How To Care For Someone With Dementia

May 16, 2012 by  
Filed under ALZHEIMER'S

LivingSenior - Memory Care Resources

If a person is suffering from dementia they are losing their mental skills that will have an effect on their everyday life. Dementia is a gradually deteriorating condition that be brought about by strokes and if a person suffers from Parkinson’s disease. Also, Alzheimer’s disease is a type of dementia.

Dementia is different in each case, but it leads to memory problems, the ability to think clearly, and problems with daily planning. Depending on the stage of dementia people can function for some time while suffering from it, but since it gradually gets worse they need to be taken care of the more they suffer from it. Here are some tips on how to care for a person that suffers from dementia.

Medication

Since memory loss and forgetfulness is a symptom of dementia, it is important that if a person is on medication for dementia that they continue to take it as prescribed.

Physical activity

Staying physically active is important for anybody that has dementia and it can also give them a feeling if independence.

Eating healthy

You will need to help the person suffering from dementia to eat healthy and give them healthy meals and snacks even if they are not hungry.

Encourage mental activities.

This can help people stay mentally active and more alert by doing such things as crossword puzzles, reading, or playing games.

Daily Routines
 
The more a person with dementia has a clear-cut daily routine, the less confused or frustrated they will be. If there is any change to the routine, you should tell the person beforehand.

Give them their independence.

As long as the person who is suffering from dementia can make their own decisions pertaining to what they would like to eat, what they would like to do with their time and what to wear. These are just a few examples as it still allows them to feel independent.

Have patience.

You must have patience when taking care of someone who has dementia, as things will take longer to do than usual. Never get frustrated with the person, as that will only make them more frustrated as well.

Be there emotionally.

The person with dementia will know what is happening and offering them emotional support can make it easier on them. Listen to their problems and be there for them in a respectful manner. Be there as a helper more than a caregiver and, as much as they can, let them do things and make their own decisions. The more you do things for them that they still believe they have the ability to do the more frustrated they may become.

Safety issues

Make the residence of where the person suffering from dementia safe. This is more of an important issue as the condition becomes gradually worse. Handrails in the bathtub, removing sharp objects, and keeping walkways clear are just a few things you can do to make the residence safer. If the person cannot drive or cook in a safe manner, do not allow them to do these things. Do not move anything or make any drastic changes in the residence, as it may confuse and frustrate the person.

Decide If You Can’t Care For Them Yourself.

It’s understandable when a loved one begins to have trouble caring for someone with dementia. However, there are professional senior living centers where they can reside and be taken care of by professionals who understand their condition

 


Alzheimer’s Disease: Warning Signs, Prevention and Treatment

April 18, 2011 by  
Filed under ALZHEIMER'S, Featured

Alzheimer’s disease is a serious condition that slowly destroys the brain. It begins by breaking down a person’s short term memory and spreads to other brain functions. It spreads through the brain and robs the victim of logic and language. In the later stages the victim loses emotional control, and long term memories. In the final stage the brain is unable to direct bodily functions, which leads to death. Tragically, there is no cure at present and its early symptoms are often ignored or misdiagnosed.

What Causes It

Medical researchers have yet to find the cause of Alzheimer’s disease. There are many different factors that seem to play a role in its development:

  • Genetic make-up can sometimes be a cause.  Generally, if it is something that runs within the family, you are at a higher risk of having it when you are older.
  • There are many different environmental faactors that may contribute to this disease as well. 

·         Age is one the biggest factors.  As you get older, your chances are drastically greater for having this disease. 

While these are all factors that can play a part in Alzheimer’s disease, you may find that even if neither of these factors relate to you that you can still find yourself with the disease. 

The Warning Signs

As with any disease or illness, it is important to understand the signs and symptoms of Alzheimer’s.  If you have a full understanding of it, then you will be more likely to notice if you or a loved one is experiencing the early signs. 

  • Early in the disease, you may find that you are more forgetful than you used to be.
  • Some people may begin to ask the same questions repeatedly. 
  • In more severe cases, they may begin to not realize who they are or where they live. 

These situations can all be very scary.  It is important to be aware of these signs early on so that you can do things that will help to slow down the progression of this disease. 

Prevention

There is no definite way to prevent Alzheimer’s disease, but research suggests that a healthy, active lifestyle can delay the onset of symptoms.  That being said, here are a few things that may help:

  • Stay active. There appears to be a very strong link between poor cardiovascular health and Alzheimer’s disease. Get regular aerobic exercise.
  • Keep your body height and weight proportionate.  Studies show that overweight people are more likely to get this disease.
  • Eat a balanced diet with a lot of fresh vegetables.

Treating the Disease

If you or a loved one has been diagnosed with Alzheimer’s disease, there are some things that you can do to treat it and help keep the symptoms at bay. 

·         Visit the doctor frequently for medications that will help to slow the progression. 

·         Make sure that you have adequate help from others as you cope with the disease. 

Caring for Alzheimer’s Patients

The early stages of the disease require monitoring the patient to make sure they stay safe. If he or she lives alone you should install a medical alert system in the home so that help can be summoned quickly. A person with Alzheimer’s may be too confused to use a telephone and these devices make it easy for them to call for assistance.

As the disease progresses the patient will require more supervision. You may need to hire a home health care worker to help provide round the clock care.  Caring for a person with the disease requires lots of energy, skill and diligence. People with the disease can easily wander away from home so make sure you have your home modified to prevent the patient from leaving the house unnoticed. Consider a GPS system that can help find the victim quickly.

About The Author

Marie Clark writes about senior health issues at ElderKind.com where you can read reviews of health care products and services like medical alerts, home health care providers and assisted living,


Caregivers deserve to have fun, too – here’s how

December 21, 2010 by  
Filed under ALZHEIMER'S, Featured, HEALTHCARE

It is a sad fact but while people are partying and celebrating during the holiday season, some people are especially put under stress at this time of the year that can lead to burn out and depression. They are the caregivers. Especially affected are the caregivers of the terminal ill, the disabled and those with dementia or Alzheimer’s disease. And the sad thing is, most caregivers do not even realize the difficult condition they are in. They take it for granted that they have to perform their duty day in and day out. In the process, they are taken for granted.

