Women Bear Greatest Burden of Alzheimer's

By Mary Elizabeth Dallas, HealthDay News 

Survey finds they're more likely than men to have Alzheimer's or take care of someone with the disease. 

 

MONDAY, July 18, 2011 (HealthDay News) — Women fear Alzheimer's disease more than any other illness except cancer, and they are more often on the front lines of providing care for loved ones battling the disease, new research shows.

"With statistics consistently pointing to the fact that more women are living with Alzheimer's and caring for people with Alzheimer's, it is clear women are disproportionately affected by this disease," said Angela Geiger, chief strategy officer of the Alzheimer's Association.

A survey of women in France, Germany, Spain, Poland and the United States revealed that women are at the center of the global Alzheimer's epidemic. The multinational research team found women in all five countries were more concerned than men about a loved one developing the disease.

Women in all countries, the survey also found, were more likely than men to be involved in the daily care of someone with the disease. In fact, women in France and Poland were significantly more involved in the decision-making and financial support of an Alzheimer's patient.

If roles were reversed and those polled were to develop the disease, most identified their spouse as the person who would be responsible for their primary care. Men, however, identified their wives 6 percent to 18 percent more often than wives identified their husbands. In contrast, women were more likely to say they would rely on their children or paid caregivers outside the family to care for them.

Despite their fear of the disease, which currently affects 36.5 million people worldwide, and their greater burden as caregivers, 71 percent of women in France and 76 percent of women in the United States seem to be more optimistic that a treatment for Alzheimer's will be developed within five years. That may be one reason why the survey also showed that women believe government spending on Alzheimer's research should be increased.

"These insights reinforce the conclusions published in The Shriver Report: A Women's Nation Takes on Alzheimer's, which found the impact of Alzheimer's on women is significant. The perspectives we see in this survey must prompt thoughtful conversations about Alzheimer's with our friends, family members and government officials to change the trajectory of Alzheimer's disease," concluded Geiger.

The research was slated for presentation Monday at the Alzheimer's Association International Conference in Paris. Research presented at medical meetings should be viewed a preliminary until it is published in a peer-reviewed medical journal.

Could a Diet Help Prevent Alzheimer's?

By Amanda Gardner, HealthDay News

Low-fat, low-glycemic eating plan improved 'biomarkers' of the disease, researchers say. 

 

MONDAY, June 13, 2011 (HealthDay News) — The low-fat, low-glycemic diet often promoted for general health and well-being may lower the risk of developing Alzheimer's disease if adopted early in life, researchers say. 

But starting such an eating plan after symptoms surface doesn't seem to help prevent deterioration of brain function, according to new research published online June 13 in Archives of Neurology. 

"This is not the first time this concept has emerged, that things you do in midlife or earlier on may have effects later on," said Dr. Marc L. Gordon, chief of neurology at Zucker Hillside Hospital and an Alzheimer's researcher at the Feinstein Institute for Medical Research in Manhasset, N.Y. 

"For example, we know that midlife obesity is associated epidemiologically with a higher risk of late-life dementia," he continued. "Whether that's causal or an effect of the disease is open to speculation, but it suggests that there may be periods of vulnerability that are different in different times in the life span." 

Although numerous studies have probed connections between lifestyle factors and cognitive ability, no solid proof yet exists that diet (or much else) can prevent Alzheimer's, the most common form of dementia among the elderly. 

A low-glycemic diet, which focuses on eating fruits and vegetables, whole grains and lean meats, avoids spikes in blood sugar and is said to promote feelings of fullness. 

A U.S. National Institutes of Health conference convened last spring concluded that, for now, older age is the leading known risk factor for Alzheimer's disease. A gene variation is also tied to increased risk for the brain disorder, the NIH review said. Experts at the conference stressed that the general public should still focus on avoiding behaviors already linked to other chronic diseases. 

This new study looked at the effect of different diets on biomarkers associated with Alzheimer's, such as blood sugar levels, cholesterol and blood lipid levels. The researchers also tested memory after participants followed the assigned diets. 

