Can changes in the eyes help diagnose Alzheimer’s Disease?

Diagnosing someone with Alzheimer’s disease can be a long and complicated process.  In addition to reviewing a patient’s full medical history, doctors must also subject individuals to expensive brain scans or invasive surgical procedures in order to be fully certain of the disease’s presence.

But now, there may be an easier way to spot the brain-wasting condition.  Researchers from Georgetown University Medical Center (GUMC) and the University of Hong Kong have found that it may be possible to diagnose Alzheimer's simply by screening for changes in two very important organs: the eyes.

In a new study presented at the Neuroscience 2013 conference, the scientists detailed how the thickness of a particular layer of retinal cells may serve as an indication of Alzheimer’s progression.

“We’re looking for biomarkers for early disease [recognition], partly for our new clinical studies focusing more on prevention of Alzheimer’s… and to test new drugs,” study author Dr. R. Scott Turner, director of the Memory Disorder Program at GUMC, told FoxNews.com.  “We’re hoping to incorporate this as a new biomarker for drug trials and potentially for screening and prognosis.”

Currently, there are two leading biomarkers that physicians can utilize to diagnose Alzheimer’s.  One is the buildup of beta-amyloid plaques in the brain, which can be observed through positron emission tomography (PET) or computed tomography (CT) scans.  The other involves measuring changes in protein levels of the cerebrospinal fluid – the liquid surrounding the brain and spinal cord.

However, brain imaging scans can be expensive for patients, and in order collect samples of the cerebrospinal fluid, doctors must administer a spinal tap, which can be a very invasive procedure.

Hoping to find a simpler biomarker, Turner and his colleagues decided to analyze the relationship between the eyes and dementia.  According to Turner, the retina serves as a direct extension of a person’s brain.

“The retinas have neurons themselves that send projections straight into the brain,” Turner said. “…Those nerve cells are directly connected to the brain via the optic nerve….So when looking at the retina, it’s the easiest place to see the brain and its neurons.”

Turner also noted that there has been an established association between glaucoma and Alzheimer’s, though the mechanisms behind the relationship remain unclear.  Most studies examining this connection have revolved around the retinal ganglion cell layer, which is responsible for transmitting visual information through the optic nerve.  However, this cell layer relies on information it receives from another layer in the retina called the inner nuclear layer, which had never before been studied in relation to dementia.

With this knowledge in mind, the researchers analyzed a group of mice that had been genetically engineered to develop Alzheimer’s disease, observing the thicknesses of the six layers in their retinas. They found that there was significant loss in thickness to both the inner nuclear layer, which experienced an average 37 percent loss of neurons, and the retinal ganglion cell layer, which experienced an average 49 percent loss.

According to Turner, these two retinal layers may be most vulnerable to neuron loss because they are larger than the other layers.

“The larger the neuron, the more vulnerable it seems to be to injury,” Turner said.  “We looked at some of the other [smaller] neurons, and they didn’t lose much because they were presumably less vulnerable. So we think whatever is killing neurons in the brain is killing the bigger nerve cells in the retina.”

The next step, Turner said, is to see if this biomarker translates to humans with Alzheimer’s.  If similar changes in retinal thickness occur in people, then a simple, noninvasive procedure known as optical coherence tomography (OCT) can be used to measure loss of neurons in these layers.

“If this holds true with humans and seems to be predicative, it could be used for screening, diagnosis, prognosis, but probably more immediately, a research tool to test new drugs,” Turner said. “…But we should probably be looking at the retinal thickness of our Alzheimer’s patients.”

Care of: http://www.foxnews.com/health/2013/11/13/can-changes-in-eyes-help-diagnose-alzheimers-disease/

What is Dementia? What Causes Dementia? Symptoms of Dementia

Dementia is the progressive deterioration in cognitive function - the ability to process thought (intelligence). It is a set of signs and symptoms in which brain function, such as memory, language, problem solving and attention are affected.

The word "dementia" comes from the Latinde meaning "apart" and mens from the genitive mentis meaning "mind".

Progressive means the symptoms will gradually get worse. The deterioration is more than might be expected from normal aging and is due to damage or disease. Damage could be due to a stroke, while an example of a disease might be Alzheimer's.

