DementiAwareness

Find me at http://dementiawareness.com

2010-06-30T17:13:00.004-04:00

That's right! I've purchased my own domain: dementiawareness.com You can find me there, from this day forward. I'm in the process of moving in and setting up shop, so please let me know if you notice anything amiss.

Thanking you in advance,
Amber Smith

A call for mainstreaming people with Alzheimer's; 'what's the harm in that?'

2010-06-23T20:37:00.008-04:00

As soon as a person is diagnosed with dementia, friends often disappear--even quite early on when the person is just a bit forgetful.

"They think it might all be a bit too awkward," Julian Hughes says of the friends.

"But attitudes must change. Those friends can adjust, let the conversation go with the flow, accept the person with dementia may be living within a few minutes of experience, so you may have to repeat your stories. But what's the harm in that? If they are enjoying it, then it's still a meaningful experience."

Hughes is a British psychiatrist who specializes in aging--his academic interest is the notion of personhood--and recently he spoke throughout Australia, calling for mainstreaming of those with Alzheimer's and other dementias and for governments to recognize this significant health issue. He also made the point that research funding for Alzheimer's lags hugely behind other areas, such as cancer. "As the numbers (of diagnosed) rise, funding will need to increase by a factor of six to eight times to keep pace," Hughes points out.

Dementia is the third-leading cause of death in Australia, behind heart disease and stroke. About 257,000 Australians have dementia today, and that's expected to rise to more than a million by 2050.

In America, deaths from Alzheimer's disease are almost equal to those from diabetes, and both rank below heart disease, cancer, respiratory disorders and accidents. But that's expected to change in the coming years, as Baby Boomers begin hitting age 65. Today, 5.1 million Americans have Alzheimer's disease; that number will climb to 13.5 million by 2050, says a report from the Alzheimer's Association, which says the costs of care will inevitably rise, too, from $172 million today to more than $1 trillion by 2050.

Read the story in The Australian.

Read my previous post about the rising cost of Alzheimer's.

Apple juice found helpful for those with Alzheimer's disease

2010-06-21T21:57:00.008-04:00

Behavioral and psychotic symptoms related to dementia seem to improve when people with moderate-to-late stage Alzheimer's disease regularly drink apple juice.

That's what researchers from the University of Massachusetts found in a study published in the June 2010 issue of American Journal of Alzheimer's Disease and Other Dementias.

For their study, the researchers assigned 21 individuals with moderate to severe Alzheimer's disease to drink a 4-oz glass of apple juice twice a day for one month.

Though caregivers reported reduction in anxiety, agitation and delusion, the individuals with dementia showed no changes in the Dementia Rating Scale.

Previous studies have suggested that apple juice may provide health benefits including reduction of central nervous system oxidative damage, suppression of Alzhiemer's symptoms, improved cognitive performance and more organized synaptic signaling. Thomas Shea says other researchers have shown similar effects with blueberries. "We have also shown similar effects with purified vitamins and nutriceuticals." Shea is professor of biological sciences and Director of the Center for Cellular Neurobiology & Neurodegeneration Research at Massachusetts.

Would apple juice be helpful in people with other dementias?

"We saw in mice that apple juice boosted neurotransmitter production, so it might help us all with mood, and the major effect would be seen on those individuals, disease or not, that had behavioral issues," he says. "However, it is certainly worth a try."

Shea says he would like to compare apple juice with apple cider in another study because "cider has the potential benefit of being fresher, and less processed."

Read the article from FoodConsumer.

Read the abstract from the American Journal of Alzheimer's Disease & Other Dementias.

Donate for Memory Walk through DementiAwareness, get your loved one on this blog

2010-06-18T21:48:00.005-04:00

While I'd love to have a huge group of people walking together at Long Branch Park Oct. 2 for the Alzheimer's Association's Memory Walk, I know that life sometimes gets in the way!

If you'd like to join us, but can't, let DementiAwareness walk in honor or memory of your loved one. Make a donation of $50 or more through our team, and we'll post your loved one's photo on this blog through the end of October. (See my example at left.)

Now, if this recession is hitting you like it's hitting me, you may appreciate this reminder: participation in the Memory Walk is free. You can raise awareness regarding Alzheimer's and other dementias just by showing up--and that costs only your time.

Join the DementiAwareness team.

Make a donation to the Memory Walk on behalf of DementiAwareness.

Learn more about the Memory Walk.

Honoring Dads who are being stolen by dementias

2010-06-18T20:35:00.004-04:00

Since I really could not have said it better myself, I'm turning my blog over to Loren B. Shook in honor of Father's Day. He is president and chief executive officer of Silverado Senior Living. My Dad residents in one of Silverado's 34 facilities. Here's Mr. Shook:

All of us fortunate enough to grow up with loving fathers are who we are today thanks to the lessons they taught us. Whether it was how to fish, ride a bike, or throw a baseball, or the values of hard work, integrity, kindness and strength, what Dad showed us decades ago remains at our core.

As one who works with the memory-impaired, I believe the growing number of now-elderly fathers whose memories are disordered are teaching us a new kind of lesson. Understanding this lesson can resolve the anguish many of us so-called "adult children" of those with Alzheimer's disease are feeling as Dad's recognition of us and his ability to communicate slip away.

It's the lesson of selfless love.

Time and again, I hear the same question from sons and daughters: "Why should I visit Dad if he doesn't know who I am and if he won't remember I was there?" Written out, it sounds shocking, but when spoken, it's always tinged with profound sorrow and hurt. It's understandable. When a father is so much a part of your own being, who are you if he no longer knows you?

My answer is always this: Your father needs you now more than ever, and what he needs from you is simpler than ever, too. Because the greatest pleasure you can give your father now is the gift of your time and your presence. You see, the worst pain suffered by the memory-impaired comes from their sense of loneliness and worthlessness. Just as you may feel that your father's condition has come between the two of you, he feels increasingly isolated from the world and from the things that have always mattered. It's no wonder that depression goes hand-in-hand with memory impairment, and sadly, it further aggravates health, both emotionally and physically.

While your dad might no longer realize who you are or greet you by name, it's more important than ever for you to spend time with him. Just being at his side brings him greater joy than you can likely even imagine. He may not be able to express this pleasure in a way that you understand, or that the world at large comprehends, but without a doubt, he feels it and he feels that he is loved. In this way, you are nourishing his spirit, and the value of this is indescribable.

So I encourage you to take the occasion on Father's Day to honor your dad in this way. Whether he resides in a senior care community or is receiving care in his own home, visit him and stay by his side for a while. Even if you can't have the kind of conversation you used to have, there are still ways to make the time together meaningful.

The great thing is that they're simple. If he has always loved a certain kind of music, bring a CD of it and listen to it with him. Those fishing trips and baseball games Dad took you to when you were a child? If you have pictures of them, go through them. Long-term memories are more durable than short-term in the memory-impaired, and I am certain he will enjoy looking through those photos with you. Even a box of candies that he has always fancied can brighten his day.

Yes, I know, after you leave you will have no assurance that he will remember that you were there.

But understand that it doesn't matter.

What matters is that during the time you spent with him, he knew he was loved, and that intangible emotion will definitely have a lasting positive impact on him.

The longer that I work with those with memory-impairment, the more clearly I understand the importance of something that I once heard: that it's when you give a gift selflessly that you will get the most in return. When you give your love selflessly to your father, not only will he benefit, but you will, too. You strengthen his spirit and your own.

So you see, your dad is still teaching all of us a very important lesson.

Thank you, Mr. Shook.

Make a $250 Memory Walk donation, and your busienss gets an ad on this blog

2010-06-18T17:50:00.001-04:00

If your company makes a donation of at least $250 to the Alzheimer's Association 2010 Memory Walk through my DementiAwareness team, here's the deal: I'll give your company an ad on my blog from now to the end of the year -- free.

This is the primary fundraiser for the Alzheiemer's Association, with a series of Memory Walks taking place throughout the country. Ours here in the Syracuse area is a 3-mile walk starting at 9:30 a.m. Saturday, Oct. 2, at Long Branch Park.

I'm honored to be asked to serve as honorary chair.

If you don't know someone with Alzheiemer's disease or another dementia, or someone caring for a person who is afflicted, chances are very good that you will in your lifetime. And more than one.

A growing number of people are dealing with a dementia, either as patients or caregivers. More than 5.3 million Americans have Alzheimer's, which is thought to only represent 60 to 80 percent of all dementias. It's a disease that affects primarily older people. And with the first of the Baby Boomers turning 65 in 2011, many health experts are saying we are not adequately prepared.

One of my roles as honorary chair of the Memory Walk is to make sure businesses understand the impact this disease has on their workers. It's profound. Sure, there are signs and symptoms of Alzheimer's, but often it sneaks up before a family realizes their matriarch or patriarch is so afflicted. One day, a dutiful daughter is a hard-charging career woman, and the next, she's struggling to take the car keys away. Caregivers are thrust into a role that is, quite simply, overwhelming. The stress is constant and can be debilitating. (Read more of my blog for multiple posts by and about caregiver issues.)

This disease is not just a personal medical issue. It is already making a huge impact on our nation's health care system and the insurance industry--the cost of the disease is estimated at $20.4 trillion over the next 40 years, by the way. Businesses large and small are impacted not only in increasing health costs, but in worker absenteeism when one must care for a loved one.

Donations to the Alzheimer's Association go toward care, support and research. Dollars raised at the Syracuse Memory Walk stay right here in Central New York. Remember, if you donate through DementiAwareness, I'll put your ad on my blog through the end of the year. (The sooner you donate, the longer your ad appears!)

Need more information? Email Amber Smith at amberink@twcny.rr.com with "Memory Walk" in the subject line. Thanks!

Finding a link between PTSD and dementia raises the question of why

2010-06-17T20:16:00.006-04:00

Male military veterans with PTSD were found to have a nearly 2-fold-higher risk of developing dementia, compared to those without post-traumatic stress disorder, an anxiety disorder that is highly prevalent because of combat. Results of a study into this link are published in this month's Archives of General Psychiatry.

The study involved 181,093 veterans 55 years or older without dementia from 1997 through 2000. Between 2000 and 2007, researchers discovered 17 percent of the men developed dementia, according to the abstract by Dr. Kristine Yaffe and colleagues at the University of California, San Francisco, and San Francisco Veterans Affairs Medical Center. They presented their work last year in Vienna at the International Conference on Alzheimer's Disease.

"Mechanisms linking these important disorders need to be identified with the hope of finding ways to reduce the increased risk of dementia associated with PTSD," they write. Some theories: that PTSD contributes to the cause of dementia, that chronic stress plays a role, or that stress damages the hippocampus or cause alterations in neurotransmitter and hormone levels that could precipitate dementia.

Finding a link between PTSD and dementia was not entirely surprising. "We already know that traumatic brain injury and certainly chronic stress increase the risk of cognitive decline and what this paper refers to as 'accelerated aging,' which may in turn lead to early dementia. So it makes sense that PTSD would increase the risk for dementia in the long run," Maria C. Carrillo, a senior director for the Alzheimer's Association, told Medscape.

