University of California, Davis Geriatric Psychiatrist Helen C. Kales is the co-creator of the DICE Approach (describe, investigate, create and evaluate), a method that helps caregivers assess and manage dementia-related behaviors. Photo courtesy of UC Davis Health

SACRAMENTO REGION, CA (MPG) - New research published in The Lancet as part of its Alzheimer’s Disease Series outlines strategies for integrating emerging and existing approaches for treating Alzheimer’s disease. The Lancet is a weekly peer-reviewed general medical journal, founded in 1823.

Forty international experts contributed to this three-part series. University of California, Davis Geriatric Psychiatrist Helen C. Kales is the only U.S. psychiatrist among this expert group and is a co-author of the new paper.

“Our findings underscore the urgent need to bring evidence-based, person-centered care into real-world dementia settings,” Kales said. “We need to prioritize non-pharmacological strategies and caregiver support while thoughtfully incorporating new disease-modifying therapies for dementia, such as lecanemab and donanemab.”

Kales is the chair of the UC Davis Department of Psychiatry and Behavioral Sciences and the Joe P. Tupin Professor of Psychiatry. She is the co-creator of the DICE Approach (describe, investigate, create and evaluate), a method that helps caregivers assess and manage dementia-related behaviors.

Developing customized integrative treatment plans for Alzheimer’s patients

The key findings in The Lancet paper include more than 90 percent of individuals with Alzheimer’s disease experience behavioral and psychological symptoms (BPSD), such as agitation, depression and psychosis.

Non-pharmacological approaches such as the DICE Approach, which consists of personalized activities and caregiver training, are often more effective and safer than psychotropic drugs yet remain underused.

Medical professionals should recognize cases when psychotropic drugs are needed for the treatment of behavioral and psychological symptoms. Still, they should use the drugs cautiously and follow clear guidelines.

Anti-amyloid monoclonal antibodies (donanemab and lecanemab) represent a historic shift in Alzheimer’s treatment, slowing cognitive decline for the first time; however, the drugs raise complex questions about eligibility, safety and long-term impact.

Combining symptomatic treatments (such as cholinesterase inhibitors and memantine) with disease-modifying therapies might offer additive benefits, although more research is needed.

Forty international experts contributed to this three-part series. Photo courtesy of UC Davis Health

The study also presented strategic recommendations, including the support of infrastructure development for Alzheimer’s disease biomarker testing and access to brain scans and funding caregiver training and non-pharmacological programs in both community and institutional settings.

The study also recommends establishing registries to monitor real-world outcomes and safety, prioritizing equitable access through pricing models, public funding and global partnerships and engaging in public dialogue about the societal value of investing in Alzheimer’s care.

“By integrating emerging therapies with proven care strategies, supporting caregivers and ensuring that innovation translates into improvements in our patients’ lives, we can make meaningful progress in the diagnosis and treatment of this disease,” Kales said.