Falls Could Signal Early Alzheimer's Disease

By HealthDay News Staff 

Seniors whose brain scans indicated preclinical disease twice as likely to fall, study finds. 

 

SUNDAY, July 17, 2011 (HealthDay News) — Compared with older people with no signs of Alzheimer's, those whose brains show early signs of the disease are twice as likely to experience a fall, researchers have found. 

In the new study, investigators looked at brain scans of 125 older adults who were participating in a study of memory and aging. The seniors were also asked to keep track of how many times they fell over the course of eight months. 

An increased risk of falls was noted among individuals whose scans showed early signs of Alzheimer's. The study authors suggested that falls could indicate the need for an evaluation for the memory-robbing disease. 

"To our knowledge, this is the first study to identify a risk of increased falls related to a diagnosis of preclinical Alzheimer's disease," study author Susan Stark, an assistant professor of occupational therapy and neurology at Washington University in St. Louis, said in a news release from the Alzheimer's Association International Conference. 

"This finding is consistent with previous studies of mobility problems among persons with very early symptomatic Alzheimer's or mild cognitive impairment. It suggests that higher rates of falls can occur very early in the disease process," Stark added. 

The study, which was slated for presentation Sunday at the Alzheimer's Association International Conference in Paris, found that of the 125 adults studied, 48 people experienced at least one fall. 

The brain scans of the participants showed that higher levels of an imaging agent that binds to the abnormal protein growth that is a signature of Alzheimer's disease, was associated with a 2.7 times higher risk of a fall for each unit of increase on the scan. 

The researchers noted that Alzheimer's has been linked to balance and gait disorders, as well as problems with visual and spatial perception, which could put people with the disease at higher risk for falls. Based on their findings, they added, these symptoms may appear before other more obvious signs of the disease, such as memory loss and impaired thinking. 

"Growing scientific evidence suggests that 'silent' biological changes may be occurring in the brain a decade or more before we can see the outward symptoms of Alzheimer's," Maria Carrillo, Alzheimer's Association senior director of medical and scientific relations, said in the news release. "According to this study, a fall by an older adult who otherwise has a low risk of falling may signal a need for diagnostic evaluation for Alzheimer's." 

The study authors concluded that additional research is needed to improve early detection and intervention in Alzheimer's disease. Lowering the risk of falls, they added, could also have an economic impact since these incidents contribute to higher rates of disability among older adults, premature placements in nursing homes and more than $19 billion in direct medical costs in 2000 alone. 

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

Can Caffeine Ward Off Alzheimer's?

By Marie Suszynski | Medically reviewed by Pat F. Bass III, MD, MPH

A hot cup of joe may do more than keep you awake through your next meeting. Research is finding that it may help prevent memory problems. 

 

Anyone with a family history of Alzheimer’s disease or dementia wants to do everything possible to avoid the diseases. Now, researchers have found that some protection may be as close as your coffee mug.

The Journal of Alzheimer’s Disease recently published a special supplement of key findings that suggest caffeine may help keep the brain functioning properly and help ward off Alzheimer’s and dementia.

Here’s what researchers are discovering about caffeine’s role in the brain and how it may protect against memory problems.

 

Key Research Findings About Alzheimer’s and Caffeine

Research shows that caffeine seems to have a big effect on adenosine receptors, which are found in brain cells. An imbalance of adenosine has been associated with neurological disorders like Alzheimer’s disease, and higher levels of caffeine intake seem to protect against Alzheimer’s disease. Researchers believe regular consumption of caffeine “normalizes” memory function, or protects against the loss of memory, especially among people who are under stress. And stress is a well-known cause of memory problems.

One study found that coffee drinking during the previous two decades was associated with a lower risk of developing Alzheimer’s disease. Another study of 1,409 people 65 and older found that drinking three to five cups of coffee a day meant a 65 percent decreased risk of developing Alzheimer’s disease, compared with consumption of little or no coffee.

Animal studies also found that caffeine had beneficial effects on the brain, but the research is conflicting. Some studies have concluded that moderate doses of caffeine helped memory, while high doses seemed to hurt it.

Though caffeine seems to help protect against memory problems, researchers aren’t convinced that it actually enhances memory. A review of studies of caffeine’s effect on memory in people who don’t have dementia found conflicting results — several studies that suggested it improved memory, while others found that it didn’t. At best, researchers say, caffeine may be mildly beneficial in this regard.

 

Applying the Research to Alzheimer’s Prevention

Although there’s no evidence that anyone can prevent Alzheimer’s disease, some doctors like Dharma Singh Khalsa, MD, the Tucson, Ariz.-based founding president and medical director of the Alzheimer’s Research and Prevention Foundation and author of Brain Longevity, believe that numerous lifestyle factors can have an important impact on the brain and be protective.