According to radio talk show host Leeza Gibbons (source: USA Today):

“Most caregivers don’t even realize the kind of pressure they’re under. They often end up with life-limiting conditions as a result of the relentless stress.”

Gibbons experienced this first hand as she witnessed her mother slowly deteriorated with Alzheimer’s. Her family became dysfunctional as they watched their loved one slowly but surely fade away. But their sad story was what inspired them after their journey to set up Leeza Gibbons Memory Foundation and Leeza’s Place, a community gathering place that provides support for caregivers.

The magazine GRAND gives 8 tips for caregivers on how to make their holidays less stressful and even enjoyable. These tips were written by Dr. James Huysman, Executive Director of Leeza’s Place.

  1. Give yourself a wellness gift. Give yourself a health and wellness gift.  Get a checkup, an assessment for anxiety or depression, and/or a health screening. Find a therapist. Join a support group. Take care of your own personal health. It is the first step toward reducing the stress and strain of the season ahead.
  2. Ask for help and make sure you are open to accept it. Asking friends and families for help may be the hardest thing we face. As caregivers, we are way too quick to accept the role of hero, martyr or savior. Too often we have a “go it alone policy” and believe that we must take care of everything ourselves.
  3. Find a friend or make a friendship even richer.  Having a friend to provide conversation, support and assistance or for any holiday activity is a wonderful therapeutic approach to the holidays. Sometimes a friend is all we need: a safe sounding board so we can get some stress out. Sometimes a friend might even offer respite that can lift your spirits and make the season more enjoyable.
  4. Learn how not to take things personally. Sometimes when families get together we are “on our last nerve.” Make sure we realize that the people around us have their dramas and traumas too and their words, though hurtful, may have nothing to do with us. Sometimes the words may come from a person with stressful challenges of their own.
  5. Identify a supportive community of friends, families or spiritual gatherings. Many caregivers are concerned they are seen as a burden and are often reluctant to come out and be connected to the world around them. Sometimes they feel no one cares. By finding a community outside the family, caregivers know they exist in a community of loving people who want to help because they care.  
  6. Plan your family’s activities with thought throughout the season. Roles and responsibilities are extremely important to explain to all involved. Ongoing family conferences throughout the holidays help maintain the boundaries necessary to the caregiving process so that no one feels out of control or inadequate. This is vital and should be done in person and as frequently as needed. Holiday family conferences are like tune-ups used to maintain the family car. This car needs to drive well, efficiently and for a long time. Schedule these conversations regularly before the wheels fall off.
  7. Keep a gratitude list in a holiday journal filled with wonderful affirmations.  That is a mouthful for sure and no doubt as a caregiver you will take this item by item or as a personal project throughout the season. Any one of these exercises can shift your focus away from darkness and worry and help empower a caregiver to create a focus on gratefulness – and hopefully begin to see the large amount of abundance that there already is in being alive. This process will begin to inspire new avenues of thought throughout the holiday season.
  8. Find humor everywhere you go. “Laughter Is the Best Medicine.” This is an old expression popularized by Norman Cousin’s book “Anatomy of an Illness,” in which he describes his battle with cancer and how he “laughed” his way to recovery. Laughter is a great tension-releaser, pain reducer, breathing improver, and general elevator of moods. Humor is so very valuable and a great elixir to get us through difficult or stressful times. Try to see the humor in being a caregiver during the holiday season. Start now. “How do you tell a caregiver from anyone else? It is the person who jumps off a cliff and someone else’s life passes before their eyes. . .  Okay, not so funny. Make sure you find your own laughter to keep smiling in your own life. Your energy for others during the holiday season will only happen when you energize and empower your own life force today.

Heart over head: weak pumping linked to smaller brain

November 16, 2010 by  
Filed under AGING, ALZHEIMER'S, HEART AND STROKE

People are supposed to be rational and shouldn’t let their heart rule over their minds. But the human anatomy and physiology say otherwise: When the heart stops, brain damage and death follows. However, a person can be brain dead for long periods of time while the heart still continues to beat.

A recent study by researchers at the Alzheimer’s Disease Center of the Boston University School of Medicine showed that a weak heart with less pumping ability can lead to a prematurely aging brain. The data was based on study of 1504 people as part of the Framingham Heart Study. The study participants were practically healthy, and had no history of stroke, heart attack or dementia. The average age was 61 years old and 54% were women. Assessments included cardiac index calculated as cardiac output/body surface area measured by cardiac magnetic-resonance imaging (MRI). Brain volume was also assessed using MRI. The results of the study indicate a strong correlation between cardiac index and brain volume, with smaller volumes observed among those with lower (yet normal) cardiac index. Lower cardiac index is indicative of decreasing cardiac function whereas smaller brain volume is indicative of brain atrophy that may be due to premature brain aging

According to researcher and author Angela Jefferson

“Individuals in the lowest or middle cardiac index groups had brain volumes that appeared about two years older than the individuals in the highest or healthiest cardiac index group.’’

Experts think that the results are cause for concern because smaller brain volume is also linked to mild cognitive impairment, early dementia or Alzheimer’s disease.

Is there something we can do about this?

Dr. Jefferson says there is. Regular exercise keeps the heart active and its pumping ability strong. If we maintain our cardiac function through physical activity, we reduce the risk for having a prematurely aging brain.

So think and use your brain, if you must, but keep your heart strong. At the end of the day, the heart wins over the mind.


Interview with an Alzheimer’s expert Part III: The genetic component

September 21, 2010 by  
Filed under . ANNOUNCEMENTS, ALZHEIMER'S

My mother died of pneumonia at the age of 76 but she suffered from dementia during the last 10 years of her life. Doctors thought she had Alzheimer’s disease (AD) but since no autopsy was ever performed, the diagnosis was never confirmed. I come from a family with no history of cancer or heart disease. But there is this possibility of AD that hangs over my head. Last week, we addressed several questions about AD to Dr. Michael Rafii of the Memory Disorders Clinic at UCSD Perlman Ambulatory Care Center in La Jolla, California and of  the University of California, San Diego. Today, I bring you the last part of this Q & A.

Today, Sept 21 is World Alzheimer’s Day.

