Can computers help to minimize psychotropic drug usage?

Cost effective, therapeutic modalities that provide non-pharmacological alternatives for the management of the behavioral symptoms associated with dementia are gaining more prominence as the Center for Medicare Advocacy calls for the reduction in the use of anti-psychotic medications.

The Center explains that its rationale for reducing the use of these medications includes not only the soaring financial costs of pharmacologic treatments, but also the increased morbidity and mortality rates associated with the inappropriate use of antipsychotic medication. Additionally cited is that such misuse has led to an increase in falls and hip fractures as well as higher incidences of urinary incontinence.

Senior living communities are realizing the benefits of using technology — specifically, computers and the Internet — to provide their residents with cognitive and social engagement activities that enhance well-being, stimulate the mind and minimize the need for behavioral medication interventions.
Computer technology that is easily accessible and includes features that consider the needs of elders while removing usability barriers allows residents to become more socially connected. This may be orchestrated via various social media outlets, email and video chat.

Beyond opportunities for interpersonal communication, computer and Internet use provide residents and senior living community staff members with a variety of content that is relevant and meaningful to each individual resident and addresses their unique interests and abilities, thus fulfilling the goal of “person-centered” care.
More importantly, research indicates that computer-based programs designed for those with dementia can improve cognitive performance (Herrera, 2013; Cipriani, 2006) and hinder the progressive decline of cognitive skills in those with Alzheimer’s Disease (Galante, 2007).

A more recent study (Zaccarelli, 2013) revealed that, when engaged in a mentally stimulating computer-based training and social activation program, subjects with Mild Cognitive Impairment, as well as subjects in the initial stages of Alzheimer’s Disease, evidenced improvement in memory and executive functions. All subjects, including those without cognitive impairment, became more confident about their computer use and increased their computer use after their participation in the study.

The referenced researchers point out that computer-based interventions for dementia are advantageous because they can be individualized for the user by designing tasks that support the user’s current cognitive skills and abilities, while improving those aspects of mental functioning that are impaired.
It is this delivery of computer-based mental stimulation via a completely customizable, easily managed suite of activities that enables professionals in senior living communities such as activities directors as well as physical, occupational, speech and music therapists to provide residents with content that entertains, invigorates the brain and promotes life-long learning.

Additionally, such activities offer administrators and therapists a non-pharmacological approach to managing behavior. Whether it be playing music to enhance mood, enabling video chats with loved ones or showing photos that elicit pleasant memories, these computer-assisted exercises may be used as part of a comprehensive treatment plan for older adults with dementia.

  1. C. Herrera, C. Chambon, B.F. Michel, V. Paban, B. Alescio-Lautier. Positive effects of computer-based cognitive training in adults with mild cogitive impairment. Neuropsychologia 50 (2012) 1871-1881
  2. Cipriani G., Bianchetti A., Trabucchi M. Outcomes of a computer-based cognitive rehabilitation program on Alzheimer’s disease patients compared with those on patients affected by mild cognitive impairment. Archives of Gerontology and Geriatrics, Volume 43, Issue 3, November-December 2006, Pages 327-335.
  3. E. Galante, G. Venturini, C.Fiaccadori. Computer-based cognitive intervention for dementia: preliminary results of a randomized clinical trial. Gironale Italiano de Medicina del Lavoro ed Ergonomia, Supplemento B, Psicologia 2007; Vol. 29, N. 3: B26-B32
  4. C. Zaccarelli, G. Cirillo, S. Passuti, R. Annicchiarico, F. Barban. Computer-based cognitive intervention for dementia, Sociable: motivating platform for elderly networking, mental reinforcement and social interaction. PervasiveHealth ’13 Proceedings of the 7th International Conference on Pervasive Computing Technologies for Healthcare 2013 Pages 430-435

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