Tag Archives: senile dementia

FOTM helps you to stave off senile dementia!

Losing memory as we age is a sign of mild cognitive impairment, which can be a gateway to senile dementia, including Alzheimer’s. By using and keeping active our brains, however, we can help keep it sharp.

According to a new study published online July 10 in the journal Neurology, keeping our brains active as you age, whether it be working on a computer, playing games or being socially involved, can ward off memory loss.

For the study, psychiatrist Dr. Yonas Geda of the Mayo Clinic in Scottsdale, Arizona, and his colleagues followed 2,000 men and women (average age 78)  who didn’t suffer from mild cognitive impairment for 5 years. The participants answered questions about mentally stimulating activities they engaged in when they were 50 and when they were 66 and older. Participants also took thinking and memory tests every 15 months. During the 5 years of the study, 532 people developed mild cognitive impairment.

The researchers found that:

  • Those who used a computer (such as accessing, reading, and commenting on FOTM!) during middle age had a 48% lower risk of developing mild cognitive impairment. Using a computer after age 66 was linked to a 30% lower risk. Computer use during middle and old age reduced the risk of thinking and memory problems by 37%.
  • Involvement in social activities (being with friends, going to the movies, etc.) and playing games were both tied to a 20% lower risk for mild cognitive impairment.
  • Doing crafts in later life was linked to a 42% lower risk for mild cognitive impairment.
  • The more activities people engaged in, the less likely they were to develop mild cognitive impairment:
    • Doing two activities was associated with a 28% lower risk of developing memory and thinking problems, compared with those who didn’t do any activities.
    • Those who did three activities lowered the risk by 45%.
    • Doing four activities reduced the risk 56%.

Heather Snyder, senior director for medical and scientific operations at the Alzheimer’s Association, said: “This study aligns with a growing body of evidence that there are steps you can take today to help keep your brain healthier as you age, and perhaps also reduce your risk of cognitive decline. Keeping your brain healthy is a lifelong pursuit and staying engaged in a variety of mentally and socially stimulating activities is important throughout one’s life.”

Dr. Geda said why keeping mentally active has this effect isn’t known, but it might be that the brain responds positively to increased use “like watering a flower.” It’s also possible that people who engage in mental activities also have other good behaviors that benefit brain health, such as exercising and eating a healthy diet.

Regardless of why being mentally active staves off senile dementia, the good news is that even people over 70 can benefit from mental activity. Dr. Geda said: “Our study shows that it’s never too late to engage in mental activities. These activities don’t need to be expensive, they’re accessible and simple and reduce the risk for mild cognitive impairment.”

Source: Medicine Net

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~Eowyn

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Some prescription drugs, incl. antidepressants, have 50% higher dementia risk

Dementia, also known as senility, is a broad category of brain diseases that cause a long term decrease in the ability to think, remember, and speak. such that a person’s daily functioning is affected. Approximately 7.7 million new cases of dementia are identified every year—which amounts to one new case every four seconds.

The most common type of dementia is Alzheimer’s disease, a severe form of dementia that makes up 50% to 70% of all cases of senile dementia, affecting an estimated 5.2 million Americans, according to 2013 statistics. As many as 1 in 9 seniors over the age of 65 has Alzheimer’s, and the disease is the third leading cause of death in the U.S., right behind heart disease and cancer.

Other common types of senile dementia include vascular dementia (25%), Lewy body dementia (15%), and frontotemporal dementia.

While we cannot change your age and family history, there are modifiable lifestyle factors we can control to reduce our risk for developing senile dementia. Those factors include diet, physical activity, weight (obesity), cognitive activitysmoking (tobacco), and diabetes.

Now comes news that certain prescription drugs, specifically anticholinergic drugs, carry a 50% higher dementia risk.

Anticholinergic drugs inhibit parasympathetic nerve impulses by selectively blocking the binding of the neurotransmitter acetylcholine to its receptor in nerve cells. The nerve fibers of the parasympathetic system are responsible for the involuntary movement of smooth muscles in the gastrointestinal tract, urinary tract, lungs, and many other parts of the body.

