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Category Archives: early signs of Dementia

Mild Alzheimer’s Patients Show Rapid Decline In Financial Skills Over One Year

I was late in discovering my mother was suffering from Alzheimer’s dementia. After my father passed away my mother took over the the bill paying. She did this without a problem for over ten years. I finally discovered that there were all kinds of problems. Looking back I realized that this is one of the early signs of dementia. My advice to all is to allow the elderly to pay their own bills and to monitor these payments. If the pattern changes this could be an early tip-off that things are changing and that you need to rule out or rule in the onset of Alzheimer’s disease. This is one of the early signs of Alzheimer’s and dementia.

Mild Alzheimer’s Patients Show Rapid Decline In Financial Skills Over One Year

New research from UAB (University of Alabama at Birmingham) shows that patients with mild Alzheimer’s disease (AD) have a dramatic decline in their ability to make financial decisions over a one year period. The findings, published Feb. 8 online in the American Journal of Geriatric Psychiatry, have strong implications for caregivers and health care providers in the areas of estate planning and fraud prevention.

The UAB team compared 55 patients with mild AD against 63 healthy older adults and followed them for one year. At the beginning of the trial, the mild AD group already showed a 20 percent decline in overall financial ability compared to the control group. By the end of the year, the AD group had dropped another 10 percent.

“After just one year, the mild AD group had dropped to 70 percent of the financial capacity demonstrated by the healthy older adult group, a significant decline,” said Daniel Marson, J.D., Ph.D., director of the UAB Alzheimer’s Disease Center in the Department of Neurology and the study’s lead author.

Patients were assessed on a variety of financial skills, including basic monetary skills, checkbook management, bill payment and understanding a bank statement. Tasks varied from simple ones such as identifying specific coins and currency to complex ones such as preparing bills, checks and envelopes for mailing.

Assessments were done using the Financial Capacity Instrument, (FCI-9), an instrument developed by Marson’s group. The FCI-9 measures 18 different financial tasks within nine domains and has two overall scores.

The AD group showed substantial declines in overall financial capacity, on eight of the nine financial domains and on 12 of the 18 financial tasks. Of particular concern was decline in the ability to recognize telephone or mail fraud.

“Elder fraud is a serious problem and our findings suggest that even patients with mild Alzheimer’s are at significantly increased risk for becoming victims of fraud,” said Marson.

Overall the study found that impairment in financial skills occurs early in AD and progresses relatively rapidly over time, and includes declines in basic judgment and monetary calculation skills. The findings underscore the importance, at the time of diagnosis, of patients with mild AD and their families promptly pursuing financial planning and transfer of financial responsibilities, Marson said.

Proactive steps by families include finalizing trust and estate arrangements, delegating financial decision-making powers, planning for eventual financial incapacity, and providing increased supervision of existing financial activities.

This research was supported by grants from the National Institute on Aging (NIA) and the National Institute of Mental Health (NIMH), part of the National Institutes of Health (NIH).

University of Alabama at Birmingham
701 20th St. S., AB 1320
Birmingham, AL 35294-0113
United States
http://www.uab.edu

Article URL: http://www.medicalnewstoday.com/articles/96795.php

 

Dementia Factsheet (Alzheimer’s Disease)


I ran across this factsheet from the Milton S Hershey Medical Center. The section entitled,What are the Symptoms, is particularly interesting.

Source Milton S Hershey Medical Center

Dementia

What is it?

Dementia is the gradual deterioration of mental functioning, such as concentration, memory, and judgment, which affects a person’s ability to perform normal daily activities.

Who gets it?

Dementia occurs primarily in people who are over the age of 65, or in those with an injury or disease that affects brain function. While dementia is most commonly seen in the elderly, it is not a normal consequence of the aging process.

What causes it?

