Keeping dementia at bay: Column

This has been a month of good news for two of my annoying habits.

The first is my penchant to watch sappy films from Indonesia. I lived in the country after college, and the films help me keep up my Indonesian language skills. A recent review of hundreds of dementia sufferers in India finds that dementia among speakers of multiple languages comes, on average, four years later than it does to people with dementia who are monolingual. Prior studies had found a similar phenomenon, but the new study shows that multilingualism likely postpones dementia regardless of a person’s class or formal education.

My next habit, forgive me, is singing along to musicals. A paper read this month at the Society for Neuroscience meeting in San Diego finds that when nursing home patients with Alzheimer’s disease sing along to The Sound of Music and The Wizard of Oz, they score better on measures of their cognitive abilities.

Monetary, emotional toll

The good news on dementia is a welcome tonic against some overwhelmingly frightening facts. Because we are adding, on average, at least two years to our lifespan every decade, we are all more prone to dementia. One’s chances of dementia double every five years after age 65; one of every two Americans older than 85 is afflicted with Alzheimer’s.

Full story of dementia at USA Today

DOG HEROES HELP PEOPLE WITH DEMENTIA LIVE BETTER LIVES

After being diagnosed with Early-Onset Alzheimer’s Disease (EOAD) at age 57, Rick Phelps was given an Exelon patch and a directive to make a follow-up appointment with his neurologist in six months.

That’s it-that’s all modern medicine could offer a man whose world had been unceremoniously upended by a terminal diagnosis.

Alzheimer’s disease has no cure, no effective treatment, and there are few resources to help families deal with the crushing effects of increasing cognitive impairment.

Fortunately for Rick, unconventional intervention would come a few months after his devastating diagnosis; in the form of a furry, four-legged savior named Sam. The spry German Shepard is a member of an elite squad of service dogs specially-trained to assist people with Alzheimer’s and other forms of dementia.

Unlike therapy dogs that assist blind or physically disabled individuals, these so-called “psychiatric service dogs” are patterned after police K9s-conditioned to analyze a situation and make decisions on how best to protect their human handlers.

Full story of dogs helping dementia at Paw Nation

Blood Pressure Drugs Tied to Decreased Dementia Risk

A new study suggests that taking certain blood pressure medications may reduce the risk of dementia due to Alzheimer’s disease.

When researchers at Johns Hopkins analyzed data on more than 3,000 elderly Americans, they found that people over the age of 75 with normal cognition who used diuretics, angiotensin-1 receptor blockers (ARBs) and angiotensin-converting enzyme (ACE) inhibitors showed a reduced risk of Alzheimer’s-related dementia by at least 50 percent.

Additionally, diuretics were associated with a 50 percent reduced risk in those with mild cognitive impairment.

Beta blockers and calcium channel blockers did not show a link to reduced risk, the scientists reported in the study, published in the journal Neurology.

“Identifying new pharmacological treatments to prevent or delay the onset of AD dementia is critical, given the dearth of effective interventions to date,” said Sevil Yasar, M.D., Ph.D., assistant professor of medicine in the Department of Geriatric Medicine and Gerontology at the Johns Hopkins University School of Medicine. “Our study was able to replicate previous findings, however, we were also able to show that the beneficial effect of these blood pressure medications are maybe in addition to blood pressure control, and could help clinicians in selecting an antihypertensive medication based not only on blood pressure control, but also on additional benefits.”

Full story of blood pressure drugs and dementia at PsychCentral

Insurance type tied to dying dementia patients’ care

The chance that nursing home residents with advanced dementia will receive inappropriate care may be related to their insurance coverage, a new study suggests.

Insurance Type Tied to Dying Dementia PatientsFewer dying people with dementia were moved to the hospital for possibly unneeded care when their insurance coverage paid on a per-patient basis, rather than for every test and treatment, researchers found.

NYU School of Medicine’s Keith Goldfeld said so-called managed care organizations are motivated to stop people from receiving unnecessary and costly care.

People with advanced dementia won’t usually benefit from being hospitalized during the last months of life for acute ailments like pneumonia, Goldfeld, the study’s lead researcher, said. The focus should be on making the person comfortable.

“When the focus is on comfort, the idea is to try to limit the type of care that could be burdensome for the patient and costly,” he said.

Nursing homes may want to send very sick residents to hospitals because it shifts the cost of treating them from the homes to the hospitals and Medicare, the government-run health insurance for the elderly and disabled.

Full story of insurance and dementia care at Reuters

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Digital dementia: The memory problem plaguing teens and young adults

Digital Dementia Plaguing Young AdultsDementia is a disease that typically affects the elderly.  But recently, a new cognitive condition has been discovered that is afflicting people in their teens and 20s.

It’s called “digital dementia.”

A recent study from South Korea found that individuals who rely heavily on technology may suffer a deterioration in cognitive abilities such as short term memory dysfunction.

Dr. Carolyn Brockington from St. Luke’s Roosevelt Medical Center in New York City sat down with Dr. Manny Alvarez, senior managing health editor for FoxNews.com, to talk about this new phenomenon.  She said one of the reasons younger adults are suffering from poor memory is because they don’t feel the need to memorize information anymore.

