Alzheimer’s Disease and Reality Orientation Therapy

About this course

Alzheimer’s disease is an irreversible neurological disorder that likely develops from multiple factors such as genetics, lifestyle, and environment. The success of Alzheimer’s disease treatment is dependent on early diagnosis, monitoring for disease progression, treatment modalities, and the presence of other medical conditions. This course provides an overview of Alzheimer’s disease, diagnosis, treatment options, and an introduction to reality orientation to help slow cognitive decline.

Learning objectives

• Define Alzheimer’s disease
• Describe medical tests commonly used to aide in the diagnosis of Alzheimer’s disease
• Review medications commonly used to treat Alzheimer’s disease
• Describe the stages of mild cognitive impairment as they relate to Alzheimer’s disease
• Understand the common forms of Reality Therapy

Course outline

14 sections · finish in any order across devices

1. 1

   Introduction

   Alzheimer’s disease (AD) is an irreversible neurologic disorder that causes the brain to shrink and brain cells to die. The brain will shrink to some degree with aging, but it usually does not lose neurons in large numbers. In Alzheimer’s disease, many neurons stop functioning because of losing conn

   4 min

2. 2

   Neuron Function

   The healthy brain consists of billions of neurons that connect with each other to send messages between different parts of the brain, and from the brain to the muscles and organs of the body. The healthy brain will usually shrink with age progression, but it does not typically lose neurons in large

   4 min

3. 3

   Diagnosis

   Early diagnosis of AD is always best so that treatment can be initiated, behavioral symptoms can be treated, and lifestyle changes can be modified to slow disease progression.6

   4 min

4. 4

   Medical Tests to Diagnose Alzheimer’s Disease

   There is no single diagnostic approach to follow to diagnose Alzheimer's disease.9 The standard for the diagnosis of mild cognitive impairment (MCI), as well as for dementia, is a structured history focused on cognitive and functional changes and corroboration from a person familiar with the person

   4 min

5. 5

   Characteristics

   Neurological exam

   4 min

6. 6

   Preclinical (Presymptomatic)

   In the preclinical stage, a person may have nerve cell changes that cause very mild symptoms; however, family and friends may be acutely aware of the symptoms. People in this stage will have diagnostic evidence of having AD.8 Common symptoms in this stage include: 7

   4 min

7. 7

   Mild Cognitive Impairment

   The mild cognitive impairment (MCI) stage is typically the longest stage and can last for many years. In this stage, a person will have impairment in either memory or nonmemory domains, such as executive ability or language function. Initially these individuals may continue to work, socialize, and f

   4 min

8. 8

   Dementia

   In the dementia stage, symptoms are severe, and a person will have incapacitating memory impairment. They will lose the ability to carry on a conversation, respond to their environment, and will eventually lose control of their body movements.8

   4 min

9. 9

   Characteristics

   Donepezil

   4 min

10. 10

    Partial N-Methyl D-Aspartate

    Partial N-Methyl D-Aspartate receptor (NMDAR) antibody encephalitis is believed to have a dominant role in the pathophysiology of AD.13 NMDAR stimulation results in calcium influx, which activates signal transduction, and consequently, triggers gene transcription that is essential for the formation

    4 min

11. 11

    Reality Orientation Therapy

    Reality Orientation (RO) therapy was first described as a technique to improve the quality of life of confused elderly people.16 Reality Orientation involves presenting orientation and memory information relating to time, place, and person. This type of therapy is thought to provide an individual wi

    4 min

12. 12

    Immersive 24-Hour Therapy

    People who live in a dedicated facility, like a memory care unit of assisted living or a skilled nursing facility may receive 24-hour therapy. 16 In this type of therapy, current date, time, location, and current events are emphasized with every interaction a healthcare professional has with them. H

    4 min

13. 13

    Classroom Therapy

    Classroom therapy means individuals attend group sessions to engage in orientation-related activities. These sessions last about 30 minutes and meet once or twice a day. The “reality orientation board” is often a focus in the classroom setting. This board displays the date, day of the week, weather,

    4 min

14. 14

    Conclusion

    Alzheimer’s disease is an irreversible neurological disorder that likely develops from multiple factors such as genetics, lifestyle, and environment. The success of Alzheimer’s disease treatment is dependent on early diagnosis, monitoring for disease progression, treatment modalities, and the presen

    4 min

This course satisfies

Requirement summaries come from our state requirement records. Always confirm details with your board before you renew.