Dementia is a set of signs and symptoms

Dementia is a non-specific syndrome in which affected areas of brain function may be affected, such as memory, language, problem solving and attention. Dementia, unlike Alzheimer's, is not a disease in itself. When dementia appears the higher mental functions of the patient are involved initially. Eventually, in the later stages, the person may not know what day of the week, month or year it is, he may not know where he is, and might not be able to identify the people around him. 

Dementia is significantly more common among elderly people. However, it can affect adults of any age.

What are the symptoms of dementia?

• Memory loss - the patient may forget his way back home from the shops. He may forget names and places. He may find it hard to remember what happened earlier on during the day.

• Moodiness - the patient may become more and more moody as parts of the brain that control emotion become damaged. Moods may also be affected by fear and anxiety - the patient is frightened about what is happening to him.


• Communicative difficulties - the affected person finds it harder to talk read and/or write.

As the dementia progresses, the patient's ability to carry out everyday tasks diminishes and he may not be able to look after himself.

Diseases and conditions that cause dementia

• Alzheimer's disease - This is by far the most common cause of dementia. The chemistry and structure of the brain of a person withAlzheimer's disease changes and his brain cells die prematurely.


• Stroke (Vascular problems) - this means problems with blood vessels (veins and arteries). Our brain needs a good supply of oxygen-rich blood. If this supply is undermined in any way our brain cells could die - causing symptoms of vascular dementia. Symptoms may appear suddenly, or gradually. A major stroke will cause symptoms to appear suddenly while a series of mini strokes will not.


• Dementia with Lewy bodies - spherical structures develop inside nerve cells. Brain cells are nerve cells; they form part of our nervous system. These spherical structures in the brain damage brain tissue. The patient's memory, concentration and ability to speak are affected. Dementia with Lewy bodies is sometimes mistaken for Parkinson's diseasebecause the symptoms are fairly similar.


• Fronto-temporal dementia - this includes Pick's disease. The front part of the brain is damaged. The patient's behavior and personality are affected first, later his memory changes.
• Other diseases - progressive supranuclear palsy, Korsakoff's syndrome, Binswanger's disease, HIV and AIDS, and Creutzfeldt-Jakob disease (CJD). Dementia is also more common among patients who suffer from Parkinson's disease, Huntington's disease, Motor Neurone disease and Multiple Sclerosis. People who suffer from AIDS sometimes go on to develop cognitive impairment.


• High glucose associated with dementia - a team from the University of Washington School of Medicine reported in NEJM (New England Journal of Medicine that people with high blood sugar (glucose) levels have a higher risk of dementia, even if they do not havediabetes.

There are two main categories of dementia

According to most experts, there are two main categories of dementia - cortical and subcortical dementias.
• Cortical Dementia - The cerebral cortex is affected. This is the outer layer of the brain. The cerebral cortex is vital for cognitive processes, such as language and memory. Alzheimer's disease is a form of cortical dementia, as is CJD (Creutzfeldt-Jakob disease).


• Subcortical Dementia - A part of the brain beneath the cortex (deeper inside) becomes affected or damaged. Language and memory are not usually affected. A patient with subcortical dementia will usually experience changes in his personality, his thinking may slow down, and his attention span may be shortened. Dementias which sometimes result from Parkinson's disease are subcortical dementias, as are those caused by AIDS and Huntington's disease.
A patient with multi-infarct dementia will have both the cortical and subcortical parts of the brain affected or damaged.

Diagnosis of dementia

Although there are some brief tests, a more reliable diagnosis needs to be carried out by a specialist, such as a geriatric internist, geriatric psychiatrist, neurologist, neuropsychologist or geropsychologist.

The following tests are commonly used:

• AMTS (Abbreviated Mental Test Score) A score lower than six out of ten suggests a need for further evaluation.
• MMSE (Mini Mental State Examination) A score lower than twenty-four out of thirty suggests a need for further evaluation)
• 3MS (Modified Mini-Mental State Examination)
• CASI (Cognitive Abilities Screening Instrument)
It is important that the patient's score is interpreted in context with his socio-economic, educational and cultural background. The tester must also factor in the patient's present physical and mental state - does the patient suffer from depression, is he in great pain? 