Read the Medscape article.

Read the abstract from the Archives of General Psychiatry.

New York's new 'gold alert' is like 'Amber alert' for adults with dementia

2010-06-16T21:00:00.010-04:00

New York has a new "gold alert" alert system for vulnerable and elderly adults, with passage by the Senate of legislation sponsored by Senator David J. Valesky (D-Oneida.)

“Too many lives have been lost as a result of adults with cognitive impairment wandering from home,” the senator says in a news release. “The Gold Alert puts their safety, and the peace of mind of their families, at the forefront.”

Searching for lost adults with dementia is nothing like searching for lost children.

The legislation builds on the existing statewide Amber Alert system used by law enforcement to alert the public to missing children.

The Alzheimer’s Association says more than 60 percent of people with dementia will wander away from home at some point. Studies have shown that 50 percent of those who are not found within 24 hours are at serious risk for injury or death.

In order to prepare local officers for gold alerts, the new program will develop training for law enforcement that helps investigators identify and manage cognitively disabled adults. In addition it creates a toll-free 24-hour hotline that residents can use to report a missing loved one.

Read about the legislation, which included other quality of life measures for seniors.

Read Valesky's news release.

Please join me at the Syracuse Memory Walk Oct. 2 to raise money for Alzheimer's

2010-06-16T19:59:00.010-04:00

The main fundraiser for the Alzheiemer's Association is a series of Memory Walks that take place throughout the country. The one in the Syracuse area happens at 9:30 a.m. Saturday, Oct. 2, at Long Branch Park. I'm honored to be asked to serve as honorary chair.

This 3-mile walk raises money for Alzheimer's care, support and research right here in Central New York. Please, join my team. It does not cost anything to walk. Of course, walkers are most welcome to make a donation of any amount. (Donate or raise $100, and you earn a 2010 Memory Walk T-shirt.)

Sign up here to join my DementiAwareness team.

You may make also make an online donation--and know that any amount is appreciated.

If you can't make the Syracuse walk, four other Memory Walks take place in September in the Central New York region, including St. Lawrence, Jefferson-Lewis, Southern Tier and Mohawk Valley.

Locating genes for clues to Alzheimer's risk, cause, diagnosis

2010-06-14T20:57:00.007-04:00

Neuroscientists have zeroed in on some target genes that may be tied to the development of Alzheimer's disease, and they've shown what abnormalities appear on brain scans of people with these genetic variations.

Both bits of scientific progress are incremental steps toward understanding what causes the disease that afflicts more than 5 millon Americans. The study, lead by researchers in Boston and Cambridge, Mass., England and Wales, appears in this month's Archives of Neurology.

"The drought of genetic findings in Alzheimer's disease has lasted a long time," write scientists based in London and Wales in an editorial accompanying the Archives study. "These findings, and the genome-wide studies that presaged them, mark a new period of optimism for those of us who study the etiologies of complex diseases of the nervous system."

The study explains the association researchers made between genetic loci that are related to Alzheimer's disease and neuorimaging measures that are related to disease risk. (These measures include the volume of the hippocampus, amygdala and other brain structures.) They identify B1N1 and CNTN5 as additional specific locations of genetic variants on chromosomes, but say their findings warrant further study.

Just one genetic variant, known as APOE, has been shown to influence Alzheiemer's disease risk and age at onset, lead authors Drs. Alessandro Biffi and Christopher Anderson write in their background information.

Study participants included 168 people with probable Alzheimer's, 357 people with mild cognitive impairment, a precursor to Alzheimer's, and 215 people who were cognitively normal. "Our results indicate that APOE and other previously validated loci for Alzheimer's disease affect clinical diagnosis of Alzheimer's disease and neuroimaging measures associated with the disease," they write.

Will that bring us closer to genetic tests for Alzheimer's?

Somewhat, John Hardy, of the University College London Institute of Neurology, says in an email, "but I think this genetic determinism argument is oversold, frankly.

"About 5 percent of the population are at high risk. About 30 percent of the population are at a moderate risk, and about 65 percent are at lower risk. These numbers are little changed by the new data. And, this is not really so useful for genetic testing."

Read the study in the Archives of Neurology.

The National Institute on Aging's fact sheet on Alzheimer's disease genetics.

What is it like to have dementia?

2010-06-11T06:47:00.010-04:00

What's it like for Dad, I've often wondered. Is he frustrated, trapped in a body with a malfunctioning mind? Does he understand that he is deteriorating? Did he, at the beginning?

Would I know, at the beginning, if I were to develop Alzheimer's? I don't want to suffer with a dementia; could I create a way out for myself now, in the event I lose my mind later?

That was one of the main character's thoughts in Lisa Genova's heartbreaking/inspiring/terrifying novel, "Still Alice." A neuroscientist, Alice Howland develops early-onset Alzheimer's disease. (The paperback, published by Pocket Books, sells for $15.)

It's a compelling question: What is it like to have dementia?

So when I got an email from WebMD with that subject line, I had to read more.

Writer R. Morgan Griffin does a good job of explaining how caregivers help themselves, and their loved one, by understanding what the disease is like for the person who has it. An excerpt:

Some people think of memory loss superficially, as merely forgetting words or names. But it’s much more profound than that. Everything we do is premised on memory. When you walk into the kitchen to make dinner, your actions are almost unconscious. You grab food from the fridge, turn on the oven, take out plates and silverware – your memories are a foundation, and they give you a context for what you’re supposed to do in a given situation.

For a person with dementia, that context is ripped away. A woman with Alzheimer’s disease may walk into a kitchen and have no idea why she’s there or what she’s supposed to be doing. She might still be able to make dinner – especially in the early stages of the disease – but it’s a struggle. Each step has to be reasoned out and thought through. That’s why people with dementia tend to act more slowly than they once did.

The rest of the article is full of additional observations and explanations. Read it, and you'll find yourself saying, "so that's why my Mom does..." or "that explains why Dad did..."

Understanding dementia from a patient's point of view can make caregiving less frustrating. Knowing the patient personally is important, too.

We fretted over how to convince Dad that he needed to live in a memory care facility. Stubborn and independent, he was unlikely to admit he needed help, that it was for his safety. Tell him he had dementia and he'd appear quietly stunned--and you could not tell if he was processing the information, angry about it, or considering what those words meant. But he was still Dad.

The facility we were considering, Silverado, had a calendar of events planned for the residents, and one of the outings was to the State Fair of Texas. Since Dad had run the midway there for years, we figured that would be an ideal day for Dad to visit Silverado. He knew Silverado was for people with various types of dementia, and he knew the residents would need help getting around the fairgrounds. He found a purpose in acting as their guide. Soon he began believing Silverado was where he worked--he returned home in the evenings to sleep at first--and the staff kept him busy stuffing envelopes and such. When I'd call, he answered the phone as he always had answered his work phone: "Cleveland Smith, may I help you?"

It broke my heart. But, I recognized Dad had found a way to cope with his diagnosis. So had we. We joined reality with his reality, and together we were understanding what it is like to have dementia.

Read more from Amber Smith, "What would Dad say about this blog?"

Read Bruce Bane's blog about living with dementia: "He Reminds me of my Dad."

Read the WebMD story, "What is it like to have dementia?"

Cases of doggy dementia go undiagnosed

2010-06-08T22:04:00.014-04:00

Dogs get dementia, too.

It's called canine cognitive dysfunction.

And it's especially interesting, from a research point of view, because canine brains more closely resemble human brains than those of laboratory rats. Also, since so so many dogs are members of human families, they are subject to many of the same environmental factors as humans.

Most senior-age dogs with dementia go undiagnosed, according to a recent study in The Veterinary Journal. Veterinary scientists at the University of Sydney studied 1,000 dogs and found 14 perent had dementia. Only about 2 percent had been diagnosed. (Researchers found no appreciative difference among breeds, by the way.)

''Like dementia in humans, canine dementia often ruins the bond between the sufferer and their carer because the dog no longer seems to recognise the owner or may develop annoying habits,'' Hannah Salvin, a doctoral student at the university who led the study, told the Sydney Morning Herald.

As with humans, the disease is incurable.

Some treatments are emerging, though, and associate professor Paul McGreevy told the newspaper "their responses could provide us with pivotal information about the potential therapeutic effects in humans.''

Salvin and McGreevy are interested in studying more dogs in the greater Sydney area. Their website, maturedogs.com, provides details.

Symptoms

Pacing, circling, wandering.

Failure to recognise familiar people or pets.

Walking into walls or furniture.

Standing over water bowl, not drinking.

Avoiding being petted or touched.

House soiling.

Read the story in the Sydney Morning Herald.

Read the abstract from The Veterinary Journal.

Learn more about Cognitive Dysfunction Syndrome in dogs, from Pfizer.

Lynn Lazarus Serper brings 'Serper Method' to Syracuse

2010-06-08T17:58:00.000-04:00

Lynn Lazarus Serper--involved in groundbreaking work on learning programs to maintain and improve brain health and vitality--presents "The Serper Method" with communication strategies and learning activities at a conference in Syracuse June 10 and 11.

Her appearance is part of Upstate Medical University's 22nd annual Alzheimer's Conference, designed for families, caregivers and health care professionals who care for people with Alzheimer's or other forms of dementia.

Registration for both days is $95 for caregivers, $115 for health care professionals and $140 for doctors.

The words my heart cannot express

2010-06-07T21:24:00.010-04:00

I'm not someone who cries. Well, at least not unnecessarily.

Maybe I lost that propensity through paramedic training, an unspoken lesson in developing professional demeanor. Maybe the cynicism of a career in the news business did this to me. At any rate, it's unusual for me to cry.

But lately, unexpectedly, my eyes will fill with tears. I do not need to be thinking of my Dad for this to happen, though the tears immediately remind me of him and his existence/life at his memory care facility. I miss him so much, though he is not entirely gone. He is slipping away or fading, as I've heard it called. I say he is stuck between the here and the hereafter.

It was October 2008 when I toured the facility where he would move a few weeks later. The administrator was kind enough and spoke knowledgeably about long term care. He showed us around. Silverado's single-floor building was designed to allow for wandering safely. At meal times, residents could exit their rooms and turn left or right and either way, the hallway would eventually feed them into the dining room. Outdoors, the pathway terrain alternated from pavement to gravel, giving residents the perception of traveling further than reality. There were spots for gardening, a cage full of parakeets and canaries, a juke box, and, best of all, dogs who lived there.

The tour began to feel a little like the tours of day care centers I'd taken not too many years before when my children were babies. Directors of day cares similarly touted their centers' features, policies and various activities.

The Silverado administrator let us peek at some rooms, and then he pointed out the memory cases on the walls outside of each resident's room. These were glass-enclosed shelves similar to shadow boxes, but bigger, and they reminded me of the cubby space at daycare that parents are invited to personalize with photographs and mementos.

