread in its scope and severity, people felt the need to institute a body dedicated to the fight against this incurable illness. For many years the symptoms of Alzheimer’s disease were similar, and as a result concluded in the symptoms of senile dementia.

Dementia is an acquired and chronic mental disorder syndrome. It is a general term for the loss of memory, language and other cognitive abilities. Forms of dementia are classified according to the DSM-5 into two categories, major neurocognitive disorder (MND) and mild neurocognitive disorder. Neurocognitive impairment (NCD) is defined as evidence of significant cognitive decline from a previous level and a decline in neurocognitive performance. Cognitive deficits are so significant that they interfere with the patient’s ability to function independently but it must not be due to another mental disorder such as depression. 

Alzheimer’s disease is the most common type of dementia that affects memory, thinking and behavior. It is a neurodegenerative disease of the brain caused by complex brain changes after cell damage typically accumulation of the harmful protein tau in brain neurons but the causes of the disease still remain unknown.The disease leads to symptoms of dementia such as short-term memory problems that gradually worsen over time. The most common early symptom of Alzheimer’s is difficulty remembering new information, because the disease usually first affects the part of the brain associated with learning. As the disease progresses, symptoms become more severe and include disorientation, confusion, and behavioral changes. Finally, speaking, swallowing and walking become difficult.Though this is one explanation, the cause of Alzheimer’s disease is still mostly unknown except for 1-2% of cases and several hypotheses attempt to explain the underlying cause. 

The main purpose of World Alzheimer’s Awareness month is to “Know Dementia, Know Alzheimer” as made known from the Alzheimer’s Disease International. In the effort of raising awareness we want to list the early symptoms of the disease. Among the reasons for the late diagnosis is that the signs and symptoms, at the early stages of Alzheimers’s Disease, are sometimes not recognised and/or mistaken for signs of old age or symptoms of other conditions. 

The most noticeable deficit is short term memory loss. It appears to be difficult to remember recent facts and inability to acquire new information. It is also known for people with AD to forget about recent conversations, names and misplace items. Other symptoms include problems with abstract thinking or impairments in semantic memory (memory of meanings) causing trouble thinking of the right. These early symptoms can affect the most complex activities of daily living such as self care activities.

The World Alzheimer day is dedicated to promote awareness for pre-diagnosis and post-diagnosis support. At least 75% of people with dementia are not diagnosed globally, and they can’t have access to proper help. It is important to recognize the early symptoms, but also to support the health, social and psychological wellbeing of people with dementia and their carers after diagnosis.

Creating an Alzheimer’s disease friendly educational program

In our latest posts, we talked about music therapy and museum therapy as different forms of therapy used for people with dementia and Alzheimer’s disease. Both of these forms of therapy are helpful. As a museum, trying to include all age groups, even those with Alzheimer’s disease and dementia, we are thinking of ways to create educational programs suitable for these people.

Educational programs are usually organized sets of learning activities designed to enable a student to develop knowledge, understanding, skills and attitudes relevant to the student’s individual needs. A museum can offer many educational programs not only for students, but also to everyone who wants to attend the place and experience the museum. Creating an Alzheimer’s disease-friendly program, so that we can also include those people, can be somehow challenging. In order to make a suitable educational program for people with dementia and Alzheimer’s disease, someone should have different targets and expectations from the common educational programs designed for children and students. 

 The main purpose of every educational program for people with dementia should be the connection of the attendants. The educators can focus on building an educational program with things that these people can make a connection with. Things that they are familiar with and are easy to focus on. A person with dementia often suffers with memory loss and brain fog, and that causes confusion and stress. Simple objects, such as a pen with ink or a school bag, can bring up memories and feelings of familiarity that can help reduce stress and exercise their memories. 

Following, the educational program ought to be designed to help the people with dementia and Alzheimer’s maintain and/or resurface their knowledge skills. The loss of their language and cognitive skills can cause negative behavior and also a lot of stress. It is important to use easy and closed-ended questions that can be easily answered and need just a little effort focusing on those questions. Also, it is important to not give much information and instructions, but to be present, support and help the attendants. 

