General measures
- Nicotine restriction (refraining from tobacco use).
- Alcohol abstinence (refrain from alcohol consumption).
- Preservation of normal weight strive!Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program or program for underweight.
- BMI ≥ 25 → participation in a medically supervised weight loss program.
- Falling below the BMI lower limit from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight.
- Review of permanent medication due topossible effect on the existing disease.
- Avoidance of psychosocial stress:
- Psychosocial stressors that lead to cognitive overload.
Vaccinations
The following vaccinations are advised:
- Pneumococcal vaccination
- Flu vaccination
Regular checkups
- Regular medical checkups
Nutritional medicine
- Nutritional counseling based on nutritional analysis
- Even in advanced dementia, do not tube feed via percutaneous endoscopic gastrostomy (PEG; endoscopically placed artificial access from the outside through the abdominal wall into the stomach). Instead, help patients eat and hand feed them.Tube feeding makes patients agitated and increases the need for restraints such as physical restraint or administration of appropriate medications.Hand feeding has no disadvantages in terms of aspiration (in this case, inhalation of food during breathing), pneumonia (pneumonia), and mortality (death rate).
- Dietary recommendations according to a mixed diet taking into account the disease at hand. Meaning:
- A total of 5 servings of fresh vegetables and fruits daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruits).
- Fresh sea fish once or twice a week, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerelNote: Low consumption of fruits, vegetables, fish and omega-3 rich oils leads to an increased risk of dementia and Alzheimer’s disease in non-ApoE subjects.
- High-fiber diet (whole grains).
- Observance of the following special dietary recommendations:
- Avoid saturated or trans-saturated fats (the fats are found in margarine, for example).
- Diet rich in:
- Vitamins (B1, folic acid, C)
- Minerals (magnesium)
- Trace elements (chromium, copper, selenium, zinc)
- Omega-3 fatty acids (marine fish)
- Acetyl L-carnitine; coenzyme Q10, phosphatidyl serine.
- Selection of appropriate food based on the nutritional analysis
- See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
- Detailed information on nutritional medicine you will receive from us.
Sports Medicine
- Endurance training (cardio training) and strength training (muscle training).
- An intervention study of 18 people without cognitive impairment and 17 people with mild cognitive impairment (MCI); all were between 61 and 88 years of age) demonstrated that exercise improves memory and language skills. Participants in this study exercised regularly in the aerobic zone for twelve weeks. Neuropsychological assessments were performed at the beginning and end of the study, among others. The results were positive. CONCLUSION: The results show that incipient dementia can be positively influenced by physical activity; however, further studies are needed.
- Preparation of a fitness or training plan with suitable sports disciplines based on a medical check (health check or athlete check).
- Detailed information on sports medicine you will receive from us.
Psychotherapy
- Psychosocial procedures/measures according to S3 guideline: psychosocial therapies for severe mental illness.
- Self-management as part of coping with the illness; in this context also references to self-help contact points.
- Individual interventions
- Psychoeducational intervention to increase knowledge of the disease.
- Training of everyday and social skills
- Artistic therapies
- Occupational therapy – work or occupational therapy.
- Movement and sports therapies
- Health promotion interventions
- Ambulatory psychiatric care (APP) as assistance in times of crisis.
- Cognitive training procedures
- Occupational therapy (in the early phase of the disease): improving quality of life and possibly slowing physical decline.
- Detailed information on psychosomatics (including stress management) can be obtained from us.