Dementia is caused by the death of brain cells. Brain cells can be destroyed by brain diseases, such as Alzheimer’s disease, or strokes (called vascular or multi-infarct dementia), which decrease blood flow to the brain. Lewy body dementia is another common cause attributed to changes in brain tissue. Other causes can include AIDS, high fever, dehydration, hydrocephalus, systemic lupus erythematosus, Lyme disease, long-term drug or alcohol abuse, vitamin deficiencies/poor nutrition, hypothyroidism or hypercalcemia, multiple sclerosis, brain tumor, or diseases such as Pick’s, Parkinson’s, Creutzfeldt-Jakob, or Huntington’s. Dementia can also result from a head injury that causes hemorrhaging in the brain or a reaction to a medication.

What are the symptoms?

In most cases, the symptoms of dementia occur gradually, over a period of years. Symptoms of dementia caused by injury or stroke occur more abruptly. Difficulties often begin with memory, progressing from simple forgetfulness to the inability to remember directions, recent events, and familiar faces and names. Other symptoms include difficulty with spoken communication, personality changes, problems with abstract thinking, poor personal hygiene, trouble sleeping, and poor judgment and decision making. Dementia is extremely frustrating for the patient, especially in the early stages when he or she is aware of the deficiencies it causes. People with dementia are likely to lash out at those around them, either out of frustration or because their difficulty with understanding makes them misinterpret the actions of others. They become extremely confused and anxious when in unfamiliar surroundings or with any change in routine. They may begin a task, such as cooking, then wander away aimlessly and completely forget what they had been doing. Dementia is often accompanied by depression and delirium, which is characterized by an inability to pay attention, fluctuating consciousness, hallucinations, paranoia, and delusions. People in advanced stages of dementia lose all control of bodily functions and are completely dependent upon others.

How is it diagnosed?

Dementia is diagnosed through a study of the patient’s medical history and a complete physical and neurological exam. The doctor will speak with those close to the patient to document a pattern of behavior. He or she will also evaluate the patient’s mental functioning with tests of mental status, such as those that require the patient to recall words, lists of objects, names of objects, and recent events. Diagnostic tests, such as blood tests, x-rays, or magnetic resonance imaging (MRI), positron emission tomography (PET), or computed tomography (CT) scans, can help determine the cause of the dementia.

What is the treatment?

In some instances, treating the cause of dementia may successfully reverse some or all of the symptoms. This is the case when the cause is related to a vitamin/nutritional deficiency, tumor, alcohol or drug abuse, reaction to a medication, or hormonal disorder. When dementia is related to an irreversible destruction of brain tissue, such as with Alzheimer’s disease, Lewy body dementia, or multiple strokes, treatment involves improving the patient’s quality of life as much as possible. This includes maintaining a stable, safe, supportive environment and providing constant supervision. While this may be done in the home, people in the advanced stages of dementia may require round-the-clock care in a long-term healthcare facility. It is important to provide the patient with structured activities and avoid disruptions to his or her daily routine. Many patients enjoy therapeutic activities, such as crafts or games, designed specifically for people with dementia. Some medications, such as donepezil and tacrine, have been effective in improving the mental functions of those in the beginning stages of dementia. Patients with hallucinations and delusions may also be treated with antipsychotic drugs, while antidepressant medications are used to treat depression.

Self-care tips

There is currently no known way to prevent dementia associated with Alzheimer’s disease. You can decrease your risk of dementia associated with stroke by maintaining a healthy lifestyle, following a heart-healthy diet, and controlling high blood pressure and high cholesterol. Healthy lifestyles, including not smoking and not abusing drugs and alcohol, go a long way in keeping most people in good health. Caring for a person with dementia is stressful. It is important to learn all you can about the disease, seek the help of support groups, and find a responsible caregiver who can give you a break when needed. There are daycare programs specifically designed for patients with dementia that are good for the patient and the family.

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This information has been designed as a comprehensive and quick reference guide written by our health care reviewers. The health information written by our authors is intended to be a supplement to the care provided by your physician. It is not intended nor implied to be a substitute for professional medical advice.

 

Scientists find early signs of Alzheimer’s

“We found the earliest predictor,” said the lead researcher, Lisa Mosconi of New York University School of Medicine. “The hippocampus seems to be the very first region to be affected.”