References and resources

• Alzheimer's Association. On the Front Lines: Primary Care Physicians and Alzheimer’s Care in America.; 2020. https://www.alz.org/media/Documents/alzheimers-facts-and-figures.pdf
• Bello AM, Olalekan SK, Azizah U, et al. Alzheimer’s Disease: An Update and Insights Into Pathophysiology. Frontiers in Aging Neuroscience. 2022;14. Accessed August 1, 2022. https://www.frontiersin.org/articles/10.3389/fnagi.2022.742408
• CDC. What is alzheimer’s disease? | CDC. www.cdc.gov. Published June 2, 2020. https://www.cdc.gov/aging/aginginfo/alzheimers.htm#:~:text=Alzheimer
• Alzheimer’s disease: Symptoms, stages, causes, and treatment. www.medicalnewstoday.com. https://www.medicalnewstoday.com/articles/159442#stages
• 2022 Alzheimer’s disease facts and figures. Alzheimer’s & Dementia. 2022;18(4). doi:10.1002/alz.12638
• Kerwin D, Abdelnour C, Caramelli P, et al. Alzheimer’s disease diagnosis and management: Perspectives from around the world. Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring. 2022;14(1). doi:10.1002/dad2.12334
• https://www.facebook.com/NIHAging. Alzheimer’s Disease Diagnostic Guidelines. National Institute on Aging. Published 2011. https://www.nia.nih.gov/health/alzheimers-disease-diagnostic-guidelines
• Anil Kumar, Tsao JW. Alzheimer Disease. Nih.gov. Published August 18, 2019. https://www.ncbi.nlm.nih.gov/books/NBK499922/
• Medical Tests. Alzheimer’s Disease and Dementia. Published 2020. https://www.alz.org/alzheimers-dementia/diagnosis/medical_tests#:~:text=Genetics%20and%20Alzheimer
• Neugroschl J, Wang S. Alzheimer’s Disease: Diagnosis and Treatment Across the Spectrum of Disease Severity. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine. 2011;78(4):596-612. doi:10.1002/msj.20279
• 10 Warning Signs of Alzheimer’s. www.cdc.gov. Published December 20, 2019. https://www.cdc.gov/aging/healthybrain/ten-warning-signs.html
• ‌Alzheimer's Association. What Is Alzheimer’s? Alzheimer’s Disease and Dementia. Published 2022. https://www.alz.org/alzheimers-dementia/what-is-alzheimers
• ‌Breijyeh Z, Karaman R. Comprehensive Review on Alzheimer’s Disease: Causes and Treatment. Molecules. 2020;25(24):5789. doi:10.3390/molecules25245789
• ‌Silva MVF, Loures C de MG, Alves LCV, de Souza LC, Borges KBG, Carvalho M das G. Alzheimer’s disease: risk factors and potentially protective measures. Journal of Biomedical Science. 2019;26(1). doi:10.1186/s12929-019-0524-y
• ‌Camargo CHF, Justus FF, Retzlaff G. The Effectiveness of Reality Orientation in the Treatment of Alzheimer’s Disease. American Journal of Alzheimer’s Disease & Other Dementiasr. 2015;30(5):527-532. doi:10.1177/1533317514568004
• ‌Spector A, Davies S, Woods B, Orrell M. Reality Orientation for Dementia. The Gerontologist. 2000;40(2):206-212. doi:10.1093/geront/40.2.206‌
• Chiu HY, Chen PY, Chen YT, Huang HC. Reality orientation therapy benefits cognition in older people with dementia: A meta-analysis. International Journal of Nursing Studies. 2018;86:20-28. doi:10.1016/j.ijnurstu.2018.06.008

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