Finally, using relaxing music during the program is helpful to maintain calm and relieve stress. However, it is helpful to use songs and melodies familiar to them and music that fits the environment the patients are in. Music and sounds are able to bring up memories and have power of bringing  and can help maintain their mental health.

Although this is a hypothetical program, the problem is that the methods used in these syntheses vary in fundamental ways, leading to inconsistent conclusions regarding which programs and practices have strong evidence of effectiveness. It is very important to evaluate the program each time it takes place from both parties. This variation is a potentially serious problem for evidence-based reform, as it could undermine the confidence that educators and policy makers place in the entire enterprise. Academic disagreements are healthy -and inevitable-, but it is important to understand the issues, at least, and to agree on basic ground rules for program evaluation syntheses.

Bennington, R., Backos, A., Harrison, J., Reader, A. E., & Carolan, R. (2016). Art therapy in art museums: Promoting social connectedness and psychological well-being of older adults. Arts in Psychotherapy, 34-43.

Brechet, L., Michel, C. M., Schacter, D. L., & Pascual-Leone, A. (2021). Improving autobiographical memory in Alzheimer’s disease by transcranial alternating current stimulation. Current Opinion in Behavioral Sciences, 64-71.

de Witte, M., Pinho, A., Stams, G., Moonen, X., Bos, A., & van Hooren , S. (2022). Music therapy for stress reduction: a systematic review and meta-analysis. Health Psychology Review, 134-159.

Ioannides, E. (2016). Museums as Therapeutic Environments and the Contribution of Art Therapy. Museum International , 98-109.

Kwak, K., Bae, N., & Jang, W. (2013). Music therapy with moderate Alzheimer’s disease in a long-term care center. Music therapy with moderate Alzheimer’s disease in a long-term care center, P880.

Lam, H., Li, W., Laher, I., & Wong, R. (2020). Effects of music therapy on patients with dementia-A systematic review. Switzerland: Geriatrics.

Rathbone, C. J., Ellis, J. A., Ahmed, S., Moulin, C. J., Ernst, A., & Butler, C. R. (2019, 12 1). Using memories to support the self in Alzheimer’s disease. Cortex, 332-346.

Storti, B., Brovelli, F., Pozzi, F., Zuffi, A., Piatti, M., Appollonio, I., . . . Ferrarese, C. (2021). Progression in cognitively impaired patients with atrial fibrillation: An observational study. Journal of the Neurological Sciences, 81.

Museum Therapy

Different forms of therapy are used lately for people with dementia and Alzheimer’s disease as there has been carried out research on the contribution of museums for the treatment and inclusion of people with dementia and Alzheimer’s disease. This can be achieved through visits to museums but also through the conduct of educational programs in the museums as museum therapy. 

Museum therapy is a form of therapy that grants the use of a museum and its collection to therapeutic processes. This form of therapy allows individuals to be submerged in the art and the exhibitions of the museums, and from viewers become creators themselves. This means that within the museum space, therapists can provide a creative experience for the participants and interact with them in new ways. 

A common goal of museum programs is to increase the well-being of people with dementia. Usually these programs are part of the type of treatment through art (art therapy). Art therapy involves use of creative techniques such as drawing, painting, collage, coloring, or sculpting to help people express themselves artistically and examine the psychological and emotional undertones in their art. One of the most well-known museum therapy programs (Museum Therapy) is Meet me of the Museum of Modern Art in New York. In this programm, people with dementia and their caregivers visited the Museum of Modern Art in New York several times. To evaluate the participants, self-report scales of the emotional state of the participants before and after the program, observation scales from the researchers and Museum staff as well as focus groups up to 3 months after the implementation of the program were used. The results showed an improvement in the relationship of individuals with their caregivers and positive emotions.