Anticholinergic medicines have short-term cognitive adverse effects, but scientists have also long found a possible link between those drugs and an increased risk of dementia

The link is now confirmed by a recent study of more than 284,000 UK adults, aged 55 and older, by a team of 6 medical scientists in England who found statistically significant associations of dementia risk with exposure to the following anticholinergic prescription drugs:

  • Antidepressants such as paroxetine or amitriptyline.
  • Antiparkinson drugs.
  • Antipsychotics such as chlorpromazine or olanzapine.
  • Anti-epileptic drugs such as oxcarbazepine or carbamazepine.
  • Bladder antimuscarinics such as oxybutynin or tolterodine to treat overactive bladder.

The study is published as “Anticholinergic Drug Exposure and the Risk of Dementia: A Nested Case-Control Study” in the journal JAMA Internal Medicine, June 24, 2019. The authors are Carol A. Coupland, PhD; Trevor Hill, MSc; Trevor Hill, MSc; Tom Dening, MD; Richard Morriss, MD; Michael Moore, MSc; and Julia Hippisley-Cox, MD.

The study:

58, 769 patients with a diagnosis of dementia and 225, 574 controls 55 years or older were matched by age, sex, general practice, and calendar time. Information on prescriptions for 56 drugs with strong anticholinergic properties was used to calculate measures of cumulative anticholinergic drug exposure. Data were analyzed from May 2016 to June 2018.

Of the entire study population (284 343 case patients and matched controls), 179, 365 (63.1%) were women, and the mean (SD) age was 82.2 (6.8) years.

Results:

The researchers found “there was nearly a 50% increased odds of dementia” associated with a total anticholinergic exposure of more than 1,095 daily doses within a 10-year period, which is equivalent to an older adult taking a strong anticholinergic medication daily for at least three years.

The odds of dementia increased from 1.06 among those with the lowest anticholinergic exposure to 1.49 among those with the highest exposure, compared with having no prescriptions for anticholinergic drugs.

Happily, the study found no significant increases in dementia risk associated with other classes of anticholinergic drugs, such as antihistamines, skeletal muscle relaxants, gastrointestinal antispasmodics, antiarrhythmics, or antimuscarinic bronchodilators.

Conclusion:

Exposure to several types of strong anticholinergic drugs is associated with an increased risk of dementia. These drugs should be prescribed with caution in middle-aged and older adults. 

Carol Coupland, the leading author of the study who is professor of medical statistics in primary care at the University of Nottingham, England, said: “The study is important because it strengthens a growing body of evidence showing that strong anticholinergic drugs have long term associations with dementia risk. It also highlights which types of anticholinergic drugs have the strongest associations. This is important information for physicians to know when considering whether to prescribe these drugs.”

Coupland cautions that “this is an observational study so no firm conclusions can be drawn about whether these anticholinergic drugs cause dementia,” and that people taking these medications are advised to consult with their doctor first before discontinuing the meds. 

However, if the association between these anticholinergic drugs and senile dementia is causal, this could mean that around 10% of dementia diagnoses are attributable to anticholinergic drug exposure, which would equate to around 20,000 of the 209,600 new cases of dementia per year in the United Kingdom.

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~Eowyn

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Early warning signs of Alzheimer's

Thu, 12 May 2016 13:00:19 +0000

eowyn2

Of late, I’ve been spending a lot of time visiting an assisted-living home — a lovely, well-maintained facility for elderly people who span the spectrum of physicial and mental disabilities, including those in hospice care.

To my shock, I discovered that a long-time acquaintance, D.V., who was the founder and editor of a Catholic journal, is a resident of the facility — in its Memory Care wing that is separated from the rest of the compound by double-doors because the patients there all have dementia. D.V. is cheerful and in good spirits, but cannot talk, nor does he recognize his family and friends.