QUESTION: There is a genetic component to Alzheimer’s. Yet, genetic markers for Alzheimer’s have yet to be identified. What makes Alzheimer’s so complex that it is extremely difficult to find genetic and biomarkers and treatment for the disease?

ANSWER:

AD is most likely due to a combination of genetic susceptibility and environmental influence. Early-onset AD is a rare form of AD, affecting only about 5 percent of all people who have AD. It develops in people ages 30 to 60.

 Some cases of early-onset AD, called familial AD (FAD), are inherited. FAD is caused by a number of different gene mutations on chromosomes 21, 14, and 1, and each of these mutations causes abnormal proteins to be formed. Mutations on chromosome 21 cause the formation of abnormal amyloid precursor protein (APP). A mutation on chromosome 14 causes abnormal presenilin 1 to be made, and a mutation on chromosome 1 leads to abnormal presenilin 2.

Even if only one of these mutated genes is inherited from a parent, the person will almost always develop early-onset AD. This inheritance pattern is referred to as “autosomal dominant” inheritance. In other words, offspring in the same generation have a 50/50 chance of developing FAD if one of their parents had it.

 Scientists know that each of these mutations causes an increased amount of the beta-amyloid protein to be formed. Beta-amyloid, a major component of AD plaques, is formed from the protein APP.

 These early-onset findings were critical because they showed that genetics were involved in AD, and they helped identify key players in the AD process. The studies also helped explain some of the variation in the age at which AD develops.

 Late-Onset AD

Most cases of Alzheimer’s are of the late-onset form, developing after age 60. Scientists studying the genetics of AD have found that the mutations seen in early-onset AD are not involved in this form of the disease.

 Although a specific gene has not been identified as the cause of late-onset AD, one predisposing genetic risk factor does appear to increase a person’s risk of developing the disease. This increased risk is related to the apolipoprotein E (APOE) gene found on chromosome 19. APOE contains the instructions needed to make a protein that helps carry cholesterol in the bloodstream. APOE comes in several different forms, or alleles. Three forms—APOE ε2, APOE ε3, and APOE ε4—occur most frequently.

 APOE ε2 is relatively rare and may provide some protection against the disease. If AD does occur in a person with this allele, it develops later in life than it would in someone with the APOE ε4 gene.

 APOE ε3 is the most common allele. Researchers think it plays a neutral role in AD—neither decreasing nor increasing risk.

 APOE ε4 occurs in about 40 percent of all people who develop late-onset AD and is present in about 25 to 30 percent of the population. People with AD are more likely to have an APOE ε4 allele than people who do not develop AD. However, many people with AD do not have an APOE ε4 allele.

 Dozens of studies have confirmed that the APOE ε4 allele increases the risk of developing AD, but how that happens is not yet understood. These studies also have helped explain some of the variation in the age at which AD develops, as people who inherit one or two APOE ε4 alleles tend to develop AD at an earlier age than those who do not have any. APOE ε4 is called a risk-factor gene because it increases a person’s risk of developing AD. However, inheriting an APOE ε4 allele does not mean that a person will definitely develop AD. Some people with one or two APOE ε4 alleles never get the disease, and others who develop AD do not have any APOE ε4 alleles.


Interview with an Alzheimer’s Expert Part II: To be tested or not to be tested

September 13, 2010 by  
Filed under ALZHEIMER'S

Today, we will continue with our Q & A on Alzheimer’s Disease (AD) with Dr. Michael Rafii and ask about tests for AD.

QUESTION: There are many experimental tests for Alzheimer’s but, there is no still no “gold standard” diagnostic procedure. Currently, the only confirmatory test is by autopsy. Do you think a standardized diagnostic test will be available soon?

ANSWER: Yes, I believe that some combination of amyloid imaging, volumetric MR I as well as cerebrospinal fluid analysis will be utilized for diagnosis of AD, before its symptoms become visible.  There will likely be a need for a screening test, before such a large, and expensive workup is ordered by physicians.

QUESTION: Recently, there was a report about a test that can to detect Alzheimer’s before the symptoms even start. How can this be possible? How can they diagnose a disease with symptoms?

ANSWER: [see above, e.g. referring to answers published in Part I last week]we now have tools such as cerebrospinal fluid analysis and neuroimaging that allow us to measure amyloid in the brain, and are helping us detect AD’s pathology before symptoms show up.

QUESTION: Given that there is no treatment in the horizon, if such a test that detects Alzheimer’s 10 years before it becomes symptomatic ever becomes available, would you recommend patients to get tested?

ANSWER: It is a personal choice.  Some patients are already deciding to get tested with current technology because of a strong family history, and have seen the burden that it places on caregivers.  They want to make financial and legal plans and perhaps make lifestyle changes as well.

QUESTION: If, at age 40, I tested positive for Alzheimer’s using this hypothetical test, are there ways to slow down or even stop the disease before it becomes symptomatic?

ANSWER:  The jury is still out on this.  There have been many studies showing certain types of diets, including the Mediterranean diet, regular physical exercise, and staying cognitively active, may all contribute to lowering the risk of developing AD.  This is an area of tremendous research activity.

About D r. Michael Rafii:

Dr. Michael Rafii, MD, PhD is the  co-director of the Memory Disorders Clinic at UCSD Perlman Ambulatory Care Center in La Jolla, California and Assistant Professor of Neurosciences at the University of California, San Diego. He is also the Associate Medical Core Director of the Alzheimer’s Disease Cooperative Study (ADCS) specializing in cognitive disorders, including dementias such as AD.

About ADCS:

The Alzheimer’s Disease Cooperative Study (ADCS) was formed in 1991 as a cooperative agreement between the National Institute on Aging (NIA) and the University of California San Diego. The ADCS is a major initiative for Alzheimer’s disease (AD) clinical studies in the Federal government, addressing treatments for both cognitive and behavioral symptoms. This is part of the NIA Neuroscience and Neuropsychology of Aging Program’s effort to facilitate the discovery, development and testing of new drugs for the treatment of AD and also is part of the Alzheimer’s Disease Prevention Initiative.


Interview with an Alzheimer’s expert, Part I: How far are we from a treatment?

September 9, 2010 by  
Filed under ALZHEIMER'S

5.3 million Americans have AD and 1 person every 70 seconds is diagnosed with the disease. There are many questions that need to be addressed regarding this disease.

