Minding Our Elders®

Why Elders Don't Come Clean with the Doctor

...My mom was a supreme example. She fell in her apartment—often more than once a week. She had memory problems. She was taken advantage of by telemarketers. She had digestive issues. However, when I took her to her doctor, what I called her "hostess personality" took over. While she may have complained of pain in the car during our drive, the minute she had a chance to tell her doctor how terrible she felt she was perkiness personified.

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Going Public with an Alzheimer’s Diagnosis

Sadly, even after years of work to educate the public about any illness that affects the brain, a stigma remains. No matter that most if not all mental illnesses have some biological basis. No matter that people aren’t any more responsible for a brain illness than they are for other bodily illnesses. Whether the illness that affects the brain occurs at a younger age in the form of depression or bi-polar disease or an older age in the form of Alzheimer’s disease, people with brain illnesses are often reluctant to acknowledge their illness for fear of being treated differently than others.

Read more about the stigma of Alzheimer's and other brain diseases:

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Photo Albums and Memory Books Helpful When Visiting Elders

Many people are reluctant to visit elders, whether they are in their homes or a facility, mainly because they wonder what they’ll talk about. While this reluctance is more of a worry if the elder has memory problems from dementia, it’s often a problem even when memory isn’t an issue.Since elders by definition have many decades of life to their credit, they will likely enjoy looking back on the past. This is especially important when people have Alzheimer’s disease, because their disease prevents them from forming new memories. Nearly everyone enjoys reminiscing to some degree.

Read more about how physical reminders can help visits with elders go more smoothly:

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BRAIN Initiative Embraces More Than Alzheimer’s Disease

Alzheimer’s disease is not only devastating those who develop the disease. It affects the family and others who love the person who must live with the disease, and it affects our nation as a whole because of the high cost of care. 

According to research led by an economist at the RAND Corporation, expenses for dementia, including nursing home care, were $109 billion in 2010. To put that into perspective, heart disease costs totaled $102 billion and cancer totaled $77 billion. The amount of money spent on heart disease and cancer is enormous, however through preventive intervention, early diagnosis and better drugs, the number of people developing these diseases are holding steady or even decreasing. Not so with Alzheimer’s disease.

Read more about brain mapping and its potential:

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Aspirin May Protect Our Brain As Well As Our Heart

Old fashioned aspirin is once again looking like a hero. More studies are reporting that people who have taken a low dose aspirin tablet daily, which is common practice in the U.S. to prevent heart attacks, are also receiving some protection from dementia. According to a study conducted at the University of Gothenburg in Mölndal, Sweden, women who took a low dose of aspirin over a 5 year period were less likely to develop Alzheimer’s disease.  This is not the first study to suggest that aspirin may be effective in combating the onset of Alzheimer's, but it adds to the body of favorable data.

Read more about how aspirin may protect us against Alzheimer's:

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More Evidence Shows Chronic Stress Increases Risk for Alzheimer's Disease

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More Evidence Shows Chronic Stress Increases Risk for Alzheimer’s Disease

A new doctoral thesis by Sara K. Bengtsson, Department of Clinical Sciences, Umeå University, Sweden, examines the reason why chronic stress can increase one’s risk for Alzheimer’s disease.

Allopregnanolon,  one of the steroids produced by a body under stress, can inhibit general brain activity. The thesis shows that chronically elevated levels of allopregnanolone accelerated Alzheimer’s disease development in genetically altered mice models. The mice with Alzheimer’s disease showed impaired learning and memory. They had also increased brain levels of beta-amyloids, which are the proteins that form plaques in Alzheimer's disease.

Read more about how chronic stress increases your risk of Alzheimer's:

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Delaying Alzheimer's with Mental Enrichment

For years researchers have tried to understand the impact and significance of a person's education level on the development of Alzheimer's disease. Many studies have shown that people who often challenge themselves to learn complex tasks will show Alzheimer’s symptoms later than those who don’t. Scientists theorized that people who work to enrich their minds, whether through formal means or through a mentally challenging lifestyle, have more cognitive resources at their disposal to mask symptoms of AD.