Nutrition, stress-management, exercise, mental stimulation, and possibly hormone therapy may all influence how healthy your brain is, Dr. Khalsa says. “Caffeine is the next level out. Caffeine is a mild stimulant — we think stimulation is synonymous with a better-functioning brain,” he explains, but adds that there’s no one magic bullet. Living a complete, healthy lifestyle is important for keeping your brain healthy.

 

Other Strategies to Thwart Dementia

While filling up your coffee mug every day may offer some protection, here are other important approaches to Alzheimer’s prevention.

• Eat a balanced diet with plenty of vitamins. Diets that focus on fruits and vegetables with little red meat, such as the Mediterranean diet, are associated with healthier brain function, Khalsa says. Getting enough B vitamins, fish oil, and vitamins C and E may also contribute to a healthy brain.
• Stop stressing. Lowering your stress level, particularly when you do it with exercise, is also part of the cognitive health picture, Khalsa says.
• Stay mentally active. Continue to constantly challenge yourself with new, stimulating experiences from travel to artistic expression to just enjoying nature. Learn to play a new musical instrument or dabble in a hobby you’ve always wanted to try.

Although caffeine looks promising and is easy to get, leading a lifestyle that includes a variety of brain-healthy practices is your best bet.

How Do Alzheimer's and Dementia Progress?

By HealthTalk Staff | Medically reviewed by Ed Zimney, MD

Learn about the seven stages of Alzheimer's and specific symptoms that typically arise during each period. 

The way the disease proceeds and the array of symptoms that arise over time can vary from person to person. For consistency, physicians use the following staging system to identify the progression of the disease:

 

Stage 1: No impairment

The person has no memory problems, no perceptible symptoms, and is functioning normally.

 

Stage 2: Very mild cognitive decline

Decline in memory or thought processing may be normal for the person’s age or may be the first signs of Alzheimer’s. The person may complain of memory lapses, such as forgetting familiar words or losing personal items, like glasses and keys. But these are subjective indicators, and problems probably will not be apparent yet to friends or family members.

 

Stage 3: Mild cognitive decline

The person may:

• Not remember the names of new people they are introduced to
• Have a noticeably impaired ability to work or interact socially
• Lose or misplace valuable items
• Have a marked inability to plan or organize

Stage 4: Moderate cognitive decline

The person may:

• Not recall recent events
• Be unable to perform relatively challenging mental tasks, such as counting backwards from 100 by 7s
• Have a diminished ability to do complicated everyday tasks, such as shopping and paying bills
• Not remember significant events in his or her own life
• Begin to be withdrawn, particularly in challenging situations

Stage 5: Moderately severe cognitive decline

The person may:

• Not remember important information, such as their address or telephone number
• Know where they are, the day of the week, the month, or the season
• Have trouble with less challenging mental tasks, such as counting backwards from 40 by 4s
• Need help choosing clothing appropriate for the season or the setting
• Retain knowledge about themselves, such as their own name and the names of their immediate family members
• Eat, use the toilet, and perform similar personal functions on their own.

Stage 6: Severe cognitive decline

The person may:

• Be unaware of their surroundings and recent events
• Know their own name, but not remember their own personal history very well
• Sometimes forget their spouse’s name, but distinguish familiar from unfamiliar people
• Need assistance to dress
• Have an abnormal sleep/waking cycle
• Need help using the toilet (wiping, disposing of toilet paper, or flushing toilet)
• Develop urinary or fecal incontinence
• Undergo personality changes, such as extreme suspiciousness
• Experience delusions or hallucinations, or exhibit compulsive, repetitive behaviors such as hand-wringing
• Wander and become easily lost

Stage 7: Very severe cognitive decline

The patient may:

• Lose their ability to speak coherently (although they may utter occasional words or phrases)
• Need help with eating, using the toilet, and personal hygiene
• Have general urinary incontinence
• Be unable to walk or sit without help
• Eventually, be unable to hold up their head or swallow

 

Is It Alzheimer's?

• By Katherine Lee

What distinguishes Alzheimer's from other types of dementia? Here's how experts make a diagnosis

Dementia is a general term that describes a significant loss of intellectual abilities, including memory, the ability to reason, and other cognitive and behavioral changes that can interfere with daily life. While a number of health conditions can lead to dementia and related brain deterioration, the most common cause is Alzheimer's disease, which according to one recent study sponsored by the National Institute on Aging, now accounts for as much as 70 percent of all cases of dementia in people 71 and older.
Alzheimer's disease strikes about 5 percent of all people between the ages of 65 and 74. Some forms of dementia can be treated, and some symptoms may even be reversed, especially if caught early. Most types of dementia, however, including Alzheimer's, become progressively worse and are, as of now, incurable.
 
