Spring Arbor Living Blog

As our population ages, people with chronic cardiovascular disease, including atrial fibrillation (or irregular heartbeat), are living longer. In a study reported in the journal Heart Rhythm (Volume 7, page 433) researchers reported that atrial fibrillation may be associated with an increased risk of developing dementia and Alzheimer's disease.

Over 37,000 people, average age 60, from the ongoing Intermountain Heart Collaborative Study database were evaluated for signs of atrial fibrillation and for Alzheimer's disease or vascular, senile or nonspecific dementia. During an average of five years' follow-up, 4 percent developed dementia and 27 percent developed atrial fibrillation.

Atrial fibrillation was associated with each of the four types of dementia, independent of other cardiovascular diseases. The youngest group with atrial fibrillation (under age 70) had the highest risk of dementia; dementia is linked to older age, so this finding suggests the relationship between atrial fibrillation and dementia is particularly strong. Atrial fibrillation was also linked with the highest risk of death.

Take away: Because subjects with atrial fibrillation were identified as having higher risks of dementia and death, people with cardiovascular diseases -- who are urged to consider measures like diet, exercise, medication and avoiding tobacco for their heart disease -- might want to take these steps also to prevent or delay the development of Alzheimer's.

All the facts you need to make informed decisions if you have to confront Alzheimer's disease -- the most common cause of dementia

Written by Dr. Peter V. Rabins, director of the Division of Geriatric and Neuropsychiatry at the Johns Hopkins School of Medicine and Medical Editor of the Johns Hopkins Memory Bulletin, Diagnosing and Treating Alzheimer's Disease is an indispensable resource for anyone concerned about Alzheimer's disease. This new report provides all the facts you need to make informed decisions if you have to confront Alzheimer's disease. You'll learn how Alzheimer's is currently diagnosed ... the existing drugs that are used to treat it ... and various new therapies that may someday provide better treatment.

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Alzheimer’s disease is a debilitating mental health disease for the patient and the family. There are ways to extend the quality of life for both the care taker and the victim, but that involves commitment and honesty on both sides of the disease.

Caregivers can extend the time that their loved ones are in their own homes by establishing routines and being committed. However, this takes a toll on the caregiver, often resulting in depression and decreased mental and physical health.

At the onset of Alzheimer’s, the most successful patients are those who have a supportive family that is involved in the process, understands the implications of what is happening, and who is cared for properly.

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Disease develops years before symptoms show.

New guidelines for diagnosing Alzheimer's disease set forth methods for identifying the disease before it progresses to full-blown dementia, and for the first time include lab and brain-imaging tests that can help identify Alzheimer's as the likely cause of a person's mental decline.

The guidelines, revised for the first time in 27 years, reflect a firm consensus among Alzheimer's researchers that the disease begins to attack the intricate structures of the brain 10 years or more before the disabling mental problems appear. Therefore, to be effective, drug or other therapies will have to begin work early in that process.

So far, though, there are no therapies that alter the course of Alzheimer's disease. And in a media briefing, authors of the new diagnosis guidelines emphasized that while testing for Alzheimer's pathology in the brain may one day be used to identify the disease at much earlier stages, today the tests are primarily a research tool. They are not ready for routine use in doctors' offices.

Delaying disability

Even so, doctors hope the new diagnostic criteria encourage people with worrisome memory problems to seek help. There's a lot patients and their families can do to minimize the impact of Alzheimer's, from structuring the patient's environment to optimizing medical care, activities, exercise and diet.

New tests outlined in the guidelines involve looking at the brain with imaging technologies and examining the fluid obtained by a spinal tap. The imaging studies can reveal so-called plaques made up of a protein called amyloid, a defining feature of Alzheimer's. They also can indicate characteristic patterns of shrinkage or reduced metabolic activity in the brain. The cerebrospinal fluid tests look for levels of amyloid as well as of another protein, tau, which makes up the twisted strands or "tangles" that, like plaques, are signature brain pathology in Alzheimer's.

Weaknesses of the tests

Research studies have demonstrated that all these tests can help identify Alzheimer's as the cause of a patient's dementia, and can help predict which patients with milder symptoms will go on to develop dementia. But the tests aren't conclusive in themselves. They aren't standardized so that a certain result means the same thing in every medical center. And there's no clear cutoff separating normal findings from those indicating a problem.

