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Is It a Good Idea to Quit Your Job to Care for Your Elderly Parent?

WomenOldYoungYou already know what may be gained by giving up employment and becoming the sole caregiver for your parents. You are the hands-on person and know their care intimately. You know how they are doing day and night and you hope they will appreciate your help. They raised you and you want to give back. You also could save the money that would be spent for in-home care or adult day care, plus you likely put off, if not eliminate, the need for nursing home care. Therefore, quitting a job and staying home to care for your aging parents could save them significant money. What do you lose if you quit your job to provide care for your parents?

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What’s Developing in Alzheimer’s Disease Treatment

 By Lawrence Friedhoff, MD, PhD


Lawrence_FriedhoffMy work in Alzheimer’s disease therapeutics began about 20 years ago. After completing my medical training, I was interested to explore another side of medicine—how new drugs are developed.

Attitudes toward dementia have changed drastically over the past two decades. Back then, the term Alzheimer’s disease wasn’t widely used, nor was Alzheimer's disease seen as a credible illness. Instead, people referred to the symptoms of Alzheimer’s disease as "senile dementia,” an inevitable consequence of aging that was considered untreatable.

In the early 90’s, I began working for a mid-size pharmaceutical company, and was placed in charge of finding promising new drugs to bring to market. In looking through many drug candidates and speaking with the scientists who had invented them, I came across a molecule, “E2020,” that I suspected would be an effective treatment for Alzheimer’s disease. I was able to obtain some development budget for E2020, and worked with a small team to get the molecule worldwide drug approval. About 5 years later, that drug became available to patients as Aricept (donepezil), which was then, and is still, the most widely used Alzheimer’s disease treatment.

Scientific and public attitudes about Alzheimer's disease changed with the approval of Aricept and subsequent medications: doctors became more educated about the disease and its diagnosis, and patients and their caregivers became more optimistic about the development of even better treatments.

The medical and scientific communities want to answer that call. Recently, there has been a push to explore medicines targeting a particular protein, beta amyloid, which tends to accumulate in the brain as we age, and is associated with dementia. The hope that these beta amyloid-targeted products could cure Alzheimer's disease meant an enormous amount of time and money was put into their development. Unfortunately, thus far, these investigational drugs have not yet shown any convincing benefit to patients with Alzheimer’s disease.

Although scientists are still pursuing new beta amyloid treatments, I believe the scientific community is turning its attention back to neurotransmitter-targeted drugs, which, like Aricept, act on essential chemicals within the brain in order to augment the brain’s normal functions. I’m currently leading the development of one such drug, called RVT-101, which has strong evidence of benefit to mild-to-moderate Alzheimer’s patients’ cognition and ability to perform daily living activities.

RVT-101 appears to be very well tolerated and is an oral, once-daily pill, so it’s easy for patients to take. Based on the results obtained to date, we believe RVT-101 has a good chance of becoming a widely-used drug for treatment of Alzheimer’s disease and other dementias. We are currently enrolling patients in a Phase III clinical trial of RVT-101, and we think it will be the final trial needed in order to get FDA approval and make the drug available to all patients. Until then, all patients who enroll in and complete our large clinical trial will have the opportunity to receive RVT-101 for up to one full year.

It's important to understand that clinical trials are a fundamental part of getting new treatments to patients, and are especially important for Alzheimer's disease drugs. Tests of Alzheimer's disease treatments in animals have not been predictive of the results in human patients except in a few rare cases. Furthermore, clinical trials can provide benefit to both the patient and future generations: they provide patients an opportunity to get a new drug earlier than would otherwise be possible, and participants may contribute to the advancement of drugs that help other patients. As Alzheimer’s disease occurs more frequently in women than in men, women’s participation in clinical research is particularly important.

However, patients should remember that there is no guarantee that the investigational drug in a clinical trial will ultimately prove to be beneficial— and all drugs have side effects. If clinical trials interest you or a loved one, make sure to discuss participation with your doctor and the staff running the clinical trial in order to determine which clinical trial, if any, is right.

BIO:

Dr. Friedhoff's career in pharmaceutical R&D has spanned more than three decades. During this time he has led and managed teams that developed and obtained approval for six new drugs, including Aricept® (donepezil), the most widely used drug for the treatment of Alzheimer's disease. Dr. Friedhoff is the Chief Development Officer at Axovant Sciences, Inc., a biopharmaceutical company focused on dementia solutions. He is the author of "New Drugs: An Insider's Guide to the FDA Approval Process for Scientists, Investors, and Patients" and has authored and co-authored numerous articles for peer-reviewed publications. He holds an MD from New York University, a PhD in Chemistry from Columbia University, and is a Fellow of the American College of Physicians.