Poor physical performance in the very elderly - researchers from the University of California found that people aged at least 90 years who had poor physical performance tend to have a much higher risk of either having or soon developing dementia. They reported their findings in Archives of Neurology, October 2012 issue. They assessed a sample of over-90s for walking, standing up from a chair, standing and controlling balance, and gripping something.

What is the treatment for dementia?

In the majority of cases dementia is incurable. Researchers are making inroads into treatments that may slow down dementia's progress. Cholinestaerase inhibitors are frequently administered during the early stages. Cognitive and behavioral therapies may also be useful. Several studies have found that music therapy helps patients with dementia. It is important to remember that the patient's caregiver also needs training and emotional support. 

In the USA, Tacrine (Cognex), donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon) have been approved for the treatment of dementia caused by Alzheimer's disease - some physicians prescribe these drugs for vascular dementia as well. Selegiline, which is used for treating Parkinson's disease, has been found to slow down the progress of dementia. 

In Canada, a country where two languages are spoken, English and French, researchers found that bilingual people who develop dementia do so four years later than monolingual people who develop dementia. The four year difference prevails even after factoring for such variables as cultural differences, education, employment, gender and immigration.

Anti-psychotics - Researchers at Aston University and the University of East Anglia reported that health authorities around the world are becoming concerned about the over-prescribing of anti-psychotic medications for patients with dementia. UK health authorities reported in October 2012 that reducing the usage of anti-psychotics has been much more difficult than originally estimated. In the United Kingdom, up to 1,800 people with dementia die each year due to this type of medication.

Common drugs may treat dementia one day - drugs that are used to treat skin conditions, high blood pressure and diabetes could eventually be used one day for the treatment of Alzheimer's disease. Researchers from King's College London reported in the journal Nature Reviews Drug Discovery (issue October 2012):
• Calcium channel inhibitors, such as Nilvadipine, used for the treatment of hypertension, may considerably reduce the risk of dementia.
• Diabetes medications, exenatide and liraglutide, activate the brain and inhibit the formation of plaques.
• The psoriasis drug, acitretin may alter the way proteins connect to dementia structure, the researchers believe.
• There may also be benefits from minoclycline, a tetracycline antibiotic that is used for the treatment of acne.
Beta-blockers may reduce dementia risk - scientists from Pacific Health Research and Education Institute in Honolulu, found that in autopsies of elderly males, those who had been taking beta-blockers were less likely to have brain changes linked to Alzheimer's and other types of dementia. Beta-blockers are medications prescribed for hypertension and heart conditions.

Keeping brain active during old age

Retiring later lowers dementia risk - a study conducted at the Bordeaux School of Public Health involving 429,000 self-employed people living in France found that those who retired later had a lower risk of being diagnosed with dementia. Study leader, Carole Dufouil, said "Our data show strong evidence of a significant decrease in the risk of developing dementia associated with older age at retirement, in line with the 'use it or lose it' hypothesis. The patterns were even stronger when we focused on more recent birth cohorts."

The aging brain benefits from simple mental activities, such as playing games, doing puzzles, reading and writing, researchers from Rush University and Illinois Institute of Technology reported at the 98th scientific assembly and annual meeting of the Radiological Society of North America (RSNA) in Chicago, in November 2012.

Lead researcher, Konstantinos Arfanakis, said:



"Reading the newspaper, writing letters, visiting a library, attending a play or playing games, such as chess or checkers, are all simple activities that can contribute to a healthier brain."



The authors invited 152 people, average age 81 years, to report how often during the previous 12 months they had engaged in mental activities, such as playing cards, board games, writing letters, reading magazines and newspapers, doing puzzles, etc. They were all clinically evaluated - none of them had any signs of dementia or mild cognitive impairment.

Over a 12-month period, they underwent MRI brain scans that allowed the scientists to produce diffusion anisotropy maps.

They found that mental activity was closely linked with positive outcomes for brain health.