Source USA Today

A subtle change in a memory-making brain region seems to predict who will get Alzheimer’s disease nine years before symptoms appear, scientists reported Sunday.
The finding is part of a wave of research aimed at early detection of the deadly dementia — and one day perhaps even preventing it. (Related: Lifestyle, Alzheimer’s link strengthen Disease explained)

Researchers scanned the brains of middle-aged and older people while they were still healthy. They discovered that lower energy usage in a part of the brain called the hippocampus correctly signaled who would get Alzheimer’s or a related memory impairment 85% of the time.

“We found the earliest predictor,” said the lead researcher, Lisa Mosconi of New York University School of Medicine. “The hippocampus seems to be the very first region to be affected.”

But it is too soon to offer Alzheimer’s-predicting PET scans. The discovery must be confirmed. Also, there are serious ethical questions about how soon people should know that Alzheimer’s is approaching when nothing yet can be done to forestall the disease.

Still, the discovery may provide leads to scientists searching for therapies to at least delay the onset of the degenerative brain disease. It already affects 4.5 million people in the U.S. and is predicted to strike 14 million by 2050 as the population ages.

Moreover, researchers are honing in on lifestyle choices that may help protect the brain in the first place.

“It’s exciting that we can even talk about prevention,” said William Thies, scientific director of the Alzheimer’s Association. He noted that just 10 years ago there was hardly any research into that possibility.

Among the findings presented Sunday at the association’s first Alzheimer’s prevention conference:

•People who drink fruit or vegetable juice at least three times a week seem four times less likely to develop Alzheimer’s than nonjuice drinkers, according to a study of 1,800 elderly Japanese-Americans. The theory is that juice contains high levels of polyphenols, compounds that may play a brain-protective role.

•Less education, gum disease early in life, or a stroke were more important than genes in determining who got dementia, concluded a study of 100 dementia patients with healthy identical twins. Education stimulates neuronal growth; gum disease is a marker of brain-harming inflammation.

•Decreasing social activity in old age is a risk factor, a National Institute on Aging study suggests. It is not clear if the men in the study became less social because Alzheimer’s already was at work, but social activity is mentally stimulating.

A brain-healthy lifestyle aside, a big quest is to develop ways to identify Alzheimer’s disease before symptoms emerge — finding biomarkers that could be targets for preventive therapies.

Think of it as hunting the equivalent of the cholesterol test for Alzheimer’s, Dr. Neill Graff-Radford of the Mayo Clinic said.

He measured blood levels of different types of beta amyloid, the sticky protein that makes up Alzheimer’s hallmark brain plaques, in 565 people. Those with lowest ratios of a particular amyloid type were three times more likely to develop dementia within five years.

The reason: Probably less amyloid was floating in the blood because it was sticking in the brain instead.

PET scans already can show Alzheimer’s plaques in advanced disease. Mosconi’s study is the first to so rigorously examine people’s brains before symptoms appear.

PET, or positron emission tomography, scans show images of how brains use glucose, or sugar, which is the brain’s main fuel.

Mosconi scanned 53 healthy people. She tracked them for up to 24 years. Six so far have developed Alzheimer’s and 19 developed an Alzheimer’s precursor called “mild cognitive impairment,” or MCI. Those people showed less glucose metabolism in the hippocampus than the still healthy.

Other research supports the hippocampus’ early role.

University of Wisconsin researchers gave a different brain scan, called a functional MRI, to healthy adult children of Alzheimer’s patients. The researchers found that the hippocampus was not as active as in people without that familial risk.

To prove if these early indicators are real, the National Institute on Aging, with financial help from the pharmaceutical industry and Alzheimer’s Association, is beginning a $60 million study to scan the brains of 800 older Americans and try to pin down Alzheimer’s earliest biological changes.

That Alzheimer’s begins developing so early means even young people should adopt a brain-healthy lifestyle, said Dr. Mark Sager of the Wisconsin Registry for Alzheimer’s Prevention. “what we’re hoping is that 55 is not too late,” he said.