“The problem is that we’re using technology, which is good, but we’re overusing in many ways,” Brockington said.  “We’re not relying on our brains to sort of retrieve the information when we need it.”

While elderly dementia is typically a permanent condition, Brockington said that’s not necessarily the case with digital dementia.  However, she said these kind of memory issues could affect future generations.

Full story of digital dementia at Fox News

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Dementia’s Signs May Come Early

Dementia Continues Among the ElderlyThe man complained of memory problems but seemed perfectly normal. No specialist he visited detected any decline.

“He insisted that things were changing, but he aced all of our tests,” said Rebecca Amariglio, a neuropsychologist at Brigham and Women’s Hospital in Boston. But about seven years later, he began showing symptoms of dementia. Dr. Amariglio now believes he had recognized a cognitive change so subtle “he was the only one who could identify it.”

Patients like this have long been called “the worried well,” said Creighton Phelps, acting chief of the dementias of aging branch of the National Institute on Aging. “People would complain, and we didn’t really think it was very valid to take that into account.”

But now, scientists are finding that some people with such complaints may in fact be detecting early harbingers of Alzheimer’s.

Full story of dementia signs at the New York Times

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Online Dementia and Alzheimer’s Screening Test Now Available to the Public on CognitiveTest.com

Online Test for Dementia and Alzheimer'sThe first interactive, clinician-verified cognitive test that identifies changes potentially associated with Alzheimer’s and other forms of dementia with 96 percent accuracy† now is available to the public online at CognitiveTest.com.

Alzheimer’s is the sixth leading cause of death in the U.S. and the fifth leading cause of death for those age 65 and older.

Yet, in the primary care setting, Alzheimer’s disease is not diagnosed in 60 percent of cases. Today, most general practice physicians are concerned with so many ongoing medical problems they have not been able to include routine cognitive testing in their scope of practice.

“Because we are beginning to see a shift in this practice, we wanted to develop a modern test that is computer-based, internet-accessible and can be taken by an individual themselves independently with rudimentary computer skills,” said John H. Dougherty, Jr. M.D., Cole Neuroscience Center at the University of Tennessee Medical Center, Knoxville, Medical Director.

Full story of online test for dementia and Alzheimer’s at San Francisco Chronicle

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Studies Find Mixed Results for Dementia Units

Mixed Results for Dementia UnitsBy their euphemistic names, ye shall know them: The Memory Care Unit. The Reminiscence Neighborhood. Homestead.

These special units for residents with dementia have spread throughout the American nursing home industry; more than 16 percent of nursing homes now include one.

The laudable idea was to move patients with dementia out of the typically over stimulating and understaffed nursing home into a separate wing, a calm and secure environment where well-trained staffers would offer tailored activities, handle problematic behaviors and provide greater support.

But I’ve always wondered whether these units actually live up to their promises and their higher price tags. In a competitive nursing home market, they may provide an edge in attracting paying customers. But do they provide better care, or mostly a reassuring name and a locked door?

The research provides some intriguing findings but, sadly, no clear thumbs-up for families trying to figure out if this is the solution for someone who wanders, gets frightened or obstreperous, or needs more attention.

Full story on dementia units at The New York Times

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Care homes use ‘doll therapy’ for residents with dementia

Doll Therapy for Dementia ResidentsThe image of an older person cuddling and singing to a child’s doll can be strange and disturbing, yet doll therapy is being used by a growing number of care homes across the UK for people with dementia.

Four Seasons Healthcare, which frequently uses doll therapy in its homes, has found that residents have become so attached to the dolls there have been tussles over them. It has even had to go as far as introducing baby high chairs into the dining halls so residents could feed their dolls while eating their meals.

Despite its growing use, doll therapy is still a controversial intervention as it can be extremely upsetting for families to see their relatives in this infantilised state. Four Seasons Healthcare admits that there has been opposition from both relatives and staff.

Caroline Baker, head of quality and dementia care at Four Seasons Healthcare, said: “On a few occasions we have had relatives question it and we always make sure we fully explain what doll therapy is to the relatives.”

Full story of doll therapy for dementia at The Guardian

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Why Your Loved One’s Dementia Doesn’t Have to Be a Death Sentence for You, Too

Loving one with DementiaYou finally convince your spouse to go to the doctor with you. He’s only in his late 60s, but lately he’s been forgetting where his car keys are, losing words and getting lost when he goes out alone. You’ve been worried for a while, so you’re relieved your spouse is willing to see a professional.

The doctor, a neurologist, is a tall, distinguished researcher in his late 50s. He wears a long, starched white lab coat and sits behind his cluttered desk. He tells your husband to remember three things: a ball, a toothbrush and a pen. You memorize them, hoping your brain is still working. Then he asks your husband to subtract seven from 100 and continue subtracting sevens down to zero if he can. Your husband says,"93, 82." What? You sit up straighter and try not to blurt "93, 86." Your husband was a math major in high school and studied engineering in college. He taught you calculus, but all of a sudden he doesn’t know 93 minus seven is 86?

You start thinking about how you’ve been in denial about his dropping things and tripping around the house. Your husband can’t remember the three things he was supposed to remember 10 minutes ago. You’re glad you can, but your heart is beating too fast.

Full story of dementia care at Huffington Post

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