Before I knew what was happening, I was sobbing, crushed by the thought of the memory case that would be my Dad's. He was 68 years old. How were we supposed to boil his life down to three shelves?

I cried, but I quickly composed myself. Just as I do now whenever my eyes start watering.

"There is a sacredness in tears.

They are not the mark of weakness, but of power.

They speak more eloquently than ten thousand tongues.

They are messengers of overwhelming grief...and unspeakable love.”

--Washington Irving

Research into cognition explains some age-related memory loss

2010-06-06T21:22:00.007-04:00

You really can't teach an old dog new tricks. Well, not if you expect the dog to remember the trick.

Through research into cognitive decline, scientists have demonstrated that "there is a biological reason why people cannot learn new things at an older age, but can retain knowledge learned years before," says John Morrison, dean of basic sciences and the graduate school of biological sciences at Mount Sinai School of Medicine.

Certain types of specializations on nerve cells called "spines" are depleted as someone ages, causing cognitive decline in the part of the brain mediating the highest levels of learning, he explains in a study published June 2 in the Journal of Neuroscience.

We lose certain spines as we age, but this study explains which ones and how their loss impacts cognition--which may lead scientists to develop new therapies that target age-related cognitive decline.

The research team studied six young adult and nine older rhesus monkeys as they participated in a delayed response test. The monkeys watched as food was baited and hidden. Then a screen was put in front of them so they could no longer see the location of the hidden reward. At the beginning of the test, the screen was raised immediately, and the monkeys found the reward right away. The memory of the monkeys was tested by increasing the time the reward was blocked from view. The aged monkeys performed significantly worse on the tests than young monkeys, especially as the time intervals increased, researchers reported.

They then studied the microscopic changes in the nerve cells within the prefrontal cortex, an area of the brain that mediates high level learning. Nerve cells in this area contain both thin, dynamic spines which are key to learning new things, as well as large, mushroom-shaped spines that likely mediate long-term memories and expertise. The older monkeys lacked the thin spines but retained the larger spines, "indicating that the loss of the thin spines may be responsible for monkeys' inability to learn and retain information during the test," says a news release from Mount Sinai.

Read the abstract.

Read the article in Science Daily.

An extended family, a photographer's studio and a camera

2010-06-04T06:52:00.006-04:00

We gathered for what we knew would be our last formal family portraits. It was Thanksgiving 2008, just after Dad had officially moved into a memory care facility. His wife, two children and six grandchildren donned clothing in matching shades of navy and khaki and directed him into a photographer's studio.

Dad was in decent spirits that day. He would generally sit where he was asked and smile when he was told. In the midst of the sitting, my then 11-year-old son held my point-and-shoot camera--and snapped this photo of his Grandpa.

It became my favorite after my son explained why he took it: because Grandpa looked as if he was looking for something and didn't know what.

A curious study of Agatha Christie and Alzheimer's -- and how our writings may one day be used for diagnosis

2010-06-03T22:14:00.009-04:00

The language of people with Alzheimer's disease includes significantly more indefinite words and repetitions than the language of healthy people of similar age and level of education.

So, an English professor at the University of Toronto, Ian Lancashire, analyzed the writing of British mystery writer Agatha Christie.

Previously, the works of British novelist Iris Murdoch were analyzed for signs of the Alzheimer’s disease that was confirmed after her death. Science Blog reported in 2004 that "while the structure and grammar of Murdoch's writing remained roughly consistent throughout her career, her vocabulary had dwindled and her language simplified in her very last novel."

Christie was never diagnosed with Alzheimer's. She continued to write in her final years, though some people believed she suffered from dementia.

Lancashire says her 73rd book, "Elephants Can Remember" is universally dismissed by critics as being full of errors and poorly plotted. The main character is a female novelist who struggles with memory loss while trying to solve a crime that happened in the past.

The professor told National Public Radio that when he read the book, he felt Christie was sensing what was happening to her, and that she kept writing "struck me as heroic."

His study involved feeding the text of 16 of her novels into a computer program that analyzed the vocabulary for the frequency of different words and the number of different words in each novel. "The richness of the vocabulary of Christie’s novels declines with her age at composition. The three novels that she wrote in her 80s, (Nemesis, Elephants, and Postern of Fate,) have a smaller vocabulary than any of the analyzed works written by her between ages 28 to 63," he writes.

Christie was 81 when she wrote the Elephants novel. Her use spiked of what Lancashire called indefinite words--"thing," "anything," "something," "nothing." At the same time, the number of different words Christie used dropped by 20 percent. "That is astounding," Lancashire told NPR. "That is one-fifth of her vocabulary lost."

Most of us don't have large collections of writing done over the course of our lives. But Lancashire points out in his conclusion that "this will begin to change as more individuals begin to keep, if only by inertia, a lifetime archive of e-mail, blogs, professional documents, and the like.

"While the diversity of topics and genres in such an archive brings methodological problems to the analysis ... we can nonetheless foresee the possibility of automated textual analysis as a part of the early diagnosis of Alzheimer’s disease and similar dementias."

Lancashire's paper, "Vocabulary Changes in Agatha Christie’s Mysteries as an Indication of Dementia: A Case Study."

The National Public Radio report.

What's in a name?

2010-06-02T21:12:00.013-04:00

Both my first-born and my brother's first-born children have the same middle name as their grandfather: Cleveland.

It's an old family name.

A paternal uncle with a few "greats" before his name was Grover Cleveland, who was the 22nd and 24th president of the United States. He died just over 100 years ago, in 1908. He spent part of his boyhood growing up in Fayetteville, NY, and I drive by Academy Street where his former home still stands almost every day.

Look at the pictures of Cleveland, the president, and compare the stately way with which he holds his head with the looks of Cleveland, my Dad in this picture taken at Silverado Senior Living where he has lived since October 2008.

President Cleveland was a lawyer and a long-time bachelor. He served as mayor of Buffalo and governor of New York before becoming president, and so far he is the only president to serve two nonconsecutive terms. Historians say he was known for his laser-sharp focus, and they say he was at first ill at ease with the niceties of life in the White House. He's described as "honest, fearless and hard working," in the 2006 Scholastic children's book, "Grover Cleveland."

One of the many Grover Cleveland biographies says much about the man with its title, "Grover Cleveland: A Study in Character," by Alyn Brodsky. The book quotes another biographer who calls Cleveland a paradigm of honesty, integrity and resolution who acheived greatness through strength of character; a man who, though flawed, exemplified "courage that never yields an inch in the cause of truth, and that never surrenders an iota of principle to expediency."

Of course, strength of character isn't necessarily handed down through generations, though I'd like to think it is. And I realize that many people hold their bodies square and firm for portraits, making them no more or less "stately" than either Cleveland. Still, I like to think we can trace some traits through our lineage.

Is/was my Dad honest and hard working and principled because his namesake was? Have my son and nephew inherited those traits, too? Sometimes I fret about what their genes hold: the same frontotemporal dementia that afflicts my Dad? Or something benign, like fearlessness or laser-sharp focus, even an aptitude for the law?

Factors that may increase risk

2010-06-01T07:47:00.011-04:00

Four factors are associated with an increased risk for Alzheimer's disease and cognitive decline. They are not necessarily causes, but science has noticed some meaningful connection between these things and an increased risk for Alzheimer's and cognitive decline. They are:
* diabetes,
* the gene variation ApoE,
* current smoking, and
* depression.

Evidence is not as strong for a connection between estrogens or nonsteroidal anti-inflammatory drugs and an increased risk for Alzheimer's, and there's no evidence of a connection between estrogens or NSAIDS and cognitive decline.

There is also not a consistent association involving cholesterol-lowering medicine, obesity, high blood pressure or blood homocysteine levels for either Alzheimer's or cognitive decline.

Download the 21-page "Preventing Alzheimer's Disease and Cognitive Decline"

state-of-the-science conference statement

Factors that may decrease risk

2010-06-01T07:45:00.008-04:00

Three factors are associated with a decreased risk for Alzheimer's disease and cognitive decline. These are not necessarily causes, but meaningful connections. They are:
* cognitive engagement, through literacy and social enrichment,
* physical activity later in life, and
* a diet low in saturated fat and high in vegetable intake.

In addition, light to moderate alcohol intake seems to be associated with reducing the Alzheimer's risk, but not for reducing the risk of cognitive decline.

There is not a consistent association involving the use of gingko biloba, beta-carotene, flavonoids, multivitamins or vitamins B12, C or E.

Read my previous post about what reduces risk (or doesn't)

Download the 21-page "Preventing Alzheimer's Disease and Cognitive Decline"

state-of-the-science conference statement

Can poor vision predict dementia? Untreated, it's associated with cognitive decline

2010-05-29T13:30:00.010-04:00

Poor vision that goes untreated is associated with cognitive decline, particularly Alzheimer's disease. Researchers from the University of Michigan, using Medicare data for 625 seniors, found those with vision problems who did not visit an ophthalmologist had a 9.5-fold increased risk of Alzheimer's disease.

”Our results indicate that it is important for elderly individuals with visual problems to seek medical attention so that the causes of the problems can be identified and treated,” says Mary Rogers, PhD. The types of vision treatment that were helpful in lowering the risk of dementia were surgery to correct cataracts and treatments for glaucoma, retinal disorders and other eye-related problems, she says. Rogers is a research assistant professor of internal medicine.

A theory about the association: visual disorders can interfere not only with normal mobility but other activities that may reduce the risk of Alzheimer's disease. These include reading, playing board games, other mentally stimulating activities and social networking.

The university news release.

The abstract from the American Journal of Epidemiology.

'I'm Still Here' tells us Alzheimer's does not mean life ends

2010-05-27T20:52:00.014-04:00

It's the disease we dread the most, isn't it? We fear how Alzheimer's wreaks minds, steals memories and personalities. We don't want to be condemned to wandering in a fog. We translate a diagnosis to mean "the end."

But in fact, many people live 10 or 15 years with the disease. A diagnosis is just the beginning, and author John Zeisel argues that Alzheimer's is not the end of the world. His book, "I'm Still Here" (Penguin, $24.95) explains how to connect with someone who has dementia. Music, art, facial expressions and touch are abilities that don't diminish with time and can be the foundation for connection.

More than 5 million Americans are living with Alzheimer's (which represents from 60 to 80 percent of all dementias), and those numbers are set to explode as the Baby Boomers begin celebrating their 65th birthdays next year. So, the practical advice Zeisel offers is assisting a growing number of caregivers.

Though it makes perfect sense, how many of us think to introduce ourselves when greeting a loved one with Alzheimer's? This is done by sitting down next to the person, holding their hand, looking in their eye and saying, 'Hi, Mom, I'm your daughter Miriam, and I love talking to you about Oakland, where you were born.' This is in place of the "test" question, 'do you know who I am?' which may frustrate those we care about and will most certainly crush our spirits when we are reminded that, no, they don't.