Then there is Emily, not yet in Memory Care, but heading that way. Emily has no short-term memory, and repeatedly makes the same request to the dining room staff she’s asked just minutes ago, “Please bring me some crackers for my soup.”

Approximately 7.7 million new cases of dementia are identified every year—which amounts to one new case every four seconds.

The dreaded Alzheimer’s disease is a severe form of dementia which affects as many as 1 in 8 people 65 and older, or an estimated 5.2 million Americans in 2013.

Alzheimer’s causes nerve cell death and tissue loss throughout the brain. As the disease gets worse, brain tissue shrinks and areas that contain cerebrospinal fluid become larger. The damage harms memory, speech, and comprehension.

Diagram of the brain of a person with Alzheimer's Disease

Diagram of the brain of a person with Alzheimer’s Disease

In its first stages, Alzheimer’s may not be obvious to friends and family because it is normal for people to become a bit forgetful as they age. So how can you tell a harmless “senior moment” from Alzheimer’s disease?

Below are the early warning signs of Alzheimer’s, from WebMD:

(1) Loss of short-term memory: In early Alzheimer’s, long-term memories usually remain intact while short-term memories become sketchy. The affected individual may forget conversations s/he’s just had and, like Emily, repeat questions that were already answered.

(2) Forgetting common, everyday words: Alzheimer’s disrupts speech, so the affected might struggle to remember common words.

(3) Confusion and behavior changes, such as:

  • Trouble balancing the checkbook, often one of the first signs of Alzheimer’s.
  • Getting lost in familiar places.
  • Mood swings.
  • Lapses in judgment.
  • Poor hygiene: people who were once stylish may start wearing stained clothes and forget to wash their hair.

(4) Sundown Syndrome: Some people with Alzheimer’s get upset when the sun goes down. This tends to last through the evening and sometimes all night long. To ease tension, keep the house well lit and close the drapes before sunset; try to distract the individual with a favorite activity or TV show; switch him to decaf after breakfast.

Don’t Ignore the Signs!

It’s hard to face the thought that a loved one could have this disease, but it’s better to see a doctor sooner rather than later. It may not be Alzheimer’s as the symptoms can be caused by a highly treatable problem, like a thyroid imbalance.

And if it is Alzheimer’s, treatments work best when they’re used early in the course of the disease. Although there’s no cure for Alzheimer’s and no way to slow the nerve damage it causes in the brain, there are medications that appear to help maintain mental skills and slow the disease’s effects. If your loved one gets treatment early on, s/he may be able to stay independent and do their daily tasks for a longer period of time.

There’s no simple test for Alzheimer’s, so the doctor will use the following to diagnose:

  • Changes in memory and behaviors of the patient.
  • A mental status test, sometimes called a “mini-cog,” or other screening tests can measure the individual’s mental skills and short-term memory.
  • Neurological exams and brain scans may be used to rule out other problems, like a stroke or tumor, and they can provide other information about the brain.

Alzheimer’s takes a different path in every person. Sometimes the symptoms get worse quickly and lead to severe memory loss and confusion within a few years. For other people the changes are gradual, taking up to 20 years for the disease to run its course. Most people live 3 to 9 years after diagnosis.

In its late stage, people with advanced Alzheimer’s may lose their ability to walk, talk, or respond to others. Eventually, the disease can hinder vital functions, like the ability to swallow, signaling that this may be the time to switch to hospice care, which provides pain relief and comfort for people with terminal illnesses.

While you or your loved one is still able to make important decisions, make sure you/he/she make a will and sign an advance care directive — a legal document that will help avoid confusion later on if you’re no longer able to state your wishes by:

  • Spelling out what you want in terms of medical treatments and end-of-life care.
  • Naming someone to make health care decisions and manage finances on your behalf.

Is there anything you can do to lower your chances of getting this disease? Research in this area is ongoing, but diet and life-style (exercise; don’t smoke!) appear to be important. Studies show people who eat a Mediterranean diet rich in vegetables, fish, and nuts and get plenty of physical activity are the least likely to get Alzheimer’s.

