Sunday, August 29, 2010

Alzheimer's Plan Listening Sessions

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Alzheimer's Axxociation

The Massachusetts Alzheimer’s Disease and Related Disorders
State Plan Steering Committee
Invites you to participate in our statewide listening sessions.
With a growing senior population, and more people likely to develop Alzheimer’s and
other cognitive disorders, the Commonwealth is committed to finding meaningful
strategies to support seniors, their families and caregivers. We want to hear from you
about your concerns and your ideas for meeting the needs of seniors in their homes,
communities and residential settings.
Listening Sessions

Wednesday
September 15, 2010
Elms College
291 Springfield Street
Chicopee, MA
6:00 – 7:30 p.m.

Thursday
September 16, 2010
Alzheimer’s Association
311 Arsenal Street
3rd floor
Watertown, MA
6:00 – 7:30 p.m.

Thursday
September 23, 2010
Worcester Senior Center
128 Providence Street
Worcester, MA
10:00 – 11:30 a.m. Thursday
September 30, 2010
Bristol Community College
777 Elsbree Street
Fall River, MA
6:00-7:30 p.m.

Sponsored by:
The Massachusetts Executive Office of Elder Affairs and
The Alzheimer’s Association, Massachusetts/New Hampshire Chapter
To RSVP, for more information, or for special accommodations, please call
Jennifer Carter at: 617.868.6718, ext 2027

Friday, August 27, 2010

An Alzheimer breakthrough is riding on your signature

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To: United States Congress

We the undersigned, hereby petition Congress to make Alzheimer's disease a national priority.

Today, more than 5 million Americans are facing the challenges of Alzheimer's disease and more than twice that number are caring for them. Alzheimer's is not simply memory loss. Alzheimer's is not normal aging. Alzheimer's is fatal, progressive and there is no cure.

Alzheimer's disease robs individuals of the anticipated golden years of their lives. It robs spouses of their companions and children of their parents and grandparents; it steals the health of caregivers and the financial resources of millions.

It's time for our nation's leaders to face the reality that Alzheimer's disease will have a devastating financial effect on our nation. Alzheimer's is already a tremendous emotional tragedy for the millions with it and their loved ones. It is time to make the fight against Alzheimer's a national priority. Specifically, we call upon Congress to:
•Pass the National Alzheimer's Project Act (S. 3036/H.R. 4689), creating an integrated federal campaign to overcome Alzheimer's disease


•Pass the Alzheimer's Breakthrough Act of 2009 (S. 1492/H.R. 3286), authorizing $2 billion in research funding for Alzheimer's disease.


•Pass the Health Outcomes, Planning and Education (HOPE) for Alzheimer's Act (S. 3674/H.R.5926) (formerly ADD-CAP Act), providing Medicare reimbursement to increase the detection and diagnosis of Alzheimer's disease and other dementias.
When you factor in the costs to others – the out-of-pocket costs to patients and families, the costs to private insurance and HMOs, and the costs of uncompensated care to healthcare providers – caring for people with Alzheimer's disease and other dementias will cost the American people $20 trillion over the next 40 years. That's enough to pay off the entire U.S. national debt today and send a check for $20,000 to every man, woman and child in America with money left over.

Our vision is a world without Alzheimer's disease. To accomplish this goal, we need Congress to make Alzheimer's disease a national priority.

An Alzheimer breakthrough is riding on your signature

Wednesday, August 25, 2010

The life of the brain: The promise of restoration

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thestar.com

We now know that even old people continue to create new brain cells. But these new neurons die off as we age. Scientists may be on the brink of discovering a compound to prevent brain cell death, offering the promise of treatment for Alzheimer's.

DALLAS—Dr. Andrew Pieper isn't sure how many hours he spent in room K3.406, a windowless space not much bigger than a broom closet, except that it all amounted to “quite a lot of time.”

This, it turns out, translates into many visits per week over the course of three years, enough to peer through a microscope at roughly 27,000 very thin sections of the brains of lab mice.

Or, to be precise, the so-called dentate gyrus in the hippocampus region of their brains.

The hippocampus is associated with memory, and the dentate gyrus is one part of the brain that generates new neurons, or nerve cells — the little building blocks that get wired into the mind's complicated circuitry.

Pieper, a biochemist at the University of Texas Southwestern Medical Center, had the “very tedious” task of detecting those new neurons, employing a series of antibodies to help amplify their telltale signal.