Twenty healthy adults and 29 with mild memory problems that could be predictive of Alzheimer's followed either a high-fat, high simple-carbohydrate diet ("HIGH" diet) or a diet lower in fat and simple carbohydrates ("LOW" diet). 

After four weeks, healthy participants on the LOW diet had changes in biomarkers, including insulin and lipid levels in the blood, which were moving away from those normally associated with dementia. 

In participants with mild cognitive impairment, this diet had the opposite effect. 

Commenting on the study, Dr. Suzanne de la Monte, professor of neurosurgery and pathology at Brown University and Rhode Island Hospital in Providence, said it remains to be seen if the changes noted in this study actually translate, over the longer term, into differences in risk for developing Alzheimer's disease. 

The bottom line, though, is the same as it's been for eons: A healthy diet lowers your risk of type 2 diabetes, heart disease, cancer and maybe even Alzheimer's. 

That means staying away as much as possible from processed foods, de la Monte advised. 

A second study, in the same issue of the journal, also looked at biomarkers and found that different levels were associated with different measures of cognitive function associated with Alzheimer's disease. 

This finding could help improve diagnosis of Alzheimer's, which now relies mostly on clinical observation.

Alzheimer's Cases Could Double With New Guidelines: Expert

HealthDay News

TUESDAY, April 19 2011 (HealthDay News) — The first new guidelines in 27 years for the diagnosis of Alzheimer's disease could double the number of Americans defined as having the brain-robbing illness.

The guidelines, issued Tuesday by the Alzheimer's Association and the U.S. National Institute of Aging, differ in two important ways from the last recommendations, which have been in use since 1984. 

First, Alzheimer's is now being recognized as a continuum of stages: Alzheimer's itself with clear symptoms; mild cognitive impairment (MCI) with mild symptoms; and also the "preclinical" stage, when there are no symptoms but when recognizable brain changes may already be occurring. 

Second, the new guidelines incorporate the use of so-called "biomarkers" — such as the levels of certain proteins in blood or spinal fluid &madsh; to diagnose the disease and assess its progress, but almost exclusively for research purposes only. 

Still, the authors of the guidelines emphasized that these revisions are unlikely to change what happens in doctors' offices when diagnosing Alzheimer's or its precursors.

"It will not change practice," said Dr. Guy M. McKhann, one of the guideline authors, at a Monday press conference. 

MCI will, however, become a new diagnosis. And that could mean that the number of people considered to be on the new Alzheimer's continuum could double, said Marilyn Albert, another author, director of the division of cognitive neuroscience at Johns Hopkins. But how MCI is determined won't change. 

The new U.S. National Institute on Aging/Alzheimer's Association Diagnostic Guidelines for Alzheimer's Disease now recognize three clear stages of Alzheimer's disease. 

The first and most severe is Alzheimer's dementia, when patients are clearly cognitively and functionally impaired. This is to be characterized now not just by memory loss but also visual, spatial and judgment problems.

The new guidelines also make a clearer distinction between Alzheimer's dementia and vascular dementia (such as that caused by stroke), McKhann said. The diagnosis will still be made by a doctor, with help from someone who knows the patient and perhaps the patient him- or herself, but biomarkers may be called in "to augment our certainty about the diagnosis," said McKhann, a professor of neurology and neuroscience at Johns Hopkins University School of Medicine in Baltimore. 

Another stage, MCI, can represent an earlier phase of dementia and consists of modest impairments, primarily in memory, which can be a harbinger of full-blown Alzheimer's years down the road. In the research arena, investigators will be working towards standardizing biomarkers which indicate, for example, the presence of amyloid protein or nerve damage in the brain.

But for now, how diagnoses are made "will be extremely similar to what's been used in the last 10 years," said Albert, who added that "a very large number" of individuals with MCI do go on to develop Alzheimer's. 

"Older adults with MCI progress to dementia at a higher rate than those with no impairment, but progression is not inevitable," according to the Alzheimer's Association's online overview of mild cognitive impairment.

