Spring Arbor Living Blog

Do you know where most of the millions of people who have Alzheimer’s disease live? At home, where family and friends provide almost 75% of their care.

That’s why caregiving has been called the fastest growing unpaid profession in the United States.

According to the National Alliance for Caregiving, during the past year more than 67 million Americans provided care to a family member, friend, or loved one, many of whom are suffering from different stages of Alzheimer’s disease or some other type of dementia.

If you’re a caregiver, you know first-hand what it’s like: Getting swept up in a flurry of tasks – bathing, shopping, cooking, feeding, making arrangements for medical care, managing behavioral problems, making decisions for the ill person that you have never had to consider before -- while simultaneously trying to cope with your own anxieties and fears.

Or perhaps you’re facing a situation where you’re likely to become a caregiver -- and you’re wondering how you can make the many difficult decisions that anyone who steps into this demanding role has to confront.

It’s an extremely hard job and often it feels like you’re in it alone. But you’re not.

With you in mind, Johns Hokins asked two world-renowned Alzheimer’s specialists -- Dr. Peter Rabins and Dr. Ann Morrison -- to write a practical, no-nonsense guide, Caring for a Loved One with Alzheimer’s Disease: A Guide for the Home Caregiver. This comprehensive special report provides detailed, authoritative advice on how to successfully manage your day-to-day responsibilities, to your patient and to yourself.

Many people think of Alzheimer’s as strictly a memory-stealing ailment. But as a caregiver, you know that it may also unleash difficult-to manage behaviors.

Feeling overwhelmed? Caregivers have been described as “hidden patients” because many of their own emotional and physical needs go unattended while they provide care to others.

For information on the guide, contact Johns Hopkins. For information on deciding to move a loved one into residential care, contact Spring Arbor. This is surely one of the hardest decisions a caregiver will face, we understand.

Johns Hopkins Health Alert

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When family members become caretakers of loved ones who suffer from Alzheimer's disease and dementia, they often study up on the condition.

"The more you can learn the better you're going to be and you better understand the disease."

Often used interchangeably, both dementia and Alzheimer's are forms of mental degradation. In many ways they seem the same but are actually two different medical terms.

"I tell people that it’s sort of like dementia is the team and Alzheimer's is one of the players," says Dr. Michael Raab, a geriatrician with Lee Memorial Health System.

Dementia covers a number of disorders; Alzheimer's is most common.

Alzheimer's has physical characteristics in the brain, which most other forms of dementia don't have.

"When you look at the brain, there are tangles and plaques. The Lewy Body dementias, the vascular dementias, the front dementias, none of them really have any plaques or tangles," says Dr. Raab.

What's more, Alzheimer's progression is gradual and can begin in middle age. General dementia is usually found in advanced years.

Finally, various conditions can affect different parts of the brain. Only a specialist can give you proper diagnosis.

"It takes very sophisticated testing which is what we do with our neuropsychologists, to try and differentiate the areas of thinking that have been lost," says Dr. Raab.
 
NBC2.com

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Recently, researchers looking into cognitive decline and dementia have made encouraging findings. Although it was believed that the adult brain could not develop new neurons (or brain cells), scientists have learned in the past decade or so that the human brain is pliable and adaptive. The brain can actually add new neurons even late in life and continually form new connections among existing neurons -- a phenomenon known as neuroplasticity.

This means that while an aging brain may have signs of damage, initially it can often compensate for them. And engaging in mentally stimulating activities like reading, taking a class or playing board games is one way to bolster this process.

This compensation process depends on your "cognitive reserve," the extra, perhaps unused, amount of cognitive ability that can make up for the loss of brain functioning when your brain shows signs of dementia due to the death of cells and their replacement by beta-amyloid plaques. Genetics, early childhood stimulation and education level can influence cognitive reserve but are essentially immutable once you're an adult.
 
Fortunately, studies have found that you can also increase your cognitive reserve and delay the onset of dementia through a variety of intellectually stimulating leisure activities in middle and later life.

A study in the journal Neurology found that among 101 people who eventually developed dementia, those who frequently participated in one or more activities, such as reading, writing, doing crossword puzzles, playing card or board games, having group discussions or playing music experienced memory decline more than one year later than those who participated in these activities less often. These pursuits built cognitive reserve and delayed dementia as much as a higher education level did.

