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

Previous 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.

 

Photo credit: stock.xchng

               

Your brain needs good cholesterol, too!

It is well-known that high blood cholesterol levels are not good for the heart. Is is also quite known that high levels of low-density lipoproteins (LDL) - the bad type of cholesterol - can build up and block arteries and adversely affect cardiovascular health.

What is not so well-known is the fact that low levels of high-density lipoproteins (HDL) - the good type of cholesterol - is linked to memory loss and increased risk for dementia. This is according to a study by European researchers.

It seems that cholesterol levels are important not only for heart health but for brain health as well.

The study followed up 3,673 people as part of the long-term Whitehall II study involving British civil servants. The results showed that low levels of HDL cholesterol are associated with diminished memory by age 60. No link was found between memory loss and levels of total cholesterol and triglycerides. The use of statins to manage cholesterol levels did not seem to have an effect.

According to lead author Dr. Archana Singh-Manoux of the French National Institute for Health and Medical Research (INSERM, France) and the University College London (UK)

“Memory problems are key in the diagnosis of dementia. We found that a low level of HDL may be a risk factor for memory loss in late midlife. This suggests that low HDL cholesterol might also be a risk factor for dementia.”

The mechanism behind this link between HDL cholesterol and dementia risk is not so clear but the following hypotheses are proposed:

• HDL cholesterol blocks the formation of beta-amyloid.
• HDL cholesterol may affect memory in relation to its role in maintaining vascular health.
• HDL cholesterol could influence memory through its -inflammatory and antioxidant.

HDL cholesterol… serves several vital biological functions. It helps clear excess cholesterol from the blood; assists nerve-cell synapses to mature; and helps control the formation of beta-amyloid, the major component of the protein plaques found in the brains of Alzheimer’s patients.

Dementia usually occurs in people 65 years or older. Alzheimer’s disease is the most common form of dementia. In the developed world where a large proportion of the population are elderly, dementia is becoming a major - and costly - health concern. The monitoring of HDL cholesterol (and not only LDL cholesterol!) should therefore be encouraged - for the heart as well as for the brain.

Photo credit: stock.xhcng

               

In the making: blood test for Alzheimer’s disease

Diagnosing Alzheimer’s disease is often a problematic process. Over the years, the field of biotechnology has tried to come up with screening and testing methods that can help identify this disease. While diagnostic biomarkers for many diseases can be identified in a blood sample, this has so far proved elusive for Alzheimer’s. However, there is a lot of promise in biomarkers found in the cerebrospinal fluid (CSF), which makes a lot of sense - considering the CSF’s proximity to the brain. CSF is a colorless liquid found in the central nervous system (brain and spinal cord).

Taking CSF samples however is a bit controversial since it entails a procedure called a lumbar puncture or spinal tap, which is basically done inserting a needle in the lower part of the spine to collect the fluid. A spinal tap is performed to diagnose diseases affecting the nervous system.

Many experts feel that a lumbar puncture can be painful and presents some risks, complicated by the type of patients - elderly and disoriented - one is dealing with. Others claim that a lumbar puncture is essentially safe and straightforward. This controversy in relation to the CSF has led many researchers to explore further the possible of developing a blood test for Alzheimer’s.

And it seems that their efforts are bearing fruit.

American researchers “have revealed a direct relationship between two specific antibodies and the severity of Alzheimer’s disease symptoms, raising hopes that a diagnostic blood test for the devastating disorder is within reach.”

The researchers focused on antibodies that the body produces in response to two Alzheimer-associated proteins. One of these proteins is the well-known amyloid-beta which is responsible for the formation of plaques in the brains of Alzheimer’s patients. The other protein is the less known RAGE which is involved in the normal human aging process. However, it has been observed the RAGE is expressed at higher levels in the brains of people with Alzheimer’s.

The researchers found that anti-amyloid beta and anti-RAGE antibodies are significantly higher in the group with Alzheimer’s compared to a control group without Alzheimer’s. Furthermore, the concentrations of the two antibodies in the blood seem to be significantly associated with the severity of the disease.