Symptoms of Dementia
While dementia presents itself differently from individual to individual, common symptoms include:

• Memory loss that increases over time
• Language problems, such as difficulty finding words or understanding spoken or written communication
• Disorientation, eventually extending to familiar places
• Persistent confusion, including about the date or time of day
• Face-recognition issues, in time even with familiar people
• Lack of self-regard, including neglect of personal safety or hygiene
• Inability to do routine tasks, such as pay bills or shop for groceries
• Erratic behavioral and psychological changes, such as paranoia, hallucinations, depression, temper tantrums, or insomnia

Diagnosing Alzheimer's
Since the only way to definitively confirm the presence of Alzheimer's disease is by looking at changes in brain tissue, which can usually only be examined after death during an autopsy, any diagnosis of Alzheimer's is essentially an educated guess. But, despite the challenge of sorting out Alzheimer's from other causes of dementia, experts at the National Institute on Aging estimate that doctors at specialized centers can now diagnose Alzheimer's with 90 percent accuracy. Some diagnostic tools doctors use for Alzheimer's include:

• Patient evaluation, including an overview of their general health, previous medical conditions, and their ability to conduct daily activities
• Cognitive tests to measure memory, problem solving, and language skills
• Lab tests of blood, urine, and spinal fluid
• Brains scans

Other Forms of Dementia
While Alzheimer's disease is the most common form of dementia, affecting an estimated 4.5 million Americans, other diseases or traumas can also lead to neurological dysfunction. In some cases, different types of dementia can coexist in one patient. Some examples of non-Alzheimer's dementia include:
Vascular dementia. Caused by impaired blood flow to parts of the brain, this form of dementia can occur when narrowed blood vessels provide less oxygen than necessary to the brain tissue, after a major stroke, brain hemorrhage, or a period of catastrophically low blood pressure, or due to other artery-damaging conditions such as systemic lupus erythematosus or temporal arteritis. Onset of symptoms can be sudden (such as following a major stroke) or can progress gradually after a series of smaller strokes (called multi-infarct dementia).

Dementia with Lewy bodies (DLB). Patients with this type of dementia have abnormal clumps of protein in their brains. DLB symptoms include progressive cognitive decline with lethargy, visual hallucinations, and loss of movement and motor control. Lewy bodies have also been found in people with Parkinson's disease and Alzheimer's, suggesting a connection among the three conditions.
Frontotemporal dementia (including Pick's disease). This rare disorder is sometimes characterized by the shrinking of areas in the front and sides of the brain (which can be detected with a brain-imaging scan). Because these areas of the brain regulate social behavior and judgment, this type of dementia is often characterized by sudden personality changes and inappropriate behavior, as well as by problems with understanding and using language.
Huntington's disease. People with this fatal genetic disorder develop involuntary movements, such as twitches and spasms, difficulty with motor tasks, mood swings, intellectual impairment, personality changes, and eventually severe dementia.
Parkinson's disease. Early symptoms of Parkinson's include stiffness of the limbs, tremors, speech impairment, and difficulty with walking and muscle control. Dementia can often occur as a secondary symptom in the later stages of the disease.
Related reactions. Some other situations that can cause dementia-like symptoms include reactions to medications, thyroid problems, infections in the brain, alcoholism, HIV-related dementia, and even vitamin deficiencies.
The Future of Alzheimer's Diagnosis
Early and accurate diagnosis offers the best chance of treating Alzheimer's symptoms and helps to give patients and their families more time to evaluate and discuss their treatment and care options. For this reason, doctors are working on ways to improve early detection. Some of the latest efforts include:

• Memory tests. Researchers are working to improve standardized memory and recall tests to better track changes that might indicate early Alzheimer's and even predict which individuals are at higher risk of developing the disease in the future.
• Tissue comparisons. Studies are examining the relationship between early damage to brain tissue and later development of Alzheimer's.
• Blood tests. Researchers are looking for ways to identify changes in blood chemistry that could one day lead to blood tests or other simple tools to identify individuals at risk for Alzheimer's.
• Imaging scans. Doctors are looking at ways to use neuroimaging, such as positron emission tomography (PET) and magnetic resonance imaging (MRI), to one day help identify individuals who are in the early stages of the disease, even before they develop symptoms.

 

Rewiring My Brain and Stepping into Alzheimer's World

Once you start to understand how things work in Alzheimer's World you get calm and comfortable.