It's worth noting that researchers have discovered that watching television is a passive activity that doesn't really stimulate the mind at all; on the contrary, watching television is associated with an increased risk of cognitive decline. One study found that TV watchers were 10% more likely than non-watchers to experience cognitive impairments over a five-year period. A possible explanation: Time spent in front of the TV means less time for the mental, social and physical activities that can help delay dementia.

Original article – Johns Hopkins Health Alert

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Alzheimer’s Disease, more and more people are trying to figure out how to prevent it, or at least, hold it off. Does eating a lot of fish and few processed foods really help protect against Alzheimer’s disease? A new study suggests that nutrition could play almost as strong a role as age, number of years of education, and high blood pressure, but not quite as much of a role as inherited genes.

In the study published in the journal Neurology, researchers measured the level of nutrients in the blood of nearly 300 seniors and found that those who had high levels of vitamin D and omega 3 fatty acids - both found in salmon, tuna, and other fatty fish - high levels of vitamins C, E, and B - antioxidants found in fruits, nuts, and green leafy vegetables - appeared to have somewhat more protection against early symptoms of Alzheimer’s. They were less likely to have cognitive difficulties, memory problems, and brain shrinkage - an indicator of Alzheimer’s - than those who had low levels of these nutrients.

The researchers also found that those who had blood markers that indicated high levels of trans fats - margarine and other partially-hydrogenated oils used in doughnuts, cookies, and other processed foods - were more likely to have memory loss and brain shrinkage.

This study may have more strength than previous studies in that it verified dietary patterns through blood measurements rather than relying on dietary recall questionnaires, which can be unreliable.

“These results need to be confirmed, but obviously it is very exciting to think that people could potentially stop their brains from shrinking and keep them sharp by adjusting their diet,’’ said study author Gene Bowman, a professor of public health at Oregon Health & Science University in Portland.

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The decision to move your loved one into an assisted living facility is not an easy one. As your loved one ages, they may need more help with daily activities like bathing or remembering medication. Moving to a facility that provides some assistance, without sacrificing independence, may be an option. This type of assisted living environment such as Spring Arbor, is a great option for long-term care.

What should you consider when looking for an assisted living community? First, think about what activities you or your loved one need help with. Here are some considerations to help guide you in your search.

What is most valuable in your loved one's life? What gives them purpose and meaning? Think about where their doctors, church, and family are. The assisted living facility should be near the things and people they hold dear. Seniors need to remain connected.

Think about current and future needs. If a progressive illness is involved look for a facility that can accommodate as mobility changes. Ask questions like: What are the levels of care offered? Are there ramps located throughout? Is the room or apartment fully accessible if a wheelchair is required in the future?

Also, if dementia is involved, there is a risk of wandering; is there an Alzheimer’s area that is safe and secure? When a loved one has Alzheimer's or a related dementia it can seem as though few options are available. As needs progress, the constant care and attention required can seem overwhelming. To meet this need, Spring Arbor offers  "Special Care Cottages" programs that are custom designed for residents with these unique challenges.

Get referrals. You will be surprised at how many people you know or how many people you can be connected with who have done this research. Also, contact your local agency on aging to find out if they can provide a list of facilities they'd recommend in your area.

Visit a few times beforehand. Stop by the community at least twice and take at least one guided tour. Show up unannounced for some other visits in order to see what happenings on a regular day. A nighttime visit is important because most of the staff has likely gone home.

Talk to current residents. If is it possible, talk to residents you meet during your on-site visits.

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Dr. Potter, chief of the Division of Geriatrics and Gerontology at the University of Nebraska Medical Center says:

Stay mentally active. What actually happens is that as we get older, synapses in the brain are stimulated by mental activity, so this helps to preserve mental ability. Just being well-educated is a good idea. Education and mental stimulation helps to create and preserve and develop new connections. So taking a course later in life is a good idea.

Following a good heart-healthy diet is good for memory because what's good for your heart is good for your brain. And you can actually stimulate develop of new brain cells with physical activity.