He found a great many nascent neurons, and this is very good news.

Monday, August 23, 2010

Stress increases dementia risk

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Mid-life stress can increase the risk of women developing Alzheimer's disease, a study has shown.

Women who reported repeated episodes of stress and anxiety in middle age were up to twice as likely to develop dementia than those who did not, a team of Swedish scientists found.

The majority of those affected were diagnosed with Alzheimer's, the most common form of dementia.

Researchers followed the progress of 1,415 women between 1968 and 2000.

Three surveys in 1968, 1974 and 1980 were carried out to assess levels of psychological stress experienced by the women, who were aged between 38 and 60 at the start of the study.

Stress was defined as a "sense of irritation, tension, nervousness, anxiety, fear or sleeping problems" lasting a month or more.

During the course of the study, 161 of the women taking part developed dementia, mainly in the form of Alzheimer's disease.

Dementia risk was 65% higher in women who suffered frequent stress in middle age. The chances of developing dementia increased as women responded to more than one survey by saying they were frequently stressed.

The risk increased by 73% when women reported frequent or constant stress on two occasions, and more than doubled when all three surveys showed they were stressed.

The findings were published in the journal Brain.

Saturday, August 21, 2010

Direct Relationship Seen Between Plasma Aβ Levels and Cognitive Decline (part 3)

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Pam Harrison (Medscape Today)

Relatively Rapid Decline

As the authors point out, the relatively rapid cognitive decline seen as a function of high baseline plasma Aβ levels and stable or decreasing Aβ42 in the entire sample is not surprising given that a similar plasma Aβ profile predicted conversion to Alzheimer's disease in the same sample in an earlier study — cognitive decline in more than one domain is a prerequisite for incident Alzheimer's disease.

"We need to further validate these Aβ levels, and we also need to understand how plasma Aβ levels relate to brain levels," Dr. Cosentino cautioned. "But once we have a better understanding of this, testing patients for plasma Aβ levels is an inexpensive and noninvasive way to identify people at greater risk for cognitive decline and Alzheimer's disease, and ultimately, this would be very important in terms of being able to provide preventive treatment when we have such a treatment."

The study was supported by grants from the National Institutes of Health. The authors have disclosed no relevant financial relationships.

Thursday, August 19, 2010

Direct Relationship Seen Between Plasma Aβ Levels and Cognitive Decline (part 2)

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Pam Harrison (Medscape Today)

Aging Project

The amyloid cascade hypothesis suggests that Alzheimer's disease develops subsequent to aberrant metabolism of glycoproteins, the precursors to amyloid, the authors write. Aβ40 and Aβ42 then accumulate, and this accumulation is considered the primary trigger for the development of Alzheimer's disease. Previous research indicates that plasma Aβ levels decrease as brain levels increase, suggesting that plasma Aβ level may be used as a biomarker of disease risk.

In this study, participants were drawn from the Washington Heights and Inwood Columbia Aging Project and represented 3 broadly defined ethnic groups: Caribbean Hispanic, black, and white. All participants were free of dementia at the time of the first Aβ sample; at follow-up, 481 patients remained cognitively healthy, 329 were cognitively or functionally impaired but not demented at any point, and 70 developed Alzheimer's disease.

Investigators then determined whether Aβ levels could be linked to either specific cognitive changes that constitute conversion to Alzheimer's disease or whether they corresponded to cognitive change independent of dementia. Cognitive change consisted of a composite score and memory, language, and visuospatial indices.

When researchers examined cognitive change in specific domains by Aβ, they determined that baseline Aβ42 predicted cognitive change in all 3 domains in the overall sample, with those in the highest Aβ quartile "consistently declining faster" than those in the lowest. "Baseline Aβ40 quartile predicted change in memory," the authors add, with those in the second and third quartiles declining faster than those in the lowest quartile.

Baseline Aβ40 quartiles also predicted change in language, with individuals in the highest quartile declining faster than those in the lowest. "Finally, change in Aβ42 predicted change in memory and visuospatial scores, with relatively stable or decreasing Aβ42 predicting faster decline," the researchers add. Among the group who remained cognitively healthy during the study interval, baseline Aβ42 predicted change primarily in memory, with higher baseline levels generally predicting faster decline.

