Tag Archives: Alzheimers-disease

The Longest Day- Is Happening Today!

For the people involved in this event, this challenge is one day. For people with Alzheimer’s, it’s every day. Run, walk, bike or challenge yourself to some other endurance activity to honor those facing Alzheimer’s. Learn More

On June 20, 2012, the longest day of the year, participants across the northern hemisphere will push their limits in a sunrise-to-sunset relay to raise awareness and funds for the fight against Alzheimer’s. It’s one day to honor the passion, dedication and strength displayed by people with Alzheimer’s and their caregivers every day.

Join us for year one of this exciting and innovative event! The Longest Day allows you to participate with ultimate flexibility – you choose your activity, route and time of day to get active. The only rule is that someone on your team is in motion throughout the 16 hours of daylight on the longest day. The Alzheimer’s Association will provide fundraising support and connect you to a virtual community of other participants. We’ll also be cheering you on throughout The Longest Day!

Each team member pledges to raise a commitment fee and is asked to raise a minimum of $100/hour of activity (suggested minimum: $400). Participants will receive a virtual fundraising toolkit, an event day experience kit (including a T-shirt and awareness and celebration materials) and ongoing staff support to help plan a great day and reach fundraising goals. Through smartphone technology and social media, every participant will be able to showcase their efforts and share their stories as part of the global movement to fight against Alzheimer’s.

We’re in it until Alzheimer’s is finished. Show your support for the cause by donating to a team or participant in The Longest Day. Give to honor the more than 35 million people worldwide who are living with Alzheimer’s and the countless caregivers who face this disease so bravely every day.

Follow the event now and donate!



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National Alzheimer’s Plan Released

Today the Obama Administration announced the release of the National Alzheimer’s Plan. U.S. Secretary of Health and Human Services Kathleen Sebelius reaffirmed our nation’s commitment to conquering Alzheimer’s disease and related dementias, with a specific goal of finding effective ways to prevent and treat the disease by 2025.

In addition to the release of the Plan the Administration also published a new website alzheimers.gov which will serve as a resource for those fighting the disease.

Read the Alzheimer’s Association comments on the plan.

Read the entire text of the National Alzheimer’s Plan (pdf) (html).

Posted on May 15, 2012 by Alzheimer’s Association

On January 4, 2011, The National Alzheimer’s Project Act was signed into law by the President of the United States after having been passed unanimously in both the Senate and House of Representatives.  This is a major victory for the Alzheimer’s Association’s chapters and advocates as well as the nation.  Once enacted, NAPA will create a national strategic plan to address and overcome the rapidly escalating crisis of Alzheimer’s.
NAPA is the largest legislative victory in many years for the Alzheimer cause.

Over the last several years, the Alzheimer’s Association has been the leading voice in urging Congress and the White House to pass the National Alzheimer’s Project Act (NAPA).  The National Alzheimer’s Project Act will create a coordinated national plan to overcome the Alzheimer crisis and will ensure the coordination and evaluation of all national efforts in Alzheimer research, clinical care, institutional, and home- and community-based programs and their outcomes.  Alzheimer’s advocates were instrumental in moving NAPA through Congress.  More than 50,000 e-mails, nearly 10,000 phone calls and more than 1,000 meetings by the Alzheimer’s Association and its advocates led us to the historic legislative victory for the Alzheimer community.

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Top 10: Holiday Advice for Caregivers and Other Caregiver News

We’ve been reading so much great advice for caregivers this holiday season, we felt it was worth a blog post just to highlight some of these informative articles. If you’re a caregiver to an aging friend or loved one, take a few minutes to read up on some useful tips that can help you travel your caregiving journey with ease.