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~Eowyn

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Too much TV-watching and lack of exercise diminish mental capacity at middle age

Thu, 10 Dec 2015 11:45:52 +0000

eowyn2

evolution of man

Alan Mozes reports for HealthDay News (via WebMD), Dec. 2, 2015, that young adults who watch tons of TV, and spend more time on the couch than at the gym, may end up paying for it with diminished mental performance in middle-age, new research suggests.

Tina Hoang, a staff research associate with the Northern California Institute for Research and Education at the Veterans Affairs Medical Center in San Francisco, said, “We found that low physical activity and high TV watching in young adulthood were associated with worse cognitive [mental] function” in middle-age. Hoang said that finding was “particularly surprising,” given that the current study pointed to a negative impact on mental function in people who were mostly in their 50s, thereby implying that mental function in people older than 50s could be even more impaired.

Nevertheless, Hoang cautioned that “this is really a preliminary study” and acknowledged that while TV time and physical inactivity seem to be associated with diminished mental ability, the study couldn’t show whether or not such lifestyle factors actually cause mental decline. “More work is needed to really understand this relationship,” she added.

The study findings were published in the Dec. 2 online edition of JAMA Psychiatry.

To gauge the long-range mental health impact of TV and physical activity habits, investigators enlisted more than 3,200 men and women. Study participants were an average of about 25 years old when the study began; 55% were white, 57% were female. More than 90% of the study volunteers had finished high school.

Over the 25-year study, all of the participants completed at least three detailed lifestyle questionnaires, including their physical activity and how many hours a day they spent watching TV.

The study defined “high TV-viewers” as people who watched more than three hours of TV per day during the prior year. Mental capacity was assessed by testing that looked at verbal memory skills, and the ability and speed with which participants were able to plan, organize and perform mental tasks.

Here are the study’s findings:

  • 11% of the study volunteers were high TV-watchers who, at middle-age, were more likely to fare poorly on most mental function testing compared with low TV-watchers. The one exception the researchers discovered was that high TV-watchers did not fare worse in terms of verbal memory.
  • 16% of the study participants had engaged in low physical activity levels. They were significantly more likely than those ranked high to fare poorly in terms of the ability to think quickly and perform mental tasks.
  • Those who were both high TV-viewers and low exercisers had up to double the risk for poor mental performance by middle-age, compared with those who had been both low TV consumers and more physically active during young adulthood.

Hoang said the researchers “did try to control for some confounding factors, such as education, body mass index, smoking and alcohol use. But there may be others that we were not able to account for.”

Susan Albers, a psychologist in the department of psychiatry and psychology with the Cleveland Clinic in Wooster, Ohio, cautioned that, ultimately, “there are too many variables and confounding factors to say that the behaviors of TV watching and a sedentary lifestyle is a direct ticket to cognitive deficits.” However, Albers conceded that “there is no surprise that there is an association” and that the study clearly shows that “what you do in your teens and early adulthood matters. “Young adults often don’t make the connection between what they do now and what happens 25 years from now. This study helps connect the dots.”

~Eowyn

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Dementia is hitting younger people and is more deadly

Dementia, also known as senility, is a broad category of brain diseases that cause a long term decrease in the ability to think, remember, and speak. such that a person’s daily functioning is affected. The most common type of dementia is Alzheimer’s disease which makes up 50% to 70% of cases. Other common types include vascular dementia (25%), Lewy body dementia (15%), and frontotemporal dementia.

Daniela Deane reports for The Washington Post, Aug. 6, 2015, that a new 21-countries study finds that people across the world are developing dementia a decade earlier than 20 years ago. 

The study, published in the Surgical Neurology International journal, compared 21 Western countries between the years 1989 and 2010, and found that the disease is now being regularly diagnosed in people in their late 40s and that death rates are soaring.