In contrast, baseline Aβ40 was generally unrelated to cognitive change in the same healthy elderly group, and change in Aβ42 was not associated with change in any domain. Finally, change in Aβ40 over time was not related to cognitive change in either the overall sample or the cognitively healthy.

Relatively Rapid Decline

As the authors point out, the relatively rapid cognitive decline seen as

Tuesday, August 17, 2010

Direct Relationship Seen Between Plasma Aβ Levels and Cognitive Decline

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Pam Harrison (Medscape Today)

There is a direct and linear association between plasma beta-amyloid (Aβ) levels and multiple aspects of cognitive decline over time, including cognitive changes that constitute conversion to Alzheimer's disease, according to new findings from a population-based, ethnically diverse longitudinal sample of older adults.

Stephanie Cosentino, PhD, from the Taub Institute for Research in Alzheimer's Disease and the Aging Brain at Columbia University Medical Center, New York City, and multicenter colleagues found that in their overall sample of 880 adults, individuals in the top 3 quartiles of Aβ42 at baseline had faster declines in cognitive function during 4.5 years of follow-up than those in the lowest quartile. The same observation held largely true for individuals who remained cognitively healthy during the same study interval.

"Individuals in the top 3 Aβ40 quartiles also declined faster than those in the lowest quartile," investigators add, "[whereas] in the healthy elderly individuals, only the highest quartile declined faster than those in the lowest."

Looking at the rate of global cognitive change by change in Aβ, investigators noted that in both the overall cohort and the healthy elderly, individuals with relatively stable or decreasing Aβ42 values had faster cognitive decline than those with increasing Aβ42 values.

In contrast, change in Aβ40 was not associated with cognitive change in either the overall cohort or the healthy elderly.

"What we tend to see in healthy elders is a steady increase in Aβ42 levels over time, so what we are trying to characterize here is the absence of an increase," Dr. Cosentino told Medscape Medical News.

She also noted that previous studies have shown that high initial plasma levels of Aβ and declining levels of Aβ over time are risk factors for Alzheimer's disease, "so changes in Aβ levels provide information about disease risk." In this particular study, changes in the same plasma Aβ levels predicted the rate of cognitive decline in patients who eventually developed dementia.

"This linear association between plasma Aβ and cognitive change increases our ability to use plasma Aβ as a marker of impending cognitive decline and Alzheimer's disease," Dr. Cosentino said, adding that interestingly enough, the same Aβ profile predicted cognitive decline even in those individuals who remained healthy over time.

The study was published online August 9 and will appear in the December issue of the Archives of Neurology.

Aging Project

The amyloid cascade hypothesis suggests that

Sunday, August 15, 2010

Alzheimer's Test Can Determine Presence of Disease, Before Dementia Symptoms Appear

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A new study provides additional evidence that a biomarker test can be used to reliably determine an Alzheimer's disease diagnosis.

(Media-Newswire.com) - A new study provides additional evidence that a biomarker test can be used to reliably determine an Alzheimer’s disease diagnosis.

The diagnostic biomarker test is able to detect the presence of known Alzheimer’s disease biomarkers found in cerebral spinal fluid ( CSF ). The ‘signature’ combination of Alzheimer’s disease indicators were found in 90 percent of patients with Alzheimer’s disease.

With a 5-year follow up, the study was able to predict 100 percent of patients with mild cognitive impairment who progressed to full blown Alzheimer’s disease.

The test also found that 72 percent of people with mild cognitive impairment and 36 percent of cognitively normal adults showed early signs of Alzheimer’s pathology, suggesting that Alzheimer’s disease pathology is active and detectable earlier than previously thought.

The study appears in the latest issue of the Archives of Neurology, a JAMA/Archives journal. The study was conducted by team of researchers using research from the Alzheimer’s Disease Neuroimaging Initiative ( ADNI ) Biomarker Core group, which is co-directed by John Q. Trojanowski, MD, PhD, Co-director, Center for Neurodegenerative Disease Research and Leslie M. Shaw, PhD, professor of Pathology and Laboratory Medicine, both at the University of Pennsylvania School of Medicine.

For additiona information, see:

JAMA/Archives press release
CBS Evening News story
Philadelphia Inquirer story
New York Times story

Friday, August 13, 2010

Nurses will test method for determining if it's dementia or delirium

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University Park, Pa. -- In the future, nurses may more accurately detect and alleviate symptoms of delirium in persons with dementia, thanks to a five-year, $2.7-million grant from the National Institute of Nursing Research.