  1. Ryan Malone, of Inside Elder Care, never fails to impress with his expert insights. His latest blog post talks about the recent Gallup poll that really drills down caregiver statistics in the U.S. Some of them are not surprising, but some will be shocked to learn just how many folks are caring for a loved one these days — and the level of sacrifice they make each day in order to do so.
  2. Registered nurse, former caregiver (for her father), current long-distance caregiver (for her mother) and our friend (we’re proud to say!), Shelley Webb of Intentional Caregiver, gives us 11 New Year’s resolutions caregivers can make this holiday season in a guest post for Maturity Matters.
  3. If you’re planning to move a loved one in the near future, check out these ten tips from AARP. And for more awesomeness from AARP, read this post if you have a caregiver on your shopping list this holiday season for some excellent caregiver gift ideas. Thinking cruises and spa getaways? Think again: an empathetic ear, a little help. You know, those intangibles that are far more valuable than expensive gifts!
  4. Montgomery Media offers tips for caregivers to de-stress this holiday season. Top of the list? Don’t forget to take care of yourself, so you can provide better care for your loved one. We’ve heard it many times, but caregivers get so caught up in caring for loved ones they easily forget this very important task.
  5. Tax season is rapidly approaching, and Forbes has some information on tax breaks to help caregivers ease the financial burden.
  6. American Medical News talks about how technology can connect doctors and caregivers. Easy communication is critical between the two, as caregivers must stay in control of their loved one’s care needs.
  7. The San Francisco Chronicle features a press release covering a new approach to caregiving for the Alzheimer’s/dementia patient. The Pines Education Institute of S.W. Florida partnered with Teepa Snow, a nationally-recognized dementia care expert, to produce a series of educational DVDs to aid caregivers.
  8. MSN takes a humorous approach to identifying the signs of Alzheimer’s disease with “7 Signs Santa Has Alzheimer’s.” This light-hearted approach excellently conveys critical signs caregivers and loved ones should look out for, especially if visiting a long-distance aging loved one over the holidays.
  9. The holidays are supposed to be a joyous time, yet many aging and disabled adults find themselves with a case of the holiday blues. If your loved one is having a difficult time this holiday season, check out these tips from Care.com to help.
  10. La Mesa Courier features a great list of tips for making this holiday season a joyous one for your aging loved ones. Try cooking a special meal together, listening to their stories from the past or taking a nostalgic ride around town.

There are so many more to share. What’s your favorite holiday tip for caregivers? Give us some ideas in the comments and we’ll feature your tips in an upcoming blog post!

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Easing the Added Stress of Caregiving During the Holidays

For millions of Americans who find themselves in the role of caregiver to an older frail, ill, or disabled relative, the holiday season can add to an already heavy load of responsibilities and cause feelings of stress to soar.

Stress occurs when we work too much, sleep too little, try to cope with difficult or troubling situations, and when we neglect to take good care of ourselves—all of which are typically everyday state of conditions for the millions of Americans who find themselves in the role of caregiver to an older frail, ill, or disabled relative. The added physical and emotional demands that are involved in celebrating the holidays can add to an already heavy load of caregiving responsibilities and cause feelings of stress to soar.

The holidays are traditionally a time when we reflect on past memories. For those who are caring for a frail and elderly family member, these reflections often deepen the awareness of the extent of the older person’s losses (for example, memory loss for those with Alzheimer’s) and how much life has changed for them. Holiday-time reminiscing can also underscore the loss caregivers face in the altered quality of their personal relationship with the older person. The emotional pain of confronting such losses can heighten feelings of stress.

The holidays are also a traditional time for family gatherings. While this can be tremendously enjoyable, when tensions among family members or unresolved conflicts surface, it can become a source of extreme stress. Caregivers too often find themselves in the middle of family discord as they try to mediate the needs of the older person as well as express their own position.

If you are a family caregiver, consider the following suggestions and think about which ones you can put in place during the coming weeks to help ease your feelings of stress during the holidays:

· Set manageable expectations and limits for yourself. Be realistic about what you can and cannot do—as well as what you want to do and don’t want to do.

· Try not to set yourself up for disappointment by comparing this year’s holiday season with the nostalgia of past holidays. Each holiday season is different and can be enjoyed in its own way.

· Ask for and accept help! It’s so often the case that, while people want to be useful, they may not always know what to do. Let other family members and friends know what they can do to share in the responsibility of caregiving. Don’t forget to consider asking people who live at a distance, as well as neighbors and people from faith-based groups or clubs, to pitch in and help.

· Maintain or establish social interaction with friends and other family members. Isolation can further increase feelings of stress. Having the chance to have fun, laugh, and focus on something other than your at-home caregiving responsibilities can help you keep stress at bay and maintain emotional balance.

· Remember the holiday season does not banish reasons for feeling sad or lonely. There’s room for feelings such as sadness, grief and/or loneliness to be present along with other more joyful emotions. If you do feel down, avoid critical self-perceptions, and, instead, try to articulate the understanding you need from those around you. Consider seeking the help of a therapist to help you sort out your feelings and deal with your concerns and troubling issues.

· If the elderly person you are caring for has dementia, avoid overly stimulating environments since that can add to their anxiety and end up increasing your stress level.

· If including the elderly person in large family gatherings creates added work and stress for you, consider alternatives, such as suggesting family members plan to spend individual quality time visiting with their elderly relative.

· Don’t abandon healthful eating and drinking habits. While it’s certainly okay to treat yourself during the holidays, avoid giving in to stress-driven urges for overeating or for overindulging in alcohol.