Original article by: Katharine Greider from AARP Bulletin

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Brain scans may help identify which individuals with a mild decline in their mental abilities will go on to develop Alzheimer's disease, according to a new study.
 
The research focused on patients with mild cognitive impairment, a condition in which people experience noticeable declines in their cognitive function, including memory and language problems. These changes are not severe enough to interfere with everyday activities, according to the Alzheimer's Association.
It is known that about 15 to 20 percent of such patients will go on to develop Alzheimer's, but researchers don't know which ones.

In the new study, which involved magnetic resonance imaging (MRI), researchers were able to identify a high-risk group – patients who had a 69 percent chance of developing Alzheimer's disease in the next year.

The study used the MRI scans to identify brain characteristics that put people at risk for Alzheimer's. The researchers determined some patients had just a 3 percent risk of developing Alzheimer's in the next year, which is about the same as for a healthy older person. Others had a 40 percent risk of developing the condition in the next year, or double the risk associated with a diagnosis of mild cognitive impairment, and still others were identified as part of the high-risk group, said study researcher Linda K. McEvoy, an assistant professor in the department of radiology at the University of California, San Diego School of Medicine.

A similar technique could be used one day by doctors to determine the Alzheimer's risk for patients with mild cognitive impairment. However, the patients in the study were not representative of the general population — they had been selected to exclude people who experienced other types of memory problems, such as those due to a stroke. A larger study would be needed before the results could be translated to the doctor's office.

Alzheimer's disease risk
The study looked at MRI scans of the brains of 203 healthy adults, 164 patients with Alzheimer's disease and 317 patients with mild cognitive impairment. Each patient had their brain scanned at the start of the study and again a year later.

The researchers first compared the brains of Alzheimer's disease patients with those of healthy people, looking for differences in the degree of  shrinkage, or atrophy, in particular areas of the brain. Once they developed a way to distinguish these two groups of people, "we could use the same equations on the mild cognitive impairment (MCI) subjects to determine their risk of developing Alzheimer's disease," McEvoy said.
 
When the researchers included information about how the brains had changed in the time between the two scans, they were able to identify the high-risk group.

Future applications
Information in this study will be critical once we have ways to prevent Alzheimer's disease, McEvoy said. "Currently there's no cure or prevention for Alzheimer's disease. But there's a lot of research going on right now into different potential therapies. If any of those therapies turn out to be useful, then this kind of information will be crucial — a doctor needs to know who's at higher risk in order to treat them".

 Original article by Rachael Rettner- MyHealthNewsDaily

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As Alzheimer's progresses, often there is a noticeable increase in aggressive behavior. Alzheimer's patients often tend to shout and become physical with loved ones. This is more common in men with Alzheimer's than women, but it often occurs suddenly, and for no apparent reason. Because we are often confused about what kind of thoughts our loved one is having, it's easy to become frustrated. Though, however difficult, patience and understanding is necessary to calm them.
 
Aggression can have many causes such as physical discomfort, poor ability to communicate or an uncomfortable environment. When your loved one becomes aggressive, try to see if you can understand the source of their anger, see if you can make them more comfortable and less upset. Maybe they are tired, hungry, or uncomfortable. Does it seem as though they are in pain? There could be environmental factors that are bothering them as well, such as noise or smells.

Keep in mind, that these feelings would make anyone frustrated, but Alzheimer's patients can be overwhelmed easily and often their only way to cope is to lash out. Also, they may become aggressive over their frustration in their inability to communicate their discomfort to you. Remember not to ask too many questions or talk about too many things at once. If you yourself are irritable, remember, they can pick up on that as well, just as you could if you were interacting with someone who was in a bad mood. It is possible that they may be picking up on your own mood.

The best way to respond to the aggression in an Alzheimer’s patient is to remain calm, reassuring, and understanding. Try to identify what is causing the behavior and focus on them, not the facts. It is very important for them and for your own health that you don't take their behavior personally. Perhaps suggest a more relaxing activity and limit their distractions so they can concentrate on remaining calm. Unless it is absolutely necessary, always avoid using force, this may cause them to become more upset. Normally, the anger does not last long. 