The project, led by Donna Fick, professor of nursing, Penn State, seeks to improve nurses' assessment skills and reduce the use of drugs to treat delirium and dementia.

Delirium and dementia have similar symptoms -- decline in cognitive abilities such as memory, attention, and problem solving -- but they have radically different causes and treatments. Dementia is a chronic, progressive condition that increases with age. Delirium, in contrast, is an acute condition that has a rapid onset and results from insults to the body, such as dehydration, infection, or a drug side effect.

"Delirium is reversible, preventable and treatable," said Fick.

About 40 percent of patients with dementia also develop bouts of delirium, a condition known as "Delirium Superimposed on Dementia" or DSD. The condition substantially worsens outcomes in a population who are already burdened by functional decline, said Fick.

Sorting through the various types of cognitive decline is not easy, according to Fick. Unfortunately, some doctors and nurses automatically opt for a drug treatment, which can lead to further problems including falls or worsened delirium.

Fick's solution is a multifaceted training approach that she will implement and test in three hospitals: one in urban Tennessee and two in rural Pennsylvania. She and her colleagues will integrate electronic medical records as one component of the training. They are testing an approach that provides decision-making support and integrates reminders to check for specific symptoms. This approach is already used to assess the risk of falling and the integrity of the skin.

The project will establish a nursing opinion leader on the staff who will encourage evidence-based practices to treat delirium and dementia. These leaders will also be reliable information sources for nurses.

The training incorporates a weekly feedback session for nurses and the use of video, in person presentations, articles, case studies, on-line presentations -- narrated power point -- for continuing education.

In addition to assessing whether the training helps nurses distinguish between delirium and dementia and choose non-drug treatment options, the study will assess how effectively the approach improves patients' health.

In past research, Fick found that nurses are common initiators of drug treatments, so educating nurses is the most efficient way to address the medication issues. A survey she conducted on nurses who deal with dementia and delirium patients showed that 32 percent of nurses would call a physician to ask for medication in a patient with DSD before trying other non-drug approaches to the problem.

"Not recognizing and treating these conditions efficiently can result in people being put in nursing homes quicker, higher health care costs, and in the worst-case scenario early death," said Fick.

Other researchers on the project include Ann Kolanowski, the Elouise Ross Eberly Professor in the School of Nursing, and Dee McGonigle, associate professor of nursing and information sciences and technology, Penn State; Sharon Inouye, the Milton and Shirley F. Levy Family Chair in Alzheimer's Disease and professor of medicine, Harvard Medical School; Lorraine Mion, Independence Foundation professor of nursing, Vanderbilt University; Jennifer Waller, associate professor of biostatics, Medical College of Georgia; and Malaz A. Boustani, associate professor, Indiana University Center for Aging Research.

Wednesday, August 11, 2010

Patience, creativity are key skills when caring for Alzheimer’s patients

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By Cindy Atoji Keene

More than 5 million men and women are living with Alzheimer’s disease in the United States, and with the nation’s aging population, the number of cases is expected to escalate.

Shirley Thompson, a dementia care professional, knows about the disease and the progress of aging firsthand. She spent nine years caring for her mother, who had Alzheimer’s, and 30 years looking after her husband, who suffered from Parkinson’s disease, arthritis, kidney failure, and prostate cancer.

Thompson, 77, a retired nurse practitioner, said she was burnt out after her mother and husband died. She gave up her nursing licenses and became a secretary, but discovered that she was quite bored.

“After being a caregiver for so long, everything else seems so dull,’’ said Thompson, who never thought that she’d end up again taking care of the elderly.

Today, she is providing home care and companionship for seniors through Home Instead Senior Care, a Boston area service that helps people remain in their homes as they age.

“The best place for a person with memory loss is familiar surroundings,’’ said Thompson, whose duties can include helping clients dress and bathe, or playing cards and chatting. “I am only a companion and helper, but those things are as valuable as nursing for many people.’’

According to government data, employment of personal and home care aides is projected to grow 51 percent by 2016.

Thompson admits the job was initially exhausting, but now she has developed a rhythm and is taking better care of herself, as well as her clients, who include a former opera singer and a retired postal worker.