· Exercise regularly. Even if it means finding someone else to take over your caregiver duties, getting regularly-scheduled exercise—for example, walking, swimming, yoga, biking, or aerobics—can be of tremendous benefit to both your physical and emotional well-being.

· Seek emotional and moral support from other caregivers—there is great strength in knowing you are not alone. Many communities have support groups for family caregivers of elderly persons through local hospitals, churches and/or community centers.

· Use community resources such as meal or shopping services, home-care aides, adult day services, and/or volunteer help from faith-based organizations or civic groups.

· Try to find time for yourself to do something you especially enjoy such as reading, walking, listening to music, gardening and/or visiting with a friend.

· Find ways to ensure you get enough rest. Sleep deprivation can sap your energy, distort your thinking and lead directly to making your mind and your body feel stressed to the maximum.

· If you experience any signs of depression (for example, extreme sadness, trouble concentrating, withdrawal, or hopelessness), don’t delay in getting professional help for yourself. Depression is a serious, but very treatable condition. If left untreated, depression does not “just go away,” instead, the symptoms progressively worsen and can even become debilitating. You can click here for information about depression, including a more detailed list of commonly experienced symptoms and ways to receive help.

Throughout the holiday season (as well as year-round!), remember to be good to yourself. As a family caregiver, you’re doing a very hard job and deserve understanding, support and quality time for yourself to help ensure you meet your own emotional needs. Many caregivers have found that therapy offers life-strengthening help in dealing with the many challenges of caregiving. Therapy can provide a time and place that is devoted exclusively to your feelings, needs, and concerns—and can result in a healthy perspective that allows you to devote your best efforts to your older loved one while also making sure you take the very best care of yourself.


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Dietary fats: Know which types to choose

When choosing fats, pick unsaturated fat over saturated or trans fat. Here’s how to know the difference.

Most foods contain several different kinds of fat, and some are better for your health than others are. You don’t need to completely eliminate all fat from your diet. In fact, some fats actually help promote good health. But it’s wise to choose the healthier types of dietary fat, and then enjoy them — in moderation.

The facts about dietary fat

There are numerous types of fat. Your body makes its own fat from taking in excess calories. Some fats are found in foods from plants and animals and are known as dietary fat. Dietary fat is one of the three macronutrients, along with protein and carbohydrates, that provide energy for your body. Fat is essential to your health because it supports a number of your body’s functions. Some vitamins, for instance, must have fat to dissolve and nourish your body.

But there is a dark side to fat. The concern with some types of dietary fat (and their cousin cholesterol) is that they are thought to play a role in cardiovascular disease and type 2 diabetes. Dietary fat also may have a role in other diseases, including obesity and cancer.

Research about the possible harms and benefits of dietary fats (sometimes called fatty acids) is always evolving. And a growing body of research suggests that when it comes to dietary fat, you should focus on eating healthy fats and avoiding unhealthy fats.

Harmful dietary fat

The two main types of potentially harmful dietary fat:

  • Saturated fat. This is a type of fat that comes mainly from animal sources of food. Saturated fat raises total blood cholesterol levels and low-density lipoprotein (LDL) cholesterol levels, which can increase your risk of cardiovascular disease. Saturated fat may also increase your risk of type 2 diabetes.
  • Trans fat. This is a type of fat that occurs naturally in some foods, especially foods from animals. But most trans fats are made during food processing through partial hydrogenation of unsaturated fats. This process creates fats that are easier to cook with and less likely to spoil than are naturally occurring oils. These trans fats are called industrial or synthetic trans fats. Research studies show that synthetic trans fat can increase unhealthy LDL cholesterol and lower healthy high-density lipoprotein (HDL) cholesterol. This can increase your risk of cardiovascular disease.

Most fats that have a high percentage of saturated fat or trans fat are solid at room temperature. Because of this, they’re typically referred to as solid fats. They include beef fat, pork fat, shortening, stick margarine and butter.

Healthier dietary fat

The two main types of potentially helpful dietary fat:

  • Monounsaturated fat. This is a type of fat found in a variety of foods and oils. Studies show that eating foods rich in monounsaturated fats (MUFAs) improves blood cholesterol levels, which can decrease your risk of heart disease. Research also shows that MUFAs may benefit insulin levels and blood sugar control, which can be especially helpful if you have type 2 diabetes.
  • Polyunsaturated fat. This is a type of fat found mostly in plant-based foods and oils. Evidence shows that eating foods rich in polyunsaturated fats (PUFAs) improves blood cholesterol levels, which can decrease your risk of heart disease. PUFAs may also help decrease the risk of type 2 diabetes. One type of polyunsaturated fat, omega-3 fatty acids, may be especially beneficial to your heart. Omega-3s, found in some types of fatty fish, appear to decrease the risk of coronary artery disease. They may also protect against irregular heartbeats and help lower blood pressure levels.

