Spring Arbor Living Blog

Elaine Vlieger is making some concessions to Alzheimer's. She's cut back on her driving, frozen dinners replace elaborate cooking, and a son monitors her finances. But she lives alone and isn't ready to give up her house or her independence.
 
Some 800,000 people with Alzheimer's, roughly 1 in 7 Americans with the disease, live alone, according to data from the Alzheimer's Association. It's a different picture from the constant Alzheimer’s care giving that they'll eventually need.
 
Many cope on their own during early stages of dementia with support from family and friends who keep in close contact.
 
But with support or not, living alone with a disease that gradually strips people of the ability to know when they need help brings concerns, and loved ones agonize over when to step in.

There's no easy answer, and it's a challenge that will only grow. About 5.4 million people in the United States have Alzheimer's or similar dementias. That number is expected to reach up to 16 million by 2050 with the population aging so rapidly.

Most older people want to stay in their homes as long as possible, and developing cognitive impairment doesn't automatically mean they can't initially, says Beth Kallmyer of the Alzheimer's Association. The association's new analysis illustrates the balancing act between a patient's autonomy and safety. People with dementia who live alone can do so initially while they are less impaired, as the disease progresses dementia and Alzheimer’s patients need caregivers. Studies also show that those who live alone have a greater risk of injuries or accidental death than those who don't live alone.
 
The first National Alzheimer's Plan, due this month, may help. It aims to increase screening to catch dementia earlier and urges doctors to help plan for Alzheimer's care.

Do you have a loved one who needs constant Alzheimer's Care? Contact Spring Arbor.

Newsday

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If you have Parkinson's disease, your body fails to produce enough dopamine, a substance necessary for smooth and coordinated movements. This loss of dopamine leads to the signature symptoms of Parkinson's disease: rhythmical shaking (tremor), stiffness, shuffling, slowness of movement, balance problems, small or cramped handwriting, loss of facial expression and soft, mumbled speech.

Although Parkinson's disease is a neurological disorder affecting movement, it is also associated with an often overlooked psychological condition known as cognitive impairment. Cognitive impairment can affect your memory and attention span as well as your ability to plan and organize. Many patients already have some degree of cognitive impairment when first diagnosed with Parkinson's disease.
 
As Parkinson's disease advances, the ability to recognize people and objects and communicate with others becomes increasingly difficult, especially in the later stages. Some experts believe that nearly all patients with Parkinson's disease will ultimately develop some degree of cognitive impairment.
 
The challenge of diagnosing cognitive impairment: Diagnosing cognitive impairment in Parkinson's disease patients is difficult because it’s often hard to tell whether certain symptoms are due to Parkinson's disease or another form of dementia. For instance, significant cognitive impairment could arise from Lewy body dementia rather than Alzheimer's or Parkinson's disease.

Lewy body dementia is associated with the abnormal accumulation in the brain of alpha-synuclein -- a protein whose function in healthy brains is still unknown. Alpha-synuclein is of great interest to researchers because it is a major constituent of Lewy bodies, the protein clumps that are a hallmark of Parkinson's. Scientists now believe that Lewy body dementia -- not Alzheimer's disease -- is responsible for most cases of dementia in Parkinson's disease patients.

Caring for patients with Parkinson's disease when there are no signs of cognitive impairment is already a complex task. But caring for Parkinson's patients when evidence of cognitive impairment is present is even more complicated. Some medications commonly used to treat classic Parkinson's disease, such as levodopa, can worsen cognitive impairment and trigger bizarre behavior. Other drugs, such as anti-psychotics (neuroleptics), can paradoxically increase hallucinations, delusions and agitation in Parkinson's disease patients who also have dementia.
 
Original article – Johns Hopkins Health Alert

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One day your doctor might give you this prescription to prevent Alzheimer’s: Eat less red meat and sugar; eat more fruits, vegetables, fish and olive oil.

At least that seems to be the finding of a new study that found that eating a diet low in saturated fat and sugary treats can improve your memory and may reduce your risk of developing dementia.

Researchers with the University of Washington and Veterans Affairs Puget Sound medical center decided to see if a change in diet could affect the risk for Alzheimer’s or benefit those already suffering some mild but early symptoms of the disease.

