[Non-drug alternatives in Alzheimer disease]

Profiles of cognitive deficits in Alzheimer patients are often heterogenous and can vary considerably from one patient to another. Studies published in the last 10 years have shown that improvement of cognitive functioning is possible in these patients. A detailed neuropsychological exam is necessary to evaluate not only disturbed functions but also preserved areas and factors which could help to improve performance. These elements, which are also part of the diagnostic procedure, are necessary to put the deficit into its context, and to propose specific methods of therapy. The aim of this therapy is to insure optimal performances at each stage of the disease. The strategies employed vary and have to be adapted to each patient and the therapy goals but they almost always make the involvement of a family member necessary, to ensure that the acquired strategies are used systematically in everyday life. In view of the importance of the social problems connected with dementia, more research is necessary to develop techniques of intervention which lead to an improvement of impaired cognitive functioning.