Foods made up mostly of monounsaturated and polyunsaturated fats are liquid at room temperature, such as olive oil, safflower oil, peanut oil and corn oil.

A word about cholesterol

Cholesterol isn’t a fat. Rather, it’s a waxy, fat-like substance. Your body manufactures some cholesterol. Your body also absorbs some dietary cholesterol — cholesterol that’s found in foods of animal origins, such as meat and eggs. Cholesterol is vital because, among other important functions, it helps build your body’s cells and produces certain hormones. But your body makes enough cholesterol to meet its needs — you don’t need any dietary cholesterol.

Excessive cholesterol in your diet can increase your unhealthy LDL cholesterol level, although not as much as saturated fat does. This can increase your risk of heart disease and stroke. Most foods that contain saturated fat also contain cholesterol. So cutting back on these foods will help decrease both saturated fat and cholesterol. The exception to this is tropical oils, which are high in saturated fat but contain no cholesterol.

Recommendations for fat intake

Because some dietary fats are potentially helpful and others potentially harmful to your health, it pays to know which ones you’re eating and whether you’re meeting national recommendations. The 2010 Dietary Guidelines for Americans, issued by the Department of Agriculture, offer recommendations about dietary fat intake.

Here’s a look at the recommendations and common sources of each type of dietary fat. Be aware that many foods contain different kinds of fat and varying levels of each type. For example, butter contains unsaturated fats, but a large percentage of the total fat is saturated fat. And canola oil has a high percentage of monounsaturated fat but also contains smaller amounts of polyunsaturated and saturated fat.

Recommendations for dietary fat and cholesterol intake
Type of fat Recommendation Major food sources
Total fat This includes all types of dietary fat. Limit total fat intake to 20 to 35 percent of your daily calories. Based on a 2,000-calorie-a-day diet, this amounts to about 44 to 78 grams of total fat a day. Plant- and animal-based foods.
Monounsaturated fat While no specific amount is recommended, the guidelines recommend eating foods rich in this healthy fat while staying within your total fat allowance. Olive oil, peanut oil, canola oil, avocados, poultry, nuts and seeds.
Polyunsaturated fat While no specific amount is recommended, the guidelines recommend eating foods rich in this healthy fat while staying within your total fat allowance. Vegetable oils (such as safflower, corn, sunflower, soy and cottonseed oils), nut oils (such as peanut oil), poultry, nuts and seeds.
Omega-3 fatty acids While no specific amount is recommended, the guidelines recommend eating foods rich in this healthy fat while staying within your total fat allowance. Fatty, cold-water fish (such as salmon, mackerel and herring), ground flaxseed, flax oil and walnuts.
Saturated fat Limit saturated fat to no more than 10 percent of your total calories. Limit to 7 percent to further reduce your risk of heart disease. Based on a 2,000-calorie-a-day diet, a 10 percent limit amounts to about 22 grams of saturated fat a day, while 7 percent is about 15 grams. Saturated fat intake counts toward your total daily allowance of fat. Cheese, pizza, grain-based desserts, and animal products, such as chicken dishes, sausage, hot dogs, bacon and ribs. Other sources: lard, butter, and coconut, palm and other tropical oils.
Trans fat No specific amount is recommended, but the guidelines say the lower the better. Avoid trans fat from synthetic (processed) sources. It’s difficult to eliminate all trans fats because of their presence in meat and dairy foods. The American Heart Association recommends limiting trans fat to no more than 1 percent of your total daily calories. For most people, this is less than 2 grams a day. Margarines, snack foods and prepared desserts, such as cookies and cakes. Naturally occurring sources include meat and dairy products.
Cholesterol Less than 300 milligrams a day. Less than 200 milligrams a day if you’re at high risk of cardiovascular disease. Eggs and egg dishes, chicken dishes, beef dishes and hamburgers. Other sources: Seafood, dairy products, lard and butter.

By Mayo Clinic

Source: Dietary Guidelines for Americans, 2010

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Improving the Management of Chronic Illness

The burden of chronic disease is increasing everywhere. According to Eurobarometer data, in European Union countries, from 20 percent to over 40 percent of adults report a long-standing health problem. People with chronic conditions are more likely to use health services, in particular those with multiple health problems, which tend to be more common among older people.

