Category: Alzheimer’s and Dementia

As our population gets older people are searching for new ways to keep their minds sharp. No one looks forward to a time when their mental faculties weaken. The latest trend is for older people to play video & computer games, as well as other games requiring mental agility. Millions of baby boomers & beyond are spending many hours each week with games designed to maintain manual dexterity & cognitive powers usually associated with people of a much younger age.

The video game manufacturers are rising to the occasion. They are learning how to market to an audience twice or two times the usual age for these products. In the past the older audience expressed a profound dislike for video & computer games. But now that they are seeing the potential benefits to their memory, attention span & problem solving ability the games seem more attractive.

Some are even saying that by playing these games on a regular basis the risk of Alzheimer’s disease may be reduced. This could also be true for all those adults with attention deficit disorder or dementia.

If you’re thinking about taking up video games as a way to stave off old age, remember that nutrition & exercise also play a large role in maintaining strong memory & other mental functions. A combination of stimulation from a variety of sources is probably the best bet if you want to keep your mind fine tuned.

Cognitive abilities can also be improved by changing your routine, like brushing your hair with the opposite hand or using your non-dominant hand to do laundry or dishes. Physical exercise for at least twenty minutes each day will also keep the blood flowing to the brain & other organs. Playing cards or board games or playing a musical instrument may also strengthen the link between the synapses & neurons in the brain.

The best idea 💡 is to keep your mind stimulated & continue to find new things to be learning. Conversation with a variety of people will also help to maintain mental acuity. A variety of methods, including video & computer games, may be the key to years of enjoying a healthy body & sharp mind.

Connie Ragen Green is a motivational writer, speaker, & mentor. To find out more visit her at http://greenhouse.typepad.com/law_of_attraction

Alzheimer’s disease has to be the most dreaded diagnosis. Right. We live in fear of it… For ourselves. For our loved ones.

Being a caregiver to an Alzheimer’s patient is hazardous to the caregiver’s physical, mental & emotional health.

The sad 🙁 fact is that most Alzheimer’s patients have to be placed in nursing homes, eventually. As symptoms worsen, patient will need round-the-clock-care. Our homes are just not equipped to give proper care. And the toll on the caregiver is monumental.

If you are looking after a parent with Alzheimer’s, you probably know that their symptoms get much worse as the day wears on. This is called “sundowning”.

~~~Reasons for Sundowning~~~

1) patient becomes exhausted as day wears on. Mentally, physically & emotionally.

2) “internal body clock” is messed up

3) as lighting declines, shadows are increased

4) patient becomes disoriented because they are simply unable to separate dreams from reality

5) the elderly have less need for sleep

~~~What Can We Do To Lessen Sundowning?~~~

1) find ways to reduce agitation & sleeplessness

2) plan more active days if patient is up to it.