According researcher Shyamala Mruthint

“Alzheimer’s is an inflammatory disease of the brain, and these two antibodies give us a way to measure that inflammation. Using them as an early diagnostic marker may allow us to start drug treatment early, when it’s most effective, to increase the patient’s quality of life.”

               

Hope and Help for the Holidays

It’s October and according to some retailers, the holidays begin now.

I don’t listen to the marketing hype, but when I am hosting Thanksgiving dinner (which I am not this year), I start thinking about the menu and planning in September. However, it’s hard logistically and emotionally to plan for the holidays when you are caring for someone who has Alzheimer’s disease.

By their very nature, the holidays cause us to look back. In most cases, celebrations and traditions of years gone by determine the tenor of today’s customs and rituals. For many of us, the holiday season begins with talking to our loved ones, planning where celebrations will be and what they will entail. We speak the plans for the upcoming holidays, but what we don’t say, what goes unspoken is the foundation upon which those plans are made. Here is where the friction comes in. Looking back is fine, but looking forward is scary. Your mom doesn’t remember the traditions that she couldn’t live without. Your dad is agitated by the very lights that he used to meticulously string on the Christmas tree; today, he couldn’t pour a cup of hot chocolate, much less man the omelet station for the traditional holiday brunch.

So, where does that leave you? I’m not sure, but I know where it left me. It left my heart aching for the past and sometimes dreading the future. It left me hanging on to old traditions and knowing that it was time to start new ones. It left me wondering how I could celebrate in a way that mom could enjoy without being scared, anxious or agitated.

In this series I’ll share my holiday experiences (some were nightmares) with the hopes that you can learn from MY mistakes. I’ll give you some do’s and some dont’s. I’ll hopefully inspire you to hold on to some old traditions, but encourage you to try some new ones as well.

So, let’s plan together as we approach the holidays. I’ll specifically reference Thanksgiving, Christmas and New Years, but it really doesn’t matter. The principles are the same for Yom Kippur or Purim.

I’ve learned, it doesn’t matter what our ethnic background or religious tradition. Alzheimer’s disease hurts all of us. It makes us all cry and it takes away a little of our past and our future as it creeps through the brains of our loved ones.

Look for upcoming posts on Hope (and Help) for the holidays. Do you have any tips for making it through the holidays? Please share.

               

Alzheimer’s Disease Information for Patients and Families

With millions of people around the world caught in its grasp, Alzheimers is a disease whose implications are still being felt. Sneaking in and slowing removing a person’s ability to recall, function and even remember their own family and friends, this condition is a nasty one that can impact not only the affected patients, but also everyone around them. With this in mind, it is very important for people faced with this condition to arm themselves with solid Alzheimers disease information.

Despite or in spite of its widespread reach, there are a lot of myths that surround Alzheimers. While having correct Alzheimers disease information won’t likely provide a family with the solace it might need following a diagnosis, it can help them better understand the condition and what to expect. Separating the fact from the fiction is very important for those who need to make decisions about future care and potential treatments.

Let’s look at some of the myths that sometimes prevent the real Alzheimers disease information from getting out:

* Memory loss is normal. While it might be normal to become a little forgetful as we age, serious memory loss is not normal. Any severe loss of memory, such as that associated with Alzheimers or other forms of dementia, is not normal under any circumstance.

* Aluminum causes Alzheimers. The real Alzheimers disease information to be had out of this one is that there is no known cause for this condition. There are some potential links, but confirmation has not been made. In regard to aluminum specifically, studies have not been able to determine a real link between drinking out of cans and contracting Alzheimers. The flu shot rumor also doesn’t seem to be true.

* The condition is not fatal. This is a false piece of Alzheimers disease information. While it is more likely that other conditions will arise that can be fatal before the deterioration progresses to the parts of the brain that control major bodily functions, the disease is considered fatal in and of itself by many experts.

* Diet sodas cause Alzheimers. This is another fallacy. The U.S. Food and Drug Administration has been studying this claim since some scientists raises concerns about Nutrasweet and Equal, but no connection has been found as of yet.