Arfanakis said "Several areas throughout the brain, including regions quite important to cognition, showed higher microstructural integrity with more frequent cognitive activity in late life."

Robot improves quality of life for people with dementia

Robot companions help dementia patients - Professor Glenda Cook, from Griffith University, Australia, and colleagues found that a fluffy robotic harp seal - PARO - helped mid-to-late stage dementia patients become less aggressive, anxious and lonely.



Professor Cook with PARO the baby seal
PARO is a baby harp seal robot that comes with artificial intelligence software and tactile sensors. The device can respond to touch or sound, shows emotions, including surprise, happiness and anger. It gradually learns and eventually responds to its own name and certain words if they are repeated often enough.

The researchers reported that PARO had a significantly positive effect on the quality of life of people with dementia. Unlike live animals, which have also been shown to help people with dementia, with PARO there is no risk of injury or infection.

Mediterranean diet lowers vascular dementia risk

People with risk factors for vascular dementia should consider following a Mediterranean dietwith added mixed nuts or extra olive oil. Researchers from the University of Navarra, Spain, reported in the Journal of Neurology Neurosurgery and Psychiatry (May 2013 issue) that such a diet considerably lowers the risk.

Virgin olive oil is the main source of fat in a Mediterranean diet. It also includes large quantities of fruits, vegetables, nuts, pulses, moderate amounts of fish, seafood and red wine, but limited quantities of red meat and dairy products.

In their study, involving 522 participants aged 55 to 80 years, who started off with no cardiovascular disease or cognitive impairment, they were randomly placed into one of three groups:
• The Mediterranean diet with added olive oil group
• The Mediterranean diet with added mixed nuts group
• The control group - they were advised on how to follow a low fat diet that is typically recommended for reducing the risk of stroke and heart attack
After a follow-up of 6.5 years, the researchers found that those in the two Mediterranean diets groups had much lower levels of mild cognitive impairment than in the control group. Mild Cognitive Impairment is often a precursor to dementia.

Omega-3 fatty acids do not reduce cognitive decline in older women, a study carried out at the University of Iowa and published in the journal Neurology found.

How common is dementia?

• United Kingdom - According to a report by the Alzheimer's Society (UK), approximately 700,000 people in the United Kingdom have dementia, out of a total population of about 61 million. Your chances of having dementia are 1 in 100 during your late 60s, this rises to 6 in 100 in your late 70s, and 20 in 100 in your late 80s. As people live longer experts predict dementia will rise significantly. According to predictions, there will be 940,000 people with dementia in the United Kingdom by 2021.
• Worldwide - According to a study published in The Lancet, approximately 24.3 million people had dementia worldwide in 2005, with 4.6 million new cases every year. The number of people with dementia will double every two decades and reach 81.1 million by 2040. The rate of increase is expected to be faster in developing countries which have rapidly-growing life expectancies. (Lancet. 2005 Dec 17;366(9503):2112-7)
Dementia care costing over $150 billion annually in America alone
A study conducted by the RAND Corporation reported in NEJM (New England Journal of Medicine) that caring for Americans with dementia is costing $157 billion annually, more than the treatments for cancer and heart disease. The bulk of the cost is not medications or other medical treatments, but the actual caring for patients either at home or in nursing homes, the authors explained.

Dementia prevalence is closely linked to age - the older people become, the higher their risk. By 2040, with longer lifespans, the financial toll of dementia could double.

Senior author, Michael Hurd, said "The economic burden of caring for people in the United States with dementia is large and growing larger. Our findings underscore the urgency of recent federal efforts to develop a coordinated plan to address the growing impact of dementia on American society."
Hot chocolate helps memory and blood flow to the brain
People who drink two cups of hot chocolate per day may be less likely to experience memory decline, especially when they are older, a team from Harvard Medical School reported in the journal Neurology.

The team was investigating the effect of cocoa consumption on thinking and memory performance, as well as neurovascular coupling, where blood flow in the brain changes in response to local brain activity.

Lead author Farzaneh A. Sorond, said "As different areas of the brain need more energy to complete their tasks, they also need greater blood flow. This relationship, called neurovascular coupling, may play an important role in diseases such as Alzheimer's."

