Spring Arbor Living Blog

Gaining weight, especially in the midsection, has been associated with a number of health conditions, including diabetes, heart disease and cancer. New research suggests that you can add shrinking brain size, an indication of Alzheimer's disease and dementia, to that list.

Using data collected from 733 healthy participants with an average age 60, investigators looked at the associations among body mass index (BMI), waist circumference, waist-to-hip ratio, amount of subcutaneous and visceral abdominal fat and four different magnetic resonance imaging (MRI) based measurements of brain volume.

Researchers discovered that although all of the assessments of weight were linked with a reduction in brain volume to some degree, the link was strongest between abdominal fat and decreased brain volume. This association was independent of BMI and measurements of insulin resistance.  The study was reported in the Annals of Neurology.

This finding sheds some light on the mechanisms that underlie the association between weight gain and dementia, which is still not well understood. People who are concerned about dementia should take steps to lower their amount of abdominal fat.

Original article - Johns Hopkins

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In this excerpt from a recent issue of Health After 50, Marilyn Albert, Ph.D., director of the Johns Hopkins Alzheimer’s Disease Research Center, talks about current methods of diagnosing Alzheimer's Dementia.

•   Traditionally, how has Dementia been diagnosed? How accurately can it be diagnosed today?

Research now tells us that Dementia progresses over time and likely begins years or decades before symptoms first appear. But right now, we can only diagnose Dementia late in the game. 

To diagnose Dementia we rule out other potential causes for cognitive decline, such as stroke, tumor or metabolic syndrome (a combination of medical disorders that raises the risk of heart disease, diabetes and stroke that may also increase the risk of dementia).

We then run a battery of cognitive tests and brain scans to rule out other neurological disorders and to determine whether the pattern of symptoms seems consistent with Dementia. If these things match up, we can give a probable diagnosis of Dementia. At major medical centers, a probable Alzheimer's Dementia diagnosis can be 80 to 90 percent accurate.

•   What are biomarkers, and how will they help with earlier, more accurate diagnosis of Dementia?

"Biomarker" is a term that describes a measurable change in a person that will give us information about what is going on in his or her brain tissue. For example, the signature of Alzheimer’s disease includes amyloid plaques [abnormal accumulation of amyloid proteins] and neurofibrillary tangles (deposits of defective tau proteins, a type of protein abundant in the brain).

The proteins related to the plaques and tangles are present in the spinal fluid of patients with Dementia. They’re also present in those with mild cognitive impairment (MCI) -- slight problems in thinking, learning and remembering that sometimes progress to full-blown dementia.

The proteins serve as biomarkers of the progressive changes taking place in the brain. In clinical research, tau and amyloid have been shown to predict the progression of patients with MCI to Dementia and ultimately Alzheimer's.

In other words, measuring these proteins allows us to say more accurately and at an earlier stage of disease that we are pretty sure this person is going to develop Alzheimer’s dementia. Imaging procedures, such as PET (positron-emission tomography) and MRI (magnetic resonance imaging), also can provide information about the pathology present in the brain. For example, amyloid can now be measured with PET.

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As a middle aged child, it is common to wonder about how to start to talk to elderly parents about the future? Few things make adult children more nervous. There are many things to fear from this conversation: resistance, denial, conflict and reminding ourselves that our parents are getting older.

But we should fear an impending problem or crisis more.

Beginning the conversation with aging parents is similar to learning to ride a bike. You don’t take off going downhill; you muster up the nerve, hold your breath and try to keep your balance.

Start the conversation now, while they are healthy and you have no real concerns; and start small. This way there is time to build the conversation slowly without pressure.  Unexpected situations or crises with aging parents without having planned can cause rifts between siblings, between parents and kids, and between spouses.

Time your conversation with your parents appropriately. Be sure that you and they have time to talk and listen.  This conversation needs an investment of time and patience.

It is easier to begin the conversation by relating it to your own experience. For example, “I met with my attorney today and drew up my will…”

You need to be clear with yourself and your parents about why you are initiating this conversation. If you are annoyed or frustrated, this is not a good time. The conversation needs to be about their safety and their future, and about the quality of life for both them and you.

Remember too that you don’t need to get the answer today. You are merely trying to begin the dialogue and get everyone thinking and talking. 