3) walking, socializing, light exercise

4) attempt to restrict sweets & caffeine to morning hours

5) seek medical advice if bladder & incontinence problems are present & medication to relax

~~~Behaviors For Sundowner’s Caregivers~~~

If patient becomes awake & is agitated, handle with kid gloves.

1) approach parent in calm manner

2) find out what they need & want

3) they will be disoriented so gently remind them of time of day

4) do not argue & demand explanations

5) reassure them with kindness, hugs & emotional warmth

For the caregiver & the Alzheimer’s patient, sundowning is a wretched part of the day. As you tend to your parent with Alzheimer’s, please take care of yourself as well.

(c) 2007 Karen Cook

For more information on Alzheimer’s & caring for a loved one with Alzheimer’s disease, drop by http://helpalzheimers.blogspot.com

Karen Cook works in a Public Library where she helps care givers find information & gives them a shoulder. Karen was sole caregiver to her Mom who resided with Karen until her death in 2006.

Amnestic disorders are characterized by inability to learn new information with the ability to recall very remote information. These disorders along with dementia & delirium were once called organic mental illnesses. But as most or all the mental illnesses have organic basis, the word organic is no more is in official use. Anything that damages the hippocampus-fornix-mammillary body-thalamus circuits can produce an amnestic disorder. In practice the most common causes of amnestic disorder are –

1. Head trauma

2. Wernicke-Korsakoff syndrome

3. Stroke

4. Neoplasm

5. Herpes encephalitis

6. Anoxia

7. Hypoglycemia

8. Surgical procedures that disrupt medial temporal structure

There are some situations that can cause transient amnesia. They are –

1. Epileptic convulsions

2. Ischemic episodes

3. Transient global amnesia

Amnestic disorder can be further divided into the following categories –

1. Amnestic disorders caused by some general medical condition that include posttraumatic amnesia, poststroke amnesia etc.

2. Substance induced amnestic disorder that mainly shows the amnestic outcome of alcohol & benzodiazepine use.

Another variety of disorders other than amnestic disorders, can be described in brief with these. It is mental disorders due to a general medical condition. It has three main categories –

1. Catatonic disorder

2. Mental disorder not otherwise specified

3. Personality change

The personality changes are described as labile, disinhibited, aggressive, apathetic, combined, unspecified etc. Catatonic features are usually immobility, staring, mutism, withdrawal, refusal to eat, posturing, grimacing etc. Treatment of all these include symptomatic approach & treatment of the underlying disorder. A common drug used for such psychiatric problems is Lorazepam. But it must be prescribed & used under the supervision of duly authorized medical person.

About the Author:

Dr. Mohammad Samir Hossain PhD is a researcher teacher of Psychiatry & a Psychotherapist in Bangladesh. He is renouned for his educational & research activity in mental health sector nationally & internationally. The Dictionary of International Biography cites his brief biography starting from its 33rd edition. One of the best educational institutions involved with his educational activity is the Harvard Medical School of USA. Visit his personal page at http://www.samirhossain.org

“This is the first time I have heard about it” was her distressed reply. “You never told me.” She accused.

I am learning how to make plans for my wife & me. If I do not communicate them to her repeatedly, or slow enough for her to grasp, when it is time to implement them she may become confused & defensive. Not knowing what to do, she will then rebuff me. “This is the first time I have heard about it.”

We have worked out a monthly calendar for recurring events & use “sticky notes” to add unscheduled events. This routine usually works. Right. When I am away from home & know she may forget, a pleasant phone call will alert me if she needs a reminder or if she is in the process of getting ready for her luncheon, appointment, or errand. Just a quick, “Hello, how’s it going?” will usually do the trick.

Over the years, due to various working hours in my wife’s career as a nurse I have often assumed a primary role in making decisions in our home & family life. . I do not intend to always be in control…as this has negative implications, howeverin the growing need for assuming the role of caregiver I am faced with this necessity. My patience often is stretched, leaving me angry, lonely, exhausted or overwhelmed.

In our marriage my wife & I have always worked together at using our individual strengths & weakness to complement each other in a team effort to get things done. I have always done the bill paying, planning, problem solving, arranging for repairs & maintenance, inside & out. We usually have had outside help to come in do cleaning, etc. We taught our four boys to share in the routine responsibilities. Now in retirement years, my wife had assumed many of these household duties.

Recently it has become more practical for me to take on evening meal planning to keep us on some kind of reasonable schedule. My wife still enjoys shopping, but often over shops, purchasing more of what’s already on our shelves & omitting priority items on her list.

Because a sense of independence is very important to each of us as individuals, I attempt to be very careful to be subtle in the area of assuming new roles & affecting new limitations, as we move forward in our journey together. In many ways our roles have changed she from mother & nurse, to a child & patient, & me from a supporting role as husband to the new role of caregiver.