The study found that deaths caused by neurological disease had risen significantly in adults aged 55 to 74, virtually doubling in the over-75s:

  • Dementias accounted for some 60% of the increase in deaths.
  • The remaining 40% were other neurological diseases, such as Parkinson’s and motor neurone disease.

The problem is particularly acute in the United States, where neurological deaths in men aged over 75 have nearly tripled and in women increased more than fivefold, the leader of the study, Colin Pritchard from Bournemouth University, told the London Times.

Pritchard said the sharp increase in death rates from dementia-related diseases cannot simply be blamed on an aging population or stepped-up diagnosis: “The rate of increase in such a short time suggested a silent or even a hidden epidemic, in which environmental factors must play a major part, not just aging.” No single factor is to blame, but instead a combination of environmental factors such as pollution from aircraft and cars, as well as widespread use of pesticides could be the culprit. “The environmental changes in the last 20 years have seen increases in the human environment of petro-chemicals — air transport, quadrupling of motor vehicles, insecticides and rises in background electro-magnetic field, and so on,” Pritchard said.

Other experts quoted by the Times were skeptical about the causes for the increase:

  • Tom Dening, professor of dementia research at the University of Nottingham, said that falling death rates for cancer and heart disease could account for the spike in deaths from neurological disease since people “had to die of something.” [That sure makes a lot of sense. Not!]
  • Dr. Simon Ridley, head of research at Alzheimer’s Reserach UK, said,  told the paper. ““We can’t conclude that modern life is causing these conditions at a younger age. We know that Alzheimer’s and other dementias can have a complex interplay of risk factors.”

Pritchard warned, however, that it was “time for us to wake up and realize that a major problem we now face is unprecedented levels of neurological disease, not just the early dementias.”

The increase in early-onset dementia has implications for both the patients, their families, and health care costs.

An article on diagnosing early onset dementia (EOD) in the International Journal of General Medicine points out that:

EOD poses a real problem to the patient, their family members and caregivers, doctors, health services, and residential programs. The challenges faced include difficulty in making the diagnosis, the impact of the diagnosis on family members and children (as EOD patients may still have younger offspring), employment, family and personal finances, and quality of life. […] as early dementia affects patients who are still at an active age and vibrant in their social circles; the financial, health, wellbeing, social structure, and family losses create chaos in the family; wreak havoc in marital dynamics; and bring major uncertainties in terms of unemployment, financial issues, and long-term health care.

By the way, a new study says obesity can increase your chances of getting Azheimer’s. I’ve hesitated to post this because of the hissy fit thrown by a reader at the last post I did on obesity.

new Iowa State University study found that obesity, or more specifically the insulin resistance that is common in those who are overweight, is strongly associated with memory loss and increases a person’s risk of Alzheimer’s disease. Past research already indicates that obesity also increases your risk of cardiovascular disease (heart attacks & strokes) and some cancers.

In addition to dementia, strokes also seem to be becoming more common among younger people. Experts think the increase may be due to a rise in risk factors such as diabetes, obesity and high cholesterol.

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~Éowyn

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20 tips to prevent senile dementia

Thu, 23 Aug 2012 19:14:17 +0000

eowyn2

A survey by Harvard University School of Public Health and the Alzheimer’s Europe consortium in February 2012 found that the second leading health concern (after cancer) among adults is Dementia.

Dementia is not a single disease, but refers to a disease syndrome  in which affected areas of cognition may be memory, attention, language, and problem solving. Some of the most common forms of dementia are: Alzheimer’s disease, vascular dementia, frontotemporal dementia, semantic dementia and dementia with Lewy bodies. Fewer than 10% of cases of dementia are due to causes that may presently be reversed with treatment.

The above medical illustration is provided courtesy of Alzheimer’s Disease Research, a program of BrightFocus Foundation.

Too many of us start worrying about dementia after retirement – and that may be too little, too late. Experts say that if you really want to ward off dementia, you need to start taking care of your  brain in your 30s and 40s – or even earlier.