Zeisel, who has a background in sociology and architecture, explains in his book how to build memory cues into living environments. He gives advice on preparing for visits with someone who has lost the knack for conversation. And, he reminds us of the importance of telling people with Alzheimer's that we love them.

"Alzheimer's is not the end of the world"
article from The Guardian

Science increasingly links exercise with cognition

2010-05-25T21:08:00.005-04:00

I have an appreciation for running. When I'm injured or otherwise unable to run, I feel it--and not just physically. When I run, my mind recharges. It solves problems. It helps me think clearly.

Lenny Bernstein feels similarly. He is the author of an article about how a growing body of evidence links exercise with mental acuity. As a runner, he experiences that cognitive boost, and he writes in The Washington Post : "The tantalizing question for those of us in middle age and beyond (I am 52) is whether this short-term cognitive benefit can be replicated over the long haul. Can exercise help keep our minds sharp? And if so, can it help delay or prevent the truly terrifying mental deterioration of dementia, most commonly seen as Alzheimer's disease?

"Researchers studying both animals and humans increasingly say the answer is yes."

OK, we're not entirely there yet. The link has been observed.

Dr. John Ratey's book, "Spark, the Revolutionary New Science of Exercise and the Brain," ($24.99, Little, Brown and Company) gives lots of examples. It says aerobic exercise has been shown to be as effective as antidepressants; that women who exercise, lower their chances of developing dementia by 50 percent; that a revolutionary fitness program helped put one U.S. school district of 19,000 kids first in the world in science; and that exercise has been shown to spark new brain-cell growth.

"The evidence is incontrovertible: aerobic exercise physically transforms our brains for peak performance," Ratey's promotional materials say. "The major implication is that exercise not only keeps the brain from rotting, but it also reverses the cell deterioration associated with aging," the doctor told the newspaper.

The Washington Post article.

Clinical trials: Should you participate?

2010-05-24T20:46:00.013-04:00

Alzheimer's disease and related dementias are still pretty much mysteries. We do not know what causes them. We do not know how to treat or prevent them. The drugs we have treat some symptoms, but not long-term.

Twenty years ago, long before dementia took over his life, my Dad told me about an extraordinary research project that began in 1986. Catholic nuns at Notre Dame had agreed to be studied and tested by researchers from the University of Kentucky. Upon death, all 678 of the sisters agreed that their brains would be analyzed and stored in a laboratory. All of this was in an effort to provide some Alzheimer's answers.

Lots of other studies are underway, that are not so involved. One that I'm aware of looks at whether Gammagard, a drug already used for immune disorders, can preserve thinking abilities in people with mild to moderate Alzheimer's. I found 18 studies having to do with frontotemporal dementia that are currently recruiting people through the U.S. Institutes of Health's clinicaltrials.gov website--which you can search for studies on other types of dementia.

If you or a loved one qualifies for a clinical trial, should you participate? It's something to discuss with your healthcare provider. The National Cancer Institute gives some guidelines, most of which could apply to any trial for any disease. Some things to ask:

How long will the trial last?

Where is the trial being conducted?

What treatments will be used, and how?

What is the main purpose of the trial?

How will patient safety be monitored?

Are there any risks involved?

What are the possible benefits?

What are the alternative treatments, besides the one being tested in the trial?

Who is sponsoring the trial?

Do I have to pay for any part of the trial?

Will I be compensated?

What happens if I am harmed by the trial?

Can I opt to remain on this treatment, even after termination of the trial?

Many people who choose to participate do so for altruistic reasons. Though they may reap some benefit, the real good comes from the incremental contributions they may make toward solving the mysteries of the brain.

Understanding dementia, from the Cleveland Clinic

2010-05-24T20:38:00.001-04:00

Understanding dementia

Nine tips on caring for your aging parents

2010-05-23T20:56:00.006-04:00

Lots of Baby Boomers transition into caring for aging parents. First you're doing their shopping. Then taking them to medical appointments. Soon, making sure bills get paid on time.

Personal finance expert Eric Tyson says "the best way to deal with this important life transition is to plan ahead for the impact the change will have on your parents, while not allowing these changes to take away from your own quality of life."

Easier said than done, right?

Tyson's new book, written with Bob Carlson, includes suggestions about how to help--without turning efforts into a depressing, full-time endeavor. They include:

1. Leverage other's experiences. Find others who have dealt with similar issues, through outreach coordinators or social workers at local senior centers. You may even discover support groups that are helpful. Also, speak with people you already know. You may be surprised how many friends and family members have been down the same road.

2. Ask for professional help. Tap social service agencies, which exist at all levels of government and are rarely advertised.

3. Invest in their health. Be proactive rather than having to react after a problem becomes evident. Focus on a concern that their health be the best it can be.

4. Get your parents' affairs in order. Contemplating one's mortality usually isn't enjoyable, but it's important to have a completed will and estate plan. "Although you may not have the slightest selfish interest in inheriting some of their money and assets, other family members may have a different take on your intentions," Tyson explains. "Be sensitive to their feelings and privacy regarding their finances and what happens with their estate upon passing."

5. Examine housing and medical care options. Be careful not to leap to conclusions about what is best for the situation.

6. Use caregiver agreements. In many families, younger members help care for older members for at least a brief period. Families should pay attention to the details and rules regarding this care partly to ensure they receive maximum benefits and partly so each member will feel he or she is treated fairly.

7. Separate living spaces if parents are moving in. Many families find that this will help set boundaries and cause less interruption of family time by the care needs of an elderly relative.

8. Take care of your family. It's easy to feel overwhelmed, between work and other commitments and caring for an elderly parent. But don't forget your immediate family, your spouse and children.

9. Take care of yourself. The best givers often tend to really neglect their own needs and their own health.

Another reason to maintain healthy weight: science connects belly fat and dementia

2010-05-22T15:55:00.009-04:00

Being overweight or obese in your 30s puts you at greater risk for developing Alzheimer's later in life, says preliminary research from Boston University's School of Medicine. A study involving 730 subjects showed those with pot bellies in their 30s were more likely to have smaller brains by their 50s--which is associated with a greater risk for dementia.

"Our data suggests a stronger connection between central obesity, particularly the visceral fat component of abdominal obesity, and risk of dementia and Alzheimer’s disease,” Dr. Sudha Seshadri, an associate professor of neurology, told The Money Times. "While preliminary, (our data) provide greater understanding of the mechanisms underlying the link between obesity and dementia."

She told WebMD that the deep fat is the culprit. "We found that subcutaneous was not [significantly] associated with any adverse effect on the brain volume, whereas visceral fat was clearly associated with smaller brain volume." The link was also strong between those with a higher body mass index, and between those with a higher waist circumference.

Article in The Money Times

Story in WebMD

Read the abstract yourself

18 months later: physically healthy -- but my how that neuropsychological test was accurate

2010-05-21T05:52:00.013-04:00

My Dad amiably answered the doctor's questions, even though the answers he provided were wrong. When asked to extend his arms, or draw shapes on paper, my Dad complied.

On the sidelines of the exam room in this geriatric psychiatrist's office in October 2008 at a medical center in downtown Dallas, I watched my Dad fail what I have since learned was a neuropsychological test. My Mom sat on my right. My then 10-year-old son sat on my left, and we all watched quietly. We encouraged husband/Dad/Grandpa with reassuring smiles and nods. But we all recognized he was not doing well.

My son stayed with his Grandpa in a waiting room while the doctor gave his assessment. It was most clearly frontotemporal dementia. He explained what that is. He mentioned some signs of Parkinson's disease, too. He told us Dad would likely live from 18 months to 3 years.

Which kind of knocked the wind out of us.

Physically, my Dad is so healthy. He was then, and he remains so now, 18 months later.

It would be easy--indeed, it was tempting--to dismiss the psychiatrist and the oddball "test" my Dad had "failed." But the doctor spoke with confidence about signs and symptoms we had not recognized previously. We still think back on things Dad said or did and wonder...was that the beginning of his decline? should that have signaled us that something was wrong with his brain? That gaze in his eyes? The appointments he showed up for a day early? The trouble he had hearing--or was it his comprehension that was off?

I asked the psychiatrist what would kill my Dad. He has this fatal disease, for which there is no treatment, but I wondered what would finally take my father down. Would his heart just stop? Would he just lapse into a coma?

The doctor explained that many people with FTD die after falls, or by choking on food, or by an out-of-control infection. They become incontinent. They forget how to swallow. It was both disconcerting and comforting to hear from a professional what lay ahead. My own subsequent research backed up every word.

So here we are, 18 months later. Dad very distinctly has that Parkison's gait. On most days, he is unaware of his loved ones, and I doubt that any pictures or memory cards I have sent him make any sense to him anymore--or that he can find them. I bet he still has his sweet tooth, but maybe not, (since some dementias steal taste, too.)

He used to fight the caregivers who tried to undress him for showers; now several of the female residents are on his arm. When we visited him once at Silverado where he lives now, Dad emphatically pointed out baboons in the trees outside his window. Since he managed a wildlife amusement park for several years, this "delusion" made sense. Sometimes I wonder if he still sees them. Or if FTD has replaced those delusions with others. He's also incontinent, a progression that adds $500 to the monthly bill.

And even though all of this was predicted by the doctor, even though we watched "Away From Her" and read Lisa Genova's "Still Alice," even though we prepared ourselves in the best ways possible.... sometimes I want to go back in time to that exam room and hear the doctor blame my Dad's confusion on his hearing, or a brain tumor. Something that could be fixed. Or if not fixed, treated. Or if not treated, immediately fatal. Anything but this lengthy deterioration that seems to be playing out just as the doctor predicted.

Cost of Alzheimer's: $20.4 trillion over 40 years

2010-05-19T20:04:00.003-04:00

Cumulative costs of care for people with Alzheimer's disease from 2010 to 2050 will exceed $20 trillion, says a report from the Alzheimer’s Association. It also says that the number of Americans age 65 and older who have this type of dementia will increase from 5.1 million today to 13.5 million by mid-century.

“We know that Alzheimer’s disease is not just ‘a little memory loss. It is a national crisis that grows worse by the day,” says Harry Johns, President and CEO of the Alzheimer’s Association. “Alzheimer’s not only poses a significant threat to millions of families, but also drives tremendous costs for government programs like Medicare and Medicaid.” He refers to the disease as an "unfolding natural disaster" to which the government's response has been "stunningly neglectful."

The report, "Changing the Trajectory of Alzheimer’s Disease: A National Imperative," indicates that without disease-modifying treatments, total costs (not adjusted for inflation) of care for people with Alzheimer’s disease will climb from $172 billion in 2010 to more than $1 trillion in 2050. The cumulative yearly cost will reach $20.4 trillion.

Annual Medicare costs are expected to rise more than 600 percent--from $88 billion per year today to $627 billion in 2050. And, annual Medicaid costs will rise more than 400 percent--from $34 billion to $178 billion in the same time period.