“I’m often reminded of the times when I took care of my mom,’’ said Thompson, who recently spent a few hours in deep conversation with a 91-year-old homebound woman who spun brilliant, albeit fictional tales, of her fabulous life. “It showed me how far the mind and brain can go without being in reality and gave me another level of my understanding of dementia,’’ said Thompson. “Sometimes you try to push for a breakthrough, and keep trying and trying, but come home drained, because it just isn’t going to happen.’’

Recently, new diagnostic criteria have been proposed that put more focus on the various stages of the condition and help identify Alzheimer’s before symptoms appear. What do you think of these proposed guidelines?
To be truthful, I have not read the new guidelines. However, this seems to me one very difficult disease to categorized. Every single client I have ever taken care of (including my own mother) has been different in behavior, length of illness (from early diagnosis), and how the disease was identified.

What would you recommend for others who might want to become home care aides?
Although no experience is needed, many agencies will train you on issues such as safety, communicating with seniors, recognizing illnesses and depression, and planning different activities. People who work with dementia patients, like I do, get additional support on dealing with advanced Alzheimer’s. You need to be comfortable in someone’s home, caring for them, and dealing with their family. It takes a lot of patience, compassion, and creativity.

You are 77-years-old yourself. What will you do if you get Alzheimer’s?
I have no control over that, and if it happens, I won’t be aware of it, and my daughter will have to do with me as she wants. It makes you think a lot and recognize things that might be coming down the road. There is no cure for dementia, but thank goodness, medical progress is being made.

Monday, August 9, 2010

Early Detection for dementia- Is it worth the cost?

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EmpowHer

For the past 25 years, diagnosis of Alzheimer’s dementia has been based on clinical presentation. However, now experts from Alzheimer's Association and National Institutes on Aging have come up with newer guidelines to help make the diagnosis of this dreaded illness earlier.

William Thies, chief medical officer for the Alzheimer’s foundation, said, "These criteria will serve us in finding the kind of diagnostic tools and interventions that will help treat people in the earliest stages of the disease and avoid the severe symptoms that are so debilitating."

Since 1984, no new guidelines have been developed and the panel wanted to address the new advances in radiological imaging and use of biomarkers. At present, these experts do not currently recommend the use of biomarkers citing that many of the tests are not standardized and there is uncertainty how the markers relate to severity of the disease.

“We think that ultimately biomarker tests will help us be able to identify individuals with Alzheimer’s disease,” said Marilyn Albert, who chaired the panel’s workgroup on mild cognitive impairment. However, for now Albert said these markers are not ready to be used by physicians in clinical practice.

The experts hope to be able to assess individuals with “preclinical A.D.,” a term they coined to refer to individuals, chiefly those with a family history, who may have developed amyloidal matter in the brain but have not yet to develop symptoms of Alzheimer’s disease.

"Understanding the earlier stages may represent the best chance for treatment prior to symptoms becoming present," explained Dr. Reisa Sperling, of Brigham and Women's Hospital. “We want to be able to monitor a change from one's baseline over time."

While all this sounds magnificent, one should remember that these new diagnostic tools are simply more expensive scans, which are not yet approved by Medicare. With the current health budget crises, it is doubtful if Medicare will even pay for these scans. In many states, doctors have already been using these high-powered scans to determine presence of biomarkers to make diagnosis of Alzheimer’s dementia.

More importantly, there is a strong possibility that pharmaceutical companies could benefit from doctors who will start to prescribe more medications for early Alzheimer dementia, which in the first stages does not need any treatment.

Thursday, August 5, 2010

Diet and Behavior Changes May Slow Alzheimer’s

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US News and World Report

By Gwyneth Dickey, Science News

A combination of diet and lifestyle changes decreases Alzheimer’s-like symptoms in dogs more than either treatment does on its own, a new study shows. The findings show the importance of taking multiple approaches to arrest the disease in humans, the authors say. Their results also provide evidence supporting recent research that suggests plaque deposits in the brain are not the cause of Alzheimer’s.


Alzheimer’s disease usually strikes people over the age of 60 and causes memory loss, shrinking brain tissue and eventually death. People with the disease get plaques in their brains made up of a small protein called amyloid-beta, which clumps together and disrupts brain signals.

Research suggests diet and exercise can improve human brain function and defend against Alzheimer’s, but researchers aren’t sure why. Dogs naturally accumulate the same brain plaque, and though they don’t get Alzheimer’s, they do experience age-related cognitive decline. So scientists can study the animals to learn more about the human form of the disease.