On a positive note, my wife is always an encourager. She can still build my ego, & regularly assures me of her love. For this I will be forever grateful.

Richard R. Blake, Christian Education Consultant, Book Store Owner

Dementia refers to certain symptoms that ultimately lead to loss of functions of the brain as a side effect of some physical or mental illness. A common misconception about dementia is that it is described wrongly as a disease. It actually consists of symptoms of a functional disorder & is not a disease in itself… Symptoms of dementia may lead to lack of abilities in certain areas such as problem solving, loss of memory & confusion. Dementia is often found in elderly people as a harmful side effect of some mental illness, such as Alzheimer’s, & might reflect as an after-effect of a medical treatment. OK. Symptoms of dementia might occur due to vitamin deficiencies, head trauma, or Parkinson’s disease. Dementia is mostly incurable with some rare exceptional cases. It is definitely not an easy task to provide home care for Dementia going by the nature of Dementia & its various symptoms.

While providing home care for patients suffering from Dementia, special considerations are required. Frequent change in routines & turnover of staff providing home care can have adverse effects on Dementia patients. It is highly recommended to ensure minimum turnover of staff & changes in support procedures. Persons providing care for Dementia need to have special training for handling Dementia patients that can be acquired from various organizations dealing with Dementia care.

Diseases such as Alzheimer’s & related symptoms of dementia are usually chronic; they can last for ten years or more after they are diagnosed. These symptoms may include paranoia, anxiety, aggression, or agitation, making persons hard to handle while providing home care. Appropriate support & care is thus required for patients as well as their families. Nature & intensity of care might again fluctuate as patients may go through different stages of effect of medication & treatment.

Most families have started forming self-help groups to provide mutual support, as it is hard & emotionally draining to provide care to terminally ill patients. Professional help is always recommended even though the family remains the core of a home care system. Community programs also play a significant role in improving the service & providing support. Necessary Government approval is also an important requirement for providing professional care for Dementia patients at home.

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There is still a lot of study going on in relation to neurological disorders such as Alzheimer’s disease. Since it is incredibly hard to study the mind, breakthroughs & advances in this area are very slow & require more study than other parts of the body. At this point, there has been some study that is suggesting that low levels of vitamin b12 in the body will contribute to the formation of neurological disorders such as Alzheimer’s disease. Alzheimer’s & vitamin b12 sublingual come together as the vitamin works to fight against the disease.

Several tests have been done that weigh Alzheimer’s & vitamin b12 sublingual & a good number of them show that those that are afflicted with these disorders have low levels of the vitamin b12 in their system. This is by no means conclusive, yet it is suggestive which would make me believe that making sure a daily vitamin b12 supplement may be help-fulto those in the early stages of the disease. Alzheimer’s & vitamin b12 sublingual are making the point that this vitamin can fight the neurological diseases. Making sure that there is a regiment of b12 every day as one enters old age may be a way to fight the onslaught of the disease.

Since there is very little known about people that may be at a higher risk for Alzheimer’s, it would make sense to fight Alzheimer’s by pairing the threat of Alzheimer’s & vitamin b12 sublingual. As there have been studies that suggest a lower level of this vitamin may lead to the neurological disorder that so many people suffer from in their old age, it would make sense to battle this disease by taking the vitamin. The vitamin itself will often help you to feel more energized which is certainly never a bad 😥 thing.

If you regularly take the vitamin b12 sublingual not only will you potentially fight off Alzheimer’s disease, but you will be easily able to increase your focus on tasks that are before you… You will not have to worry about your mind wandering off topic because the vitamin will help it to stay where it belongs. In addition to being more focused, the b12 sublingual vitamin has been proven to improve your mood. This means that while you are focused on getting things done, you will keep your focus on the positive.

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alzheimers & vitamin b12 & sublingual

Vascular dementia (VaD) is caused by inadequate functioning of the supplying vessels in the brain. Vascular inadequacy is the second most common cause. Men are more vulnerable & usual age of onset is after 60 years. Risk factors for VaD are hypertension, heart disease, cigarette smoking, diabetes mellitus, excessive consumption of alcohol, & hyperlipidemia.