A disease-modifying treatment that has the ability to delay the onset of Alzheimer's, or a treatment that slows the disease progression, could significantly improve the financial outlook.

“Today, there are no treatments that can prevent, delay, slow or stop the progression of Alzheimer’s disease,” Johns says. “While the ultimate goal is a treatment that can completely prevent or cure Alzheimer’s, we can now see that even modest improvements can have a huge impact.”

Read the full report yourself.

The story from Reuters.

Deciphering the role of plaques and tangles -- on the Huffington Post

2010-05-19T18:40:00.009-04:00

Dr. Scott Mendelson, author of the book, "Beyond Alzheimer's: How to Avoid the Modern Epidemic of Dementia," is a psychiatrist in Roseburg, Ore. who writes for the Huffington Post.

I asked him about the debate among scientists about whether the "plaques" and "tangles" that are hallmarks of Alzheimer's are actually caused by the disease or byproducts of the neurodegeneration that takes place. And here is his reply:

"You ask a very interesting question. What appears to be the case is that the 'plaques and tangles' are both the cause and byproducts of the disease.

There is a big circle of damaging processes in the illness. Thus, for example, accumulation of amyloid plaque can cause inflammation and poor blood supply that can cause oxidative damage and other lesions. In turn, inflammation and oxidative stress can increase deposition of amyloid. Thus, the illness can begin with inflammation and oxidative damage, or with a genetic predisposition to amyloid deposition. There are many such 'circles' of damage in the illness than can be generated by different problems. I hope this oversimplified answer is helpful."

Read Dr. Scott Mendelson's "The Unfortunate NIH Report on Alzheimer's Disease"

Good news brewing: Caffeine in coffee seems to reduce amyloid-beta production in Alzheimer's

2010-05-18T21:21:00.007-04:00

The caffeine in coffee may have the ability to slow Alzheimer's disease and other dementias, according to Portugese reseachers writing in The Journal of Alzheimer's Disease.

They told ScienceDaily that epidemiological studies showed an inverse relationship between chronic caffeine consumption and the motor deficits and neurodegeneration in Parkinson's disease. Later, similar studies showed a similar relationship between caffeine and Alzheimer's disease. The same has been demonstrated in animal models.

It's early, but researchers--Alexandre de Mendonça of the University of Lisbon and Rodrigo A. Cunha of the University of Coimbra--believe caffeine may prevent brain degeneration, play a role in improving thinking and memory, and protect against Alzheimer's.

Read the studies yourself, (for a fee.)

A dilemma for caregivers: How to occupy the time

2010-05-17T18:59:00.007-04:00

My father's move to a memory care facility was much harder on us than it was on him. When he came to Silverado, he believed he ran the place. They placed him in an "office" to stuff envelopes, had him "lead" tours, allowed him to greet visitors and collect the mail from the mailbox at the street.

I fretted about how he would spend his days, and what I could do to help add some purpose.

A friend told me what helped her mom: a box (or cannister) full of memories written on paper. So I cut card stock into rectangles and typed memory after memory, a sentence or two each, and invited friends and relatives to do the same. Slowly we filled a plastic box the size of a shoe box with which--for a while--my Dad would not part. Of course they were all good memories. That was important. But to him, each time he read them, he relived those good times.

My Dad loved reading, but I knew he was no longer able to devour the Thomas Jefferson biographies he used to love. I struggled to find short stories that would hold his interest. I resorted to big coffee table books with photos he might like, and the "I Spy" series of children's books, (hoping he would not realize they were children's books.)

I'd send him letters and/or packages every other day, since I knew he would be getting the mail. But beyond that, from my distance, I was at a loss. Cynthia Green wrote recently in The New York Times' "The New Old Age" column about some ideas, and collected several from readers. Here are 10 of my favorite:

* Adapt a lifelong hobby--for instance, someone who loved cooking could help mash apples for applesauce; a gardener may work with planting small pots.

* Capitalize on interests--a golfer may enjoy watching videos of the game; a gardener may enjoy coffee table books featuring flowers, or even leafing through garden catalogs.

* Scrabble! Verbal skills may diminish, but this game is worth a try.

* Sort through a collection of buttons. They may tell stories about the clothing buttons came from, or comment on each button's characteristics.

* Jigsaw puzzles, the ones that are not too complicated. (You can have them made from a favorite photograph.)

* Sing the first line of a familiar song. They may sing the one that comes after.

* Create a photo book and/or photo DVD that they can look at and share with other residents whenever they want.

* Rhyming games. Have them come up with words that rhyme with a word you choose.

* Watch the cars go by, and start conversations based on what goes past.

* Painting. Potentially messy, but good way to stimulate creativity.

Some dementias rob taste sensation, too

2010-05-15T15:24:00.005-04:00

We know that dementia robs our loved ones of memories and verbalization. Semantic dementia, which affects the temporal lobes, can also take away their ability to discern flavors, according to new research in the journal, Cortex.

Researchers from Washington University and City University London used flavored jelly beans in their study, which The Independent said "shows that the brain plays an integral role in unusual eating preferences and highlights how the brain manages and evaluates flavors and tastes."

"It's quite interesting and unexpected that one would find these sensory signals behaving in the same way words or music might behave," study researcher Jason Warren told MCNBC. "Flavor information is one example of a complex environmental signal that people can lose understanding about, it's part of a more general problem," he said.

Read the MSNBC story.

Read the Science Daily story.

Read the abstract in the journal, Cortex.

Grief poetry that leaves a nice feeling

2010-05-12T13:34:00.000-04:00

The Dead, by Billy Collins

The dead are always looking down on us, they say,
while we are putting on our shoes or making a sandwich,
they are looking down through the glass-bottom boats of heaven
as they row themselves slowly through eternity.

They watch the tops of our heads moving below on earth,
and when we lie down in a field or on a couch,
drugged perhaps by the hum of a warm afternoon,
they think we are looking back at them,

which makes them lift their oars and fall silent
and wait, like parents, for us to close our eyes.

-from Kevin Young's collection, "The Art of Losing, Poems of Grief & Healing."

Forget-Me-Not Days are May 14 and 15

2010-05-12T07:15:00.003-04:00

Donate money to the Alzheimer's Association during "Forget-Me-Not Days" and receive seeds to plant in your own garden. The fund-raiser brought in more than $229,000 in 2009.

This will be the eighth consecutive year that Bankers Life and Casualty Company, a national life and health insurer, has undertaken the fundraiser which puts volunteers in distinctive green aprons, handing out seed packets to raise awareness of the disease.

What a great idea.

These beautiful blueish-purple flowers will come back year after year. They're a pretty way to "carpet" an area of your garden. Plant them after the last frost, spacing them 4 to 5 inches apart and covering them with 1/8-inch of garden soil. They like the shade the best, must be kept moist, and in northern climates will require mulching over winter.

These are the flowers of remembrance, and of true love.

How to grow forget-me-nots from seed.

Certain about our times in Uncertain

2010-05-12T06:11:00.005-04:00

They say it's the stomping grounds of the legendary Bigfoot, but our times at Caddo Lake on the Texas-Louisiana border never included a sighting. Our family camped in a rustic cabin in Uncertain, Texas on the banks of the swampy forest that is Caddo Lake. We did this during football season, for I remember listening to Cowboys games via radio. I remember hooking catfish. And traveling by boat to nearby restaurants. And how my Dad--who apparently explored the area extensively as a boy--could navigate without a map.

To understand what a big deal that is, you have to know Caddo Lake.

It's Texas' only natural lake. (Yes, all the rest are man-made.) It's the largest natural freshwater lake in the south, containing the largest cyprus forest in the world. Its trees are 400 years old. And they have a creepy beauty about them. It's a cinch to get lost within them, to look down one channel and convince yourself that's the way back to the cabin, only to discover you are deeper in trouble. That's probably what feeds the legend of Bigfoot. A person could easily disappear within, and survive upon, Caddo Lake.

We never got lost with Dad, though. Either he knew his way around, or he faked it well enough to get us where we were going.

I have good memories of our long weekends in Uncertain. And I was happy to see it made Texas Monthly's "bucket list" of 63 things all Texans should do before they die. I do not know if my Dad had his own personal bucket list, (though he did many bucket list-able things--Machu Picchu, scuba, Alaska) but I have no doubt if he did, Caddo Lake was on it.

The New York Times' "A passage into primeval on a bayou lake in East Texas"

Dementia destroys the father-daughter bond

2010-05-11T19:58:00.008-04:00

"Do you have a boyfriend?" he asked me. He was about 84 years old and interested in a date.

Sitting before him with my young son on my lap, I gave him the bad news: "No, but I have a husband and two kids. And I am your daughter, Dad."

My father's confusion was the consequence of his battle with Alzheimer's disease. One day he recognized me, the next, maybe not. Though my brain could process that, my heart could not. No matter how realistic I tried to be about my father's decline and our awkward exchanges, I found it impossible to accept that he really didn't know me.
Kathy Tyrer writes in the Los Angeles Times about realizing that the father-daughter connection she had with her dad is gone. That's something to which I can relate.

In my case, it has been a gradual realization. Did our relationship disintegrate when he could no longer safely drive, and I was the one driving his car? Was it when he stopped saying my name or recognizing my voice? Or when I knew I could no longer seek his guidance?

If I lived close enough to visit at his memory care center, would that just prolong the process, make it more evident, more painful? Probably. Though, distance doesn't seem to make it easy. If I lived near my Dad, I could have transitioned if not from daughter to caregiver, at least to care helper or care over-seer, or even to daughter who dutifully visits.

From afar, I'm just daughter who reads about frontotemporal dementia and feels frustration and anger at how the disease has taken my Dad away from me.

3 important steps for adult children caring for parents, from Dr. Mom

2010-05-10T21:00:00.002-04:00

5 ways to keep minds young, sharp -- and stave off Alzheimer's

2010-05-08T18:06:00.010-04:00

What can we do to keep our brains healthy?

A new book by Paul David Nussbaum, a clinical neuropsychologist at the University of Pittsburgh School of Medicine, provides a recipe for a "brain health lifestyle."

"It does work," he says. "Research suggests if you engage in this type of proactive behavior, you build up brain reserves." A decade ago, science didn't understand that cellular connections in the brain continued to be made at any age, what Nussbaum calls "reserves."

Here's the recipe:

1. Physical activity. Did you know that 25 percent of blood flow from each heartbeat is used by the brain? That's why activity matters so much. Walking, aerobic exercise and dancing are good choices.

2. Nutrition. Our brains are comprised of 60 percent fat. To nourish them, we have to consume the right kinds of fats, unsaturated fats found in foods such as fish. Blueberries and spinach are also good choices.

3. Socialization. Brains that are isolated become lonely. It's important to stay integrated and involved, to have a reason for getting up in the morning.

4. Mental stimulation. We need to keep exposing our brains to things that are new and challenging in order to have a brain that develops brain cells. The more brain cells that we have that connect with each other, the more brain reserve we have. Those reserves can fight off dementia--not prevent it, not cure it, but fight it off.

