Psychotherapy with Alzheimer disease patients. A challenge for neuropsychologists.

Cognitive, emotional and behavioral changes are highly interwoven in Alzheimer’s disease, due to progressive ubiquitous neurodegeneration. This complexity falls in the domain of Neuropsychological Therapy. Anosognosia, apathy and amnesia are among the core symptoms of Alzheimer’s disease, and an appropriate treatment should integrate approaches for treating emotional as well as cognitive sequelae of the disease, and involve the patient’s caregivers and families. Differential techniques in dealing with anosognosia depending on severity of deficits will be presented. Increasing the number of pleasant everyday activities has shown to be a central method in the treatment of depression and apathy. The implementation of daily routines, based on intact procedural memory, is discussed as a means to compensate for episodic memory deficits. Finally, working on patient’s biography will be introduced as a means to preserve a feeling of personal identity despite of increasing retrograde memory deficits. Neuropsychological Therapy for patients with Alzheimer’s disease is yet at its starting point. It will successfully develop, if an integration of the various dimensions of the disease is achieved, and if patients are treated in a holistic way