 

Catching the first signs of dementia (Alzheimer’s)

Looking back, there is little doubt in my mind that if I had had the proper education or information I would have realized my mother was suffering from dementia sooner. Most people like me tend to ignore the symptoms at first believing they are simply signs of “old age”. Anyone who ends up in my shoes knows and understands that a person in the early stages of dementia or Alzheimer’s can function with normality–even drive a car. It is not until they deteriorate or until some “event” takes place that we wake up to reality.

The basic underlying premise in this article is that behavior changes slowly in the elderly and if they begin to suffer cognitive impairment it will be evidenced in behavioral changes. Sometimes these changes can be quite subtle but if detected could raise a “red flag”.

If my mother had been enrolled in any of these studies I feel certain she would have been diagnosed with dementia sooner. This would have allowed me to get her in an exercise program, get her proper nutrition, and insure that she was taking her medicines as prescribed. I learned in the last three years how important these three factors are in the quality of her life.

My mother (in the photo) turned 91 years old in June and she suffers from Alzheimer’s disease. I am her CarGiver.

Sensors could help catch first signs of dementia
Monitors and online tests track subtle changes in daily mobility, behavior

Source Associated Press and MSNBC

WASHINGTON – Tiny motion sensors are attached to the walls, doorways and even the refrigerator of Elaine Bloomquist’s home, tracking the seemingly healthy 86-year-old’s daily activity.

It’s like spying in the name of science — with her permission — to see if round-the-clock tracking of elderly people’s movements can provide early clues of impending Alzheimer’s disease.

“Now it takes years to determine if someone’s developing dementia,” laments Dr. Jeffrey Kaye of Oregon Health & Science University, which is placing the monitors in 300 homes of Portland-area octogenarians as part of a $7 million federally funded project.

The goal: Shave off that time by spotting subtle changes in mobility and behavior that Alzheimer’s specialists are convinced precede the disease’s telltale memory loss.

Simple early signs

Early predictors may be as simple as variations in speed while people walk their hallways, or getting slower at dressing or typing. Also under study are in-home interactive “kiosks” that administer monthly memory and cognition tests, computer keyboards bugged to track typing speed, and pill boxes that record when seniors forget to take their medicines.

More than 5 million Americans, and 26 million people worldwide, have Alzheimer’s, and cases are projected to skyrocket as the population ages. Today’s medications only temporarily alleviate symptoms. Researchers are desperately hunting new ones that might at least slow the relentless brain decay if taken very early in the disease, before serious memory problems become obvious.

So dozens of early diagnosis methods also are under study, from tests of blood and spinal fluid to MRI scans of people’s brains. Even if some pan out, they’re expensive tests that would require lots of doctor intervention, when getting someone to visit a physician for suspicion of dementia is a huge hurdle. And during routine checkups, even doctors easily can miss the signs.

Bloomquist, of Milwaukie, Ore., knows the conundrum all too well. She volunteered for Kaye’s research because her husband died of Alzheimer’s, as did his parents and her own mother.

“It’s hard to know when people begin Alzheimer’s,” she reflects. “Alzheimer people do very well socially for short periods of time. If it’s just a casual conversation, they rise to the occasion.”

‘Typical’ days monitored

Measuring how people fare at home — on bad days as well as good ones, not just when they’re doing their best for the doctor — may spot changes that signal someone’s at high risk long before they’re actually demented, Kaye told the Alzheimer’s Association’s international dementia-prevention meeting last week.

“If you only assess them every once-in-a-blue-moon, you really are at a loss to know what they are like on a typical day,” Kaye explains.

High-tech monitors under study:

Researchers at New York’s Mount Sinai School of Medicine are heading a study that ultimately plans to recruit 600 people over age 75 to help test in-home “kiosks” that turn on automatically to administer monthly cognitive exams. A video of a smiling scientist appears on-screen to talk participants through such classic tests as reading a string of words and then, minutes later, repeating how many they recall, or seeing how quickly they complete connect-the-dot patterns.
An Oregon pilot study of the motion sensors tracked 14 participants in their upper 80s for almost a year. Half had “mild cognitive impairment,” an Alzheimer’s precursor, and half were healthy. Impaired participants showed much greater variation in such day-to-day activities as walking speed, especially in the afternoons.