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The terms Assisted Living Community and Nursing Home are often used interchangeably, however this is a mistake. They are actually very different, and a candidate for one is not necessarily a candidate for the other. However, that being said, Spring Arbor and The Oaks are assisted living residences. However, we recognize that just as every resident is unique and different, so too are his or her care needs. The fact is some residents require more time and attention than others. We address those needs individually rather than increase service fees for everyone.

The following are some differences between the Assisted Living and Nursing Homes.

Assisted Living Communities:

• Individuals in assisted living are more independent and can usually get through most of their day on their own. Generally, they only need help with daily activities like bathing, dressing, and preparing food.
• They still enjoy social activities and make autonomous decisions.
• Assisted Living Communities require limited to no medical care or specialized medical care.
• In Assisted Living Communities, residents are able to maintain their independence in a more secure atmosphere and they focus more on personal privacy and self-sufficiency than a nursing home.
• They offer their clients a comfortable apartment that is luxurious and comfortable.

• Those in nursing homes need a great deal more care. They usually require 24-hour nursing supervision and are generally not in good health.
• Nursing home patients require help with much more than three or more daily tasks:walking or being pushed in wheel chairs, eating, and regular medical tests.
• A nursing home is a place for someone who is unable to be cared for at home, but is not a candidate for hospital care.
• Nursing homes also provide rehabilitation to help people gain back their independence after a serious health problem.
• Similar to hospitals, nursing home patients have little to no privacy and quite often share rooms.
• Those in Nursing homes are viewed as patients, not clients. They are there to get well. If you or your parent is well, a nursing home is not ideal.

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Alzheimer’s symptoms grow worse as time progresses, the disease may have unpredictable changes; making it an extremely difficult task to care of a person with Alzheimer’s disease. For both the person with Alzheimer’s and the caregiver, arranging basic activities of daily living can be difficult. Eating, talking, sleeping, and finding things to do: all these things become difficult as the disease becomes more severe.  There are many ways to help manage these difficulties.

Nighttime can seem like a blessing for some, but for those with Alzheimer’s it can be difficult. Most people with Alzheimer have become restless and irritable around this time. Putting the person to bed may require some advance planning.

Limit daytime napping and encourage exercise during the day, but still allow for a sufficient amount of rest during the day. Try to schedule more physical activities such as bathing earlier in the day. And in the evening set a peaceful, quiet tone to encourage sleep. Make certain that the lights are dim and the noise is down to a minimum. In some cases playing soothing music may help, but only if the person enjoys it. Try to keep the person’s bedtime routine. NO caffeine late in the day.  If the person gets frightened or disoriented use night lights around the halls and bathroom. Spring Arbor knows that caring for a person with Alzheimer's takes time and patience which is why if you know someone with Alzheimer's and have any questions or wish you explore our communities, please contact us today.

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In 2006, experts at Johns Hopkins University estimated that over 26 million people globally were living with Alzheimer’s disease. They also projected that instances of Alzheimer’s disease would increase globally to more than 106 million cases by the year 2050. By that time, 43% of Alzheimer’s patients will require high-level health care from highly skilled assisted living facilities. These troubling statistics were presented at conference for the prevention of dementia in Washington, D.C. on June 10.

The good news is that there is also growing body of evidence that suggests there are thing we can do to ward of the signs and symptoms of decline associated with Alzheimer’s disease and dementia. And it may be as simple as adding apple juice to our diets. Thomas B. Shea, PhD, and his team of researchers have conducted several laboratory studies which indicate that mice performed better than average in maze tests after drinking apple juice. It also seems to have prevented the normal decline in performance observed in the mice as they age.

In their most recent study, Shea and his colleagues found that mice who were giving the equivalent of 2 glasses of apple juice a day for an entire month produce less beta-amyloid, a protein fragment that is the cause of “senile plaques” that form in the brains of people who suffer from Alzheimer’s. The findings are significant because they suggest that something as simple as drinking apple juice routinely can improve brain function and possible delay key symptoms of Alzheimer’s disease.

The delayed onset of Alzheimer’s behaviors isn’t the only reason to drink apple juice. Here are some other benefits of drinking the beverage regularly:

• It contains nutrients and vitamins that may protect the body from other illnesses, like common colds.
• Apple juice also contains antioxidants, which are known to help prevent heart disease the development of some cancers.
• It can help reduce cholesterol.
• When consumed in moderation, it may also help promote weight loss.

Be sure to contact us should you have any questions about Alzheimer's or how we can provide custom care plans for individuals with this disease. We encourage you to seek out support as you take this journey and allow us to join you along the way.

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