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As Memory Fades, Emotions Live On

If you have a friend or loved one who has Alzheimer’s disease or a related condition, you might wonder whether the things you do with them have any benefit. “I took Mom out to lunch, and she doesn’t even remember,” sighed one daughter.

But here’s some research that confirms what most caregivers sense: people with Alzheimer’s don’t have to remember an interaction or activity to receive emotional benefit from it.

A study from University of Iowa, published in the journal Cognitive and Behavioral Neurology, showed that caregivers have a profound influence—good or bad—on the emotional state of individuals with Alzheimer’s disease. Even if the person forgets a visit or interaction, the feelings they had during that interaction can have a lasting impact on how they feel.

The researchers showed individuals with Alzheimer’s disease clips of sad and happy movies. The patients experienced sustained states of sadness and happiness, despite not being able to remember the movies. “This confirms that the emotional life of an Alzheimer’s patient is alive and well,” said lead author Edmarie Guzmán-Vélez, who conducted the study with Daniel Tranel, University of Iowa professor of neurology and psychology, and Justin Feinstein, assistant professor at the University of Tulsa and the Laureate Institute for Brain Research.

Tranel and Feinstein published a paper in 2010 that predicted the importance of attending to the emotional needs of people with Alzheimer’s, which is expected to affect as many as 16 million people in the United States by 2050 and cost an estimated $1.2 trillion. “It’s extremely important to see data that support our previous prediction,” Tranel says. “Edmarie’s research has immediate implications for how we treat patients and how we teach caregivers.”

Despite the considerable amount of research aimed at finding new treatments for Alzheimer’s, no drug has succeeded at either preventing or substantially influencing the disease’s progression. Against this foreboding backdrop, the results of this study highlight the need to develop new caregiving techniques aimed at improving the well-being and minimizing the suffering for the millions of individuals afflicted with Alzheimer’s.

For this behavioral study, Guzmán-Vélez and her colleagues invited 17 patients with Alzheimer’s disease and 17 healthy comparison participants to view 20 minutes of sad and then happy movies. These movie clips triggered the expected emotion: sorrow and tears during the sad films and laughter during the happy ones.

About five minutes after watching the movies, the researchers gave participants a memory test to see if they could recall what they had just seen. As expected, the patients with Alzheimer’s disease retained significantly less information about both the sad and happy films than the healthy people. In fact, four patients were unable to recall any factual information about the films, and one patient didn’t even remember watching any movies.

Before and after seeing the films, participants answered questions to gauge their feelings. Patients with Alzheimer’s disease reported elevated levels of either sadness or happiness for up to 30 minutes after viewing the films, despite having little or no recollection of the movies.

Quite strikingly, the less the patients remembered about the films, the longer their sadness lasted. While sadness tended to last a little longer than happiness, both emotions far outlasted the memory of the films.

The fact that forgotten events can continue to exert a profound influence on a patient’s emotional life highlights the need for caregivers to avoid causing negative feelings and to try to induce positive feelings.

“Our findings should empower caregivers by showing them that their actions really do matter,” says Guzmán-Vélez. “Frequent visits and social interactions, exercise, music, dance, jokes, and serving patients their favorite foods are all simple things that can have a lasting emotional impact on a patient’s quality of life and subjective well-being.”

Source: University of Iowa Healthcare, adapted by IlluminAge AgeWise.