5. Spirituality. Strong research indicates that chronic stress can lead to memory deficits and perhaps even structural problems in the brain. We combat this by relaxing, meditating and/or praying on a daily basis.

Nussbaum's book is called "Save Your Brain--5 Things You Must Do to Keep Your Mind Young and Sharp" (McGraw-Hill, $16.95.)

The Pittsburgh Post-Gazette story.

KDKA television interview with Nussbaum.

Poem about grief, healing

2010-05-06T20:33:00.003-04:00

Kevin Young's "The Art of Losing, Poems of Grief and Healing" (Bloomsbury USA, $24) is an interesting collection of poetry, broken into sections: Reckoning, Regret, Remembrance, Ritual, Recovery and Redemption.

When a loved one has dementia, the stages of grief seem all out of whack. We cannot mourn a physical passing, but the person we so loved is--in many ways--gone. Sure, we see glimpses of the real person in the eyes, in familiar gestures, in quips. While our heart holds them dear, our mind mourns their impending passing. Anyway, maybe that's why I am drawn to a book such as this. One excerpt:

"The Reassurance" by Thom Gunn

About ten days or so
After we saw you dead
You came back in a dream.
I'm all right now you said.

And it was you, although
You were fleshed out again:
You hugged us all round then,
And gave your welcoming beam.

How like you to be kind,
Seeking to reassure.
And, yes, how like my mind
To make itself secure.

Spouse have dementia? Your risk increases

2010-05-05T20:44:00.004-04:00

Married adults who have a spouse with dementia are much more likely themselves to develop dementia, says a study in the Journal of the American Geriatrics Society.

Why? Researchers theorize it could be because of the stress of being a caregiver or something about the shared environment of the couple.

Caregivers of people with dementia provide more assistance and report more personal sacrifices and stress than those who care for the physically-impaired elderly without dementia. Research has shown how that puts caregivers at risk for health problems and depression--but until now hadn't looked specifically at the risk for the caregiver developing dementia.

The study involved monitoring 1,221 married couples, who were intially symptom-free, for up to 12 years for onset of dementia in husbands, wives or both. The majority of individuals whose spouse developed dementia did not develop dementia themselves. However, a spouse's development of dementia meant the caregiving spouse had a six times increased risk of developing the same disease.

Researchers are not sure what factors make someone more vulnerable.

"Given the significant public health concern of Alzheimer's disease and other dementias, and the upcoming shift in population age composition, continued research into the causes of dementia is urgent," one of the researchers, Maria Norton of Utah State University, told HealthDay.

The Salt Lake Tribune story.

The Time Magazine story.

Searching for those who are wandering is not like looking for missing children

2010-05-05T20:04:00.010-04:00

Wandering, confused dementia patients are becoming more frequent "missing person" cases than those of lost children. Numbers bear this out in Virginia, according to a New York Times story by Kirk Johnson. This demographic shift points out the need for retraining of public safety officials, who must "throw out just about every generally accepted idea when hunting for people who are, in many ways, lost from the inside out," writes Johnson.

Wanderers often follow fence or power lines, and tend to be drawn toward water. Calling out their name often does no good, since the people have often forgotten their names. But learning about their life can be helpful "because Alzheimer’s disease, the leading cause of dementia, works backward, destroying the most recent memories first.

"Wanderers are often traveling in time as well as space."

Johnson's article tells of World War II veterans traveling great distances believing they needed to report to base or the front lines, and of a man in Virginia who was lost for days until searchers learned he had been a dairy farmer long ago. The man had headed for a cow pasture not far from his home, believing it was time for the morning milking.

A retired FBI agent, Robert Schaefer leads two-day training sessions on how to look for dementia wanderers, who may take evasive action to avoid detection or be paranoid about authority figures, due to their disease. Schaefer cared for his wife for 15 years at home through her journey into Alzheimer's.

Schaefer answers reader questions.

This 4-minute video,

"Lessons from the Lost -- Searching for Alzheimer's Patients,"

is worth watching.

New book examines the middle-aged brain

2010-05-04T21:24:00.007-04:00

Barbara Strauch's new book,"The Secret Life of the Grown-Up Brain" ($26.95, Viking) provides some good news about the state of human brains at middle age. They don't necessarily deteriorate, and they in many ways improve with age.

By the time we hit our 40s, our brains have created connections and pathways over time, and Strauch--the health editor at The New York Times--says studies show how humans and animals function better if we have background knowledge, if we know something about a situation before encountering it.

"By middle age we’ve seen a lot. We’ve been there, done that," she tells Tara Parker-Pope on the Times' "Well" blog. "Our brains are primed to navigate the world better because they’ve been navigating the world better for longer."

Is that fascinating, or what?

Parker-Pope asks Strauch (in a Q&A that's worth reading in its entirety) what a middle-aged brain does better than a younger brain.

Her answer: "Inductive reasoning and problem solving — the logical use of your brain and actually getting to solutions. We get the gist of an argument better. We’re better at sizing up a situation and reaching a creative solution. They found social expertise peaks in middle age. That’s basically sorting out the world: are you a good guy or a bad guy? Harvard has studied how people make financial judgments. It peaks, and we get the best at it in middle age."

National study underway: Can Gammagard preserve thinking abilities?

2010-05-04T07:00:00.010-04:00

A national study is underway to determine if a drug used to treat immune deficiency and autoimmune disorders, Gammagard, can preserve thinking abilities in people with mild to moderate Alzheimer's disease.

Gammagard is made from human plasma and delivered through an intravenous infusion. It contains antibodies against beta-amyloid, which make up the plaques that develop in the brains of people with Alzheimers. A Syracuse neurologist is among the researchers participating in the GAP (Gammaglobulin Alzheimers Partnership) Study paid for by the National Institutes of Health and Baxter Healthcare Corporation, which makes Gammagard.

Find a research site near you.

To join the study, participants must have a mild to moderate Alzheimers diagnosis, be between 50 and 89 years of age and have relatively good health. You cannot enroll if you had cancer within the previous five years or if you take blood thinners.

Participants will continue to take their regular medications and will not know if they are assigned Gammagard through the study. Two thirds will receive the Gammagard infusions once every two weeks. The rest will take a placebo therapy.

After the first three infusions at an infusion center, participants will receive their infusions at their homes. The study continues for 18 months. It also involves office visits, regular blood work and five magnetic resonance imaging studies of the brain. The GAP Study pays for all costs.

Vintage objects can soothe those with memory troubles

2010-05-03T19:42:00.005-04:00

One muggy, hot summer day in San Antonio, my Dad wore a khaki jacket with a stitched Six Flags emblem on the breast. He would not remove that jacket, no matter that his face was red and sweat beads covered his forehead.

We were at Fiesta Texas, in typical blazing heat, and we couldn't reason with him to peel down to the T-shirt he wore beneath. So we conspired to stand near a ride that splashed. If he got drenched--along with the rest of us, of course--surely Dad/Grandpa would remove the jacket. It worked.

We've joked about his attachment to that jacket ever since.

Recently, I've come across an explanation for why--maybe--Dad is so attached to his Six Flags jacket.

The health group Bupa Australia says it has evidence that providing famliar objects from the past can help settle dementia patients. The objects they're talking about are clothes lines, laminated kitchen tables, vegetable gardens and other items that people of a certain generation may appreciate.

Don't you bet certain music,
television shows and recipes
could have similar effects?

Maryann Curry, Bupa's group director of nursing, said there was anecdotal evidence that providing familiar objects from the past did help to settle patients and the company was examining just how significant a benefit it could be, particularly for patients who tended to aggression and hostility.

Maryann Curry, the group's director of nursing, told The Sydney Morning Herald that the pleasant experience might only last a minute or two, but the benefits in patient wellbeing lingered for some time until it was overridden by another sensory experience. "Their facial expression actually changes. We often see in their faces the joy of that moment. They are comfortable in that moment," she told the publication.

For many American Baby Boomers, vintage objects may be the laminated kitchen tables and the clotheslines. For my Dad, that vintage object is his Six Flags jacket.

The connection between hormone replacement therapy (estrogen) and Alzheimer's

2010-05-01T16:58:00.000-04:00

Can estrogen help or hurt a woman's chances of developing Alzheimer's or another dementia?

Scientists are debating just that, and the concept of neuroprotective effects of the hormone remains controversial. Some research suggests it's protective, some that it's harmful depending on the age of the woman and the type of menopause (natural or surgical.)

Dr. Walter Rocca of the Mayo Clinic gives a concise description of "the timing hypothesis" in his abstract for Neurodegenitive Diseases, March 2010.

"Timing" refers to the time at which estrogen supplements are delivered--before, during or after menopause.

Rocca's team reviewed studies already published on the matter and, in some cases, reanalyzed data. They concluded that the neuroprotective effects of estrogen depend on age, type of menopause and the stage of menopause.

They found research suggesting that estrogen could be protective for women taking it in the premenopausal years, commonly before age 50; and also for women in the early postmenopausal phase (commonly from 50 to 60 years of age.) But they found recent trials that showed estrogen treatment initiated in the late postmenopausal phase (ages 65 to 79) led to an increased risk of dementia and cognitive decline.

A 2006 study in Menopause, the Journal of the North American Menopause Society, made the same suggestions--but also said more research is necessary.

The New York Times Magazine recently published a story called "The Estrogen Dilemma" in which the timing hypothesis was mentioned.

What mountaineering and Alzheimer's have in common

2010-05-01T15:15:00.009-04:00

Alan Arnette reports on the people attempting to summit Mount Everest, and other mountains. He describes himself as a passionate amateur mountaineer and says Alzheimer's research is important to him, personally, because the disease took his mother in August 2009.

His climbing blog is soliciting votes (not money, just votes) to help raise money for the Cure Alzheimer's Fund. Pepsi is running the contest, and the cause that generates the most votes will receive a $250,000 donation. Wouldn't it be cool to have that money go toward Alzheimer's research? (Vote directly, here. Watch a 1:44-minute clip about the fund, below.)

I stumbled on Arnette's blog--and voted, of course--because I've been trying to keep track of a Central New York doctor who is climbing Everest and hoping to summit on May 17. Read about Dr. Manoj Vora, here.

Letting go of a father; proposing unity, assistance for caregivers

2010-04-30T20:59:00.007-04:00

"As I walked the streets, did interviews, conducted business, I took to wondering which of the middle-aged people I encountered were quietly struggling to cope with their own crisis. How many of them felt utterly out of their depth? How many others, having come through an ordeal, had experience that they had no ready opportunity to share? According to the National Alliance for Caregiving, about 50 million Americans are providing some care for an adult family member. I was swimming in an invisidle crowd of caregivers every day, but, like streams of photons, we passed through each other."

This passage comes from The Atlantic writer Jonathan Rauch in a thought-provoking piece with which dementia caregivers surely can relate. It's called "Letting Go of My Father."