Apparently, regularly drinking hot chocolate improves neurovascular coupling.



Risk factors for young-onset dementia

Young-onset dementia - dementia that is diagnosed before 65 years of age - is associated with nine risk factors, researchers reported in JAMA Internal Medicine.

Their study involved 488,484 Swedish males who had enlisted in mandatory military service between 1969 and 1979. They were followed up for up to 37 years.

The following are major risk factors for early-onset dementia:

• Alcohol abuse
• Depression
• Father having dementia
• High systolic blood pressure when enlisting
• Low cognitive function when joining up (to the military)
• Low height at enlistment
• Stroke
• Taking antipsychotics
• Taking illegal drugs

As most of the risk factors are "potentially modifiable" and began during adolescence, the authors believe they are excellent opportunities for early prevention.

Written by Christian Nordqvist
Copyright: Medical News Today 

http://www.medicalnewstoday.com/articles/142214.php

Post office debuts Rosa Parks stamp on 100th birthday

DETROIT -- The first national unveiling ceremonies for a commemorative U.S. Postal Service stamphonoring civil rights icon Rosa Parks, will be held in Detroit and Dearborn, Mich., on Feb. 4.

Events at the Charles H. Wright Museum of African American History in Detroit and the Henry Ford Museum in Dearborn are expected to draw large crowds, including stamp collectors from around the country, on what would have been Parks' 100th birthday.

The first Rosa Parks Forever stamps will be sold at the Wright museum, with a dedication ceremony starting at 7:30.a.m. The Henry Ford Museum, where the Rosa Parks bus is on permanent display, will host the First-Day-of-Issue stamp event at 10:45 a.m., as part of a daylong celebration dubbed the National Day of Courage.

Parks made history on Dec. 1, 1955, by refusing to give up her seat to a white man on a Montgomery, Ala., bus -- an act that spurred a movement to end legally sanctioned racial discrimination. She and her husband Raymond moved to Detroit in 1957.

Speakers at the Henry Ford event will include activist and former NAACP Chairman Julian Bond and U.S. Rep. John Conyers, a Democrat from Detroit for whom Parks worked as a secretary and receptionist from 1965-88.

"Stamp collectors and other people travel to events like this because they want to be part of history," said Don Neal, editor of "Reflections," a newsletter published by theEbony Society of Philatelic Events and Reflections, a group focused on collecting stamps depicting people and events relating to the experiences of black people worldwide.

As with other first-day stamp events, people attending the Rosa Parks debuts will get to purchase the first stamps issued, in this case, postmarked Feb. 4 and canceled with Detroit or Dearborn postmarks.

"All of these things have value to collectors. It's kind of a neat thing to go to," Neal said.

Other speakers scheduled for the event at the Henry Ford Museum are author and scholar Henry Louis Gates, Newsweek contributing editor Eleanor Clift and Rosa Parks biographers Douglas Brinkley and Jeanne Theoharis. A video message from former President Bill Clinton, who presented Parks with the Presidential Medal of Freedom in 1996, also will be shown.

Parks died Oct. 24, 2005, in Detroit, at the age of 92.

C/O http://www.usatoday.com

Live Online Chats with Alzheimer's Experts

The next Live Chat for those caring for a loved one with Alzheimer's is scheduled for Friday, Nov. 16th at 12 pm EST. What questions would you like to ask the expert? Do you have any tips you'd like to share for capturing memories? Please share and be sure to register for this informative chat.

Please take time to register today:

https://www.helpforalzheimersfamilies.com

Is Long-Term Use of Ginkgo Biloba Effective for Alzheimer’s Disease?

An estimated 5.1 million adults in the United States have Alzheimer’s disease, according to the National Institute on Aging. A common form of dementia, Alzheimer’s disease affects cognitive and behavioral function.

In the later stages of the disease, Alzheimer’s disease significantly affects memory and cognition, resulting in patients being unable to recognize their family members and understand language.

Because of the serious effects of the disease, research has investigated new treatment possibilities. Currently, there is no cure for Alzheimer’s disease.