Strokes cause Vascular dementia in many ways. Both intra & extracranial vessels can be involved. According to the prevalence rates the most common causes are subcortical lacunar infarction, extracranial atherosclerosis, multiple cerebral emboli etc. Mixture of more than one stroke is also common in cases of VaD. Volume, number & location of infarction are the factors that modulate the dementic outcome of after a stroke. But among these location of infarction is the most important factor.

Clinical features of Vascular dementia are abrupt onset, stepwise progression, fluctuating course, depression, pseudobulbar palsy, history of hypertension, history of strokes, evidence of associated atherosclerosis, & focal neurological signs & symptoms. Ischemia score can help differentiate in between VaD & DAT. If the Hachinski ischemia score is 4 or less then the diagnosis should be DAT. But if it is 7 or more then it should be VaD.

VaD is diagnosed with the help of different neuroimaging techniques in presence of the following clinical features present in a patient –

1. Memory impairment
2. Cognitive disturbances like aphasia, apraxia, agnosia etc
3. Impairments cause significant practical disturbances
4. Presence of neurological or laboratory findings in support of causative cerebrovascular disease
MRI is the most useful & important neuroimaging technique for the diagnosis of VaD.

VaD is treated with the target to halt the progression of cognitive deterioration & for optimization of the intact cognitive capacity. So the following steps are taken for the above purposes –

1. Management of risk factors
2. Intervention for medical illnesses
3. Treatment of psychiatric illnesses

But as long the risk factors can also be the causative factors, preventive measures are very important so that situations or diseases risking us for VaD do not occurs.

About the Author:

Dr. Mohammad Samir Hossain PhD is a researcher teacher of Psychiatry & a Psychotherapist in Bangladesh. He is renowned for his educational & research activity in mental health sector nationally & internationally. The Dictionary of International Biography cites his brief biography starting from its 33rd edition. One of the best educational institutions involved with his educational activity is the Harvard Medical School of USA. Visit his personal page at http://www.samirhossain.org

Other categories of dementia worth mentioning are dementia due to Pick’s disease, dementia due to Creutzfeldt-Jakob disease, dementia due to Huntington’s disease, dementia due to Parkinson’s disease, dementia due to HIV disease, substance induced dementia, & dementia syndrome of depression.

Dementia due to Pick’s disease is a variety of frontotemporal dementia. In it there is progressive reduction of speech, loss of insight & stereotyped, perseverative behaviors, together with relatively late onset of memory & visuospatial disturbance. SPECT & PET are the two most useful imaging technique for diagnosis it.

The infectious agent for Creutzfeldt-Jakob disease is the Piron. Clinical deterioration is very rapid in this dementia. Progressive decline with death within one year is common for this problem. Intellectual devastation, myoclonic jerks, muscle rigidity, & ataxia are some features of this illness. EEG, functional imaging & biopsy are some useful techniques for this illness.

Dementia in Huntington’s disease occurs due to some idiopathic, inherited, autosomal dominant neurodegeneration. It starts after 40 years of age & deteriorates to the extreme in around 17 years course. Irritability, apathy, depression, mania, defective cognition, memory retrieval deficit etc are common features. Absence of aphasia helps to differentiate it from DAT. CT or MRI can be very useful for the diagnosis of this dementia.

Prevalence of dementia among Parkinson’s Disease patients is about 25%. It is noted especially among late onset patients. Presentation of dementia in PD is complicated that mainly represents degeneration of subcortical ascending system with neuronal loses in multiple neurotransmitter related systems.

HIV type 1 causes dementia. It causes atrophy & demyelination of subcortical white matter. Three subtypes are seen among HIV type 1 seropositive patients. There is more. They are subcortical, cortical & non affected variety according to the neuropsychiatric impact. OK. Substance induced dementia is mainly seen in persons with alcohol abuse.

Depression can cause dementia syndrome that is called pseudodementia. But dementia & depression can occur due to the same underlying pathology. Other causes of dementia include mainly the structural damage to the brain in different situations. But causes like brain tumor, vitamin B 12 deficiency are also there in the enlisted causes.

About the Author:

Dr. Mohammad Samir Hossain PhD is a researcher teacher of Psychiatry & a Psychotherapist in Bangladesh. He is renouned for his educational & research activity in mental health sector nationally & internationally. The Dictionary of International Biography cites his brief biography starting from its 33rd edition. One of the best educational institutions involved with his educational activity is the Harvard Medical School of USA. Visit his personal page at http://www.samirhossain.org

Among all the patients with progressive cognitive decline about fifty percent suffers from Dementia of Alzheimer’s Type (DAT). The risk of developing DAT increases with age. Other risk factors including genetics are also present. Macroscopic features of a DAT brain are cortical atrophy, widening of sulci, & ventricular enlargement. Microscopic features of the same are –

1. Neuronal loss
2. Neurofibrillary tangles
3. Neuropil threads
4. Neuritic plaques 5. Dystrophic neuronal processes