Why? The theory is that as Alzheimer’s begins destroying brain cells, signals to nerves may become inconsistent — like static on a radio — well before memories become irretrievable. One day, signals to walk fire fine. The next, those signals are fuzzy and people hesitate, creating wildly varying activity patterns.

Study receives unique grant

The pilot study prompted a first-of-its-kind grant from the National Institutes of Health to extend the monitoring study to 300 homes; 112 are being monitored already, mostly in retirement communities like Bloomquist’s. They’re given weekly health questionnaires to make sure an injury or other illness that affects activity doesn’t skew the results.

In addition, participants receive computer training so they can play brain-targeted computer games and take online memory and cognition tests. The keyboards are rigged to let researchers track changes in typing speed and Internet use that could indicate confusion.

Finally, a souped-up pill dispenser called the MedTracker is added to some of the studies, wirelessly recording when drugs are forgotten or taken late.
Electronics giants already sell various medical warning technologies for the elderly, including dementia patients, such as pill boxes that sound reminder alarms at dose time. And the Alzheimer’s Association and Intel Corp. are jointly funding research into how to use television, cell phones and other everyday technology to do such things as guide dementia patients through daily activities.

The next step of companies selling early symptom monitoring isn’t far off, and unbiased data on what really helps will be crucial, Kaye warns.

 

Mental Activity Helps to Lower Risk of Alzheimer’s Disease

Taken directly from the Rush Memory and Aging Project news release.

How often older adults read a newspaper, play chess, or engage in other mentally stimulating activities is related to the risk of developing Alzheimer’s disease, according to a study by researchers at Rush University Medical Center.

Frequent Brain Stimulation in Old Age Reduces Risk of Alzheimer’s Disease

(CHICAGO) – How often older adults read a newspaper, play chess, or engage in other mentally stimulating activities is related to the risk of developing Alzheimer’s disease, according to a study by researchers at Rush University Medical Center published June 27 in the online edition of Neurology®, the medical journal of the American Academy of Neurology.

For the study, more than 700 people in Chicago with an average age of 80 underwent yearly cognitive testing for up to five years. Participants were part of the Rush Memory and Aging Project, a longitudinal study of more than 1,200 older people. Of the participants, 90 developed Alzheimer’s disease. Researchers also performed a brain autopsy on the 102 participants who died.

The study found that a cognitively active person in old age was 2.6 times less likely to develop dementia and Alzheimer’s disease than a cognitively inactive person in old age. This association remained after controlling for past cognitive activity, lifetime socioeconomic status, and current social and physical activity.

Researchers say the findings may be used to help prevent Alzheimer’s disease.

“Alzheimer’s disease is among the most feared consequences of old age,” said study author Robert S. Wilson, PhD, a neuropsychologist at the Rush Alzheimer’s Disease Center. “The enormous public health problems posed by the disease are expected to increase during the coming decades as the proportion of old people in the United States increases. This underscores the urgent need for strategies to prevent the disease or delay its onset.”

Wilson says the study also found frequent cognitive activity during old age such as visiting a library or attending a play, was associated with reduced risk of mild cognitive impairment, a transitional stage between normal aging and dementia, and less rapid decline in cognitive function.

The study was supported by grants from the National Institute on Aging and the Illinois Department of Public Health.

The Rush Alzheimer’s Disease Center is one of 29 NIA-supported Alzheimer’s Disease Centers across the U.S. which conduct basic science, clinical, and social and behavioral research on dementia and AD. General information on aging and aging research can be viewed at the NIA’s home website, http://www.nia.nih.gov. For more information on the Rush Alzheimer’s Disease Center, visit http://www.rush.edu.