We are pleased here at Battling for Health to have an exclusive interview with one of world’s foremost experts on Alzheimer’s disease (AD).

Dr. Michael Rafii, MD, PhD is the  co-director of the Memory Disorders Clinic at UCSD Perlman Ambulatory Care Center in La Jolla, California and Assistant Professor of Neurosciences at the University of California, San Diego. He is also the Associate Medical Core Director of the Alzheimer’s Disease Cooperative Study (ADCS) specializing in cognitive disorders, including dementias such as AD.

We sent several questions on AD to Dr. Rafii and we are happy to share with you his responses.

QUESTION: AD has been the subject of numerous research studies but till now, no effective treatment has been found. Why is it so difficult to find a treatment for this disease? How far are we from a treatment?

 ANSWER: Current research indicates that AD may in fact be silently developing in the brain over 10-20 years, BEFORE its key symptom of short term memory loss even shows up in patients.  The idea is that a protein called beta-amyloid is slowly accumulating in the brain, first damaging brain cells, and then depositing into plaques.  Many drugs, some of which target amyloid, have been tested in the symptomatic phase, which is likely too late in the course of the disease to have a tremendous impact.  However, we now have tools such as cerebrospinal fluid analysis and neuroimaging that allow us to measure amyloid in the brain, and are helping us detect AD’s pathology before symptoms show up.

 I think a good analogy for AD is heart diease.  If a patient presents with a Heart Attack, starting them on a cholesterol lowering medication at that time will be a little too late.  Rather, if they start lowering their cholesterol years earlier, they may never have the heart attack in the first place.  Some believe that amyloid is analogous to cholesterol.  The challenge is to measure the amyloid and to get drugs that lower amyloid INSIDE the brain.  By lowering amyloid levels, we might lower the risk of having symptomatic AD, that is memory loss and dementia.

 We currently have trials in progress for medications that are being evaluated in the mildest stage of AD, when memory loss is just starting to occur.  I am optimistic that in the next few years we will have new treatments available.

Medical research such those being conducted at Dr. Rafii’s clinic will hopefully bring AD treatment closer to reality. However, in order for research studies t be conducted, research subjects and volunteers are needed. Check out how you can help at: www.adcs.org/Studies/ImagineADNI.aspx.

 Follow Alzheimer’s Research on Facebook: www.facebook.com/pages/Alzheimers-Disease-Research/114211355284888

We have many more Q & A on AD with Dr. Rafii which we will share with you in the coming posts. Stay tuned!


Blood tests for neurological disorders

July 14, 2010 by  
Filed under ALZHEIMER'S, SCHIZOPHRENIA

The hunt for biomarkers in the blood that can be used to screen for neurological disorders such as schizophrenia and dementia seems to be making headway. Two groups of researchers report about promising tests using biomarkers. Let us take a look at their discoveries.

Predicting Alzheimer’s

Researchers from the Institute of Psychiatry at King’s College London report that they may have develop an early test for Alzheimer’s disease – a test that can predict its onset up to ten years before the symptoms appear.

The biomarker used for the test is a protein called clusterin which surrounds the brain plaque characteristics of the disease. High clusterin levels were found to be closely linked to brain shrinkage and rapid memory loss. Clusterin is easily and reliably detectable in the blood. As a biomarker for Alzheimer’s, clusterin seems very promising.

According to lead author Dr Madhav Thambisetty:

“We are very enthusiastic about these results because they identify a strong signal in blood from clusterin protein that appears to be relevant to both pathology and symptoms in patients with Alzheimer’s disease, adding further evidence to the role of clusterin in Alzheimer’s disease… A primary goal in Alzheimer’s research is to develop an inexpensive, easily administered test to accurately detect and track the progression of this devastating disease.  Identifying clusterin as a blood biomarker that may be relevant to both the pathology and symptoms of the disease may bring us closer to this goal.”

Detecting schizophrenia

Researchers from Cambridge University report about another potential blood test – this time a test for diagnosing schizophrenia. Currently schizophrenia is diagnosed by psychiatrists based on patient interviews, a method which is not necessarily accurate, sensitive and objective.

The researchers discovered a set of 51 biomarkers with linked to schizophrenia. These biomarkers are detectable in a blood sample and can be used as a diagnostic tool complementary to the patient interview-based method. The test is called VeriPsych

According to Professor Sabine Bahn, Director of the Cambridge Centre for Neuropsychiatric Research, who developed VeriPsych together with his collaborators at Psynova Neurotech and Rules-Based Medicine:

“Schizophrenia is a complicated and challenging disease, yet current diagnostic approaches continue to be based on patient interviews and a subjective assessment of clinical symptoms. We expect VeriPsych to be used as an aid to this current process, and we hope it will provide the psychiatrist with additional confidence in their evaluation, as well as speed up the process.”


Alzheimer’s and your purpose in life

March 4, 2010 by  
Filed under ALZHEIMER'S

Do you have a purpose in life, a purpose that drives you to go on living and be healthy? For the young, this question is easy to answer. For the elderly, the answer to this question is not an easy one. But your answer may actually be determinant whether you develop Alzheimer’s disease or not.

Over the years, a lot of risk factors associated with Alzheimer’s have been identified, including, genetics, nutrition, physical activity, and psychosocial factors. Latest research indicates that psychological factors that may include conscientiousness, extraversion and neuroticism are linked to risk for Alzheimer’s disease.

This latest study by American researchers suggests that having a greater purpose in life than just while the days away can reduce to risk for mild cognitive impairment, which is a precursor to Alzheimer’s.

According to researcher Dr. Patricia A. Boyle and her colleagues at Rush University Medical Center, Chicago:

“Purpose in life, the psychological tendency to derive meaning from life’s experiences and to possess a sense of intentionality and goal directedness that guides behavior, has long been hypothesized to protect against adverse health outcomes.”

The Chicago researchers looked at more than 950 older adults living in communities and are part of the Rush Memory and Aging Project. The participants had to answer questionnaires that assess their purpose in life. As an example, they are asked to rate their level of agreement with the following statements.