"Not everyone diagnosed with MCI goes on to develop Alzheimer's," the association noted.

The preclinical category was formulated for research purposes only, namely to study biomarkers that may be present in the blood or cerebrospinal fluid or evident on different imaging tests that would indicate the build-up of amyloid plaque or damage to nerve cells.

"The main conceptual point was to define Alzheimer's on the basis of the underlying brain changes rather than just requiring clinical symptoms," said Dr. Reisa A. Sperling, a neurologist at Brigham and Women's Hospital and associate professor of neurology at Harvard Medical School in Boston. "We thought our best chance for disease-modifying therapy was to detect evidence of the disease and intervene much earlier."

As in cancer and diabetes, McKhann pointed out, if you're trying therapies "only in people who have advanced dementia, the chances of them working is not very great."

"We're worried that there could be drugs around now that could be beneficial but that we could be using them too late in the disease course," added Albert. 

The new guidelines, summarized William Thies, chief medical and scientific officer of the Alzheimer's Association, "will result in little change in current clinical practice of medicine as applied to Alzheimer's disease. . . . [However] the new criteria are really extending the range of our ability to investigate this disease and eventually to find treatments that will be so necessary to avoid the epidemic of Alzheimer's that we see facing us."

The new guidelines appear in four papers in Alzheimer's & Dementia: The Journal of the Alzheimer's Association.

The 'Grey's Anatomy' Alzheimer's Test: Could You Pass It?

By Sharon Tanenbaum | Medically reviewed by Ed Zimney

Characters from the hit show are testing patient memory as part of an Alzheimer's disease clinical trial — but should you worry if the questions trip you up? 

 

Wednesday, March 30, 2011 — What did you do for Thanksgiving last year? Where did you go on your honeymoon? Starting at 100, count backward by seven. Remember the following three-word sequence: truck, cabin, spoon.

These are among the series of questions Derek Shepherd and Meredith Grey are asking of Alzheimer’s disease patients to determine whether they’re qualified for entry into a clinical trial on this season’s Grey’s Anatomy.

But if you’re sitting on the couch five minutes later struggling to remember the word “cabin,” should you worry about your own brain health? And just how accurate is such a test at gauging Alzheimer’s disease risk? Everyday Health asked leading memory experts for answers. 

What the Grey’s Memory Tests Means

 

Although the test used on the TV show is not identified by name, some of the questions, like the three-word memory sequence and counting back directive, are included in the Folstein Mini Mental State Examination (MMSE), a 30-point questionnaire introduced in 1975.

“It’s the most commonly used cognitive evaluation for memory loss,” says Cynthia Green, PhD, assistant clinical professor of psychiatry at Mt. Sinai School of Medicine in New York City. “It’s a screening test, so it doesn’t delve deeply into someone’s mental functioning across different areas of intellectual performance.” (Other types of MMSE questions include drawing certain pictures and performing a three-step command, such as “take a piece of paper, fold it in half, and place it on the floor.”)

Keep in mind that the questions used by Derek and Meredith in their fictional version of the test are just a sampling of the total number of questions that would be used in a real test. Otherwise the limited number of answers wouldn’t tell clinicians much. The questions portrayed on TV are such a small snippet that the results are not that significant for the average person, says Dr. Green. And the question of whether a patient can remember where she spent her honeymoon isn’t likely to be on a real test: “That’s more of a remote memory, which is usually retained until later stages of the disease,” Green notes.

 

Senior Moments vs. Real Red Flags

 

So why can’t you remember the above word sequence or where you parked the car at the supermarket? You probably just weren’t paying attention, or you were multitasking or just plain distracted. Such everyday “senior moments” aren’t enough to raise a red flag for dementia, says Green.

“Everybody forgets things once in a while. It’s important to forget, otherwise think how awfully full your brain would be. You wouldn’t be able to sleep at night,” says Laurel Coleman, MD, a geriatric physician in Augusta, Maine, and national board member of the Alzheimer’s Association.