What they found was that a diet rich in fruits, vegetables, grains, fish and olive oil can improve some memory skills in both healthy older adults, as well as those already experiencing cognitive difficulty.

More importantly, eating this kind of diet can help healthy adults reduce their risk of developing dementia, says study researcher Suzanne Craft with the Memory Wellness Program at the VA.

Researchers found that after four weeks on the low-fat diet, subjects had fewer toxic proteins and evidence of inflammation in their spinal fluid, both considered to be bio-markers for Alzheimer’s, Craft said.

“I like to think of this kind of diet as promoting healthy brain aging, as well as reducing the risk of Alzheimer’s,” she said.

The Washington state researchers wrote that they decided to take a “whole-diet” approach, rather than focus on a single dietary component, such as omega-3 fish oil. They also chose to test the subjects’ spinal fluid for bio-markers because of the importance of the central nervous system to brain health.

The 49 subjects, all older than 60, included 20 healthy adults with no signs of memory decline, and 29 who were at high-risk for Alzheimer’s, having already been diagnosed with some cognitive impairment.

They were randomly selected to either follow a four-week low-saturated fat, high-fiber plan similar to a Mediterranean diet, or a four-week high-saturated fat diet that included foods like red meat, butter, french fries and soda.

Both groups ate the same amount of protein and the diets were balanced so subjects did not lose or gain or weight.

However, for those who want to protect their brain health, it seems pretty clear from these preliminary results that eating a healthy diet is a powerful first step.

Original article on AARP

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An older person who cares for a spouse with dementia is also at an increased risk of developing problems with attention and memory, according to a new review of studies.

This is because the spousal caregiver likely shared lifestyle risk factors with the person with dementia, and undergoes ongoing stress from caring for the person.

Researchers from the University Of Washington School Of Medicine reviewed more than 100 studies that examined the cognitive health of older adults who cared for a family member with dementia, with the majority of the subjects being spouses. They found that these caregivers have more trouble with attention and memory, also known as cognition, than people who don't have to care for a family member with dementia.

The review of the studies showed that those caregivers had a higher risk of cognitive decline or dementia than people who do not have to care for someone with dementia. This could be due to a number of factors, including depression, loneliness, sleep problems, social isolation, exercise, diet and even obesity.

People who are caring for a spouse with dementia may themselves be at risk for cognitive problems which, in turn, will not only negatively influence their quality of life, but may reduce their ability to provide the necessary care for their spouse.

Most care-recipients prefer to be cared for in their homes, and, by remaining in their homes, health care costs are reduced greatly, therefore, often spouses of end up providing care.

The study was published in the Journal of the American Geriatrics Society.

People with dementia are not the only ones who have health problems – a spouse who cares for them are also at risk for attention and memory problems.

Original article on MSN.com

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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 we get older, many of us will notice changes in our memory. Forgetfulness is a normal part of getting older, however, dementia and Alzheimer's disease is not. How can we tell the difference? We all worry, about ourselves and our parents as we watch them age; and with good reason.

Presently, one in ten people 65 and older has Alzheimer's, about 5 million people. But only half have been diagnosed with the disease. It is estimated that by 2050 as many as 16 million people will have it.
As we become more and more educated about this terrible disease, we often find ourselves wondering when we or someone we love will get it, not if we or someone we love will get it. You may be concerned because you have noticed recurring "senior moments".  As we age, we notice our senior moments more and more.
 
So where does normal forgetfulness end and mild cognitive impairment begin? Some experts think that mild cognitive impairment (MCI) is the early signs of Alzheimer's disease. Unfortunately, there is no definitive test for diagnosing Alzheimer’s, but your personal history and mental status exams are accurate about 90% of the time. Alzheimer's progresses very slowly for most people. The downward slide of thinking, memory, and judgment are gradual, over the span of many years.

If you have concerns about yourself or a loved one, find out all you can about your own, or their, personal history and speak with your doctor. Education about Alzheimer’s Disease is the best way to understand an prepare yourself, if necessary, for this terrible disease.

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