High scores were indicative of greater purpose in life. The participants were followed up for 4 to 7 years, including psychological and clinical evaluations. Upon the analyzing the scores based on questionnaire responses, the researchers found that patients who scored the highest (4.2 out of 5) were 2.4 times more likely not to develop Alzheimer’s than those with low scores (3 out of 5). The high scorers had also a significantly reduced risk for cognitive impairment and lower rate of cognitive decline. However, the biological significance of the findings is poorly understood. Nonetheless, this suggests a potential for behavioral therapy and preventive measures for the elderly. The authors concluded:

“In particular, these findings may provide a new treatment target for interventions aimed at enhancing health and well-being in older adults. Purpose in life is a potentially modifiable factor that may be increased via specific behavioral strategies that help older persons identify personally meaningful activities and engage in goal-directed behaviors. Even small behavioral modifications ultimately may translate into an increased sense of intentionality, usefulness and relevance.”


Exercise your way away from dementia

February 10, 2010 by  
Filed under ALZHEIMER'S

As we grow older, we might experience mild cognitive impairment, which is basically a consequence of the aging process. Mild cognitive impairment, which usually starts at midlife, is defined as “an intermediate state between the normal thinking, learning and memory changes that occur with age and dementia.” Those who have mild cognitive impairment are likely to develop full-blown dementia than those who do not have it. About 1 to 2% of the general population will eventually develop dementia. This number could be 10 times higher in those with cognitive impairment – 10 to 15% each year.

The good news is that there is a simple way of slowing down the progression of dementia – physical exercise. This has been reported in several research studies.

In one study, researchers from University of Washington School of Medicine and Veterans Affairs Puget Sound Health Care System in Seattle investigated the effects if aerobic exercises in 33 adults with an average age of 70 years.  The results showed that those who engaged in regular aerobic exercises experienced significant improvement in cognitive function while those who did exercise showed no improvement. The improvement was more evident in women than in men even though there was no significant difference in exercise intensity between genders. The researchers think “the sex differences may be related to the metabolic effects of exercise, as changes to the body’s use and production of insulin, glucose and the stress hormone cortisol differed in men and women.”

Another study by Mayo Clinic researchers reports that moderate exercise such as brisk walking, aerobics, walking, strength training and swimming performed have beneficial effects that prevent mild cognitive impairment. When these exercises were performed at midlife, the likelihood of cognitive impairment is reduced by 39%. When performed later beyond middle age, the reduction is 32%. Unlike in the previous study, no differences between men and women were observed. Surprisingly, light exercises (dancing, golfing with a cart) and vigorous exercises (jogging, racquetball) do not seem to as beneficial in preventing mild cognitive impairment as moderate exercises.

So how does physical exercise slow down cognitive impairment?

Physical exercise may protect against mild cognitive impairment via the production of nerve-protecting compounds, greater blood flow to the brain, improved development and survival of neurons and the decreased risk of heart and blood vessel diseases.

Physical exercise may be a marker for a healthy lifestyle… A subject who engages in regular physical exercise may also show the same type of discipline in dietary habits, accident prevention, adherence to preventive intervention, compliance with medical care and similar health-promoting behaviors.


Memory loss is not necessarily dementia

December 9, 2009 by  
Filed under ALZHEIMER'S

grandmothers_birthdayWhen we see an elderly person who is confused or incoherent, we tend assume it has something to do with senility or dementia. Loss of memory is not necessarily a sign of dementia and senility is not necessarily a sign of Alzheimer’s disease, even in the elderly. This is a comforting message from aging experts.

However, there can be other causes for memory loss. Stress is one. Side effects of medications are another. There are many more.

According to Mara Mather, reasercher on aging at USC:

“Memory loss is not always due to dementia and it’s not always due to aging… Stress has an impact on memory and long-term stress can diminish the size of the hippocampus and diminish memory abilities and it looks like to some extent that’s recoverable.”

In fact, there are many factors that can influence memory skills. Some of these are listed below (source: USNews.com)

  • Aging
  • Nutritional deficiency, e.g. deficiency in certain vitamins and minerals
  • Depression
  • Diseases and medical conditions such as diabetes or hypothyroidism
  • Oxygen deprivation of the brain, which can be cause by stroke, heart attack, or severe trauma
  • Structural abnormalities in or damage to the parts of the brain associated with memory formation
  • Free-radical damage.
  • Chemical poisoning, including consumption of alcohol, tobacco, and illicit drugs
  • Infections of the central nervous system (CNS) infections such as encephalitis, toxoplasmosis and neurosyphilis
  • Stress, emotional as well as physical
  • Sensory overload, e.g. when a person is trying to do too many tasks or worry about too many things at the same time, the brain is overloaded with information and cannot process short-term memories.
  • Low blood sugar
  • Genetic factors
  • Seizures, such as those related to epilepsy
  • Severe emotional trauma
  • Low estrogen levels in postmenopausal women

Thus, there is no reason to jump into conclusions about older people’s diminishing mental capacities. This could just well be temporary or “reversible” dementia due to one or more of the abovementioned factors. Instead, when signs of memory loss or confusion arise, we should first look at the possible factors involved. Is the person under mental or emotional stress? What sort of medications is the person taking? Family members and caregiver are also advised to talk to the patient’s doctor.

“To find the underlying cause of memory loss, your physician will obtain a detailed medical history, which documents the pattern, symptoms, and types of memory loss. He or she will also inquire about contributing factors that may worsen or trigger memory loss. A routine physical and detailed neuropsychological examination with a focus on memory function will be conducted. In addition, he or she will order several diagnostic tests.”

Photo credit: stock.xchng


Diet and Alzheimer’s disease

October 22, 2009 by  
Filed under ALZHEIMER'S

BrainLow-fat, low-calorie diets are not only good for cardiovascular health. It may also delay the onset or progression of dementia. Many epidemiological studies have presented evidence that diet plays a role in the clinical course of Alzheimer’s disease. Diet low in fat and calories and rich in fruit, vegetables and fish seem to be best for the brain.

Currently, there is cure or preventive therapy for AD. Many research studied looked into how nutrition can affect brain damage by dementia, hoping a certain type of diet can lower the risk, delay the onset, and slow down the progression of the disease.

Evidence suggests that high intake of saturated and trans fats can increase the risk for AD whereas a Mediterranean diet is associated with slower cognitive decline and reduced risk for AD.