About two thirds of people of pensionable age have at least two chronic conditions. This is expensive: it is estimated that chronic diseases such as diabetes represent 2 to 15 percent of healthcare expenditure in Europe.

This leaves healthcare systems struggling to cope. A key challenge is that healthcare systems have developed from a traditional model of acute, episodic care that focuses on individual diseases and is based on a relationship between an individual patient and a doctor. In contrast, the goal of chronic care is to minimize distressing symptoms; prolong life through secondary prevention; and enhance the overall quality of life. This requires moving to multi-professional, inter-sectoral delivery systems and for health systems to overcome existing fragmentation of services. A lack of coordination often leads to patients being left on their own to navigate through the maze of different providers and agencies.

In 2008 the Commonwealth Fund carried out a survey of people with complex healthcare needs in eight countries. About 40 percent of those interviewed reported that they had received inefficient care or that time was wasted — their time, in fact. Just over half also reported discharge gaps, for example, by being sent home from hospital without being given a written care plan or making arrangements for a follow-up visit. Involving patients in the management of their own condition is a core component of effective chronic care. The Commonwealth Fund survey found that only 40 to 60 percent of people with chronic health problems were involved in their own care by, for example, discussing goals or being given written plans or clear instructions on how to look for symptoms that indicate that they should see a health professional for follow up. What is needed is a model of care that involves working in partnership with the patient and other healthcare personnel, viewing patients as co-producers of care to optimize health outcomes.

Some European countries have taken up measures to respond to these challenges. Within the DISMEVAL project (Developing and validating DISease Management EVALuation methods for European healthcare systems), funded by the E.C., we looked at the various approaches taken by a range of EU countries, and three major themes emerged.

The first theme is around approaches aimed at strengthening care coordination through structured disease management. The content and scope of these programmes varies considerably however and there is a wide variation in the extent to which non-medical staff are involved in the delivery of care. For example, approaches in England, the Netherlands, Hungary and Italy make extensive use of nurses, whereas approaches in other countries do not.

The second theme centers around strengthening the role of nurses in care coordination and delivery. This is quite common in countries where there is a tradition of multidisciplinary team working such as in England, the Netherlands, Italy, Spain and, to a certain degree, Hungary. A number of countries, including Austria, France and Germany, are also introducing models that involve the delegation of certain medical tasks to nurses. However, this tends to be done under the supervision of a GP or a physician.

A third theme is attempts to overcome barriers between sectors in order to reduce the fragmentation of service delivery.
Our work has identified key elements for achieving high performing systems; these are not necessarily specific to chronic care but form important components for enhancing system performance everywhere. The first is the provision of adequate incentives within the system that actually get us where we want to get to. Second is an appropriately prepared workforce. Third is information technology. Fourth is the embedding of prevention in all stages. And the fifth element is the creation of systems that enable patients to self manage much more effectively.

To achieve higher-performing systems we need to find a balance between top down and bottom up approaches. […] We also need ongoing evaluation in order to know what works best in what circumstances.

Ellen Nolte directs the Health and Healthcare Research Policy programme at RAND Europe. Her main research is the field of health systems, including approaches to health system performance assessment, health system responses to chronic disease, international health system comparisons, and population health in the countries of Central and Eastern Europe. RAND Europe is a not-for-profit research organization that helps to improve policy and decision making through research and analysis.

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How You Can Help Medical Researchers

BETHESDA, Md., Sept. 22, 2011 /PRNewswire-HISPANIC PR WIRE/ — There are many ways to participate in medical research. One of those is to join a clinical trial. Another is to donate a sample of your tissue��materials from your body such as skin, hair, nails, blood, and urine. Such samples, called biospecimens, are carefully analyzed and stored for future use by researchers working to prevent and treat diseases such as cancer, diabetes, Alzheimer’s and other diseases.

(Logo: http://photos.prnewswire.com/prnh/20110316/MM66939LOGO )

Opportunities to donate a biospecimen arise when you are scheduled for surgery; for a biopsy, which is a procedure to look for cancer; or for some other medical procedures, even a simple blood test. The process is entirely voluntary, and you can change your mind and withdraw permission for use of your biospecimen at any time. Whether or not you decide to donate, there will be no impact on the medical procedure itself.

Keeping your identity private

It is understandable that people worry about the privacy of their medical information. You are entitled to ask any questions you may have about donating your sample, and then decide not to donate if you are not satisfied for any reason. It is important for you to understand as much as possible about donating your tissue in order to make an informed consent.

But you should know that the process has been carefully designed to make certain that your personal information will be secured as effectively as possible. This means that any scientist who uses your sample for research purposes will not be given your name, social security number, or any personally identifying information when the sample is transmitted. Federal laws protect your privacy by limiting who can have access to your private medical information. Federal law also prohibits employers or health insurers from discriminating against you or your family members based on your genes.

