Mental stimulation enhances the efficiency of our brain. For example, if I am feeling a little sluggish it often helps to go on a short walk or go to a movie or a concert. The brain is built to respond to change and stimulation. This is true for those with normal memory as well as those with memory loss. Indeed, an essential ingredient of any treatment plan for those with progressive memory loss such as Alzheimer’s disease is to keep them engaged. The activity doesn’t matter. It is in the doing that counts. Participants at well run residential and day care programs for the memory impaired are provided with “palliative” memory rehabilitation through engagement therapy. In essence, therapy allows those with memory loss to remain engaged in joyful and stimulating activities such as walking, socializing, thinking (e.g., word games, watching […]
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The nicotine patch may present a treatment for Mild Cognitive Impairment and early Alzheimer’s disease. This study is new but the idea is old and there are other studies. Before you run off and ask for the patch or chew nicotine gum, let’s put this in the context of current medical treatment. The only FDA approved treatments for Mild Cognitive Impairment and Alzheimer’s disease are medications known as cholinesterase inhibitors (Namenda is not approved for early changes and works through an entirely different neurotransmitter). These medications have been available since 1993. They work by increasing the amount of the neurotransmitter acetylcholine in the brain. Acetylcholine has important actions on cognitive functions such as attention and some forms of memory. It is one of the neurotransmitters that act on the frontal cortex, amygdala, and hippocampus – structures very important to attention, […]
Jan. 30 2012: Remembering What not to Forget Description: Aging and memory, Improve memory, Sharpen your brain skills Where: Foxfire Country Club, Davis Blvd; Kings Way, Time: 6pm-social hr, 6:30 dinner, 7:15-talk Contact: Carol Hollenbeck 261-8520 and also January 31, 2012 Where: Naples Healthcare Assoc., Hilton Ballroom When: 4:30 pm-6:30 pm Contact: Pearl at Naples H.C Assoc. 596-1111 Feb 2, 2012 : Managing your Memory Description: Aging and memory, Improve memory, Sharpen your brain skills Where: Minor League Club @ Cub @ Pelican Bay When: 11:30 – 1:30 Contact: Mike Kelly 908-233-2263 Feb. 8, 2012: Remembering What not to Forget Description: Aging and memory, Improve memory, Sharpen your brain skills Where: Naples Center When: 1:30-3pm Contact: John Guerra (FGCU) 287-5196 Feb. 9, 2012: Assessing and Treating Progressive Memory Loss Where: Naples United Church of Christ When: 2pm Contact: Dr. Greg […]
One headline reads “Dementia’s first signs appear long before old age, study finds.” (Bloomberg) Alternatively, another headline reads that “Cognitive decline can start at age 45.” (Medscape). These differing interpretations are the leads for two “alerts” I follow to try to keep up with current topics related to memory and aging. In both cases, the actual data are the same and come from a recent article published in The British Medical Journal. The headlines are based on a large, prospectively designed longitudinal study of more than 7,000 volunteers aged 45-70. Each participant (ranging in age from 45 – 70) underwent cognitive assessment three times during ten years. Overall scores on tests of memory and reasoning declined during the ten years. Only scores on tests of vocabulary remained stable. On face value these findings appear to be worrisome. However, on closer […]
Many are more fearful of a diagnosis Alzheimer’s than a diagnosis of cancer. However, cancer is much more fatal (cancer is the second leading cause of death in the United States; Alzheimer’s disease is the sixth). This fear stems from a misunderstanding of Alzheimer’s disease and leads many to fear memory assessment. Alzheimer’s disease unfolds over the course of decades; it does not occur suddenly. There are seven stages of decline in Alzheimer’s disease but current diagnostic standards often don’t identify those with problems until stage 4. Not everyone with Alzheimer’s disease becomes demented and disabled. Not everyone who becomes demented has Alzheimer’s disease. Memory loss is the hallmark feature of Alzheimer’s disease but not everyone with memory loss will have Alzheimer’s disease or become demented. During the early stages of Alzheimer’s disease and memory loss, there is so much […]
It’s that time of the year again. The top ten lists of the year are out to help us recall the year. It triggers both year and life review and stimulates our long term memory of where we have been, where we are, and where we are going. Seneca said it well. “It’s not that we have a short time to live, but that we waste a lot of it.” This of course comes with end of the year resolutions that often amount to trying to do better next year. I often remark during my talks that the most grievous memory error is “trying to remember.” Instead, plan on how you will remember. Good intentions often fall short when a well placed post-it note would serve us well. It’s the same for New Year’s resolutions. A resolution needs to be […]
What are the warning signs that the stress of caregiving may be beyond the normal and that you need help? 1. Easily lose patience 2. Easily anger 3. Experience a loss of energy 4. Lose sleep but not from providing care 5. Appetite changes 6. Provide care 24/7 7. Find no joy in any aspect of your life 8. Have frequent crying spells 9. Feel a constant sense of depression, anguish, and despair 10. Don’t think you can go on much longer. 11. Don’t know to whom to turn 12. Use drugs or alcohol to get by If you check most or all of these feelings, you are likely depressed in a clinical sense. There are many support groups, clinicians, and organizations that will provide help and guidance. Asking for help is not a sign of weakness. If you have […]
In the past few weeks I have covered several issues regarding depression. It is clear that being demented does not necessarily cause one to be depressed. Furthermore, being diagnosed with dementia or being placed in a care facility does not necessarily lead to depression. Depression is common but not inevitable outcome for all of us as we age. Medications work in less than half of those who are depressed and are clearly not a panacea. Finally, treating depression requires getting moving despite a lack of motivation. What about depression in those who care for someone who is demented? Caregiving does not itself cause depression. Many caregivers have never had to deal with these feelings before and are too busy giving care to attend to their own needs and feelings. Statistics provide a wide range of estimates (20 to 60%) suggesting […]
As discussed the past two weeks, depression is frequent in both community dwelling elders and those with dementia. No matter what the source of depression, the most effective treatment for depression is to get activated even though you don’t want to. This is true for the young as well as the elderly and for caregivers as well as care receivers. We have often discussed the benefits of exercise for cognitive skills but there is also considerable evidence suggesting that exercise improves mood. For example, active people are less depressed on average than inactive people. Furthermore, people who exercise regularly and stop tend to show a decline in mood when compared to those who start or maintain exercise. A recent study randomly assigned depressed adults to an exercise group, a medication group, or a placebo group. Both exercise and medications improved […]
As discussed last week, depression is frequent in both community dwelling elders (by most standards those over 55) and those with dementia. Depression is more likely in dementias due to either vascular disease (strokes) or Lewy body disease than in Alzheimer’s disease (maybe there’s a benefit to short term memory loss). In short, depression is a common but not inevitable outcome for all of us as we age. What are the best treatments for depression? How well do different treatments work for those who are demented as well as for those who are not? Medications in the class called selective serotonin reuptake inhibitors (SSRIs) such as Lexapro, Prozac, Zoloft, Celexa, and Paxil are the most common medical treatment for depression. However, they are not a panacea – especially in the elderly and those who are demented. A large portion of […]