In a more recent study using laboratory animals, a team of researchers from Europe and North America reported that a diet rich in protein may lead to shrinkage of the brain. The researchers tested four different diets on mice, namely:

The purpose of the study was to look at plaque development but one of the results came as a surprise: mice fed with a diet of high protein and low carbohydrate had brains which are 5% lighter that mice with other diet regime. Mice on diet with high fat/low carb had higher levels of plaque proteins but no effect on brain mass.

The results of the study highlight the necessity of more studies on the effects of diet on the brain in prospective randomised double blind clinical diet trials.

According to lead researcher Sam Gandy, a professor at The Mount Sinai School of Medicine in New York City

“Given the previously reported association of high protein diet with aging-related neurotoxicity, one wonders whether particular diets, if ingested at particular ages, might increase susceptibility to incidence or progression of AD. This would be a challenging undertaking but potentially worthwhile. If there is a real chance that the ravages of AD might be slowed or avoided through healthy eating. Such trials will be required if scientists are ever to make specific recommendations about dietary risks for AD.”

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Palliative care for patients with advanced dementia

October 15, 2009 by  
Filed under ALZHEIMER'S

wheelchairWhen we hear the words “terminal disease,“ we always think of cancer. “Terminal cancer” is a term that everybody has heard before. But have you ever heart of the term “terminal dementia?”

According to researchers at the Institute for Aging Research of Hebrew SeniorLife,, the clinical course of advanced dementia is very similar to those experienced by patients with terminal conditions. Dementia is just about being senile and forgetful. It also comes with symptoms such as discomfort, distress, pain, and eventually death. However, patients with advance dementia seem to be underecognized as being terminal or at high risk of mortality and tend to receive suboptimal end-of-life care. This was the result of the “Choices, Attitudes and Strategies for Care of Advanced Dementia at the End-of-Life,” or CASCADE study.

According to scientist and study author Dr. Susan L. Mitchell:

“Dementia is a terminal illness. As the end of life approaches, the pattern in which patients with advanced dementia experience distressing symptoms is similar to patients dying of more commonly recognized terminal conditions, such as cancer.”

Unlike those with terminal cancer, however, patients with dementia are seldom rendered the appropriate palliative care for the terminally ill. Instead, many receive interventions and treatments that are not only futile, but may also add to pain and distress.

The clinical progression of dementia is not as well understood as that of cancer. Most of the patients are elderly who are confined to nursing homes. Many of these have difficulty in communication or recognizing family members. It is not clear, however, whether these nursing homes are equipped to recognize the signs of advanced dementia and whether they are well-equipped to provide end-of-life care.

Currently, more than 5 million Americans suffer from dementia, a number that is expected to increase by almost three-fold in the next 40 years. A recent study by Alzheimer’s Disease International estimates that the number of people with dementia worldwide will exceed 35 million by 2050. Dementia is a group of symptoms severe enough to interfere with daily functioning, including memory loss, difficulty communicating, personality change, and an inability to reason. Alzheimer’s disease is the most common form of dementia.

Prof. Greg Sachs writes in his editorial in the New England Journal of Medicine,

“Since individuals with advanced dementia cannot report their symptoms, these symptoms often are untreated, leaving them vulnerable to pain, difficulty breathing and various other conditions. We shouldn’t allow these people to suffer. We should be providing palliative care to make them more comfortable in the time they have left.”

He recommends that caregivers and medical personnel should learn to look for nonverbal cues of pain and distress. Palliative care should focus relieving symptoms such as pain, shortness of breath, fatigue, nausea, eating problems, and sleeping difficulties.


Choosing a nursing home

September 30, 2009 by  
Filed under ALZHEIMER'S

laughing_elderly_womanWhen our mom was diagnosed with Alzheimer’s disease at the age of 68, we didn’t know what to do. Coming from a culture which strongly believes that the young should take care of the aged, it was hard for us to face the fact that we had to place her in a nursing home. Having somebody come in to take care of her 24 hours a day, 7 days a week, has become a big financial burden. Add to that the emotional burden of seeing her deteriorate each day. Luckily, we found a home for the elderly run by a religious order, with professionally trained nursing nuns to take care of her. Our guilt was appeased when we saw how her physical health improved in an environment where she gets professional medical care as well as the social interaction with people of her age. Visits on weekends became a fun affair for everybody. Her dementia did not improve but we were glad to see her happy and comfortable during the last few years of her life.

Choosing the right nursing home is the key to our loved one’s quality of life and to our peace of mind. It is also a big responsibility.

As HealthCare 411 at the Agency for Healthcare Research and Quality (AHRQ) rightly said

Unfortunately, it has been easier to find more detailed information about the best flat-screen television or most fuel-efficient vehicle than on a good local nursing home.

It is for this reason that AHRQ developed a special tool as part of their Navigation Healthcare Program. The online tool called Nursing Home Compare is aimed to help find the nursing home that suits your loved ones needs by giving detailed information about every Medicare and Medicaid-certified nursing home in the US. The homes are rated on a 5-star quality system based on health inspections, staffing levels, and quality evaluations, among others.

The Department of Health and Human Services recommends taking the following steps when using the tool:

There are also alternatives to nursing homes, including community-based services, home care, or assisted living and information on these are also available in the AHRQ site.

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Pesticide exposure and Alzheimer’s

August 27, 2009 by  
Filed under ALZHEIMER'S

toxin5Can be pesticide exposure be a contributing factor in developing Alzheimer’s disease. This could well be, a recent study reports.

American researchers looked at 4,000 senior residents (aged 65 and older) of an agricultural county in Utah. The study participants were assessed for cognitive function (e.g. memory, attention span, and problem solving) at the start of the study was given at the outset and two other times over a six- to seven-year period and interviewed about exposure to environmental toxins such as pesticides.

The study results showed that pesticide exposure increases the likelihood of developing Alzheimer’s by 53%. The results were reported at the Alzheimer’s Association 2009 International Conference on Alzheimer’s Disease in Vienna, Austria last July.

Although Alzheimer’s has been closely linked to genetic factors, it hasn’t been clear while some individuals get and some not, regardless of genetic predisposition. Experts believe that environmental factors, e.g. pollutants and toxins may play a role.