What is concerning, according to Green: “When a change in memory lasts for four to six months, impairs your ability to function independently at work or at home, and if your family and friends notice a change in your abilities or behavior.” If you or a loved one experience any of these symptoms of possible dementia, you should talk to your doctor and get evaluated.

Even then, keep in mind that memory loss doesn’t automatically mean you have Alzheimer’s, which counts language problems, disorientation, and face-recognition issues among its other symptoms. “Memory loss can be a symptom of at least 75 different medical conditions,” says Green, including a vitamin B12 deficiency, thyroid disorders, emotional distress, depression, and side effects from medication.

Alzheimer’s is the most common form of dementia, accounting for about 70 percent of cases in people age 71 and older. But it strikes only five percent of people between 65 and 74. The younger you are, the more likely a memory-related issue is something other than Alzheimer’s.

“We worry so much about memory loss because it’s something we’re afraid of,” says Green. “But since there are so many different things that can cause it and many of those conditions are reversible, it’s important to seek evaluation, and to do it sooner rather than later.” 

The Role of Memory Tests in Real-Life Alzheimer’s Studies

 

Diagnosing Alzheimer’s disease is challenging, since the only way to definitively determine the presence of disease is by looking at brain cells after someone has died. Instead, doctors evaluate the likelihood of Alzheimer’s with a variety of tests that also seek to rule out other possible causes of dementia.

These can include a thorough medical history, complete physical examination, lab tests of blood, urine, and sometimes spinal fluid, and brain scans, in addition to cognitive testing. Doctors at specialized Alzheimer’s treatment centers can diagnose the disease with 90 percent accuracy, according to the National Institute on Aging. Read more about how Alzheimer’s is diagnosed here.

During the cognitive tests, clinicians check on a wide range of brain functions — assessing not just memory— but a patient’s calculation ability, attention, insight, judgment, and how they prioritize things, says Dr. Coleman. “We examine a variety of things because people think in so many different ways.” 

Clinical Trials for Alzheimer’s Disease

 

The fictional Grey’s Anatomy clinical trial highlights the importance of real-life research: According to the Alzheimer’s Association, there currently are more than 100 Alzheimer’s clinical trials that need 50,000 volunteers — with and without the disease — to participate. Such trials are studying new ways to detect, treat, and prevent Alzheimer’s and related types of dementia.

Although researchers can’t offer regular mental state exams by Dr. McDreamy, if you or a loved one is coping with an Alzheimer’s diagnosis, consider finding a study that may be right for you through the Alzheimer’s Association Trial Match program or on ClinicalTrials.gov. Research shows that people involved in studies tend to do somewhat better than people at a similar stage of Alzheimer’s who are not enrolled in trials, the association says.

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.

What's Involved in Reaching an Alzheimer's Diagnosis?

By Dennis Thompson Jr. | Medically reviewed by Niya Jones, MD, MPH

Learn which medical exams and screening tests may be needed before a clear diagnosis of Alzheimer's disease can be made. 

Diagnosing Alzheimer's disease as early as possible can help patients and their families to better prepare for the progression of the disease. But diagnosing Alzheimer's can be a complicated process, given that it is only one of a group of brain diseases known as dementia, meaning neurological disorders that rob the mind of its intellectual ability.

Alzheimer's expert Malaz Boustani, MD, MPH, recommends that family members get a potential Alzheimer's patient checked out, even if they just have a "gut feeling" something might be wrong. "That feeling in and of itself is a big red flag, and families need to get their loved one evaluated as soon as possible. If you have any doubt — even if it just crosses your mind — it's worth investigating," says Dr. Boustani, assistant professor at the Indiana University School of Medicine and a center scientist with the Indiana University Center for Aging Research.

Alzheimer's Diagnosis: Finding a Doctor
If you or a family member needs to be evaluated for Alzheimer's disease, medical experts say the first stop should be your primary care physician. Your family doctor will often coordinate the diagnostic process. If your doctor wants more input from a specialist, you could be referred to one of the following professionals:

• A geriatrician, a medical doctor who specializes in the care of elderly patients
• A neurologist, a medical doctor who specializes in diseases of the brain or nervous system and can assess different types of dementia
• A psychiatrist, a medical doctor who specializes in mental disorders and can diagnose a mood disorder, such as severe depression that may mimic Alzheimer's symptoms.
• A psychologist, a licensed medical professional (a PhD or PsyD) who can test such mental functions as logic, memory, and concentration.