It tells his personal story. It also shows a parallel between today's invisible caregivers and the endemic lonliness and boredom among yesterday's housewives that Betty Friedan described as "the problem that has no name."

Anyway, Rauch's essay is a lengthy narrative, what we in journalism used to call "a good read," and it's more than worthwhile, especially if you are a caregiver.

Poem about grief, healing

2010-04-29T21:35:00.005-04:00

Wait, for now.
Distrust everything if you have to.
But trust the hours. Haven't they
carried you everywhere, up to now?
Personal events will become interesting again.
Hair will become interesting.
Pain will become interesting.
Buds that open out of season will become interesting.
Second-hand gloves will become lovely again;
their memories are what give them
the need for other hands.

--Galway Kinnell's poem, "Wait"

A friend of mine mentioned the book, "The Art of Losing; Poems of Grief and Healing," edited by Kevin Young. So I've got it on loan from the library, and I'm sifting through it for poems that speak to me. I'll share some of my favorites, from time to time.

Panel: no proof for ways to prevent, slow Alzheimer's

2010-04-29T20:38:00.009-04:00

In hopes of staving off Alzheimer's or other dementias, we seek crosswords for mental stimulation, we make it a point to exercise, we down various supplements.

But guess what -- any proof that any of it actually works is lacking.

An independent panel convened by the National Institutes of Health reported that the value of these strategies at delaying the onset or reducing the severity of decline or disease hasn't been demonstrated in rigorous studies. No evidence of even moderate scientific quality supports Alzheimer's risk reduction through dietary supplement intake, use of prescription or non-prescription drugs, diet, exercise, or social engagement, they say.

"Alzheimer's disease is a feared and heart-breaking disease," Dr. Martha L. Daviglus, says in a news release. The panel's chair, she is a professor of preventive medicine and medicine at Northwestern University, Chicago. "We wish we could tell people that taking a pill or doing a puzzle every day would prevent this terrible disease, but current evidence doesn't support this."

Neil Buckholtz from the National Institute on Aging told National Public Radio that "doing crossword puzzles, Sudoku, those kinds of things — they're interesting, but the evidence is not available at this point that they actually have an effect." Evenso, many Alzheimer's researchers say such mental exercise seems like a good idea, since it increases connections in the brain and makes the brain more resilient.

It's certainly not going to hurt.

Now consider: do people stay mentally sharp as they age because they are physically active and socially engaged? Or are they physically active and socially engaged because they are mentally sharp? Daviglus says that's a chicken-or-egg quandary and that such association only tells us the two things are related and not necessarily that one causes the other.

It's the same with some other associations the panel found, between cognitive decline and diabetes, depression, and smoking.

Read the summary from the National Institutes of Health

Read the panel's statement to the NIH.

Exciting discovery suggests protein clumps lead to memory loss in Alzheimer's

2010-04-28T20:05:00.011-04:00

Researchers at Mount Sinai School of Medicine say Alzheimer's pathology originates in amyloid-beta oligomers in the brain, rather than the amyloid plaques previously thought by many researchers to cause the disease.

"The buildup of amyloid plaques was described over 100 years ago and has received the bulk of the attention in Alzheimer's pathology, but there has been a lonstanding debate over whether plaques are toxic, protective or inert," lead author Dr. Sam Gandy says in a news release. A professor of neurology and psychiatry, he serves as Associate Director of the Alzheimer's Disease Research Center at Mount Sinai.

The study, paid for by the "Oligomer Research Consortium" of the Cure Alzheimer Fund and a MERIT Award from the Veterans Administration, appears in the journal Annals of Neurology.

Several research groups had previously proposed that rather than plaques, floating clumps of amyloid, called oligomers, are the key components that impede brain cell function in Alzheimer's patients. To study this, the Mount Sinai team developed a mouse that forms only these oligomers, and never any plaques, throughout their lives.

The researchers found that the mice that never develop plaques were just as impaired by the disease as mice with both plaques and oligomers.

"These findings may enable the development of neuroimaging agents and drugs that visualize or detoxify oligomers," Gandy says. That could lead to breakthroughs in managing, slowing, stopping--or even preventing Alzheimer's.

More about oligomerics, from the National Academy of Sciences

The abstract in the Annals of Neurology

Watch out: Stress of caregiving can lead to shingles

2010-04-27T21:33:00.008-04:00

My friend has shingles.

She is the primary caregiver to a mother who has Alzheimer's disease. Does the stress of that role make her more prone to shingles?

Probably.

A weakened immune system is one risk factor.

It's not proven, but "most researchers believe that when the body's immune response, which normally keeps the virus in check, is temporarily weakened, the shackles on the virus are somehow removed, allowing it to multiply and travel along nerve fibers toward the skin on the surface of the body," says HealthCentral. "The fact that the disease occurs more often in people over the age of 50 supports this theory, as the immune response is believed to wane with age. Other factors that can also trigger a zoster attack in healthy people include trauma or stress."

Not only can stress lead to shingles, if you get shingles, stress can make it even worse, making the itching, burning, painful rash seem worse--and lengthening your recovery time, reports Everyday Health.

Learn more about shingles, from eMedicine.com

5 spices to keep our brains healthy

2010-04-27T20:50:00.007-04:00

Dr. Daniel Amen writes in the May/June issue of AARP Magazine about the spices that are good for our brains. (Learn more about Amen.)

1. Cinnamon. Amen says studies show that this spice can speed the rate at which your brain processes visual cues, which could come in handy in, say, tennis. One possible explanation is that cinnamon regulates blood sugar levels, which can help you stay focused.

2. Garlic. A study in 2007 the journal Cancer noted that garlic compounds can eliminate brain cancer cells, Amen says, adding that some experts predict garlic-based treatments will be created.

3. Ginger. More than 80 percent of migraine-prone people with mild headaches were able to stave them off with a combination of ginger and feverfew, Amen says.

4. Saffron. Amen says the pungent herb, saffron may make more sense to try before popping an antidepressant for a case of mild to moderate depression.

5. Turmeric. The Alzheimer's disease rate in India, where people eat curry almost daily, is one-fourth the rate in the United States. The turmeric effect may be because of curcumin, the active ingredient. In research using mice, it was able to break up brain plaques of amyloid beta, the protein buildup that is a hallmark of Alzheimer's.

Art meets science in opera about dementia

2010-04-26T22:57:00.010-04:00

Mr. D is the main character in a new opera, "The Lion's Face," which tours across England and Wales in May. Scientists and artists worked together to create the story, which focuses on dementia, reports the Alzheimer's Society. (Pictured above, David Calder portrays Mr. D; Carol Rowlands portrays his wife.)

Other characters include his wife, caregiver and her daughter, and a clinical psychiatrist.

Librettist Glyn Maxwell told the society the opera is "about a man with dementia who is trying to make sense of a confusing world. He is still able to communicate but doesn't recognise his family anymore, but the focus isn't just on him. It's about what the others go through. Mr D is the only one with a spoken role; the others all sing."

Artistic Director John Fulljames says in a news release that “opera seems to be the ideal art-form in which to explore a retreat into an inner world in which the patient’s ability to communicate with the world diminishes. One of the aims of the project is to find ways of communicating the experience of being touched by the condition – either as patient, carer, clinician or scientist – with a view to increasing public understanding.”

Read more about "The Lion's Face," including venues, at thelionsface.wordpress.com

Amusement parks as a metaphor for life

2010-04-24T15:57:00.001-04:00

Whenever we visited amusement parks together--whether at a park he ran, or one at which he was a visitor like everyone else--my Dad always picked up trash. He could not help himself.

If someone had discarded a cigarette butt, a drinking cup, a candy wrapper onto the ground, my Dad would pick it up and carry the trash in his hands until he found a proper receptacle.

Having a father in the amusement industry meant my brother and I got to spend lots and lots of time at amusement parks. We would go to Six Flags over Texas after school each day. One summer, when Dad ran Old Chicago, we spent the summer riding rides and playing carnival games. Another summer we stayed in Knoxville, Tennessee for the World's Fair, since Dad ran the midway there. My brother has followed Dad's footsteps into the amusement industry. I've watched from the sidelines.

I've watched, over the years, how Dad pays attention to keeping the lines moving. There's a whole science to those queues we stand in to ride roller coasters. Park managers don't want us standing in line all day; if we're standing in line, we're not buying lemonades and souvenir T-shirts and balloons. I've watched how Dad pays the same respect to the parking lot attendant as to the visiting dignitary. And, of course, how he picks up trash without qualm, in order to keep the park--his or someone else's--looking nice.

I suspect he loved his industry from the very first job he had as a ride operator. I know he loved roller coasters and thrill rides; I inherited that gene from him. He told me he wants to be cremated rather than buried because he would rather have cemetery land available for an amusement park.

When I was a baby, above, he would carry me through the park on his shoulders or in his arms. Two years ago, on our last trip to an amusement park together, I tried to hold hands so he would not wander. Eventually, we came to The Scream, below.

And of course my Dad could not help himself. He rode that ride with gusto, like the grandchild sitting next to him, not dwelling on the ups and downs or what lays ahead, but just enjoying the moment.

*** UPDATE ***
The morning after I posted this article, I was brushing my teeth. That picture you see at the very top of this post sits in that porcelain frame atop a high shelf in my bathroom. Very securely, I might add.

Well, it leapt from its perch, landing on my arm. It did not break. And, though heavy, did not hurt me.

Of course I risk sounding loony, but...I suspect the frame was my dad, somehow, reaching out to me.

Orange prompts pondering on life with dementia

2010-04-24T13:16:00.008-04:00

He's always in my heart, of course, but once my Dad is in heaven, I'm sure that he'll pop into my mind often--like when my daughter grabs an orange at breakfastime.

I was reading the newspaper. She was digging her fingernails into the skin of an orange and removing small chunk after small chunk of rind. Eventually she got to pulling away the stringy pith. Juice ran down her hands. I told her I would have sliced the orange for her, if she had asked.

"One of my friends puts the orange in his mouth and bites the skin off," she told me.

"You know who else does that?" I asked, suddenly remembering. "Your Grandpa."

From my childhood all the way into my adulthood, my Dad would bite into the skin to start peeling an orange. Often he could peel the entire fruit in one intact piece. He probably started perfecting his trick in childhood, maybe about the age of 9, Sabrina's age. It's something I never picked up.

Sabrina was mildly impressed. "Do you think he still does?" she asked.

What a good question.

I wondered. I wonder, still. Is orange-peeling a skill that dementia would allow? Is it a habit so well-ingrained as to not be taken from my Dad by his disease? He can't reliably recognize his grandchild, or child, or wife. But I bet he can still peel oranges.

So instead of getting all sad about how oranges have made a longer-lasting impression on my Dad than I have, I look at that piece of fruit and say a quiet little 'thank you' for the memories.

To my daughter, I say: "I think he probably does."

