Authored by Noah Goodman
Art by Jenny Li
Every year, Alzheimer’s rates soar to new heights — with a projected 13 million patients by 2050 [1]. Thus, it is necessary that supportive programs be implemented for this growing population. The disease causes the destruction of brain tissue, making many previously learned cognitive tasks difficult to complete [2]. Therefore, the introduction of relearning programs for Alzheimer’s patients could serve immense benefits. Meanwhile, an innovative and well-known program, Head Start, has shown tremendous results in improving the cognitive development of young children [3]. Given Head Start's effectiveness in promoting the development of immature brains, it is reasonable to infer that a similar educational program could produce similarly beneficial outcomes for Alzheimer’s patients.
Such a program could promote the recovery of lost neural connections. Alzheimer’s disease leads to the destruction of synapses — gaps between neurons in which information is chemically exchanged. Early childhood programs like Head Start have proven to be crucial in directing the neural connectivity process in immature brains, which have yet to develop an abundance of their synaptic connections [4, 5]. In addition, brain training games have been used to improve cognitive mechanisms in Alzheimer's patients, suggesting the possibility of neural pathway regeneration [6]. Therefore, a formal educational program similar to Head Start could provide an appropriate method of neural pathway stimulation in Alzheimer’s patients, potentially sparking neuronal regenesis and connectivity.
Furthermore, a learning program could lead to the improvement of memory-based functions in Alzhiemer’s patients. Damage to medial temporal lobes causes the characteristic semantic and working memory troubles seen in individuals with the disease [7, 8, 9] and also contributes to issues with spatial place learning [10]. Similar problems with memory and spatial place learning are seen in children under five years old [11. 12]. For such children, the Head Start program has yielded an increase in working memory function [13], long term memory consolidation, and spatial awareness [14, 15]. Therefore, the Head Start program provides tremendous contributions to temporal lobe development. In addition, the working memory functioning of Alzheimer's affected brains has shown a tendency to increase upon the introduction of chunking teaching techniques, implying that proper stimulation of the temporal lobe can lead to remarkable progress [16]. Due to this apparent plasticity of the Alzheimer’s temporal lobe as well as its functional similarities to that of Head Start participants, it seems that an educational program similar to Head Start could help patients recover and maintain past memories.
Moreover, a structured teaching program could improve the executive functioning of patients. Alzheimer’s disease often leads to frontal lobe damage, causing issues with attention, decision making, planning, motivation, and inhibitory control [17]. These same troubles are often encountered by children due to the fairly undeveloped nature of their frontal lobes. For such children, Head Start participation is linked to increases in attention span, inhibitory control, mathematical competency, and thus overall frontal lobe development [18, 19]. In addition, studies have shown that proper frontal lobe stimulation can lead to cognitive improvements in Alzheimer’s patients [20]. Therefore, implementing a program that offers patients with adequate frontal lobe neuronal incitement could lead to improved competencies similar to those seen in Head Start children.
Finally, a program similar to Head Start could offer socioemotional benefits to Alzheimer's patients. Due to damage caused to the frontal and temporal lobes, many Alzheimer’s patients experience troubles in socioemotional functioning [21]. Similar difficulties are common among Head Start participants, who oftentimes lack support systems at home. For such children, participation in Head Start programs is associated with lower aggression levels [22], more positive approaches to learning [22], and overall increases in socioemotional functioning [14]. Furthermore, research has shown that cognitive stimulation can improve emotional symptoms and social interactions in Alzheimer’s patients [23]. Therefore, an interactive, stimulative, and educational program could provide extensive socioemotional benefits to Alzheimer’s patients.
This discussion raises the question: what exactly would the framework of a program similar to Head Start look like if it were geared towards an audience of Alzheimer’s patients? The resounding answer is: structurally similar to the program given to the older range of children covered by Head Start, but with a stronger emphasis on mathematical competence, reading comprehension, memory consolidation, and attention retaining skills. In turn, lessons in Head Start that specifically prepare children for schooling would be dropped. In addition, it may be beneficial to incorporate physical activities into lesson plans for Alzheimer’s patients. A multitude of research supports this claim, linking physical exercise to increases in overall cognitive function, neurocognitive performance, visual memory recognition, and physical fitness in Alzheimer’s patients [24, 25, 26, 27]. Further research must be completed to determine the level of difficulty and strenuosity required for the program, although these factors would likely vary on a case-by-case basis anyways. Another important point to consider is that the relearning process is generally faster than the learning process, suggesting the potential for a faster-paced lesson plan than that of Head Start — although there is not adequate research to suggest that this principle applies as well for Alzheimer’s patients.