Boustani says that ideally, any specialist you see should have training in memory disorders and dementia. It can often be difficult, however, to find someone with those qualifications. "Our current health care system, unfortunately, doesn't have enough memory-care practitioners capable of performing a full diagnostic assessment," he says.

Screening Tests for Alzheimer's
Currently, the only definitive way to diagnose Alzheimer's disease is by looking at brain cells under a microscope after a person has died. But since that's too late to do the person any good, physicians have come up with a battery of tests that can help determine the likelihood of an Alzheimer's diagnosis. Experts believe that a skilled doctor using these tests can diagnose Alzheimer’s accurately in nine out of 10 cases.

Doctors can evaluate the possibility of Alzheimer's disease by:

• Taking a medical history. During this process, the doctor will learn whether anyone in the patient's family has suffered from Alzheimer's or other forms of dementia. The doctor will also ask about any medications or illnesses that could cause side effects that resemble Alzheimer's symptoms. Both the patient and their family must be involved in this step, since short-term memory loss is an early symptom in 75 percent of people with Alzheimer's and family members may have to help provide key information.
• Administering a mental exam. A series of tasks will test the patient's memory and problem-solving skills. Attention span is also assessed, as well as the ability to count and speak logically.
• Performing a thorough physical examination. This hands-on exam includes a general check-up as well as a neurological exam that tests things like muscle tone, reflexes, and coordination. The doctor will also order blood work and urine test(s), and may order other, more specialized testing such as an MRI or CT scan of the brain.

Alzheimer's Diagnosis: Ruling Out Other Causes
Most of the aforementioned tests aren't just used to look for Alzheimer's disease. They're also aimed at ruling out other conditions that could be interfering with a person's memory. For example, problems with memory or concentration can stem from an emotional disorder. "You might have depression, which can include memory complaints," Boustani says.

A person with symptoms common to Alzheimer's also might be suffering from a brain tumor, or bleeding inside the brain caused by a bad fall or a stroke. In other cases, memory loss could be caused by different forms of dementia, by a reaction to a medication the person is taking for an unrelated illness, or even by a vitamin deficiency. The important thing is to undergo the screening process so you know what's wrong and can address it appropriately, Boustani says.

As with most medical conditions, an earlier diagnosis can bring quicker treatment and help ease the stress of dealing with a new illness. If you have any concerns about your risk of Alzheimer's, do not hesitate to contact your doctor. Together you can decide on what, if any, testing is best for you or a loved one.

 

Alzheimer's: A Woman's Disease?

By Dennis Thompson Jr. | Medically reviewed by Pat F. Bass III, MD, MS, MPH

Women are more likely to develop Alzheimer's disease and other forms of dementia than men — but why?

There are many theories as to what may cause Alzheimer's disease but here’s one thing researchers know for sure: Women are diagnosed with various forms of dementia, including Alzheimer's, at greater rates than men. In fact, the Alzheimer’s Association’s 2011 Alzheimer’s Disease Facts and Figures report shows that 3.4 million of the 5.4 million Americans living with Alzheimer’s are female.

Why the Gender Discrepancy?

The current state of research seems to favor the simplest explanation for this phenomenon: Women just live longer. According to Malaz Boustani, MD, assistant professor of medicine at the Indiana University School of Medicine and a center scientist with the Indiana University Center for Aging Research, "Alzheimer's disease depends so much on time. Men tend to die earlier, and therefore they have less prevalence of Alzheimer's. There is a mortality difference."

On average, a girl born in 2005 is expected to live to age 80, according to the U.S. Centers for Disease Control and Prevention. A boy born that same year is expected to live to age 75. According to current consensus, that's why more women tend to develop Alzheimer's disease. They are simply more vulnerable to the greatest risk factor associated with Alzheimer's: advancing age.