Once you get calm and comfortable you give off a better "vibe" to someone that has Alzheimer's.

By Bob DeMarco Alzheimer's Reading Room 
I would find a new way to communicate with my mother who was suffering from Alzheimer's disease.
I wrote that on my da Vinci pad in 2004. This was at the same time I was coming to another conclusion, something had to change and that something was me.
I did not perceived the changes in communication as being difficult. After all, I had been studying communication and decision making all the way back to college days, and ever since. I figured some practice and I would get the hang of it.
What I did not immediately perceive was how difficult it would be to change all the things I had learned over the course of my life.
For example, I had to learn how NOT to feel bad when my mother said something mean spirited to me.

I knew consciously that every time my mother said something "mean" to me, she didn't mean it. I knew this because she never said any of those things to me before dementia started affecting her brain. Her ability to think and feel.
So, I knew it was Alzheimer's that was causing her to be so "mean".
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• Problems with Balance, Walking, Falling Can Be an Early Sign of Dementia

Nevertheless, when Dotty said something mean, and even though I knew she didn't mean it, I still felt sad, angry, and often snapped back at her. In other words, I reacted the way I would react to anyone that treated me in that way.

All I can say is, Wowie Zowie. It is very hard and very difficult to change patterns of behavior that you learned over 50 years.

I had to rewire my brain.

I decided it would be easier if I could put myself in a new place. This is why I invented Alzheimer's World. Instead of trying to relearn my entire life, I decide I would start a brand new life, a second parallel life.

My new second life would reside within the confines of Alzheimer's World. In Alzheimer's World all the rules, feelings, and methods of communication would be different.

I started developing some ideas about how I would communicate effectively with someone that couldn't remember they were mean to me, and really couldn't remember my "too long" explanations of this and that.

In order to get control of my emotions I knew I had to move fast and seamlessly into Alzheimer's World. I had to get there before the anger came up. Anger, even though I knew I shouldn't be angry.

At first, I was having trouble getting to Alzheimer's World on time.

I came up with an idea that worked. As soon as the craziness started, I would take one giant step to the left. An actual physical step to the left. As I made this step, I would tell myself that I was going into Alzheimer's World.

It took a while, but it worked. My brain was rewired. More or less segmented into two parts, real world and Alzheimer's World. Over time I learned to separate one from the other.

Once I learned how to step seamlessly into Alzheimer's World something wonderful started to happen. Dotty finally, after a few years, stopped saying all those mean and nasty things to me.

She started telling people, Bobby is a good boy.

Here is the best part. The better I became at communicating in Alzheimer's World, the sweeter and more cooperative Dotty became. Not that the world is perfect. Dotty is still Dotty and she can still be a big pain in the butt.

You see, once I accepted that I needed to communicate and interact with Dotty in her new world she became happier and easier to deal with.

Now, we didn't leave the real world. Alzheimer's World is a combination of the two worlds. In Alzheimer's World it is understood that the person can't remember the now. They can't remember the sentence before this one.

In Alzheimer's World it is perfectly fine if someone asks the same question 20 times in a row. This is how communication goes in Alzheimer's World. In Alzheimer's World it is perfectly fine if a person says NO 50 times a day. NO does not have the same meaning in Alzheimer's World. In fact, in my opinion NO has no meaning in Alzheimer's World. Just think, duh.

Once you start to understand how things work in Alzheimer's World you get calm and comfortable. Once you get calm and comfortable you give off a better "vibe" to someone that has Alzheimer's. If you can get to the "vibe", the person suffering from Alzheimer's becomes calmer and feels more secure.

Let's put it this way. If you were sent to live somewhere where all the people were purple and they spoke so fast you couldn't understand a word they were saying -- how would you feel?

If you felt like all the purple people didn't like you -- how would you feel all day long?

If you were stuck in this purple world and couldn't figure out how to get out, and couldn't understand how you got there in the first place -- how would you feel?

Alzheimer's World can be a wonderful place. In fact, most Alzheimer's patients are very sweet once you get to know them. They are very appreciative.

Keeping stepping to the left. You'll find the door to Alzheimer's World.

This article is a repeat of an article that was published previously. It ranks in the top 25 most frequently read articles on the ARR, and has been widely shared via on Google+ and Facebook.

_________________________________________________

Bob DeMarco  is the Founder of the Alzheimer's Reading Room (ARR). Bob is a recognized expert, writer, speaker, and influencer in the Alzheimer's and Dementia Community worldwide. The ARR Knowledge Base contains more than 4,900 articles. Bob lives in Delray Beach, FL.

Original content the Alzheimer's Reading Room