In this study, 24 beagles 8 to 12 years old received one of four treatments over about 2 ½ years. Some dogs were fed a diet enriched with high-antioxidant foods, like spinach, tomatoes, grapes, carrots and citrus fruit. Other dogs were given behavioral enrichment, in which they socialized with other dogs, played with new toys, took long walks and learned new tasks. One group of dogs received both treatments, while the last group received none.

This is the first study to look at antioxidant and behavioral enrichment treatments in dogs that naturally accumulate amyloid-beta plaques, says neuroscientist Viorela Pop, who conducted the research as a graduate student at the University of California, Irvine. The results were published July 21 in the Journal of Neuroscience.

The researchers found that compared with controls, dogs given the combined treatment had the greatest benefit. Those dogs had the biggest improvement in cognition and moderately reduced plaques in their brains. Dogs given just antioxidants fared better than dogs that underwent only enrichment activities. “The combination treatment is a key component of this study,” says Pop, who is now a postdoctoral fellow at Loma Linda University in California. “If we were to try to slow down Alzheimer’s disease in humans, we would want to try a multifactorial treatment.”

Her study also adds to a growing body of research that suggests amyloid-beta plaques, once thought to be the cause of Alzheimer’s, are just a symptom of the disease. Beagles receiving both dietary and behavioral treatments showed major improvements in cognition, but only minor decreases in amyloid-beta plaques in their brains.

The results fit with evidence showing that humans and dogs immunized against amyloid-beta plaques have no clumps but continue to experience cognitive decline, says Alex Roher of the Banner Sun Health Research Institute in Sun City, Ariz. “Patients continue to deteriorate in spite of all treatments, which tells you the plaques are not the ultimate cause of the disease.”

That’s not to say amyloid-beta isn’t important. “It just doesn’t seem to be the main thing responsible for cognitive decline in dogs and Alzheimer’s disease in humans,” Pop says.

Researchers need to conduct more studies before these results can be generalized to humans, says psychologist Catherine Roe of the Washington University School of Medicine in St. Louis. “Going from dogs to people is a big jump,” she says, and researchers need to find links between enriched diet and environment in humans. “So far we haven’t found any association.”

---

Tuesday, August 3, 2010

Understanding Alzheimer's: Patients, caretakers can struggle with the stigma of the disease

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By Katherine Kipp ~ Southeast Missourian

A brain scan is shown. Protein deposits around neurons in the brain can be a sign of dementia or Alzheimer's disease.

People who suffer from Alzheimer's disease sometimes never seek treatment because of a fear of the stigma attached to the disease, which is considered the seventh leading cause of death in the United States. Alzheimer's tears down a patient's brain, leaving them without the ability to remember significant events or faces, or the ability to perform day-to-day tasks. The disease afflicts 110,000 in Missouri alone and, as of yet, there is no cure for it as researchers continue to hunt for Alzheimer's cause.
"It's a very hard experience when you go visit [family members] and watch the decline and see them taken from their home because they can't support themselves," said Rhonda Bramlett, a nutritionist for the Southeast Missouri Area Agency on Aging and a volunteer for the Alzheimer's Association Memory Walk committee.

Bramlett and Lisa Hicks, one of the Alzheimer's Association outreach coordinators in Southeast Missouri, said getting rid of the stigma and encouraging people to seek help are the most important factors. That's where both the Alzheimer's Association and neurologists in the Cape Girardeau region come into play.

"Alzheimer's is a disease where abnormal structural changes are taking place" in the brain, said Dr. Abdul Basit Chaudhari, a neurologist at Neurosciences Center of Southeast Missouri Hospital. "People need to have a better understanding of these occurrences or signs of Alzheimer's. If we know they are occurring, it can be the key to solving the problem."

Alzheimer's falls under the umbrella of dementia, in which the brain is weakened because of many possible reasons, including head injuries, strokes, high cholesterol or diabetes that stress the brain.

"Dementias are basically problems with thinking. Usually it's memory, and all dementias have a pathology behind them," said Dr. Andrew Godbey, a neurologist at Cape Neurology Specialists, part of Saint Francis Medical Center.

Godbey said to initially diagnose a dementia patient, a doctor takes note of protein deposits accumulating around different neurons in the brain. For an Alzheimer's patient, protein deposits will initially develop around short-term memory cells before spreading, which explains the person forgetting about talking to someone or forgetting where they are going in the early stages. As the protein deposits spread, so does the memory loss.