* Alzheimers can be stopped in its progression. Sadly, this is not true. While there are some treatments that might slow the steady pace of progression, stopping it is not possible at this time. It might even be possible to stabilize a patient for a while, but no treatments have proven effective over the long haul.

Alzheimers disease information available to date doesn’t provide a lot of answers for patients and their families that might be struggling to come to grips with a diagnosis. The reality is there is still much to learn about this condition and with how little is actually known, many myths seem to thrive.

Patients and families with questions and concerns should seek medical advice. There are even some very good support groups for those impacted by this mysterious and devastating condition.

For more information on Alzheimers, try visiting http://www.helpwithalzheimers.com - a website that specializes in providing Alzheimers related tips, advice and resources to include information on Alzheimers disease information.

Article Source: http://EzineArticles.com/?expert=Samantha_Kay

               

Dementia, Alzheimer’s, the Elderly and Sex (part 3)

Okay, this is my last post on the whole dementia, Alzheimer’s and sex subject. But this subject really has me thinking about the rights of people with dementia.

Is a 14 or 15 year old any more able to give consent than a person with dementia?

Is it actually possible for caregivers to discuss this issue and come to a conclusion when the loved one is in the earlier stages of Alzheimer’s disease?

Should long term care facilities/nursing homes make provision for spouses or “friends” to have sexual relations?

How does the dynamic change is one person has dementia and the other does not? Does it matter if the affected person is a male or female?

Should families or facilities make arrangements for safe/clean sexual encounters between residents?

At what point, if any, should facility staff/management get involved in relationship between patients?

Was there a relationship prior to the dementia (as in the case of a spouse or a person who entered the facility for something other than dementia, but now has dementia)

What part do the persons past morals and values play in the decision?

Should the caregiver’s morals be considered?

I suppose all of these questions mean that it’s an area that must be carefully studied, that there are as many answers as there are individual situations. In many religious traditions, sex outside of marriage is forbidden. The “rule” is usually enforced for the young or for divorcees. Does it actually apply to the elderly as well?

Please, I’ll give you a virtual penny for your thoughts. What’s your opinion?

               

Alzheimer’s Disease and Incontinence

Yesterday, we talked about the fact that incontinence and Alzheimer’s disease are companions.

Today, I want us to investigate incontinence a little deeper. We’ll look at types of incontinence and some differences between men and women. Hopefully, we’ll help you to be able to ask the right questions and/or figure out if your loved one’s incontinence is temporary and due to some underlying medical issue, or if it’s the incontinence brought on as Alzheimer’s disease progresses.

Women are more likely than men to be incontinent. Chalk that up to pregnancy, the resulting childbirth, menopause, and the structure of the female urinary tract.

There are also several different types of incontinence. I’ll go through them quickly, just to give you an idea.

Stress–Leakage generally caused by coughing, exercising, laughing, sneezing. or some physical pressure on the internal abdominal area.

Urge–Urination begins at the same time the urge to go is felt. The bladder contracts for seemingly no reason. Can be brought on by the sound of water or even by the washing of impacted person’s hands.

Overflow–Usually caused by a physiological issue that causes the bladder to be full most of the time.

Functional–Caused by brain function issues, such as inability to carry out the steps necessary to go to to the bathroom when the urge is felt. Inability to translate the feeling into urge to use the bathroom, and/or deterioration of brain function.

A urologist or gynecologist can help to make the proper diagnosis. In the early stages, simply adjusting liquid intake or prompting affected person to use the bathroom may be helpful. You do want to rule out physiological issues if your loved one is in the earlier stages of Alzheimer’s disease. Even something as simple as a urinary tract infection can cause urinary incontinence.

Now, here’s the tricky part, getting your loved one to ACT NOW before it gets unsanitary and embarrassing for all involved. There is no easy way to approach the subject, but the smarter way is earlier rather than later. If you start talking about it while your loved one can still communicate fairly logically, it will be easier. If the affected one understands that she has Alzheimer’s disease, then that may take away a little of the resistance.