Pesticides are environmental toxins that have been linked to a lot of chronic diseases including cancer. It may also have some long-term harmful effects on the nervous system that can lead to dementia and Alzheimer’s.

According to author Dr. Kathleen M. Hayden of Duke University Medical Center in Durham, N.C.

“While no cause for Alzheimer’s disease has been found, [non-inherited] cases are likely due to a combination of genetic and environmental factors.”

The researchers say that the use of pesticides has increased during the last 50 years, mainly in agriculture. It is estimated that in the US alone, more than 2 billion pounds of the 18,000 licensed pesticides are used and released into the environment.

Certain pesticides are believed to interfere with the production and release of acetylcholine, a neurochemical that plays a major role in memory.

The study results alone are not enough proof that pesticides cause Alzheimer’s. However, the association is so strong that it warrants further investigation of the role of environmental toxins (pesticides as well as others) in the pathogenesis of Alzheimer’s.

According to Dr. Ralph Nixon, vice chairman of the Medical and Scientific Advisory Council at the Alzheimer’s Association and an Alzheimer’s expert at New York University

“You can look at environmental toxins as being something that promotes the root cause of the disease, or as a second hit. If someone is already predisposed to Alzheimer’s due to genetics, cardiovascular disease, or some other risk factor, the environmental toxin may push their risk over the top,”


Then and now: language skills and Alzheimer’s disease

August 14, 2009 by  
Filed under ALZHEIMER'S

wordsPlaques and tangles in the brain are typical manifestations in people with Alzheimer’s disease, as autopsies have shown. So how come some people with these brain features have dementia and some haven’t?

Researchers looked at the brain structure of 38 deceased Catholic nuns, their medical and life history. There were two distinct groups: the asymptomatic and the symptomatic individuals who developed dementia. Autopsy revealed that both groups exhibited brain morphology characteristic of Alzheimer’s, e.g. plaques and tangles. However, the asymptomatic nuns had large neurons with better functionality and more connections compared to their symptomatic counterparts.

Looking into the life history of these nuns, the researchers examined essays written by the deceased nuns in their late teens/early twenties upon entering the convent. Analysis of the written works revealed that the asymptomatic nuns have significant better and richer language skills during the first three decades of their life. The richness was based, among others, on the number of ideas were expressed per 10 words, the number of verbs and adjectives used in one sentence, but not based on grammatical correctness. The asymptomatic nuns scored 20% higher than their symptomatic counterparts.

This is an interesting finding because the language-rich nuns have Alzheimer’s pathology in their brain which somehow did not manifest in clinical symptoms of cognitive decline and dementia. There seems to be a protective mechanism at work and the researchers this has something to do with the larger neurons that compensated for the abnormal plaques and tangles. In addition, the larger neurons may then be linked to better language skills.

According to Dr. Diego Iacono, neuropathology researcher at Johns Hopkins University in Baltimore

“The idea is that we have a sort of cognitive reserve that we start to increase during our second and third decades of life, and you can spend this reserve when you get older. In this way, you can avoid the manifestation of dementia even if you have some pathology. This is something we didn’t expect.”

This is not the first study to find structural differences between symptomatic and asymptomic dementia Alzheimer’s patients. Another study also showed larger neurons in otherwise “plaqued and tangled” brains of men who did not develop Alzheimer’s disease. However, their language skills were not analyzed.

One major limitations of the current study is the sample size. However, it is difficult to conduct such long-term studies on a large scale to include a large number of participants. The current analysis was part of the ongoing Nun Study, which in the coming years, might yield more conclusive data.


Can caffeine reverse memory decline?

July 22, 2009 by  
Filed under ALZHEIMER'S

coffee-machineMornings aren’t the same without a cup of coffee in hand. Whether it may be a broadsheet you have in front of you or your computer monitor, hold that coffee cup nice and tight because a new research shows that coffee has more than just antioxidants under its belt of health benefits.

The research involved genetically modified aged mice that exhibit symptoms of Alzheimer’s disease being proportionally given an equivalent of five cups of coffee a day worth of caffeine. The results were astounding. The cognitive issues of the said mice were reversed, according to a report coming from the Florida Alzheimer’s Disease Researcher Center (ADRC) researchers lead by Dr. Gary Arendash.

Recently published studies show that caffeine is a very good inhibitor of the protein linked to the disease, based on test results from both blood and the brains of the mice that showed symptoms of Alzheimer’s. These studies are considered as a continuation of previous research conducted by the Florida ADRC team showing that introduction of caffeine during early adulthood inhibits the onset of cognitive problems in old age in mice genetically modified to develop the symptoms of Alzheimer’s.

55 mice were bred to exhibit dementia as they age, mimicking the symptoms of the said disease. Behavioral tests were then done to confirm the test mice aged18 to 19 months were showing signs of cognitive issues at an equivalent age of 70 human years. Half of the animals were given caffeine through their drinking water (test group) while the control group was given plain water. The test group mice took an equivalent of five cups of regular coffee every day. This is the same amount of caffeine you get from a large frap drink from your local coffee shop, or 20 soda cans or 14 cups of tea.

After two months of research, not only have did the caffeinated mice scored better on their tests measuring cognitive skills, researchers also have verified that the memory skills of the said mice were of the same level as to normal mice of younger age exhibiting no symptoms of Alzheimer’s disease. The control mice showed very little or no difference at all with their memory skills.

Results also show a very significant decline (around 50% reduction) in the percentage of beta-amyloid, the protein responsible for the plaques on the brain, which when in abundance, is a classical sign of Alzheimer’s. Caffeine not only inhibits beta-amyloid but also suppresses inflammatory changes in the brain that lead to the high production of the said protein.

Promising as it may seem, questions always arise to clarify certain possible issues that may have been overlooked or questions that may lead to further knowledge or new discovery. Since it has been established that caffeine boost the memory of mice with Alzheimer’s, is it then safe to say that those that are exposed to caffeine from a very young age will do better in terms of memory? The researchers wanted to know if there would be any difference. To set things straight, another set of mice were given caffeine this time with the group being normal and is from young adulthood through old age. After a long research period, they collated the results for the control group and the caffeinated mice with both groups performing as well as the other.

“This suggests that caffeine will not increase memory performance above normal levels. Rather, it appears to benefit those destined to develop Alzheimer’s disease,” according to Dr. Arendash.