Alzheimer's Symptoms in Men Vs. Women

Alzheimer's also appears to affect men and women differently. Here are some ways in which the condition can present itself in men versus women:

• Men with Alzheimer's disease tend to develop more aggression — physical, verbal, and sexual — than women do as the disease progresses. They also tend to wander and perform socially inappropriate actions more frequently than women diagnosed with Alzheimer's.
• Women with Alzheimer's disease tend to become more reclusive and emotionally unstable. They hoard items more often than men do, refuse help more often, and exhibit laughter or crying at inappropriate moments. They also seem more vulnerable to depression and to suffering from delusions.

Alzheimer's Risk: Other Roles Gender Might Play

New studies have found that hormonal differences might also play a role in increasing the risk of Alzheimer's in women. Beyond that, there appear to be gender differences in which risk factors for Alzheimer's affect men and women. Gender also appears to affect how Alzheimer's develops, since men and women exhibit different symptoms of dementia.

Gender is a factor in Alzheimer's disease for "a combination of reasons," says Allen Levey, MD, chair of neurology at Emory University School of Medicine and director of the Emory Center for Neurodegenerative Disease and Alzheimer’s Disease Center. "There are more women who are living longer. There may also be an increased risk for women beyond that. There has been a lot of research pointing toward the effects of female hormones, like estrogen, on dementia."

One study, for instance, has found that hormone replacement therapy can increase a person's risk of developing dementia. Another study found that high or low levels of a thyroid hormone called thyrotropin may be associated with an increased risk of Alzheimer's disease in women.

Gender also seems to play a role in which risk factors matter in the development of dementia. A French study found that men who had suffered a stroke were three times more likely to develop dementia, while stroke seemed to have no effect at all as a risk factor in women. But women with depression were twice as likely to suffer from dementia, and women unable to live without assistance due to an inability to perform routine tasks were 3.5 times more likely to develop dementia.

Researchers will continue to probe these gender differences in hopes of finding different ways to help men and women with Alzheimer's disease and, perhaps, find new treatments or, eventually, a cure.

 

What Was the First Sign of Alzheimer's Disease in Your Case?

Was memory loss the first sign of dementia or did something else tip you off that something was wrong?

 

By Bob DeMarco
Alzheimer's Reading Room 

When interviewed I get a version of this question every time. What were the early signs of Alzheimer's disease in your mother?

As many of you know, if you look at the various lists of the early signs of Alzheimer's disease you will usually see this listed first -- Memory loss is the most common sign of Alzheimer's disease.

Memory loss. Was memory loss the sign that "tipped" me to my mother's dementia. NO.

I am interested in hearing what you believe were the early signs that caused you to think that it might be Alzheimer's disease or dementia.

I know that most Alzheimer's caregivers conclude after the diagnosis, and after they gain a better understanding of Alzheimer's disease, that there were early signs that they missed or ignored.

For this discussion, I am interested in what you noticed as the early signs of Alzheimer's disease or early signs of dementia.

I'll write about our experience later. However, I can say this -- number one on my list is number ten on most lists.

Please use the comments box to answer the question. I would appreciate your insight. I might be able to use this information when I am interviewed on television and radio.

You are also welcome to write about this and submit an article if you care to do so.

 

Bob DeMarco is the Founder and Editor of the Alzheimer's Reading Room (ARR). Bob is a recognized influencer, speaker, and expert in the Alzheimer's and Dementia Community Worldwide. The ARR Knowledge Base contains more than 5,000 articles. Bob lives in Delray Beach, FL.

5 Ways to Help Prevent Alzheimer's Disease

By Jan Sheehan

Healthy habits that are good for you now have been shown to help prevent Alzheimer's later

Even though no drug therapy or treatment regimen has yet been found that will definitively prevent Alzheimer's disease, lifestyle choices can make a big difference in your risk of developing the condition down the line. Researchers are now discovering, in fact, that certain healthy habits and lifestyle practices appear to reduce your chances of developing Alzheimer's — and they say it's never too early to begin making healthy changes.