The Emotional Survival Guide for Caregivers: Looking After Yourself and Your Family While Helping an Aging Parent

 

Drinking juice may delay onset of Alzheimer’s disease


Drinking fruit or vegetable juice may be better for you than you think. A new research study shows that drinking fruit or vegetable juice may delay the onset of Alzheimer’s disease.

Researchers at the Group Health Center for Health Studies in Seattle, Washington
following nearly 2,000 adults for 10 years found drinking fruit or vegetable juice more than three times a week cuts the risk of developing Alzheimer’s by 76 percent compared to drinking it less than once a week. They found having juice once or twice a week reduced risk by 16 percent.

Highlights from the Study include:

“The theory is that the brain accumulates damage due to oxidation as we age, and if you can protect the brain from that damage you can protect the person from Alzheimer’s disease and other causes of dementia,” said Eric Larson, MD.

Researchers saw the protective benefits from any type of juice. The study also found there are more antioxidants in juice than in vitamin C and E supplements.

According to Dr. Larson, juice is made using parts of the fruit with the highest concentration of natural antioxidants. “The theory is the brain accumulates damage due to oxidation as we age and if you can protect the brain from that damage, you can protect the person from Alzheimer’s disease and other causes of dementia,” he said.

In most cases, juice is produced using the core, the seeds and the skin — parts of the fruit or vegetable people do not normally consume. The food is mashed together to create a concentrate. Juice is made in cold process, so nutrients aren’t damaged by heat. Juice will usually have a defined level of purity based on percentage of fruit juice. Juice should not be confused with squash, which is usually an artificial juice that can be diluted with water.

In theory, grape, apple and orange juices are very potent in antioxidants and could be the most effective at preventing Alzheimer’s disease, according to Dr. Larson. In the study, those who did not drink fruit juice, but ate several servings of fruit per week, saw some benefit. However, those who drank juice saw the most benefit.

Study participants who drank juice once or twice a week reduced their Alzheimer’s risk by 16 percent. Those who drank juice three times per week reduced their risk by 76 percent. Before you drink 10 glasses of orange juice each day, be aware there may be threshold for antioxidant consumption. Going above that amount may not necessarily bring benefits.

More on this study as it becomes available

 

Exercise slows decline in Alzheimer’s patients

I can attest, exercise makes a difference. My mother now has the tendency to sit around all day. On those days when I can get her to go to Gold’s Gym with me she is a completely different person. The look on her face, from dull to smiling, is more than enough to tell me that exercise works to her benefit.

The article on the next page talks about the effects of exercising on Alzheimer’s patients.

“Nursing home residents with Alzheimer’s disease who participate in a moderate exercise program have a significantly slower deterioration than those who receive routine medical care, researchers have shown.”

Exercise slows decline in Alzheimer’s patients

NEW YORK (Reuters Health) – Nursing home residents with Alzheimer’s disease who participate in a moderate exercise program have a significantly slower deterioration than those who receive routine medical care, researchers have shown.

Dr. Yves Rolland, of Hospital La Grave-Casselardit in Toulouse, France, and colleagues examined the effects of a program of exercise for one hour twice weekly on activities of daily living, physical performance, nutritional status, behavioral disturbance and depression among 134 Alzheimer’s disease patients in nursing homes.

The patients were 83 years old on average. They were assigned to the exercise program, which focused on walking, strength, balance and flexibility training, or to routine medical care for 12 months.

As reported in the Journal of the American Geriatrics Society, 110 participants completed the study. Among the 56 subjects in the exercise group who completed the study, the rate of adherence to the program was about 33 percent on average.

At the end of the 12 months, the average activities-of-daily-living score was significantly more improved in the exercise group than in the routine medical care group, Rolland’s team reports.

In addition, average walking speed improved significantly more in the exercise group than in the routine medical care group at 6 months and 12 months.

However, the exercise program had no apparent effect on behavioral disturbance, depression or nutritional assessment scores.

ORIGINAL SOURCE: Journal of the American Geriatrics Society, February 2007.

 
 
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