Explain that incontinence doesn’t make her any less of a person (mom, grandmother, sister, wife), it’s just an inconvenient part of Battling Alzheimer’s disease. Often, by the time the affected person is incontinent, he or she is in the later stages of the disease and it may just be a matter of selecting the best products and using them without the need for explanation or coaxing on your part.

Even still, you’ll need some information and guidance as to the products, how to use them properly and how to manage the process  so that it is clean and healthy for you and your loved one. That’s what we’ll talk about in the upcoming posts.

Until then, remember … Like I said in the post, “You gotta do what you gotta do….dealing with Incontinence.”  Everyone poops!

               

You Know it is Time To Stop Driving When

You’ve been thinking about it, but you are not sure if it’s really time to take the car keys from your loved one who has Alzheimer’s disease.  Below is a list to help you make the decision, but in the meantime keep these thoughts in mind.

Alzheimer’s is not just “getting old” and losing memory.   So the, “to drive or not to drive” issues are more complicated than driving too slowly, or getting a little turned around in terms of directions. 

Those with Alzheimer’s lose some visuospatial ability.  In English that means that they have difficulty perceiving and understanding the space between objects in their field of vision.  So, the car that is just ahead of them may appear to be way down the road.  And the man jogging across the the street two blocks ahead, may seem as if he is running out in front of the car.

Another issue is judgment and the ability to prioritize and respond to events in an appropriate manner.  So, that Uncle Bill may carefully give way to an ambulance with no lights or sirens, but may not respond at all to the stopped car in front of him.

So,  here goes, “You know its time to stop driving when…….”

10.   Dad, usually a careful and safe driver, has received several tickets or warnings in a short and recent period of time.

9.     You make lame excuses like, my puppy needs to practice her driving skills or the goldfish has swimming lessons, to keep your loved one from driving even short distances.

8.    There are unexplained scratches and dents on the car, garage doors, and mailbox.  And “vandals” have been showing up at night driving into the flower bed near the street or driveway.

7.     Uncle Bill perfectly straddles the yellow line in the middle  of the road.

6.     There is a hole or indentation on the floor where you or other passengers continually use the passenger side brakes.

5.     Grandma stops completely and waits a long time in order to merge with traffic or get onto a highway entrance/exit ramp.

4.     When you ride with Aunt Gertrude, you don’t see very much because your hands are covering your eyes.

3.    Mom sails through the red light and swears at the person who (had the green light) because he blew the horn.

2.     Dad drives 60 mph hour through the park and 25 mph on the highway.

1.     And the number one reason you KNOW its time to take the keys is if you have laughed AND related to one or more of the items in this list.

Hopefully, you smiled as you read the list.  It’s important to keep a sense of humor about these difficult issues.  However, safety is no laughing matter.  So, if you can relate to the above, then its time to get serious about taking those keys.

So, check out the joke below and smile.

 A guy is driving home from a round of golf.  His wife calls him and she is frantic.  “Honey, be very careful, I just heard the news and there is a crazy guy driving down the wrong side of the freeway.”  He replies.  ”Honey, it’s much worse than that, there are HUNDREDS of people driving on the wrong side of the freeway.”

So, are you thinking of taking the keys? Have you already taken them? Do you have a funny or not so funny driving experience?  Let’s talk about it!

               

Civil rights for Alzheimer’s patients

Do Alzheimer’s patients have civil rights? Of course, they do. But what are they? How do they get them? In the area of civil rights, they are under a double or triple cloud. Last month the Alzheimer’s Society in the UK issued a new report about abuses of Alzheimer’s patients.

Why do Alzheimer’s patients have trouble getting their civil rights? First, they are vulnerable and powerless. You can’t stage a protest march when you’re in a wheelchair and need someone to push it. You can’t organize a boycott when you no longer pay your own bills. You can’t give impassioned speeches if you can’t organize your thoughts. And a disproportionate number of people with dementia are African American or Hispanic, since those groups have a disproportionate amount of stroke, high blood pressure, and diabetes.