Your privacy is protected by the tissue storage facility, known as a tissue bank or biorepository, where your sample will go to keep it safe and in good condition after you donate it. The professional collecting the biospecimen may need your name, address, phone number or social security number in order to associate your sample with relevant information from your medical record, but the sample itself will not be stored with any of this information. A computer assigns a random identifying number to your sample, and no researcher can ever learn the name of the person who was the donor.

To make the best use of your specific tissue, researchers may need to know your age, gender, race, or ethnicity–or even your family history and the details of your medical condition and treatment. But these are all ways to describe your biospecimen, they do not refer to you as a person with an identity. The privacy wall is erected by the random number, and the biorepository is the broker that makes certain that wall is never breached.

A patient education booklet, Providing Your Tissue for Research: What You Need To Know, is available online at http://www.cancer.gov/clinicaltrials/learningabout/providingtissue. A fact sheet on donating tissue for research is also available online, at http://www.cancer.gov/cancertopics/factsheet/Information/donating-tissue-research. Copies of both can be ordered by calling NCI at 1-800-4-CANCER.

NCI leads the National Cancer Program and the NIH effort to dramatically reduce the burden of cancer and improve the lives of cancer patients and their families, through research into prevention and cancer biology, the development of new interventions, and the training and mentoring of new researchers. For more information about cancer, please visit the NCI web site at http://www.cancer.gov or call NCI’s Cancer Information Service at 1-800-4-CANCER (1-800-422-6237). More articles and videos in the culturally relevant Lifelines series are available at http://www.cancer.gov/lifelines.

SOURCE National Cancer Institute


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Alzheimer’s and the Importance of Early Detection

Alzheimer’s disease is one of the top 10 diseases Americans die from each year, but it is the only one on that list that is expanding as the other causes of death are declining. Alzheimer’s disease is a degenerative brain disease and the most common form of dementia.

“Alzheimer’s is becoming a more common cause of death as the populations of the United States and other countries age,” notes the Alzheimer’s Association. “While other major causes of death continue to experience significant declines, those from Alzheimer’s continue to rise.”

One reason for this difference is that the other leading fatal illnesses are preventable, such as stroke and heart disease, but Alzheimer’s cannot be prevented with lifestyle changes. According to the Alzheimer’s Association, preliminary data from between 2000 and 2008 showed that deaths attributed to Alzheimer’s increased 66 percent, while those attributed to the No. 1 cause of death, heart disease, decreased by 13 percent.

Such statistics make the latest Alzheimer’s research so vital for those who suspect they may get the disease, those already suffering from it and their friends and family, who may provide some level of in-home caregiver support during the long course of the disease.

Some of the biggest news about Alzheimer’s currently is the importance of early detection.

“Biological changes associated with Alzheimer’s disease are thought to begin 10 to 15 or perhaps 20 years before an individual displays symptoms,” states Dr. Heather Snyder, senior associate director of medical and scientific relations at the Alzheimer’s Association. “But there is no single generally accepted way to identify the disease in its earliest stages — before symptoms are evident. At the same time, Alzheimer’s therapies are in development that may be able to slow or stop the progression of the disease.”

There are efforts underway to update the diagnostic criteria in a variety of ways, including biomarker measures. This spring, the National Institute on Aging (NIA) and the Alzheimer’s Association published new diagnostic criteria guidelines for Alzheimer’s disease in Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association.

You might ask: If the disease cannot currently be stopped or cured, what difference does early detection make?

“The benefits of early detection are many,” says Beth Kallmyer, senior director of constituent services at the Alzheimer’s Association. “People who are diagnosed early can participate in the planning of their future — they can talk to their families about advanced directives, how they want to have their finances handled, what they want to have happen when they can’t drive anymore.”

Not only does this allow the person with Alzheimer’s disease to feel empowered, Kallmyer says, but it’s a huge relief to their caregivers and loved ones who otherewise may have to make decisions under a great deal of stress later, when the disease is in its advanced stages.

We recently posted an article on Homewatch Caregivers that pulls from the Alzheimer’s Association’s own 10 Signs of Alzheimer’s list. There is a distinct difference between the signs of normal aging and early Alzheimer’s disease. For example, someone may answer the phone and simultaneously put down their keys, then not be able to find them a few minutes later. A normal aging brain will retrace their steps and remember the moment that they answered the phone, whereas an individual with Alzheimer’s disease will not remember the phone call or be able to retrace their steps.