Though further, more rigorous research is needed, the use of caffeine has the great potential as a viable treatment for patients with Alzheimer’s disease. Caffeine is easily available and cheap. Give or take a couple of years from now, these new findings may be the start a new line of therapy and prophylaxis for Alzheimer’s. Caveat: do not forget that caffeine is not completely harmless. Excessive caffeine intake does come with health risks!

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Married at midlife: lowering your risk for dementia

July 7, 2009 by  
Filed under ALZHEIMER'S

married-handsSocial life is important for patients with Alzheimer’s disease and other forms of dementia, as many research studies have reported. A more recent study pinpointed something even more specific – that patients who are married or living with a partner at midlife have a much lower risk of developing dementia later in life. The research was conducted by Swedish researchers on more than 2000 Finnish adults.

Furthermore, the increase in risk seems to be dependent on the type of singlehood. The researchers reported that:

  • People who were single during their entire adult life were two more likely to develop some form of dementia compared to married or partnered people of similar age.
  • People who were married but were divorced at middle age have a three-fold increase in risk.
  • Those who were windowed or suffered through the death of a partner have an even higher risk for Alzheimer’s – almost 6 times higher than their married counterparts.

According to author Krister Håkansson of the well-known Karolinska Institute in Sweden “This suggests two influencing factors — social and intellectual stimulation and trauma. In practice, it shows how important it is to put resources into helping people who have undergone a crisis. If our interpretation holds, such an intervention strategy could also be profitable for society considering the costs for dementia care.”

So what does marriage and partnership have to do with cognitive decline?

Researchers believe that partnership and marriage provide social as well as intellectual stimulation that keep the brain functioning even in old age. The next step is to look into the effect of other types of relationships (children, grandchildren peer support groups) and the quality of the relationships (happy or not happy):

Previous studies have shown that an active social life help keep the mind and the memory sharp late in life. A study by Harvard researchers revealed that those who have the most social interaction within their social circle, be it with friends or family showed the slowest rate of memory decline.

These results give some important insights on currents standard of care for people with dementia and Alzheimer’s. In addition, it gives people who are approaching the middle age a strategy to counteract the cognitive decline that comes with age.


Fundraising for dementia research: a million for a million

July 2, 2009 by  
Filed under ALZHEIMER'S

plane-1When you think about companies giving to charity, you wouldn’t think of a budget airline company as being among the generous, right? Wrong! easyJet, one of Europe’s budget carrier has just announced its pledge of raising one million pounds for charity. The beneficiary of this corporate generosity is no other than the Alzheimer’s Society of the UK. The fund raising drive is called “a million for a million”, a million pounds for a million people who will suffer from some form of dementia in the next ten years.

According to Andy Harrison, CEO of easyJet

‘I was shocked to learn that one million people will develop dementia in the next 10 years. That’s why we have committed to raising a million for a million – one million pounds to help the million people who will be facing dementia.

Dementia is not a natural part of ageing but it is often still viewed in these terms, meaning it doesn’t get the attention it deserves. The government only invests 2% of its medical research budget on dementia. We call on the government to boost research funding and make this condition a priority.’

Hre’s how the fundraising will work: Passengers on board all easyJet flights will be asked to donate their spare or excess foreign currency to dementia research. A collection bag will probably be given out to each passenger and collected just before landing. In addition, the Alzheimer’s Society will receive a percentage of the sales of scratch cards sold on easyJet flights. Collection starts this summer.

I think this is a splendid idea to raise money for charity. Those of you who are travelling international would know the hassle of different currencies and all those small change that clutters your purse. This is a great way of getting rid of them. And if you have more to spare, you can give more, too.

Neil Hunt, CEO of Azheimer’s Society UK says

‘easyJet has set a fantastic example by boosting funding for dementia. Charities, companies and the government can all work towards the goal of defeating dementia. We look forward to the forthcoming Dementia Research Summit and hope to see the development of an ambitious plan that drives real change.’

Thank you and happy landings.

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Pain relievers: do they or do they not prevent Alzheimers?

June 25, 2009 by  
Filed under ALZHEIMER'S

old_man_and_dovesPrevious studies have reported that pain relievers such as the anti-inflammatory drugs (NSAIDs) may prevent the onset of Alzheimer’s disease. This study by American researchers, however, shows a different story.

The researchers looked at 2,736 members of Group Health, an integrated healthcare delivery system, who did not have any form of dementia when they were enrolled in the study. The average age of the study group was 75 years. The researchers then tracked these patient for 12 years, monitored their use of NSAIDs, both as prescription and over-the-counter (OTC) drugs, and their likelihood of developing dementia especially Alzheimer’s disease.

In the study group, 351 participants had a history of heavy NSAID use at the start of the study. Over the follow up period, another 107 participants became heavy NSAID users. “Heavy use was defined as having prescriptions for NSAIDs at least 68 percent of the time in two years.

The results of the monitoring for dementia gave the following results:

  • 476 participants developed Alzheimer’s disease or dementia during the study period.
  • Heavy NSAID users were 66% more likely to develop dementia compared to those who use little or no NSAID.

According to study author Dr. Eric B. Larson, executive director of Group Health Center for Health Studies.

“Although we hoped to find a protective effect, there was none. Thus, for this age group, there’s no basis for taking NSAIDs to prevent Alzheimer’s disease. Our study in this quite elderly population showed more risk of dementia with NSAIDs, especially when used heavily.”

The study results indicate a need to re-evaluate earlier research findings that suggested that NSAID use can delay or even prevent onset of Alzheimer’s disease.

There were, of course, key differences between previous studies and this study. For one thing, the study participants in this study are on average older. This could have a big influence on the results considering that dementia and Alzheimer’s disease are basically an elderly disease, even though there are cases of early onset.

NSAIDs such as Ibuprofen are available over-the-counter are popularly used as anti-fever drugs and pain relievers. In the older population, NSAIDs, marketed in the US as Advil, Motrin and Aleve, are used as pain relievers especially among those who suffer from arthritis. Recently, the US FDA has issued new labelling requirements for OTC drugs including NSAIDs, which should provide warnings about safety, including interaction between NSAIDs and alcohol.

 

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.