A life-course and multifactorial approach to Alzheimer’s disease: Implications for research, clinical assessment and intervention practices

Linden, Martial Van der; Linden, Anne-Claude Juillerat Van der

doi:10.1177/1471301216657270

Cited by 12 publications

(7 citation statements)

References 58 publications

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“…Whilst several of these are trialled in the included studies, more are emerging from new evidence that nearly 600 factors can potentiate the development of AD (Kostoff, Zhang, Ma, Porter, & Buchtel, 2017). This understanding that dementia is multifactorial and determined by mechanisms that interact and intervene throughout life (Van der Linden & Juillerat Van der Linden, 2016) has given rise to the emergence of multimodal approaches to prevention.…”

Section: Introductionmentioning

confidence: 99%

A mixed methods systematic review of multimodal non-pharmacological interventions to improve cognition for people with dementia

2018

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Objective: Multimodal non-pharmacological interventions have been argued to have the potential to complement current pharmacological approaches to improving quality of life for people living with dementia. The aim of this review was to identify, synthesise and appraise the evidence for the effectiveness of multimodal non-pharmacological interventions for improving cognitive function specifically. Method: After a comprehensive search strategy including grey literature, 26 studies were reviewed. The inclusion criteria concerned adults with a primary diagnosis of dementia. Studies used two or more different modes of intervention, and measured a cognitive outcome. Due to differences in the conceptualisations of the term 'multimodal', a typology of modes and methods was developed to facilitate classification of candidate studies. Results: Twenty-one group studies and five case studies were found. Group studies used two or three modes of intervention and multiple methods to implement them. Interventions utilised were cognitive, physical, psychological and psychosocial, nutrition, fasting, gut health, sleep hygiene, stress reduction, detoxification, hormonal health and oxygen therapy. Five individual case studies were found in two separate papers. Each personalised patient treatment utilised in-depth assessments and prescribed up to nine different modes. In 19 (90%) of the 21 group comparisons, participants were reported to have cognitive improvements, stability with their

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Section: Introductionmentioning

confidence: 99%

A mixed methods systematic review of multimodal non-pharmacological interventions to improve cognition for people with dementia

2018

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“…Rather than having a precise neurobiological cause, Alzheimer's and other dementias represent a heterogeneous state, determined by multiple factors and mechanisms that interact and intervene throughout life [5,6]. Reduction of modifiable risks is currently the preferred strategy to reduce future cognitive decline.…”

Section: Dementia Prevention -Current Evidence On Multimodal Non-pharmentioning

confidence: 99%

Personalised Medicine for Dementia: Collaborative Research of Multimodal Non-pharmacological Treatment with the UK National Health Service (NHS)

Chalfont¹,

Simpson²,

Davies³

et al. 2019

obm geriatr

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The dominant narrative around dementia argues that progression cannot be halted or reversed. However, evidence on multimodal non-pharmacological treatments formulated around a 'personalised medicine' approach challenges this view. This paper reviews the current evidence for dementia prevention utilising such treatments and explains the logic of applying personalised medicine. The functional medicine treatment approach to 'root cause' analysis is presented as currently practiced with patients experiencing cognitive decline. We report six case reports including in-depth practitioner evaluations, recommendations and follow-ups. We cover the various presentations of memory and concentration problems and the screening process with advanced functional testing. The case reports appear in a table, followed by 11 key points, insights and findings. To our knowledge, this is the first paper reporting practitioner case reports documenting improvements in symptoms of memory

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“…Altogether, these findings have lead a growing number of authors to suggest that we must free ourselves from the reductionist biomedical conceptualisation of AD and that, instead of imprisoning people in pathologising and stigmatising diagnostic categories, we should reinstate the different expressions of this supposedly specific disease in a broader framework of cerebral and cognitive ageing (see Van der Linden 19 for a detailed presentation of this perspective).…”

Section: A Life-span Plurifactorial View Of Alzheimer's Diseasementioning

confidence: 99%

“…Adopting a perspective that takes into account the variability and complexity of cerebral and cognitive ageing calls for a shift in terms of research objectives and leads to envisaging significant changes with regards to neuropsychological assessment and intervention in clinical practice 26 (see Van der Linden 19 for a more detailed presentation). Explicitly, in terms of research, it now seems essential that more studies be conducted from a perspective that considers cerebral and cognitive ageing as a continuum rather than on a categorical basis 27 .…”

Section: Implications For Research and Clinical Practicementioning

confidence: 99%

A life-span and plurifactorial view of Alzheimer's disease

Linden¹

2017

J Neurol Neuromedicine

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The dominant biomedical position considers Alzheimer's disease (AD) to be intrinsically different from normal ageing and other neurodegenerative diseases and proposes that, by pursuing extensive research on what are considered the specific neuropathological characteristics of AD (i.e., neurotic plaques and neurofibrillary tangles), we will eventually be able to identify the cause of this disease and develop medical treatments that will allow us to successfully cure it. However, results of numerous recent studies go against this essentialist and category-based view and instead suggest that the cognitive, emotional, behavioural, and functional difficulties that some people experience as they grow older are modulated by a myriad of factors and mechanisms that interact throughout the lifespan. Importantly, this alternative way of conceptualising Alzheimer's disease implies a shift of focus in terms of research objectives and calls for significant changes in terms of neuropsychological assessment and intervention in clinical practice.

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A life-course and multifactorial approach to Alzheimer’s disease: Implications for research, clinical assessment and intervention practices

Cited by 12 publications

References 58 publications

A mixed methods systematic review of multimodal non-pharmacological interventions to improve cognition for people with dementia

A mixed methods systematic review of multimodal non-pharmacological interventions to improve cognition for people with dementia

Personalised Medicine for Dementia: Collaborative Research of Multimodal Non-pharmacological Treatment with the UK National Health Service (NHS)

A life-span and plurifactorial view of Alzheimer's disease

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