“More and more research is suggesting that lifestyle is very important to your brain’s health,” says Dr. Paul Nussbaum, a neuro-psychologist and an adjunct associate professor at the University of Pittsburgh School of Medicine. “If you want to live a long, healthy life, then many of us need to start as early as we can.”

So what can you do to beef up your brain – and possibly ward off dementia? Nussbaum, who recently gave a speech on the topic for the Winter Park (Fla.) Health Foundation, offers 20 tips that may help.

1. Join clubs or organizations that need volunteers. If you start volunteering now, you won’t feel lost and unneeded after you retire.

2. Develop a hobby or two. Hobbies help you develop a robust brain because you’re trying something new and complex.

3. Practice writing with your non-dominant hand several minutes everyday. This will exercise the opposite side of your brain and fire up those neurons.

4. Take dance lessons. In a study of nearly 500 people, dancing was the only regular physical activity associated with a significant decrease in the incidence of dementia, including Alzheimer’s disease. The people who danced three or four times a week showed 76% less incidence of dementia than those who danced only once a week or not at all.

5. Need a hobby? Start gardening. Researchers in New Zealand found that, of 1,000 people, those who gardened regularly were less likely to suffer from dementia! Not only does gardening reduce stress, but gardeners use their brains to plan gardens; they use visual and spatial reasoning to lay out a garden.

6. Walking daily can reduce the risk of dementia because cardiovascular health is important to maintain blood flow to the brain.Or… buy a pedometer and walk 10,000 steps a day.

7. Read and write daily. Reading stimulates a wide variety of brain areas that process and store information. Likewise, writing (not copying) stimulates many areas of the brain as well.

8. Start knitting. Using both hands works both sides of your brain. And it’s a stress reducer.

9. Learn a new language. Whether it’s a foreign language or sign language, you are working your brain by making it go back and forth between one language and the other. A researcher in England found that being bilingual seemed to delay symptoms of Alzheimer’s disease for four years.  And some research suggests that the earlier a child learns sign language, the higher his IQ – and people with high IQs are less likely to have dementia. So start them early.

10. Play board games such as Scrabble and Monopoly. Not only are you taxing your brain, you’re socializing too. Playing solo games, such as solitaire or online computer brain games can be helpful, but Nussbaum prefers games that encourage you to socialize too.

11. Take classes throughout your lifetime. Learning produces structural and chemical changes in the brain, and education appears to help people live longer. Brain researchers have found that people with advanced degrees live longer – and if they do have Alzheimer’s, it often becomes apparent only in the very later stages of the disease.

12. Listen to classical music. A growing volume of research suggests that music may hard wire the brain, building links between the two hemispheres. Any kind of music may work, but there’s some research that shows positive effects for classical music, though researchers don’t understand why.

13. Learn a musical instrument. It may be harder than it was when you were a kid, but you’ll be developing a dormant part of your brain.

14. Travel. When you travel (whether it’s to a distant vacation spot or on a different route across town), you’re forcing your brain to navigate a new and complex environment. A study of London taxi drivers found experienced drivers had larger brains because they have to store lots of information about locations and how to navigate there.

15. Pray. Daily prayer appears to help your immune system. And people who attend a formal worship service regularly live longer and report happier, healthier lives.

16. Learn to meditate. It’s important for your brain that you learn to shut out the stresses of everyday life.

17. Get enough sleep. Studies have shown a link between interrupted sleep and dementia.

18. Eat more foods containing Omega-3 fatty acids: Salmon, sardines, tuna, ocean trout, mackerel or herring, plus walnuts (which are higher in omega 3s than salmon) and flaxseed. Flaxseed oil, cod liver oil and walnut oil are good sources too.

19. Eat more fruits and vegetables. Antioxidants in fruits and vegetables mop up some of the damage caused by free radicals, one of the leading killers of brain cells.

20. Eat at least one meal a day with family and friends. You’ll slow down, socialize, and research shows you’ll eat healthier food than if you ate alone or on the go.

H/t my sis-in-law Shireen.

~Eowyn

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