Overall, the effectiveness of the Head Start program supports the need for the introduction of similar programming on a systemic level for Alzheimer’s patients. Although structurally and fundamentally similar to that of Head Start, the curriculum for this program would have to undergo rounds of building, testing, analyzing, reviewing, and editing before further details can be extrapolated regarding the specifics of its optimal composition.
Works Cited
Alzheimer's Facts and Figures Report. (n.d.). Alzheimer's Association. Retrieved September 23, 2023, from https://www.alz.org/alzheimers-dementia/facts-figures
What Is Alzheimer's Disease? | National Institute on Aging. (2021, July 8). National Institute on Aging. Retrieved September 23, 2023, from https://www.nia.nih.gov/health/what-alzheimers-disease
Puma, M., Bell, S., Cook, R., Heid, C., Shapiro, G., Broene, P., Jenkins, F., Fletcher, P., Quinn, L., Friedman, J., Ciarico, J., Rohacek, M., Adams, G., & Spier, E. (2010). Head Start Impact Study Final Report. U.S Department of Health and Human Services Administration for Children and Families. https://files.eric.ed.gov/fulltext/ED507845.pdf
Alzheimer's Disease Fact Sheet | National Institute on Aging. (2023, April 5). National Institute on Aging. Retrieved September 23, 2023, from https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet
Brain Development. (n.d.). First Things First. Retrieved September 23, 2023, from https://www.firstthingsfirst.org/early-childhood-matters/brain-development/
Ning, H., Li, R., Ye, X., Zhang, Y., & Liu, L. (2020, May 28). A Review on Serious Games for Dementia Care in Ageing Societies. IEEE Journal of Translational Engineering in Health and Medicine. Retrieved September 23, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7279699/
Schwab, S., Afyouni, S., Chen, Y., Han, Z., Guo, Q., Dierks, T., Wahlund, L. O., & Grieder, M. (2020, August 18). Functional Connectivity Alterations of the Temporal Lobe and Hippocampus in Semantic Dementia and Alzheimer’s Disease. Journal of Alzheimer's Disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7504988/
Flores, R. d., Das, S. R., Xie, L., Wisse, L. E. M., Lyu, X., Shah, P., Yushkevich, P. A., & Wolk, D. A. (2022, March 9). Medial Temporal Lobe Networks in Alzheimer's Disease: Structural and Molecular Vulnerabilities. Journal of Neuroscience. https://doi.org/10.1523/JNEUROSCI.0949-21.2021
Heerema, E. (2022, May 29). How Working Memory Is Affected by Alzheimer's Disease. Verywell Health. Retrieved September 23, 2023, from https://www.verywellhealth.com/working-memory-and-alzheimers-98572
Silva, A., & Martinez, M. C. (2023, January 12). Spatial memory deficits in Alzheimer’s disease and their connection to cognitive maps’ formation by place cells and grid cells. Frontiers in Behavioral Neuroscience. 10.3389/fnbeh.2022.1082158
Menon, V., Boyett-Anderson, J.M., & Reiss, A.L. (2005, September). Maturation of medial temporal lobe response and connectivity during memory encoding. Cognitive Brain Research, 25(1). https://www.sciencedirect.com/science/article/pii/S092664100500193X
Townsend, E. L., Richmond, J. L., Vogel-Farley, V. K., & Thomas, K. (2010, September 1). Medial temporal lobe memory in childhood: Developmental transitions. Dev Sci, 13(5), 738-751. 10.1111/j.1467-7687.2009.00935.x
Hattie A. Harvey & Gloria E. Miller (2017) Executive Function Skills, Early Mathematics, and Vocabulary in Head Start Preschool Children, Early Education and Development, 28:3, 290-307, DOI: 10.1080/10409289.2016.1218728
Bierman, K., Nix, R., Greenberg, M., Blair, C., & Domitrovich, C. (2008). Executive functions and school readiness intervention: Impact, moderation, and mediation in the Head Start REDI program. Development and Psychopathology, 20(3), 821-843. doi:10.1017/S0954579408000394
Math Learning Trajectories: Spatial Awareness | ECLKC. (2019, February 22). ECLKC. Retrieved September 23, 2023, from https://eclkc.ohs.acf.hhs.gov/school-readiness/article/math-learning-trajectories-spatial-awareness
Huntley JD, Hampshire A, Bor D, Owen A, Howard RJ. Adaptive working memory strategy training in early Alzheimer's disease: randomized controlled trial. Br J Psychiatry. 2017 Jan;210(1):61-66. doi: 10.1192/bjp.bp.116.182048. Epub 2016 Oct 6. PMID: 27758836; PMCID: PMC5209631.