In a recent study carried out in Italy, the effectiveness of «Museum Therapy» was investigated in a group of patients with dementia. This research involved 30 people diagnosed with various types of dementia who were hospitalized in a nursing home for over approximately 80 days.The patients were divided into two groups, one group visited the Museum of Contemporary Art 3 times, while the other group engaged in outdoor activities. As a result of this research, both groups of patients improved their performance in tests of memory, attention, executive functions and also a reduction in behavioral disorders. However, patients who participated in museum therapy improved their performance on tests of cognitive assessment and pragmatic abilities.

In these results someone can observe how art in a museum, combined with discussion, journaling and note-taking as well as creating artwork, can lead to increased self-awareness and promote social connectedness in older adults. Museums can be of great help to people with dementia and can improve their mental and emotional state

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Bennington, R., Backos, A., Harrison, J., Reader, A. E., & Carolan, R. (2016). Art therapy in art museums: Promoting social connectedness and psychological well-being of older adults. Arts in Psychotherapy, 34-43.

Brechet, L., Michel, C. M., Schacter, D. L., & Pascual-Leone, A. (2021). Improving autobiographical memory in Alzheimer’s disease by transcranial alternating current stimulation. Current Opinion in Behavioral Sciences, 64-71.

Ioannides, E. (2016). Museums as Therapeutic Environments and the Contribution of Art Therapy. Museum International , 98-109.

Rathbone, C. J., Ellis, J. A., Ahmed, S., Moulin, C. J., Ernst, A., & Butler, C. R. (2019, 12 1). Using memories to support the self in Alzheimer’s disease. Cortex, 332-346.

Storti, B., Brovelli, F., Pozzi, F., Zuffi, A., Piatti, M., Appollonio, I., . . . Ferrarese, C. (2021). Progression in cognitively impaired patients with atrial fibrillation: An observational study. Journal of the Neurological Sciences, 81.

Music Therapy in Museums

Music therapy is a form of therapy that is increasingly used as a form of therapy in all age groups, but also as a form of therapy for people suffering from dementia and Alzheimer’s disease. Listening to music, composing, singing and/or playing an instrument can help someone reduce stress, reduce the emotional charge, get into a positive mood, feel more relaxed and improve their sleep quality in general. In music therapy specifically, the therapist uses music to help patients with dementia improve and maintain their health.

Dementia is an acquired and chronic syndrome of mental disorder. It is a general term for the loss of memory, language and other cognitive abilities. Alzheimer’s disease is the most prevalent type of dementia that affects memory, thinking and behavior. The purpose of music therapy for people with dementia is to direct their emotions, thoughts and memories. It can also affect their social interactions and behavior because music has a great physical and emotional impact on people.

Using music therapy in a museum as a form of therapy is somehow difficult, but not impossible.  Every person has a musical imagery, the recall of a song or a melody without it being heard in the environment that time. The most important thing is to use songs and melodies that fit the environment the patients are in. For example, when someone is visiting a museum about school life, it would help them hear sounds that will make them think about their school years and bring back childhood memories.

Although music therapy is increasingly used in many fields, it is still in need of research and practical use in other fields as well, such as museums. People with Alzheimer’s disease and Dementia should not be excluded, and we should try more therapeutic interventions for them.

Brechet, L., Michel, C. M., Schacter, D. L., & Pascual-Leone, A. (2021). Improving autobiographical memory in Alzheimer’s disease by transcranial alternating current stimulation. Current Opinion in Behavioral Sciences, 64-71.

de Witte, M., Pinho, A., Stams, G., Moonen, X., Bos, A., & van Hooren , S. (2022). Music therapy for stress reduction: a systematic review and meta-analysis. Health Psychology Review, 134-159.

Kwak, K., Bae, N., & Jang, W. (2013). Music therapy with moderate Alzheimer’s disease in a long-term care center. Music therapy with moderate Alzheimer’s disease in a long-term care center, P880.

Lam, H., Li, W., Laher, I., & Wong, R. (2020). Effects of music therapy on patients with dementia-A systematic review. Switzerland: Geriatrics.