Kallmyer points out that the role of an in-home caregiver to someone with Alzheimer’s is unique in the length of the disease and increased need. “It starts with helping with memory aides and then ends when the person with Alzheimer’s can do nothing for themselves,” she says.

Another benefit to early detection of Alzheimer’s disease is that the individual can decide if they want to be part of future Alzheimer’s research by signing up to participate in clinical trials. “When somebody has a fatal illness, clinical trials can be a great way for them to feel like they are making a change,” Kallmyer says. “They might feel like they are making a difference for their kids and grandkids.”

Ultimately, with hopes that there will be treatments for Alzheimer’s disease, the time to intervene will be in the earliest stages of the brain disease. “This approach envisions what is now common practice in heart disease,” says Dr. Snyder. “Where early signs of risk — for example, in genetic markers or in blood cholesterol and/or blood pressure levels — can be treated to reduce the chances of heart attack or stroke later on.”

Dr. Snyder said there is a lot more research to be done on Alzheimer’s disease. “There are many unanswered questions in Alzheimer’s disease,” she says. “We do not yet know the causes of the disease, we do not know risk factors associated with Alzheimer’s disease.”

By Leann Reynolds

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When Lapses Are Not Just Signs of Aging

Who hasn’t struggled occasionally to come up with a desired word or the name of someone near and dear? I was still in my 40s when one day the first name of my stepmother of 30-odd years suddenly escaped me. I had to introduce her to a friend as “Mrs. Brody.”

But for millions of Americans with a neurological condition called mild cognitive impairment, lapses in word-finding and name recall are often common, along with other challenges like remembering appointments, difficulty paying bills or losing one’s train of thought in the middle of a conversation.

Though not as severe as full-blown Alzheimer’s disease or other forms of dementia, mild cognitive impairment is often a portent of these mind-robbing disorders. Dr. Barry Reisberg, professor of psychiatry at New York University School of Medicine, who in 1982 described the seven stages of Alzheimer’s disease, calls the milder disorder Stage 3, a condition of subtle deficits in cognitive function that nonetheless allow most people to live independently and participate in normal activities.

One of Dr. Reisberg’s patients is a typical example. In the two and a half years since her diagnosis of mild cognitive impairment at age 78, the woman learned to use the subway, piloted an airplane for the first time (with an instructor) and continued to enjoy vacations and family visits. But she also paid some of the same bills twice and spends hours shuffling papers.

Dr. Ronald C. Petersen, a neurologist at the Mayo Clinic College of Medicine in Rochester, Minn., described mild cognitive impairment as “an intermediate state of cognitive function,” somewhere between the changes seen normally as people age and the severe deficits associated with dementia.

While most people experience a gradual cognitive decline as they get older (only about one in 100 lives long without cognitive loss), others experience more extreme changes in cognitive function, the neurologist wrote in The New England Journal of Medicine in June. In population-based studies, mild cognitive impairment has been found in 10 percent to 20 percent of people older than 65, he noted.

Dr. Petersen described two “subtypes” of the condition, amnestic and nonamnestic, that have different trajectories. The more common amnestic type is associated with significant memory problems, and within 5 to 10 years usually — but not always — progresses to full-blown Alzheimer’s disease, he said in an interview.

“Subtle forgetfulness, such as misplacing objects and having difficulty recalling words, can plague persons as they age and probably represents normal aging,” he wrote. “The memory loss that occurs in persons with amnestic mild cognitive impairment is more prominent. Typically, they start to forget important information that they previously would have remembered easily, such as appointments, telephone conversations or recent events that would normally interest them,” like the outcome of a ballgame would a sports fan.

The forgetfulness is often obvious to those who are affected and to people close to them, but not to casual observers.

The less common nonamnestic type, which is associated with difficulty making decisions, finding the right words, multitasking, visual-spatial tasks and navigating, can be a forerunner of other kinds of dementia, Dr. Petersen said.

In general, Dr. Reisberg said, “mild cognitive impairment lasts about seven years before it begins to interfere with the activities of daily life.”

The Correct Diagnosis

Distinguishing mild cognitive impairment from the effects of normal aging can be challenging. Typically, new patients take a short test of mental status, provide a thorough medical history and are checked for conditions that may be reversible causes of impaired cognition. Problems like depression, medication side effects, vitamin B12 deficiency or an underactive thyroid can mimic the symptoms of mild cognitive impairment.

Other tests, like an M.R.I. or CT scan of the brain, can look for evidence of a stroke, brain tumor or leaky blood vessel that may be impairing brain function.