6. Granulovacuolar degeneration
7. Amyloid angiopathy

In DAT the most severe pathological change occurs in medial temporal lobe. The first changes are seen in the entorhinal cortex. The location & number of lesions are the main factors behind clinical features of DAT.

DAT usually starts after the age of 50 years. It is progression it too silent to be noted by the family members initially. Initially the patients are more rigid, inflexible, less adventurous, more irritable, & less spontaneous. There is more. The overall quality of performance declines & patient becomes gradually dependent on others. There is more. The patient deteriorates over months or years, very especially on the aspect of cognitive function. In case of patients with concurrent medical illnesses dramatic deterioration may occur. Independence of the patient’s daily activity gets severely hampered. Psychotic features like delusion, hallucination often develop. In the end the patient fails to recognize their family members or even their own face. Seizures are seen at the late stage of the disease. The final stage of the disease is usually characterized by the followings –

1. Incontinence of urine & feces
2. Loss of intelligible vocabulary
3. Difficulty in walking & sitting up

The diagnosis of DAT mainly requires gradual, progressive development of multiple cognitive deficits. Both memory impairment & cognitive disturbances are included in these deficits. Patient fails to remember three unrelated words for 3 minutes. Cognitive disturbance patterns are more or less consistent with those described in the introductory portion of dementia.

For the purpose of treatment the following steps are necessary –

1. Control of abnormal behavior related to the disease
2. Attempts to restore cognitive functions
3. Attempts to delay cognitive decline

The above three purposes are connected with pharmacotherapy in the line of the biological abnormality present. Other environmental approaches are also important.

About the Author:

Dr. Mohammad Samir Hossain PhD is a researcher teacher of Psychiatry & a Psychotherapist in Bangladesh. He is renouned for his educational & research activity in mental health sector nationally & internationally. The Dictionary of International Biography cites his brief biography starting from its 33rd edition. One of the best educational institutions involved with his educational activity is the Harvard Medical School of USA. Visit his personal page at http://www.samirhossain.org

Alzheimer’s disease, having no sure diagnosis in the patient’s lifetime & no cure, has a tremendous impact on the lives of patients as well as their family members. More & more adults are finding themselves filling the role of sole caretaker of an elderly parent or other family member who has Alzheimer’s disease, & enduring all of the worry, stress & unpredictability that inevitably accompany such responsibility. The degenerative nature of the disease makes initial diagnosis of probable Alzheimer’s disease a challenge, & the profound effect it has on a patient’s ability to think logically can make it hard to reason with the patient regarding the most suitable arrangement for her or his health care.

In the early stages of Alzheimer’s disease, many patients are unable to distinguish or unwilling to acknowledge that they may be experiencing a decline in judgment, mental ability & memory. Additionally, Alzheimer’s disease develops in elders, who generally have cared for themselves for decades & are resistant to the notion that another person has the power to determine that they may no longer be capable of doing so. Often, family members such as patients’ adult children are among the first to notice changes in a patient’s behavior, prompting the need to visit a doctor for analysis. Even if a family member who is showing signs of dementia is reluctant or obstinate, taking him or her to a specialist for evaluation is an important step in order to rule out certain conditions & to determine if Alzheimer’s disease is a likely culprit for changes in behavior. In the case that a patient is diagnosed with the disease, part time or full time care may be required.

Depending on the stage of Alzheimer’s disease, a patient may need periodic care or may require 24 hour constant supervision. Patients often move into the home of an adult child or into an assisted living community for Alzheimer’s patients. A major challenge associated with Alzheimer’s disease is the emotional & financial toll it takes on caregivers, which are usually family members who begin to spend many hours each week attending to the basic & medical needs of the patient. The degenerative nature of Alzheimer’s disease makes it increasingly complicated to fulfill the basic needs of a patient, with many becoming unable to cook, eat & bathe on their own over time.

Sole care givers of Alzheimer’s patients often exhibit high rates of stress & depression related to the extent of responsibility. Caregivers can ease the burden by becoming educated about the physical & mental changes that are affecting their loved one, so as to better understand how to most effectively respond to her or his behavior. Many care givers find relief in the company of others who are experiencing similar circumstances at support group meetings for Alzheimer’s caregivers.

About the Author: John Trevey is the C.E.O. of Uncommon Care, an assisted living Austin Texas home specializing in Alzheimer’s care. He is the manager of both The Barton House & the Breckinridge. For lots more information, please visit http://www.uncommoncare.com