The U.S. Food and Drug Administration have approved four medications for Alzheimer’s disease: donepezil, rivastigmine, galantamine and memantine.

Rivastigmine and galantamine are for mild to moderate Alzheimer’s disease, while memantine is for moderate to severe Alzheimer’s. Donepezil is used for mild to moderate as well as severe Alzheimer’s.

Some patients have looked into alternative treatments to help with the symptoms of Alzheimer’s disease. One such alternative treatment is ginkgo biloba. The herb contains two components thought to have medicinal effects: flavonoids and terpenoids.

The University of Maryland Medical Center noted that in Europe, ginkgo biloba is used for the treatment of dementia, with the original rationale being that the herbal medicine improved flow of blood to the brain. Currently, it is thought that it protects cells in the brain that are damaged by Alzheimer’s disease.

Possible benefits of ginkgo biloba include improvements in cognitive function, social behavior and activities of daily living, according to the University of Maryland Medical Center.

However, long-term use of ginkgo biloba may not protect users’ Alzheimer’s disease from progressing. A randomized double-blind study investigated the effects of gingko biloba on Alzheimer’s disease progression over five years.

The study included 2,854 participants, who were divided into two groups: a group that received at least one ginkgo biloba extract dose (1,406 individuals), and a group that received at least one placebo dose (1,414 participants).

Article care of:  http://www.empowher.com/alzheimer039s-disease/content/long-term-use-ginkgo-biloba-effective-alzheimer-s-disease

September is World Alzheimer's Month!

World Alzheimer’s Month 2012 - Dementia: Living together

September is World Alzheimer's Month!

September 2012 marks the first global World Alzheimer’s Month, an international campaign to raise awareness and challenge stigma.

The theme for World Alzheimer's Month 2012 is Dementia: Living together.

Alzheimer associations across the world will focus their activities on reducing the stigma associated with dementia and making communities more dementia-friendly by offering a range of programmes and events. Activities will include educational seminars, workshops and enjoyable social events for people with dementia and their carers. Memory Walks will take place in numerous countries with communities gathering to show their commitment to remembering those who they have lost and creating a society where people with dementia and their families can live without the fear of discrimination.

For More info visit:  http://www.alz.co.uk/world-alzheimers-month

GO PURPLE TO END ALZHEIMER'S

GO PURPLE TO END ALZHEIMER'S






September is World Alzheimer's Month. Worldwide, 35 million people and their families are affected by dementia. Join us by raising awareness, reducing stigma and sharing your story. Together, we can help end Alzheimer's.

GO PURPLE!

Wear purple on Sept. 21, Alzheimer's Action Day; then turn Facebook and Twitter purple by changing your profile picture to our END ALZ icon & telling your friends to do the same.
Go purple!

SHARE YOUR STORY!

Whether it's by sharing a diagnosis — or taking action to honor a family member — read how these brave individuals are overcoming stigma & facing Alzheimer's head on.
Be inspired!


BE INSPIRED!

Whether you are a caregiver, family member, person with the disease or friend – tell us how you are fighting stigma and taking action to end Alzheimer's.
Share your story.

Go to:  http://www.alz.org for more info

Home Instead CAREGivers Receive Alzheimer's Training

In mid 2009, the U.S Census Bureau released a report titled An Aging World: 2008. Highlights included the prediction that by 2040 more than 1.3 billion people around the world will be over the age of 65. In many countries, those over age 80 make up the fastest growing segment of the population, one that's predicted to increase 233% between 2008 and 2040. And it's expected that of those over 85, one of every two people will have Alzheimer's disease.

A Global Crisis

Every year, 4.6 million new cases of dementia are reported worldwide -- one new case every seven seconds. The 2009 World Alzheimer's Report estimates 35 million people around the globe are living with Alzheimer's and other forms of dementia. By 2050, the incidence will quadruple, meaning 115 million, or 1 in 85 persons, worldwide will be living with some form of dementia. The number of people with dementia is anticipated to increase by 40% in Europe and 89% in the developed Asia-Pacific countries.