The MINDSET Study for Mild-to-Moderate Alzheimer’s Is Open for Enrollment! 

As a participant in the MINDSET study, Alzheimer’s patients and their caregivers can have access to study-related medical care from specialized teams in this field.  Participants can continue to see their regular doctor(s) while participating in this study, and medical insurance is not required to participate. 

Interested patients and caregivers are invited to visit www.AlzheimersGlobalStudy.com to see if they may pre-qualify.


Caregiving: For Some It's a Legacy

Sky5The word from hospice personnel and others who help dying folks is that few people say, at the end of their lives, that they wish they'd spent more time at work. What these dying people do say is that they wish they'd loved more easily, spent more time with those they love, forgiven others more quickly and that they hope they've been forgiven for being a human being who has made mistakes. What would you want your obituary to convey?

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Poor Dental Hygiene Linked to Brain Tissue Degeneration

MossytreeThe strongest evidence to date that poor dental hygiene is linked to brain degeneration has emerged from a recent study at the University of Florida Dental College. While cardiologists have long known that the bacteria that causes gingivitis (gum disease) may enter the blood stream adding to  heart issues, there had been fewer studies to link Alzheimer’s or other dementia to oral health. 

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Commonly Used Drugs with Surprising Mental Side Effects

Medical_tablets_01_hd_pictures_168382Many of us have become aware that prescription medications such as Ativan, Xanax and Klonopin may have serious side effects including memory issues. These drugs, which are generally prescribed for anxiety, can possibly increase the risk of developing Alzheimer’s disease since they are in a class known as anticholinergic drugs. They work by blocking a neurotransmitter called acetylcholine in the nervous system. 

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Long-term Caregiving May Significantly Shorten Life Expectancy of Caregiver

Alone...The team’s research provided physical evidence that the effects of chronic stress, which is often part of the caregiving life, can be seen both at the genetic and molecular levels. They used volunteers who were Alzheimer’s caregivers and compared them with an equal number of non-caregivers matched for age, gender and other health and environmental aspects. The researchers looked at blood samples from each group for differences in the telomeres as well as populations of immune cells.

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Reversing Memory Loss Without Drugs

RunningWoodsWe frequently hear about some promising new potential drug breakthrough, yet there is at this time no medical cure and it’s not likely that there will be one anytime soon. Thus, the interest in exercise, diet, vitamin and herbal remedies and brain challenges. 

Read more on HealthCentral about reversing memory loss without drugs

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“I hold onto your book as a life preserver and am reading it slowly on purpose...I don't want it to end.”  Craig William Dayton, Film Composer


Home is All About Heart: When Your Loved One Wants to Go Home

DementiaMan... More likely, at least in the case of Alzheimer's disease, the home this elder misses is a childhood home. It's the home where he or she felt the comfort of a mother's arms; the safety of a father's protection. Again, this home is a state of mind rather than a building. Even if we could take our loved one to the actual house of his or her childhood, it's not likely that this structure would bring comfort. A sense of comfort comes from being with other human beings who love us and will do what they can to care for us.

Read more on Agingcare about what home symbolizes:

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“I hold onto your book as a life preserver and am reading it slowly on purpose...I don't want it to end.”  Craig William Dayton, Film Composer


Could Life Experience Offset Cognitive Decline Due to Aging?

Exercise5Could life experience make up for some of the effects of age on the brain? According to researchers from the School of Business Administration at the University of California, Riverside, it can and does. The research group measured a person's decision making ability over their entire lifespan. Using two difference types of intelligence - fluid and crystallized – they found that experience and acquired knowledge from a lifetime of decision-making often offset the declining ability to learn new information.

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8 Dementia Activities Targeted toward Unique Interests

GetImage.aspxFinding activities for people with dementia can be challenging. For example, my dad’s dementia was caused by failed surgery during his 70s. He was always interested in archaeology, science of any type, space exploration and a variety of human cultures. I focused his activities on those things he loved. The music of his youth was another priceless tool to help him get through the days. What activities or topic of interest would work for your loved one?

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