"At first, it's remote memory," Godbey said. "It develops to where you can't remember how to feed or dress yourself, or even understand your own language."

Symptoms such as losing communication skills or becoming confused with one's surroundings are also a result of the neurotransmitters in the brain not being able to communicate with each other, Chaudhari said. An effect called "sundowning," where a patient becomes more confused at night, can be a major indicator of Alzheimer's.

"Memory neurons are needed, and [researchers] have discovered that is what is lacking in Alzheimer's patients," Chaudhari said. "The neurons are not functioning or are destroyed."

The protein deposits are a major part of what researchers are trying to figure out as they spend billions of dollars to find the root cause of Alzheimer's and why these protein deposits accumulate. Much of this funding comes from the Alzheimer's Association Memory Walk, which takes place each fall in cities across the country. Cape Girardeau's walk will be Sept. 18.

Until researchers develop a cure or better medication, they suggest families coping with an Alzheimer's patient seek what treatment is available and maintain a healthy lifestyle at home.

"At home, keeping them busy with quizzes or literature [that] is challenging," Chaudhari said. "Participation is good for them."

Staying healthy through exercise and diet is another suggested way to try to slow down Alzheimer's, Bramlett said.

"Any diet where you get a high fruit and vegetable count with the omega-3 oils is helpful," she said.

Godbey said preparing an Alzheimer's patient and the family for the long road ahead is just as important as treating the patient. He emphasizes the importance of making sure the caretaker is prepared for things to come.

"Alzheimer's patients don't have insight into their problems, they don't think there's anything wrong at all," Godbey said. "But their personalities can change, and they can become very agitated and aggressive. [The caretaker] has the burden of taking care of the patient, and it's important to gauge how the caretaker is doing and engage them in support groups. It's much better when you have someone who is going through the same thing to talk to."

As an outreach coordinator, Hicks offers seminars on how to deal with Alzheimer's patients and help them develop good communication skills.

Hicks helps coordinate not only support groups, but educational programs for families and health care professionals in an effort to spread more awareness about Alzheimer's. She worked as a nurse with Alzheimer's patients for 25 years before coming on board with the association.

"We're here to offer the best care and education possible, and to help advance research and promote brain health," Hicks said.

She said she emphasizes the 10 warning signs and the fact Alzheimer's "is not normal for aging, and not everyone is going to get it, but there are a lot of help and resources out there for those who do."

Researchers are currently exploring the relationship of vitamin D and Alzheimer's.

Godbey said research shows people with vitamin D deficiency oftentimes have MS, Parkinson's disease, Alzheimer's disease or other complications.

"We have discovered many great effects [in vitamin D]," Chaudhari said. "However, I don't think we can say that by taking doses of vitamin D that we can benefit, but someone who has a vitamin D deficiency should take it."

According to the the Alzheimer's Association, 5.3 million people in the United States have Alzheimer's disease. The association estimates that by 2050, up to 16 million people will have the disease unless a cure is found.

"The population is getting older," Chaudhari said. "It's a very devastating disease. People are supposed to be getting into their golden years and then something comes and robs them."

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My mother is 78 and has Alzheimer's - which was diagnosed in December, 2009. In your publication you say that patients with Alzheimer's 'don't have any insight to their problem'. Well i can assure you they do. My mum gets really upset with the fact that she can't remember things - family names, objects, what she did the day before, what she had for lunch. So she certainly knows 'something is wrong'.

I do debate some of the information you have written in this publication as some facts just aren't correct.

-- Posted by mariesandra on Tue, Aug 3, 2010, at 9:07 AM
I agree with mariesandra. It is hard to say exactly how someone with alzheimer's disease or a related dementia will behave and how they will feel. Certainly in the early phase of the disease, these individuals know something is wrong. It can be very frustrating to them. It is best to provide them with memory aids and give them meaningful things to do and look at.

By Susan Berg author of

Adorable Photographs of Our Baby-Meaningful Mind Stimulating Activities and More for the Memory Challenged, Their Loved Ones and Involved Professionals a book for those with dementia and an excellent resource for caregivers and healthcare professionals.

http://www.alzheimersideas.com

http://dementiaviews.blogspot.com

-- Posted by alzheimersideas on Tue, Aug 3, 2010, at 6:13 PM
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