Individual Needs 

To us, these statistics are not just numbers. They are individuals who require special care. They are families trying their best to care for an aging loved one. We know that the best place for a person with memory loss is in familiar surroundings. The services provided by the Home Instead Senior Care^® network of locally involved franchise offices is a valuable, trusted solution to help those struggling with the challenges of dementia to maintain a regular routine, enhancing quality of life. With more than 900 independently owned and operated offices internationally, Home Instead Senior Care is uniquely positioned to provide reliable, one-on-one senior care through more than 65,000 compassionate CAREGivers^SM. Because we've been caring for seniors with Alzheimer's since 1994, we have the experience and knowledge to help millions of families make what can be a most difficult time much less stressful.

Alzheimer's Training for CAREGivers Worldwide

Home Instead Senior Care's Alzheimer's care training programs are an important part of the training we provide. They give CAREGivers the latest in Alzheimer's education and dementia care techniques, so all franchises in your master territory can offer the care of a trusted professional, skilled in dealing with dementia-related issues.

CAREGivers are trained to:

• Maintain a safe environment
• Manage changing behaviors
• Provide nutritious meals
• Provide mind-stimulating activities
• Create social interaction
• Supervise daily activities
• Provide personal care and continence care

In addition, CAREGivers can provide assistance with enhancing and restoring the simple pleasures of life, such as a walk in the park, a ride in the car to get ice cream or spending time in the garden. These elder care activities are proven to maximize abilities and independence, and they remain one of the best treatments for this disease. Home Instead Senior Care's approach of encouragement and assistance helps family members cope with the challenges of dementia. As a Home Instead Senior Care Master Franchisee, you can offer an effective solution for this ever-growing worldwide need.

Visit the National Alzheimer's Association at alz.org or log onto the Alzheimer's Foundation web site at alzfdn.orgfor more information and resources.

Scientists See Progress In Alzheimer's Despite Growing List of Drug Failures

Another once-promising Alzheimer's drug has just been tossed on the pharmaceutical scrap heap.

This time it's a drug called bapineuzumab. Like several previous experimental drugs, it was designed to attack the plaques that build up in the brains of people with Alzheimer's.

And like those earlier drugs, it failed.

The drug company Pfizer issued astatement yesterday saying a study of about 1,300 patients with mild-to-moderate Alzheimer's disease found that bapineuzumab didn't help. Pfizer also announced it was discontinuing all studies of the intravenous form of the drug.

The failure of bapineuzumab is the latest evidence that treating Alzheimer's may not be as simple as going after plaques in the brain.

But scientists remain confident that treatments will need to target the major component of those plaques, a protein called amyloid beta or "A-beta."

"It all begins with A-beta," Robert Vassar, an Alzheimer's researcher at Northwestern University, tells Shots. "If we could limit the production of A-beta in the brain or enhance its clearance out of the brain then I think we could really make some headway in terms of preventing Alzheimer's disease and perhaps curing it."

The question is whether it makes sense to attack the A-beta in plaques that have already formed.

Recently, some scientists have suggested that the sticky plaques actually protect the brain by trapping bits of A-beta. These scientists suspect that it's free-floating particles of A-beta that actually damage brain cells.

If that's the case, drugs would have to eliminate free floating bits of A-beta, not just the A-beta in plaques.

One way to accomplish this may be to interrupt the process that forms A-beta in the first place, researchers say.

Several drugs designed to do this are in the pipeline. And their prospects are looking bright after a study found that people with a gene mutation that reduces A-beta production were much less likely to develop Alzheimer's.

The failure of plaque-attacking drugs may also be a sign that treatments need to begin well before people begin showing symptoms of Alzheimer's.

"My opinion and the opinion of many colleagues is that once the A-Beta begins to accumulate in the brain and a person actually has memory symptoms it may actually be too late," Vassar says.

And ultimately, treating Alzheimer's may require going after A-beta in several different ways, says William Mobley, chairman of the department of neurosciences at the University of California, San Diego. That could mean finding a way to both reduce production of A-beta and remove it from the brain, he says.

"Several shots on goal may be needed," Mobley says.

Article care of : http://www.npr.org 

Health 411: Aging mom may have dementia, and family doesn't know what to do

First, try talking to your mother's doctor. If that doesn't work, you'll need legal documents to gain medical access. There are many resources available for caregivers of aging parents.