Now, an article in the Harvard Gazette reports on a study showing evidence that continually challenging our minds may be an even more powerful ally against AD symptoms than previously thought.

Read more about mental exercise and Alzheimer's:

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Study Shows Stress Hormones Increase Alzheimer’s Risk

If we’re alive, we are coping with a significant amount of stress. Yet stress hormones have been shown to have a negative effect on our health.

Now, the recent article, "Stress may increase risk for Alzheimer’s disease: Stress hormones lead to Alzheimer-like protein modifications,” brings to light epidemiological studies by scientists at the Max Planck Institute of Psychiatry in which the scientists hypothesized that adverse life events, which generally cause stress, may be one trigger for Alzheimer’s disease.

Read more about how stress increases risk for Alzheimer's:

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Elders Covering for Each Other Can Hide Dementia Symptoms

Long married couples are often said to “finish each others sentences.” They work as a unit, and friends and family members are used to this interaction. This ability to work as a team is a wonderful thing until one of the team isn’t functioning well and the other is in denial. When couples cover up for each other, precious time can be lost. So, adult children need to be on the lookout for signs that things aren’t going well.

Read more about elders with long--term marriages covering up health issues:

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Staying Ahead of Alzheimer’s Wandering

Dear Carol: My mom has mid-stage Alzheimer’s. She lives with me and, for now, seems safe enough at home while I’m at work. What concerns me is that she’s started talking about wanting to “go home.” I’m aware that this could mean that she’s looking for her childhood home, and that makes me worry about her making a sudden decision go off by herself to look for that home. What steps can I take to help keep her safe? Emma

Dear Emma:  You are right that this could be a signal for you to be vigilant about wandering. While frequently caregivers don’t feel like they’ve had any warning that their loved one may wander, often there are subtle signs that this behavior is a possibility at any time.

Read more about preventing Alzheimer's wandering:

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Reminiscing Powerful “Drug” for People with Dementia

I love stories. When I was a teenager, I’d encourage grandparents to relate stories of their young years struggling to survive on the wind-swept prairie. When I grew older, I was fascinated by the stories my parents and in-laws told of their early years of growing up during the Great Depression. Little did I know at the time that peoples’ stories would become the springboard for my life’s work. Now there is mounting evidence that encouraging our elders to reminisce about their past is therapeutic as well as enjoyable.

Read more about how reminiscing can improve life for people with dementia:

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PBS Airs "Hopeful Aging" This Week

Alzheimer's symptoms can often be managed through compassionate, non-pharmacological methods, or in conjunction with pharmacological methods. In 2010, I reviewed the remarkable book by John Zeisel, Ph.D., titled "I'm Still Here."

Within the next two weeks or so, your local PBS station should be airing "Hopeful Aging," which is based on the "I'm Still Here" approach to helping people with Alzheimer's live a quality life. Take a look at the trailer below. If you're interested, check you local listings. This is bound to be an informative, compassionate look at aging.

Trailer for "Hopeful Aging"

 

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Vitamin D, Mediterranean Diet Help Lower Risk of Alzheimer’s

Two different studies have highlighted natural weapons we may have at our disposal in our fight against developing Alzheimer’s disease. One is Vitamin D and the other is our diet.  We’ve long known that vitamin D, generally absorbed through sun exposure but often supplemented, is necessary for bone strength. During the last few years, evidence has been accumulating showing that a low level of vitamin D likely contributes to cardiovascular disease, some cancers, strokes, depression and some metabolic disorders. Now, a review recently published in the journal Neurology, assessed 37 studies that evaluated vitamin D concentrations and cognitive function.

Read more about vitamin D and the Mediterranean diet as tools to avoid Alzheimers:

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Bilingual people may be better protected against Alzheimer's

The first elder for whom I became a primary caregiver was my neighbor, Joe. Joe was born of Norwegian immigrant parents and spoke Norwegian at home until he started first grade. Joe needed to repeat first grade because he spent his first year in school learning English. While, in the end, this didn’t hurt him and he went on to become a well educated engineer who spoke English with no Norwegian accent, he did tell stories about how difficult his first years in school were.