456LP Dementia and the brain. (n.d.). Alzheimer's Society. Retrieved September 23, 2023, from https://www.alzheimers.org.uk/sites/default/files/2019-05/456lp-dementia-and-the-brain-190521.pdf
Why Head Start. (n.d.). Utah Head Start Association. Retrieved September 23, 2023, from https://www.uhsa.org/Why-Head-Start
Choi, J. Y., Jeon, S., & Lippard, C. (2018). Dual language learning, inhibitory control, and math achievement in Head Start and kindergarten. Early Childhood Research Quarterly, 42, 66-78. https://doi.org/10.1016/j.ecresq.2017.09.001
Chang CH, Lane HY, Lin CH. Brain Stimulation in Alzheimer's Disease. Front Psychiatry. 2018 May 22;9:201. doi: 10.3389/fpsyt.2018.00201. PMID: 29910746; PMCID: PMC5992378.
Nash, S., Henry, J. D., Mcdonald, S., Martin, I., Broadaty, H., & Peak-O'Leary, M.-A. (2007). Cognitive disinhibition and socioemotional functioning in Alzheimer’s disease. Journal of the International Neuropsychological Society, 1060-1064. 10.10170S1355617707071184
Head Start Advantage: Children's Social-Emotional Development. (n.d.). National Head Start Association. Retrieved September 23, 2023, from https://nhsa.org/resource/head-start-advantage-social-emotional-development/
Chapman, S. B., Weiner, M. F., Rackley, A., Hynan, L. S., & Zientz, J. (2004, October 1). Effects of Cognitive-Communication Stimulation for Alzheimer’s Disease Patients Treated With Donepezil. Journal of Speech, Language, and Hearing Research, 47(5). https://doi.org/10.1044/1092-4388(2004/085)
Vreugdenhil, A., Cannell, J., Davies, A. and Razay, G. (2012), A community-based exercise programme to improve functional ability in people with Alzheimer’s disease: a randomized controlled trial. Scandinavian Journal of Caring Sciences, 26: 12-19. https://doi.org/10.1111/j.1471-6712.2011.00895.x
Smith PJ, Blumenthal JA, Hoffman BM, Cooper H, Strauman TA, Welsh-Bohmer K, Browndyke JN, Sherwood A. Aerobic exercise and neurocognitive performance: a meta-analytic review of randomized controlled trials. Psychosom Med. 2010 Apr;72(3):239-52. doi: 10.1097/PSY.0b013e3181d14633. Epub 2010 Mar 11. PMID: 20223924; PMCID: PMC2897704.
Ruthirakuhan M, Luedke AC, Tam A, Goel A, Kurji A, Garcia A. Use of physical and intellectual activities and socialization in the management of cognitive decline of aging and in dementia: a review. J Aging Res. 2012;2012:384875. doi: 10.1155/2012/384875. Epub 2012 Dec 31. PMID: 23365752; PMCID: PMC3549347
Rolland, Y., Pillard, F., Klapouszczak, A., Reynish, E., Thomas, D., Andrieu, S., Rivière, D. and Vellas, B. (2007), Exercise Program for Nursing Home Residents with Alzheimer's Disease: A 1-Year Randomized, Controlled Trial. Journal of the American Geriatrics Society, 55: 158-165. https://doi.org/10.1111/j.1532-5415.2007.01035.x