• 

(Curtis Parker / For The Times)

My 82-year-old mother has been accusing family members of spying on her, listening in on her phone conversations and entering her home when she's not there, among other things, off and on for about 10 years. She told her doctor she won't talk with us. Is there anything we can do? Are there resources and/or free counseling services to help us work out issues with our mom so we can talk with her doctor?

You can try to contact your mom's doctor to discuss her condition, particularly given that you're concerned she may be suffering from dementia and unable to properly care for herself.

In some states, doctors will talk to a family member about a person's condition even without a legal release, says Garvin Reiter, a certified elder law attorney in Portland, Ore., and a member of the National Academy of Elder Law Attorneys. That's especially true if it is suspected or known that the patient is suffering from dementia.

But if the doctor is aware of a rift in the family, you're unlikely to get through, Reiter says. "They will definitely put up firewalls," he said. In that case, you'd need legal documents to gain access.

When it comes to planning for situations like these, you'll need four legal documents to be fully prepared, said Kathleen Kelly, executive director of the National Center on Caregiving in San Francisco.

The first document is a trust. This allows a family member or friend to manage a person's assets.

The second is a durable power of attorney for finances, which grants someone authority to make financial decisions on another person's behalf.

To make decisions about someone's medical care, you'll need a separate durable power of attorney for health. Finally, an advance healthcare directive allows someone to specify their wishes so they can maintain control over the type of treatment they do — or do not — receive. An advance healthcare directive may also designate a person to communicate those wishes on their behalf when they are unable to do so.

"Having all of those documents together is the biggest gift a person could [give] their family and friends," Kelly says.

Although it sounds like your mom may be tough to reason with, don't assume that setting up a power of attorney for health, which would give you access to her doctors, is out of the question, Reiter says. Dementia is progressive in nature. Until it reaches a stage where all cognitive function is lost, there are moments, albeit decreasing in frequency, when an individual retains the ability to reason. Depending on the stage of her dementia, you may be able to catch your mom at a time when she is lucid and clear-thinking.

To get the necessary legal papers in place, you'll have to demonstrate that she has transactional competency, meaning your mom understands the transaction in front of her at that moment she's carrying it out, Reiter says.

An attorney can help establish your mom's competency and get the legal papers in order. Since laws vary greatly by state, it's a good idea to work with a local attorney with experience in elder law. You can find one in the online directory of the National Academy of Elder Law Attorneys at http://www.naela.org. You can also search for attorneys with experience in this area on the National Elder Law Foundation's website. Go to http://www.nelf.org, click on "About NELF" and enter your state under the heading "Finding a CELA."

If it's too late to get these legal papers together for your mom, you can consider becoming your mom's legal guardian or, as it is known in California and some other states, a conservator, says Sarah Clingman, a certified elder law attorney in Columbia, S.C. Guardians have the authority to make medical, legal and financial decisions on someone's behalf.

But first, you'll need a physician to determine that your mom is incapacitated, Clingman says. Then an independent lawyer will be appointed to represent her interests. Finally, a judge will decide whether to make you her guardian. Keep in mind that this can be an onerous and expensive process. "Guardianship is a last resort," Clingman, says.

There are a number of places you can turn to for assistance in these matters.

Geriatric case managers, who plan and coordinate care for the elderly and disabled, can be very helpful in identifying and navigating the range of needed resources. You can find one through the Assn. of Certified Geriatric Care Managers by visiting http://www.caremanager.org and looking under the "About Care Management" tab.

For information about healthcare documents, estate planning and more, try Help4srs.org, operated by the Torrance-based nonprofit Healthcare and Elder Law Programs Corp.

Services can also be located through the Family Care Navigator on the Family Caregiver Alliance's website, http://www.caregiver.org.

All states have an agency on aging, and the federal Department of Health and Human Services offers an Eldercare Locator at http://www.eldercare.gov to connect families to services for older adults. The department can also be reached at (800) 677-1116.

Article care of Los Angeles Times
For more info: Health 411: Aging mom may have dementia, and family doesn't know what to do