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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A much-anticipated test developed by Eli Lilly that detects the presence of proteins in the brain that are related to Alzheimer's disease was approved by the US Food and Drug Administration.

This test could enable clinicians to detect Alzheimer's earlier and more accurately in patients at the earliest sign of memory problems -- a potential boon to treatment and developing drugs against the disease.

The test uses a chemical known by the brand name Amyvid, a radioactive agent that tags clumps of a sticky substance called an amyloid. Amyloid proteins are hallmarks of Alzheimer's disease. The chemical is then detected using a brain imaging technique called positron emission tomography, known as PET scans.

For patients who already have some symptoms of cognitive decline, a positive scan suggests that moderate to frequent amyloid plaques are present in the brain, which is consistent with Alzheimer's disease.

If the scan is negative, indicating no clumps or few clumps of amyloid, "that gives the clinician a clue that Alzheimer's is less likely to be the cause of those symptoms," according to Daniel Skovronsky, who developed the agent at Lilly. For those patients, doctors can look for other potential causes of the memory decline, which may have another prognosis or be treated differentially than Alzheimer's.

The imaging agent cannot be used to diagnose someone with Alzheimer's disease if the individual does not experience memory impairment because the presence of amyloid in the brain does not alone suggest that someone has Alzheimer's.

Before the development of imaging agents, amyloid plaques could be determined only after death, by examining the brain during an autopsy.

Some 20% of cognitively healthy older adults have been found during autopsies to have large quantities of amyloid in the brain.

"It is likely to play an important role in learning both how to diagnose and treat the disease, but it's still an open question at this point for asymptomatic people," according to Park, a behavioral and brain-sciences professor who uses Amyvid in her research on aging of healthy older adults.

Amyvid will be available in limited quantities starting in June after being approved Friday, Lilly said.

Wall Street Journal

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Those daily activities and chores like folding the laundry may help keep dementia at bay.

New research finds that seniors who expended the most energy doing chores, running errands and simply going about their business were less likely to experience mental decline as they aged.

"All those things that you would never think of as exercise get our heart rate up and make our blood vessels pump blood," said study co-author Todd Manini, an assistant professor of aging and geriatric research at the University of Florida, Gainesville. " What this study is telling us is those other activities might also count for health benefits."

One of the challenges of the study was how challenging it is to keep track of chores and daily activities. So researchers measured how many calories people burned over the course of two weeks by having them drink a non-radioactive isotope -- basically, water that had been chemically altered slightly.

Participants, 200 older adults whose average age was 75, were divided into thirds based on how much energy they used daily, minus the amount the body needs while at rest.

Those in the most active group burned about 1,000 calories a day during activity. They were also 91% less likely to experience declines in memory, concentration and language abilities after five years than those in the least active group.

The middle-range group was also less likely to experience mental declines, but those results were not statistically significant.

So, what were those seniors who were burning 1,000 calories a day doing?

Well, they were no more likely to say they did vigorous exercise, such as walking or swimming, than those in the group that burned the fewest calories. Instead, those who burned the most calories were more active overall -- they reported doing more walking, they climbed more stairs, did more volunteering. They were people who were just moving more.

This study didn't look at younger people, but they may want to look at their daily habits, researchers added.

When people ask, 'What is the one thing I can do to keep dementia at bay?' researchers would say “exercise”. "That has the most clear-cut evidence that it will do something beneficial for your brain.”

Original article Health MSN

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