It is natural, Dr. Petersen said, for patients and their families to want to know whether and how quickly the disorder might progress. While patients decline by about 10 percent each year, on average, certain factors are associated with more rapid progression. Among these are the presence of a gene called APOE e4, more common among patients with Alzheimer’s disease; a reduced hippocampus, a region of the brain important to memory; and a low metabolic rate in the temporal and parietal regions of the brain.

Amyloid plaques in the brain, while a hallmark of Alzheimer’s disease and a predictor of progression, have also been found at autopsy in people with perfectly normal cognitive function.

Preserving Cognitive Function

Despite a number of clinical trials that tested various medications, no drug to treat mild cognitive impairment has been approved by the Food and Drug Administration. But experts like Dr. Reisberg and Dr. Petersen suggest several approaches that may slow the decline in cognitive function.

Although studies did not show that medications like donepezil (brand name Aricept) and memantine (Namenda), both used to treat Alzheimer’s disease, change the ultimate course of mild cognitive impairment, Dr. Reisberg said they can be useful temporary treatments that may stabilize patients for a few years.

Although the drugs are not approved for this condition, licensed physicians can prescribe approved medications “off label.” “Clinicians have to work with what we have,” Dr. Reisberg said.

There are people who think they are having memory problems, but tests do not show anything definitive. Some may be in Stage 1 of Alzheimer’s disease, Dr. Reisberg said, and perhaps could benefit from early treatment with the drugs.

It is also important to reduce cardiovascular risk factors like smoking, elevated cholesterol and high blood pressure; keep blood sugar at normal levels; minimize stress (which in animal studies can cause the hippocampus to shrink); and avoid anticholinergic drugs that can interfere with brain chemicals important to memory. These include Demerol to treat pain, Detrol to treat a leaky bladder, tricyclic antidepressants, Valium, and over-the-counter medications with Benadryl (diphenhydramine), like Tylenol PM, Dr. Petersen said.

Some cognitive rehabilitation exercises, like computer games that enhance focus, may be helpful, Dr. Petersen said, but there have been few good studies to demonstrate a benefit. Compensatory techniques, like taking notes, creating mnemonics and making structured schedules, can be useful aids, he added.

But most promising is regular physical exercise, which in animal studies was found to reduce the accumulation of amyloid in the brain. An Australian study in patients with memory problems showed that brisk walking for 150 minutes a week improved cognitive function.


New York Times

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Alzheimer’s Association: Walk to End Alzheimer’s

The Alzheimer’s Association Walk to End Alzheimer’s™ is the nation’s largest event to raise awareness and funds for Alzheimer care, support and research.  Since 1989, we’ve mobilized millions of Americans in the Alzheimer’s Association Memory Walk®; now, we’re continuing to lead the way with the Walk to End Alzheimer’s. Together, we can end Alzheimer’s — the nation’s sixth-leading cause of death.

Walk to End Alzheimer’s is an all-age, all-ability, family-friendly event. Activities will vary by location, but will likely include:

  • Scenic 1-2 mile walk route
  • Times of remembrance
  • Music and family entertainment
  • Kids play areas
  • Snacks and water
  • Information on Alzheimer’s Association programs and services
  • Exhibits featuring our sponsors’ products and services
  • Opportunity to advocate to Congress to support research funding and Alzheimer’s policy initiatives

The end of Alzheimer’s disease starts here.
Start or join a team today at alz.org/walk.

Find a walk or support a walker

The South Carolina Chapter is proud to host several walk locations throughout the state in 2011.  Click here to view a list of walk locations in South Carolina.

If you are interested in supporting a team or walk participant, we have made it easy to pledge your support online.  Simply select the appropriate walk location and search for the walker or team that you’d like to support.

Getting started

Form a team:
Forming a team for Walk to End Alzheimer’s can enhance your experience and multiply your impact. Together, as a team, you are a force much greater than what you can accomplish alone.  While we encourage you to recruit as many people as possible to join your team, there is no minimum number of people for a team.  So gather at least one friend to begin. For tips on building your team, check out our tips for team captains at alz.org/walk.

Register online:
To register online, choose the “Register Here” button on the walk location site.  To register a team, choose “Start a Team” to register as team captain.   Each team member can then choose to “Join an Existing Team” when they register.  If you’d rather register as an individual, select that option instead.  It’s that simple!

Set a goal:
Each walk participant is encouraged to set a fundraising goal. Remember, the all donations will support Alzheimer research and services for South Carolina families who have a loved one with the disease.  So set your goal high!  In order to receive a Walk to End Alzheimer’s t-shirt at the event, you will need to raise a minimum of $100.  Incentive prizes are also available to participants according to their totals.

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