Second, nobody really wants to give full rights to mentally handicapped people. My grandmother was never declared mentally incompetent, and I was never declared her legal guardian, but I had no trouble signing for her or getting access to her personal information from people who were supposed to be protecting it. Why? How? Because I told them that she had Alzheimer’s and that was all they needed to know. That was fine for me and her, because she wanted me to handle her affairs, and I would never take advantage of her. But in a system where nobody questioned her DNR (Do Not Resuscitate) wristband, it was not safe to grant full rights over her to a disinterested professional because they insisted they wanted what’s best for her. She lived happily for two more years after that incident - she was not exactly on her last breath.

Third, we don’t really know how to give civil rights to Alzheimer’s patients. If someone can’t communicate their wishes, it’s difficult to follow their wishes. If someone gets violently frustrated when she has to make a decision, to give her too many decisions is not compassionate. Mental disabilities are a difficult legal challenge.

But that doesn’t mean we shouldn’t try to preserve the human rights of Alzheimer’s patients. Health Professions Press is one group who has published an Alzheimer’s Bill of Rights. The issues are not all that different from those faced by other groups in our society. People are prejudiced against them, and feel justified in doing so. When they can still work, they have trouble getting work. When work becomes difficult, they have trouble receiving the accommodations they need to keep working.

In the United States and elsewhere, of course, this is all illegal. The Americans with Disabilities Act prohibits discrimination on the basis of a disease. And I’m sure that some employers don’t discriminate. If some workers with Alzheimer’s disease must have all their instructions in writing because they forget easily, some employers provide all their instructions in writing.

But I’m not naive enough to believe that happens all the time. I heard about an 87-year-old retired cleaning lady who was denied coverage for home health care because she couldn’t provide copies of her rent checks as evidence. Except that, because of Alzheimer’s disease, she could no longer write checks. No, discriminating against a certain class of people is common and easy - people with terminal diseases, which Alzheimer’s is. Because, eventually, these people won’t be able to protest their treatment.

               

For the elderly, Alzheimer’s is not the only problem

One reason why Alzheimer’s disease is so difficult to treat, and sometimes even to identify, is that its symptoms can be caused by other diseases. Earlier I mentioned that, besides Alzheimer’s, my grandmother also had macular degeneration - she was losing her vision in her 60s, and was legally blind for thirty years. Sensory deprivation can cause delusions in itself. People with macular degeneration can hallucinate. Perhaps the mind, struggling to make sense of the fog it sees, gets a little too creative.

Alzheimer’s is primarily a disease of the old, and the older you are, the more likely you are to have it. There are hundreds of thousands of exceptions, in both directions. Kris, who writes Dealing with Alzheimer’s, is one of hundreds of thousands of people under 65 who have early-onset Alzheimer’s disease. 82-year-old blogger Millie Garfield, who writes My Mom’s Blog, has a better memory than I do. The ageless project lists ten bloggers over 75.

But the fact remains that Alzheimer’s disease affects more than half of all people over 85, according to the Mayo Clinic.

But when you put it that way, the question is: what else affects most people over 85? What else affects how they think and how they are treated?

• Older people move slower. If you move slowly, people assume you think slowly. If you talk slowly, as many older Southerners were trained to do, people become convinced that you think slowly.
• Older people get less respect. If people believe that you think slowly, they won’t ask you any mentally stimulating questions. And they certainly won’t listen to hear if you have any mentally stimulating answers. It takes patience to walk and talk with a slower person. Even I have trouble with that, after living for years with my grandmother.
• Older people can’t hear or see as well as young people. As my grandmother’s doctor explained, sensory deprivation causes mental deterioration. That’s one reason why endless solitary confinement is so cruel, and why people who have been institutionalized for years have trouble recovering in their minds.
• Older people have less stimulation. They play few video games. You and I have millions of things to think about - maybe too many things - because they’re bombarding our eyes and ears dozens of times a minute (hundreds of times a minute if you’re living la vida electronica). But when you can’t see or hear, you don’t have much to think about.

               

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