Dr. Mastrianni, Associate Professor of Neurology; Co-Director, Center for Comprehensive Care and Research on Memory Disorders at the University of Chicago Medical Center says:

There things one can do to avoid developing Alzheimer's disease or memory decline associated with aging.  Lifestyle changes that have shown benefit include routine physical exercise, staying socially active and eating a heart-healthy diet. At least 30 minutes a day of physical activity gets your heart pumping and improves oxygenation of brain cells.

Social activity may include staying actively working, or volunteering in local organizations or clubs.  Research suggests that having a large network of social interactions helps to maintain good brain function and even delay Alzheimer's disease.

Finally, eliminating unhealthy practices such as cigarettes, too little sleep, and too much stress can't hurt and are likely to help your brain function better.

Dr. Shulman, assistant professor of neurology and associate director of Cognitive and Behavioral Neurology at the Pearl Barlow Center for Memory Evaluation and Treatment at the Silberstein Alzheimer's Institute at NYU Langone Medical Center says:

There are four main pillars of keeping healthy memory or maintaining brain fitness: healthy diet, exercise, keeping mentally stimulated and avoiding depression. There is no single entity that we can modify that will decrease the likelihood of someone developing Alzheimer's. It's a combination of applying all of these.

The issue with avoiding depression is a controversial one: Is depression itself a risk factor for dementia, or is the early sign of depression the earliest sign of dementia itself? It looks increasingly like it's a risk factor for Alzheimer's disease, and there's a whole host of complicated reasons, but it does seem that if you keep stress-free and depression-free, that in and of itself is insurance for healthy aging.

Original article My Health News Daily

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Carrying around extra pounds during middle age was associated with a higher risk of dementia later in life in a new study that followed twins in Sweden for 30 years.

The research was not set up to prove that dementia was caused by the added weight, but Dr. Weili Xu, the study's lead author, said that the evidence is pointing in that direction.

The findings suggest that "control of body fat as early as middle life is important to prevent dementia later in life," she told Reuters Health.

Xu and her colleagues analyzed data from close to 9,000 Swedish twins.

When the participants were an average age of 43, they gave researchers information about their height and weight.

Thirty years later, the researchers examined the same individuals for signs of declining thinking and memory skills, and then diagnosed some of them with Alzheimer's disease and other types of dementia.

Close to one in three of the participants were overweight or obese in middle age. And those that were had about an 80 percent higher chance of getting any kind of dementia than people of normal weight.

The more participants weighed in mid-life, the higher their chance of getting dementia or "questionable dementia" - meaning they had signs of thinking and reasoning problems, but not enough to be diagnosed with dementia.

In total, about 4 percent of everyone in the study was diagnosed with dementia, and another 1 to 2 percent with questionable dementia.

Despite the link between excess pounds in midlife and later dementia, when the researchers looked specifically at 137 twin pairs who were "discordant" - one twin had dementia and the other didn't - the tie to midlife overweight shrank considerably.

While Xu said that finding suggests that "there are some common genes that predispose (people) to both diseases (overweight and dementia)," it could also be that it was just more difficult to establish a solid link in such a small sample.

Whether genes predispose a person to being overweight in adulthood, or it's just bad eating habits, the likely explanation for the link to dementia is that fat tissue in the body releases hormones and other signaling cells that may affect the brain's functioning.

In addition, extra weight has been shown to increase a person's risk for diabetes and heart and blood vessel diseases - and those conditions are related to a higher dementia risk. However, the link between weight and dementia remained even after the researchers took other diseases into account.

The findings are the latest evidence that preventing Alzheimer's disease and dementia starts long before their signs and symptoms show up.

"People need to understand that what they do today could have an effect on them 30 or 40 years from now.”
When it comes to maintaining a healthy weight, what's good for the heart is good for the brain.

Original article - MSN

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Up to half of Alzheimer's disease cases worldwide are potentially attributable to seven preventable risk factors, a new study suggests. 

The findings show that Alzheimer's cases could be reduced if people quit smoking, increased their physical activity, enhanced their mental activity, controlled their blood pressure and diabetes, and managed their obesity and depression. 

The top 3 factors

In this study by University of California, San Fransisco, the authors reviewed previous research that examined factors that predispose people to developing Alzheimer's. They identified seven factors that were potentially within a person's control to change. 

