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Plasticity in Early Alzheimer Disease: An Opportunity for Intervention

Hill, Nikki L. MS, RN; Kolanowski, Ann M. PhD, RN, FGSA, FAAN; Gill, David J. MD

doi: 10.1097/TGR.0b013e31821e588e
Alzheimer Disease Cognitive-Communication Interventions

The scientific evidence of plasticity, or the brain's dynamic ability to alter its organization and activation throughout one's lifetime, has increased significantly over the last decade. This analytic review evaluates selected evidence regarding the persistence of plasticity in people with early-stage Alzheimer disease (AD). Functional neuroimaging provides persuasive evidence of plasticity throughout aging as well as the early stages of dementia, including the possibility of a heightened response during the prodromal period of AD. Behavioral outcomes research demonstrates the ability of people with early-stage AD to relearn previously forgotten information or otherwise improve cognitive abilities after a cognition-focused intervention. Both of these bodies of evidence support the existence of compensatory processes at work, even in the presence of dementia-related pathology. This retained ability of the brain to adapt to neurodegenerative disease in an attempt to maintain function may provide a valuable opportunity for intervention, particularly in the prodromal or earliest stages of AD.

School of Nursing, The Pennsylvania State University, University Park (Ms Hill and Dr Kolanowski); and Department of Neurology, PennState Hershey College of Medicine, Hershey, Pennsylvania (Dr Gill).

Correspondence: Nikki L. Hill, MS, RN, School of Nursing, 201 Health & Human Development East, The Pennsylvania State University, University Park, PA 16802 (

Nikki Hill is a John A. Hartford Foundation Building Academic Geriatric Nursing Capacity (BAGNC) Scholar and thanks BAGNC Award Program for its support. Ann Kolanowski acknowledges support from the National Institute of Nursing Research, The National Institutes of Health (NIH), grant R01 NR012242. The National Institute of Nursing Research had no role in the writing of the manuscript or in the decision to submit the manuscript for publication. David Gill acknowledges support from the NIH, grant RO1 AG027771-01A2 and the Michael J. Fox foundation. The NIH and Michael J. Fox Foundation had no role in the writing of the manuscript or in the decision to submit the manuscript for publication.

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

© 2011 Lippincott Williams & Wilkins, Inc.