For decades, scientists have searched for a cure or treatment for Alzheimer’s disease. Over the past thirty years they have run 400 clinical trials on 200 drugs. Of that 200, just one obtained FDA approval, yet neither it nor any other drug has proven to be effective in preventing, inhibiting, or curing the disease. The best modern medicine can do is prescribe drugs like Cholinesterase inhibitors and Memantine, both of which have limited efficacy. In the meantime, the world spends more than $800 billion annually on care. In the US, dementia is the nation’s sixth leading cause of death, and caring for sufferers costs nearly $300 billion a year. Doctors expect that the death tolls will increase significantly in the coming decades because the number of patients with Alzheimer’s disease and other forms of dementia is set to grow rapidly due to people living longer.
Apart from the devastating physical toll, most patients with any form of dementia suffer from anxiety and depression, and this dementia related anxiety and depression are not confined just to the patient. A recent study showed that they also adversely affect the patient’s family members, close friends, and sometimes the patient’s professional caregivers. This situation is further aggravated by the fact that people can suffer from dementia for extended periods of time. Alzheimer’s survival rates vary from five to twenty years, according to Neil Buckholtz, PhD, chief of the National Institute on Aging’s dementia branch. Various anti-depressant and anxiolytic medications are used to attempt to treat those conditions. Like most pharmaceutical remedies, however, they don’t work equally well for everyone and often produce unpleasant side effects.
An entirely different approach to dealing with patient’s depression and anxiety, which doesn’t involve medication, shows promising results. Since the 1970s, doctors caring for Alzheimer and dementia patients have known that helping them reminisce on positive and pleasant aspects of their earlier lives eases the severity of the depression and anxiety. In addition to improving their psychological wellbeing, this kind of reminiscing also helps improve their cognitive abilities, though these improvements are small. For many years, doctors tested a number of variations of this therapeutic approach in order to establish the most effective and structure way to apply it. This led to the creation of a new type of therapy aimed at reducing the psychological distress associated with dementia and other illnesses without the use of pharmaceuticals. This therapy is called Reminiscence Therapy (RT) and, though it has been around for over 40 years, has become especially popular in recent years.
Reminiscence Therapy (RT)
In the case of dementia patients, RT usually involves members of the family and old friends compiling a stock of items from the patient’s past like photos, cards, documents, letters, music recordings, etc. that are likely to stimulate good memories in the patient’s mind – a kind of scrapbook, although it could also sometimes contain solid objects like ornaments and books, in which case it could be called a scrap box. It doesn’t really matter which mementoes are in the box as long as they’re not too awkward to handle and that they stimulate good memories from the distant past. In fact, they’re more likely to do that because the areas of the brain that stores older memories are the last to be damaged in dementia patients.
Along with long-term memory, many patients retain vital skills until late in the disease. These can include, for example, the ability to sing, read, tell stories, and even dance. The reason is that these skills and habits were learned early in life. Capitalizing on this characteristic through reminiscence therapy by, for example, singing along with the patients, reading stories with them, or even dancing with them, enables many patients to have a better quality of life as the disease progresses than would otherwise be the case. Since each patient is different, this approach may work with some, but not with others. It’s a matter of trial and error.
People not very familiar with dementia are often surprised to discover that their loved ones can recall events and even skills from decades earlier, but they may not remember what happened yesterday or last week. Indeed, they sometimes become agitated when they try to. The agitation gently floats away when they’re immersed in the comfort of RT and are reliving good memories and experiences from past decades.
When RT is administered as intended, it can be an outstanding success. Before and after tests demonstrate that it potentially benefits anyone suffering from dementia related depression, but the best results were noted in patients with the most severe depression. The test showed that while most patients experienced a reduction in depression they also showed marked improvements in general psychological wellbeing, ego integrity, social integration and cognitive performance. Furthermore, analysis of the therapy’s effects found no difference in its success between male and female participants. Overall, RT it is a relatively inexpensive, non-invasive, non-drug related treatment that has proven results.
RT helps dementia patients in any situation, but it is particularly helpful at easing the stress caused by moving from one living environment to another, for example, when the patient has to leave their own home to go to a care facility. Moving house is stressful even for young healthy people. For old people with dementia it can be especially traumatic. Placing some of their own well-loved items in the new location in advance and engaging in RT sessions before and after they move helps reduce the anxiety.