"We know that alterations in the brain associated with Alzheimer's can start decades before symptoms appear, so it may be wise to start thinking about prevention as early as your 30s and 40s," says Zoe Arvanitakis, MD, an Alzheimer's researcher at Rush University's Alzheimer's Disease Center in Chicago and associate professor of neurology at Rush University Medical School.

But what behaviors really make a difference? While there are no guarantees, experts believe that concentrating on the following five areas may give you a leg up on this difficult and debilitating illness.

1. Eat Smart
   Sticking to a healthy, low-fat diet has been linked to Alzheimer's prevention. One Harvard study of 13,000 women, age 70 and older, found that those who ate the most vegetables — especially green leafy ones (like spinach and romaine lettuce) and cruciferous ones (like broccoli and cauliflower) — experienced a slower rate of cognitive decline than those who ate the fewest vegetables. Turmeric, a traditional Indian yellow spice used in curry, also shows promise in Alzheimer's prevention. In animal studies, UCLA researchers discovered that Alzheimer's-like brain plaques disappeared after treatment with compounds found in this spice. A diet loaded with heart-healthy foods may also help stave off the disease. "High cholesterol increases the risk of developing Alzheimer's since clogged arteries around the heart can lead to damaged blood vessels in the brain," says Dr. Arvanitakis. Because it is thought that this type of damage may disrupt brain circuits that are important for memory, eating a diet low in saturated fat and trans fats may help keep cholesterol in check and protect against Alzheimer's.
2. Get Moving
   Simply getting off the couch and going for a brisk walk may help prevent dementia and Alzheimer's disease. An Australian study recently published in the Journal of the American Medical Association found that as little as six months of regular exercise produced improvement in memory and cognitive function in a group of older adults. A separate six-year study of 1,700 seniors 65 and older found that working out three or more times per week slashed the risk of developing Alzheimer's and dementia by 35 percent.
3. Maintain a Healthy Weight
   Obesity during midlife appears to raise the risk of developing Alzheimer's in the later years. A 2008 Kaiser Permanente study of 6,500 men and women found that those who were 30 or more pounds overweight and accumulated lots of belly fat in their 40s were 3.6 times more likely to develop Alzheimer's decades later. Studies also show that diabetes, which is linked to obesity, also increases the risk of Alzheimer's. "This may be a direct result of high blood sugar or because diabetes is associated with high cholesterol," says Arvanitakis. But dropping weight during midlife, especially in the belly, can reduce your risk of developing Alzheimer's.
4. Consider Supplements
   Scientists are studying whether certain nutrients acquired in dietary-supplement form can help protect against Alzheimer's. Folic acid, which is known to reduce levels of the amino acid homocysteine, shows some promise because elevated homocysteine levels can increase the risk of both heart disease and Alzheimer's. In one European study, a daily dose of 800 mcg of folic acid lowered homocysteine levels and significantly improved memory and cognitive function in a group of middle-aged and senior adults. At one time, high doses of vitamin E were also thought to have a possible protective role against Alzheimer's disease, but recent studies have found no link between vitamin E supplements and Alzheimer's development. Some research, however, has suggested that ginkgo biloba, a popular memory-enhancing herb, may be helpful in delaying the development of Alzheimer's.
5. Stay Mentally Active
   Exercising your mind is one of the easiest ways to help prevent Alzheimer's. Researchers at Rush University's Alzheimer's Disease Center found that seniors who stayed mentally active by reading, doing crossword puzzles, and taking classes were more than twice as likely to stay free from Alzheimer's disease in comparison to less mentally active people. Other studies have produced similar results. "Using your brain to learn new information, solve problems, and form memories not only helps to maintain existing brain circuits but may also create new ones," says Arvanitakis. "This could prevent Alzheimer's disease from ever developing." So pick up a book or click on an informative Web site today. You may be helping to keep Alzheimer's at bay!

 

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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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.

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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