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Alzheimer's disease is the most common form of dementia. Unfortunately, it is presently incurable. With every stage issues crop up, and it is very challenging to care for someone with this disease as their condition deteriorates. However, there are some activities to keep Alzheimer patients engaged and to assist them in coping with this disorder. Those who suffer from Alzheimer’s need care, motivation, support, encouragement and patience. The following activities will help.

• Puzzles and crosswords that are simple and easy will stimulate their brains and help slow down degeneration. These cognitive activities will help in reducing memory loss.
• Crafts and activities with little complication like maintaining a photo album, sorting photographs, making collages, or writing small notes to relatives can be engaging for these patients. It is important that the task is well described, sequenced and easy to handle.
• Reading a story aloud to them that has pictures will enable them to comprehend and answer relevant questions. This will also strengthen the bond between the caregiver and the patient. Alzheimer’s patients have a better chance of remembering information about the caregiver through activities they did together.
• Household work should be encouraged. Alzheimer's sufferers should perform their daily chores. This will create lesser dependency and will assist them in remembering things better.
• Gardening and keeping busy weeding, planting, and watering will enable them have a better approach to cope.

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Have you ever walked into a room and then forgotten what you wanted once you got there? Have you ever put an item in a “safe place” and then forgot where it was when you needed it? Do you think sometimes that you are going “crazy” because you forget people’s names? Or maybe you forgot to do something you said you were going to do?

Sometimes we are having a “senior moment” as they say; but that’s just what it is–a moment. Usually the name is just on the tip of your tongue and you remember it when you can take the time to think. Or the reason for walking into the other room becomes clear when you slow down and let your thought catch up with you.  These are ”normal” occurrences usually due to stress, being too busy, not feeling well, or simply not paying attention.

However, when you misplace something and you have a problem retracing your steps to find it, this might be a warning sign.  If you are making a familiar recipe and forget how much salt to use, this could be normal.  But if you are confused about whether to use a measuring spoon or a measuring cup for the salt, this could be a warning sign.  If you drive to the mall and forget where you parked the car, this is typical of someone not paying attention or making a mental note of where they parked.  But, if you forget where you are and how you got there, this is a warning sign.

There are several warning signs to watch for in detecting early stage Alzheimer’s.  No one sign is an indication of having a problem in and of itself. Keeping track of abnormal behavior will give your physician details to help diagnose the problem, and only a qualified professional can make a diagnosis after appropriate testing. For more information on the warning signs, contact us today and we'll be happy to assist you in any way we can.

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The former site of Loudoun Country Day School again is bustling with activity as the Spring Arbor assisted living community welcomes residents to its new 70,000-square-foot facility on Fairview Street in Leesburg. Executive Director Zoie Nikov said the facility expects to have 13 residents fully moved in by the end of the week. The remaining 57 rooms are expected to fill up within the next month, she said, noting pre-sales have been strong.

The facility provides plenty of amenities for residents, including a kitchen serving three prepared meals a day in a dining room with outdoor patio space for uses during the warmer months; a library and reading area complete with computers for Internet access, where volunteers can help residents setup e-mail and social networking accounts to stay connected with family and friends; a wellness center with daily exercise activities and on-site physical rehabilitation specialists; a walking path around the grounds of the facility; and transportation around town via a van and bus service.

Spring Arbor also is the first assisted living center in the county to have a secure area for Alzheimer's patients, in 13 cottage-style apartments with one to two beds available. The facility provides entirely independent accommodations for patients with Alzheimer's and other memory-related illnesses, including a separate kitchen and dining area, activity room and outdoor patio.

As guests continue to move in over the coming days they are likely to see the final touches being placed on the facility as crews work to finish the construction of patio areas for both the standard and memory care areas, and the bus that will be used to transport residents to doctors appointments, shopping destinations and other venues around town arrives next week.

Nikov said community response to the new facility has been positive, with more than 200 people turning out for a neighborhood open house over the weekend. Spring Arbor, which is owned by HHHunt of North Carolina, worked closely with nearby homeowners in assuring the new facility would match the aesthetic design and feel of the community, Richard Williams, senior vice president of senior living for the real estate company, said. Contact us today to learn more about Spring Arbor and how we strive to help our residents.

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