In terms of specific proven results, universities and medical schools all over the world have run studies on RT and backed up the existing studies that showed its effectiveness in reducing depression and improving cognitive ability. A recent study carried out by the Faculty of Psychology at the University of Valencia, Spain, for example, reported that “the treatment group significantly improved their depressive symptoms and self-acceptance, positive relations with others, autonomy, and environmental mastery.” The Spanish report concluded that integrated RT improved psychological well-being and was an effective intervention in people with dementia.
The Downsides of RT
Reminiscence therapy has one significant drawback. It is labor and time intensive particularly for family members. First, working with the help of the patient, the family members must assemble the items from the patient’s past. This requires time and dedication. Second, the paraphernalia have to be kept somewhere convenient – not all nursing homes have appropriate storage facilities. Third, they have to be stored in a handy format that allows new items to be added when necessary and fourth, someone – a member of the family, therapist, or close friend – must sit and engage with the patient, at least sometimes, while he or she goes through the reminiscing process. For this procedure to work well it needs to be ongoing and frequent. That puts a lot of pressure on the family members and friends who agree to participate. After initial enthusiasm, it’s not unusual for some to drop out over time.
While it is possible to offer a version of RT in a group setting, thus getting more productivity from each therapist or leader, customized therapy that targets one patient at a time is more effective for many patients. The one-to-one sessions with a family member or friend are ideal, but are not always possible or practical. That means that some families give up the practice or have to employ therapists to do the work in their place. Up until now, that involves higher costs for the patient and the patient’s family, meaning that not everyone who might benefit from it could afford it. That changed recently when a new player entered the stage: digital technology.
Technology Rides to the Rescue
Three years ago, San Diego based publicly-traded digital therapeutics company, Dthera Science, was launched. (Digital therapeutics refers to systems of healing and treatment based on digital technology.) The company’s purpose is to develop digital therapies that improve quality-of-life and reduce anxiety in people with dementia and/or who suffer from isolation. To this end, it designs and develops innovative digital therapies for neurodegenerative diseases and oncology.
The company’s current lead product, ReminX, uses artificial intelligence (AI) to streamline how RT is structured and delivered, so that the conventional difficulties associated with it are largely eliminated. In practical terms, that means that the patient’s family members, therapists, or nursing home personnel no longer have to worry about where to store the patient’s mementos, how to add new mementos, who to put in charge of the process, or how to ensure regular RT sessions take place. In other words, what used to be a labor-intensive activity becomes plain sailing.
ReminX – How the System Works
To easier understand the ReminX system, it’s useful to think of it as having three parts. The first part is an app, which family members install on their smartphones. The second part is a custom ReminX tablet computer, which the patient keeps. The third part is what happens behind the scenes in the cloud.
Family members independently source material and upload it through the app. Using the app is largely intuitive, but it has a smart digital assistant at hand if needed. The material uploaded can be any kind of digitized data: documents, photos, videos, sound files, etc. even personal audio or video messages. Family members can upload material whenever they wish, and they don’t have to meet other participants and can do it from anywhere. The system then generates narratives from the uploaded content and delivers them directly to the patient’s tablet. The digital data is cloud stored so the patient can access it anytime from anywhere. When it’s not being used, the ReminX tablet sits in a neat docking/charging unit. It starts playing stories only when the patient picks it up. It couldn’t be simpler to use. It has no confusing buttons or controls, and it plays automatically.
The key to ReminX’s success is its ease of use and relatively low price – around $39 per month per family. It streamlines the traditional RT process and removes the burden on individual family members to act as memento curators because the system curates itself. Thus, the system ensures a higher participation rate of family members and friends, as well as a much lower drop-out rate of such participants.
Conventional RT reduces depression and helps improve cognition in dementia patients. In the process, it reduces or eliminates the use of anti-depression medication with the associated cost savings and side-effects. But, as mentioned, conventional RT is problematic. Now digital therapy in the form of ReminX eliminates those problems. It’s a win-win situation for patients, their families, friends, and caregivers.
For investors who get in at these early stages, Dthera Science promises big returns with low risk. And it’s likely to pay more than just monetary dividends. Investors gain a second dividend: they help bring a smile to the faces of fellow human beings at the most vulnerable stage of their lives. You could call it a solid investment with an ethical bonus. And you don’t come across that kind every day.
Very bullish, $2.50 in the coming 12 months is how we see it.
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