Read more about bi-lingual elders and Alzheimer's:

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Hearing Loss Compounds Problems of Dementia

Corrected link. Sorry!

Dear Carol: My mom is 89-years-old, lives in assisted living and has dementia. She also has substantial hearing loss which isn’t helped very much by her hearing aids.  Her dementia prevents her from understanding closed caption TV, so that spoils TV as entertainment for her. Basically, she’s bored and miserable. Her dementia has progressed to where she thinks people are coming into her room to rob or hurt her.  I feel like she should move in with me and my family, but we don’t have enough room as it is, and I work full time. I don’t know what to do to make her happier. – Marie

Dear Marie: Since your mom is in an assisted living facility, she should have many chances to socialize with others, but poor hearing probably makes being in a group uncomfortable for her.

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Driving and Dementia: When and How to Have the Talk

Taking away an elder’s driving privileges is one of the most dreaded challenges that adult children, or spouses of people with dementia, face. The ability to drive oneself to a chosen destination is often the ultimate sign of independence. Conversely, being forced to stop driving is generally viewed by elders as a major loss of independence. Yet, an unfit driver is a potential killer. When should a person quit driving, and how do we convince our loved one that he or she must give up this independence?

A story in the January edition of the Mayo Clinic newsletter focuses on the dementia and driving problem. The article points out that while memory is an issue, a person with Alzheimer’s or another dementia may have trouble prioritizing visual cues which could have even more of an impact on driving safety.

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Life After a Dementia Diagnosis

Most Alzheimer’s organizations have found that, in general, people are more afraid of a dementia diagnosis than finding out that they have cancer. One reason for this fear is the stigma that accompanies dementia. While sympathetic to those who have Alzheimer’s and other dementias, people who haven’t been close to anyone with the disease often think that any type of satisfying life is out of reach after such a diagnosis. 

According to the Alzheimer’s Foundation of America (AFA) and the Alzheimer’s Association, people with Alzheimer’s and other dementias want others to know that they can still “function.” They can still have a meaningful life. Some develop a renewed sense of purpose because they know that they have a disease that will cause cognitive degeneration, so that every moment they have is precious and should be lived to the fullest.

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Study Concludes Preventing or Managing Diabetes Prevents Cognitive Decline

As far back as 2006, the New York Times was reporting on the deepening link between diabetes and Alzheimer’s disease. Now, new results from a study led by researchers from the University of California San Francisco show that there is a link between the risk of cognitive decline and the severity of diabetes.

An article on the UCSF website reports on a 9-year long study by researchers at the University of California, San Francisco (UCSF) and the San Francisco VA Medical Center. The Health, Aging, and Body Composition (Health ABC) Study enrolled 3,069 adults over 70 at two community clinics in Memphis, TN and Pittsburgh, PA beginning in 1997. All the patients provided periodic blood samples and took regular cognitive tests over time.

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Alzheimer’s Vaccine May Be Available in Three to Five Years

If we choose, we may view the many conflicting reports on drug trials for Alzheimer’s during 2012 as discouraging. After all, two very promising drugs in late-stage trials last fall failed to show the potential that researchers were looking for. Yet, on a quieter level, progress was being made. CBS News recently aired a segment about an Alzheimer’s vaccine that may be available, depending on funding – and volunteers for the studies – in three to five years. This vaccine is in mid-stage testing.

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Memantine May Help Prevent Damage from Mini-Strokes

Unlike Alzheimer’s disease which is still poorly understood, it’s well accepted that vascular dementia is caused by strokes, often a series of small, “silent” strokes. While early stage Alzheimer’s is characterized mostly by memory loss, vascular dementia more generally affects executive function, multi-tasking, problem-solving and reasoning. It’s important to understand that more than one type of dementia can be present, which can further complicate a diagnosis.

When people are having a major stroke, they are likely to be aware that something is happening that could cause significant damage unless immediate medical intervention is sought. However, the undiagnosed mini-strokes that can result in mild cognitive impairment leading to vascular dementia often occur without any immediate evidence that something is wrong.

Read more about Memantine and vascular dementia:

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