Enhancing mental activity could make the biggest difference in developing Alzheimer's. That's because the study showed "low educational attainment" was the factor that impacts the largest portion of Alzheimer's cases worldwide. They defined low educational attainment as not completing higher education, having a low IQ or not participating in mentally stimulating leisure time activities, and found it contributes to 19% of Alzheimer's cases, or 6.5 million cases worldwide. 

Smoking contributes to the second-highest number of cases, 14% of cases, or 4.7 million cases worldwide.
Physical inactivity contributed to 13% of worldwide cases and was the third-largest factor. However, it was the highest contributor to cases in the U.S. — contributing to 21%, or 1.1 million cases. 

What really mattered was how common the risk factors were in the population. In the U.S., about a third of the population is sedentary, so a large number of Alzheimer's cases are potentially attributable to physical inactivity. 

However, worldwide, low education was more important, because so many people throughout the world are illiterate or are not educated beyond elementary school. And, smoking also contributed to a large percentage of cases worldwide because it is still very common. 

This suggests that smoking cessation and initiatives to increase physical activity could dramatically decrease  the number of Alzheimer's cases. 

A note of caution

It has been noted that while these seven factors may contribute to the development of Alzheimer's, none of the factors have been shown to cause the disease. 

However, the findings suggest "that preventive and therapeutic interventions have great potential," and that interventions should be carried out in high-risk populations. 

Globally, an estimated 33.9 million people have Alzheimer's, but that number could be reduced by 3 million if there was a 25% reduction in all seven of these risk factors. A 10% reduction in these seven factors could prevent 1.1 million cases. The number of worldwide cases is expected to triple over the next 40 years.

The results of the study were presented July 20 at The Alzheimer's Association 2011 International Conference on Alzheimer's Disease (ICAD), held in Paris. The study was simultaneously published online in the journal The Lancet Neurology. 

Original article on MSNBC.com

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Americans spend over $25 billion each year on dietary supplements that promise everything from slender waistlines to better sex lives. A large and growing portion of this market is devoted to products that claim to improve memory or prevent the onset of dementia and Alzheimer's disease.

But as researchers investigate dietary supplements to see if there is merit to the claims, they are coming up empty-handed. Ginkgo biloba, perhaps the most well known of the “memory enhancers,” has been declared ineffective by medical experts based on recent, high-profile studies.

Other dietary supplements are marketed for their alleged ability to boost memory or cognitive functioning, including phosphatidylserine (PS), choline, bacopa, vinpocetine, piracetam, lemon balm and coenzyme Q10 (CoQ10).

However, the reality is that these dietary supplements either have not been studied extensively or have shown little potential. Part of the problem is that the U.S. Food and Drug Administration (FDA) doesn’t require dietary supplements to be tested to the same degree as prescription drugs.

Remember that there is no “silver bullet” that will undo bad habits, so continue to follow the fundamentals of good health: Exercise, eat a well-balanced, nutritious diet and do not smoke.

And if you do decide to take any kind of dietary supplement, always remember to use caution and inform your doctor. Dietary supplements can worsen certain health problems and interact with prescription drugs to cause severe side effects or render your medication less effective.

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Do you know where most of the millions of people who have dementia live? They live at home where family and friends provide the vast majority of their care.

That's why caregiving has been called the fastest growing unpaid profession in the United States.

During the past year more than 67 million Americans provided care to a family member, friend, or loved one, many of whom are suffering from different stages of Alzheimer's disease or some other type of dementia.

If you're a caregiver, you know first-hand what it's like: Getting swept up in tasks -- bathing, shopping, cooking, feeding, making arrangements for medical care, managing behavioral problems, making decisions for the ill person that you have never had to consider before. All the while trying to cope with your own anxieties and fears.

Possibly your are facing a situation where you're likely to become a caregiver. You are most likely wondering how you can make the many difficult decisions that anyone who steps into this demanding role has to confront.

It's an extremely hard job and it usually feels like you're in it alone. But you're not. When a loved one has Alzheimer's or a related dementia it can seem as though few options are available. Spring Arbor offers "Special Care Cottages" programs that are custom designed for residents with these unique challenges.

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