Scientists discover promising new drug target

2010-04-21T20:23:00.003-04:00

Scientists at the University of Illinois say a protein fragment associated with Alzheimer's disease, called amyloid-beta protein, activates the AMPA receptor, embedded in the neurons of other cells. This activation eventually leads to cell death -- and could provide a meaningful target for drugs that fight the disease.

These bundles of amyloid-beta proteins, also known as amyloid plaques, are what's used to diagnose Alzheimer's, after death.

Research already has shown that these proteins can stimulate the AMPA receptor, and that when amyloid-beta binds to a neuron, that receptor opens a channel allowing calcium or sodium ions to enter the cell. This quick influx of ions causes a nerve impulse. Up to now, scientists did not know the mechanism by which amyloid-beta causes the AMPA receptor channel to open.

“If a mouse is exposed to amyloid-beta in the brain, it impairs neuron function, causing memory deficits and behavioral deficits,” Kevin Xiang, a professor of molecular and integrative physiology at Illinois says in a news release. "The question is how this peptide causes all these detrimental cellular effects.”

For their study, Xiang and colleagues focused on the beta-2 adrenergic receptor, a protein that, like the AMPA receptor, resides in the cell membrane. Neurotransmitters and hormones normally activate the beta-2 adrenergic receptor, but amyloid-beta also induces a cascade of events in the neuron by activating the beta-2 adrenergic receptor, the researchers found.

The story from United Press International.

The study abstract in the FASEB Journal.

The news release from the University of Illinois.

Actor David Hyde Pierce receives Tony for fighting Alzheimer's disease

2010-04-21T19:38:00.006-04:00

My friend's Gratuitous Violins blog tells about some special Tony Awards, including one to actor David Hyde Pierce (whom you may recognize as Dr. Niles Crane from the TV show, "Frasier.") He is receiving the Isabelle Stevenson Award for his volunteer work in the fight against Alzheimer's disease, which killed his grandfather, and probably his father, too.

Hyde Pierce is a board member of the Alzheimer's Association, which WedMD describes as his longest-running role. He spoke to ABC News in Novemeber 2009 in this almost 7-minute video interview.

"It's a very cruel disease," he says. "For that reason it's very hard emotionally and also physically on the health of the caregiver or the spouse." Hyde Pierce goes on to share what his family went through, and to speak about how angry this disease makes him.

He also asks us to help in the fight through "The Champions" program at www.actionalz.org -- which sounds like a fitting way to offer congratulations for his special Tony.

On the horizon: A better way to diagnose Alzheimer's disease

2010-04-21T19:14:00.003-04:00

Autopsy provides the only way to definitively diagnose Alzheimer's disease. Brain tissue samples may reveal a buildup of amyloid plaques, (left, courtesy the University of Liverpool) thought to contribute to the disease--though scientists debate about whether it's the cause. Wouldn't it be nice to be able to determine if someone has Alzheimer's before they die? Or before they develop symptoms?

Medical imaging companies are heading in that direction, developing molecules with radioactive markers that will bind to amyloid plaques. Patients could receive an injection that would prompt regions of the brain to become colorized in a scan and reveal the location of those Alzheimer's-related plaques, the Wall Street Journal describes.

Learn more about those amyloid plaques.

Find out how doctors diagnose Alzheimer's.

When is it time to take the keys away?

2010-04-18T18:09:00.011-04:00

Up to 76 percent of people with mild dementia are still able to pass a driving test. Does that mean they should be behind the wheel of a car?

PLEASE: Take the poll at the bottom of this post.

The American Academy of Neurology issued new guidelines recently to help neurologists and other doctors determine when to take the car keys away. The group's work was based on a study of articles on dementia, driving and aging from 1970 to 2006.

Here's what they say is useful:
* the "clinical dementia rating scale"
* caregiver’s rating of a patient’s driving ability as marginal or unsafe
* a history of crashes or traffic citations
* reduced driving mileage or self-reported situational avoidance
* mini-mental state examination scores of 24 or less
* aggressive or impulsive personality characteristics

Here's what they say is not:
* a patient’s self-rating of safe driving ability
* a lack of situational avoidance

The new guidelines don't have universal support.

“We don’t have a blood-alcohol level for dementia,” Dr. Gary Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York, told the New York Times. But he pointed out that dementia accelerates the risks older drivers face from declining vision, hearing and reaction time. He told the newspaper that the American Association for Geriatric Psychiatry, of which he is a past president, uses a stricter standard: “Our recommendation is that you stop driving once you have a dementia diagnosis.”

Giving up driving has a significant impact on the life of a person with dementia--no matter when that happens.

"We sometimes gloss over how devastating taking away the keys can be," says the GeriPal blog, (a geriatrics and palliative care forum with multiple contributors.) "There is a tendency to suggest patients find alternative means of transportation, even though we are fully aware that for many patients, there is no alternative. Loss of driving privileges will often lead to isolation, an impaired quality of life, and depression.

"Our aging unfriendly world is often not kind to people who can no longer drive. We provide them no alternative transportation options, and offer little in the way of supportive services that will help them stay socially engaged after they stop driving."

From the American Academy of Neurology: Evaluation and management of driving risk in dementia

The news release summarizing the new guidelines

The story in Business Week

Driving with early Alzheimer's even riskier than first believed, from the archives of DementiAwareness

Living a fulfilling life -- even with a demenita diagnosis

2010-04-17T19:39:00.006-04:00

Be honest. Do you think a person who has Alzheimer's loses the ability to lead a full life? Is a diagnosis of dementia a death sentence? Can friendships survive the disease?

A report from the United Kingdom's Alzheimer's Society, called "My Name is Not Dementia," challenges some strongly-held beliefs. Through interviews with people who have dementia, researchers ranked what is important in their lives:

* Maintaining relationships with family and friends, and having someone to talk to.* Living in a good environment.

* Physical health.

* Keeping a sense of humor.

* Having the ability to communicate.

* Maintaining a sense of personal identity.

* Ability to participate in activities that provide enjoyment.

* Church attendance and/or practice of faith or religion.

Author Sir Terry Pratchett, who has posterior cortical atrophy, a rare form of dementia, welcomed the study.

"Dementia is undoubtedly a cruel and debilitating condition," he told the Independent. "However, a diagnosis does not strip a person of their identity. That person still has a voice and they deserve to be heard. Dementia requires not just care but also understanding. We have to learn to be good at it."

The article in Nursing in Practice.

The article in the Independent of London.

The article from the Alzheimer's Society.

Emotions outlast memories for people with dementia

2010-04-16T20:03:00.009-04:00

"One of the loneliest things about loving someone with early Alzheimer's is the feeling that any good times the two of you share just don't matter."

Deborah Franklin got that absolutely right in her story for National Public Radio about emotions outlasting memories.

We may feel that way, but here's why we should do what we can, anyway, to keep sharing good times:

Scientists in neuropsychology at the University of Iowa focused on people with damage to the hippocampus, the area of the brain that hangs on to new memories. They suspected that the feelings associated with meaningful events might be captured by a different part of the brain and, therefore, might linger.

Using patients with amnesia, the researchers conducted an experiment using movie clips. They wanted to see if feelings of sadness would last after the memory of a sad movie clip--the scene in "Forrest Gump" where he is crying at the grave of his dead wife, Jenny.

The study participants were visibly moved, some to tears. But a half hour later when researchers quizzed them about the movie, they remembered nothing. One woman, in particular told researchers she was extremely sad but had no idea why.

"Is it the sort of tightness in the gut or in the throat, or the face, somehow cuing her into the fact that she's sad?" graduate student Justin Feinstein said on NPR. "Is it some sort of nonverbal image resonating in her mind, a sort of gloomy image of despair? We don't know. It's an excellent question and one that needs to be followed up on."

As Franklin reports, there is good news.

When researcher repeated the experiment, showing the same people clips from funny movies, including "When Harry Met Sally" or a Bill Cosby special, people were left in good moods--and those happy feelings also outlasted their memories.

That's worth remembering the next time we consider spending time with a loved one who has Alzheimer's.

Listen to the NPR story.

Read the study abstract from the Proceedings of the National Academy of Sciences.

Gene may predict increased risk for late-onset Alzheimer's

2010-04-16T19:35:00.005-04:00

Researchers at the University of Miami have identified a gene that seems to double a person's risk of developing late-onset Alzheimer's disease. The discovery means scientists may learn more about how the disease develops, and they may be able to tell who is at increased risk.

``I hope that in the next five to 10 years we can see major improvements -- a combination of therapies and prevention through exercise, both physical and mental, diet and other things,'' Margaret Pericak-Vance told the Miami Herald. She is director of the John P. Hussman Institute for Human Genomics at the UM Medical School and principal investigator in the study.

The new gene influences homocysteine levels, high levels of which have been shown to be a risk factor for Alzheimer's disease.

The news release from the American Academy of Neurology.

The story from MedScape.

Dying from dementia -- on her own terms

2010-04-16T19:13:00.004-04:00

At the time of diagnosis, doctors can explain what the end is likely to be like. They can project how long someone with, say, Lewy body dementia has to live. And, if pressed, they can describe the process of death.

I remember asking my Dad's neurologist what would actually kill him. The doctor said many people with frontotemporal lobe dementia lose the ability to chew, and they choke. Or they fall, break bones, become bedbound and wither away with urinary tract infections that blossom out of control. It all sounded awful to me at the time, and it still does. My strong-willed, physically healthy father to be taken down by a swallow, or a trip...?

So I liked reading about Lynn Forbish, who is described as living and dying on her own terms in a story that Beth Macy wrote on Roanoke.com.

She explains that Forbish was diagnosed with Lewy body dementia in 2006. She died April 14, in a memory care facility.

"She'd started refusing food last week, clamping her teeth tight and turning her head; pretending to fall asleep. Her final hours were pain-free, with hospice workers and her favorite cousin by her side," Macy writes. Forbish's daughter-in-law told Roanoke.com that "She was done. As headstrong as she was, by God, she was going to go on her own terms."

The profile of Lynn Forbish, and how dementia took away her edge.

Dreams are far from sweet: REM sleep behavior disorder could predict dementia, Parkinson's

2010-04-14T20:58:00.009-04:00

A bizarre sleep disorder that affects mostly men and colors their dreams with violence and aggression may be a precursor to the development of Parkinson's disease or Lewy body dementias.

Judith Graham writes in the Chicago Tribune about the little known condition called REM sleep behavior disorder, caused by a dysfunction in the part of the brain that suppresses muscle activity during the dream-filled phase of sleep. Men with the disorder typically describe dreams in which they are chased by large insects or animals or threatening people, which requires them to defend themselves. They can become violent with their partners, and often couples take protective action by putting mattresses on the floor or hiding sharp objects.

Doctors don't know why, exactly, but a growing body of research is showing a link between REM sleep behavior disorder and Parkinson's disease and Lewy body dementia in up to 25 to 50 percent of patients. Dr. Carlos Schenck, one of the doctors who first described the disorder, told the Tribune that neurons in adjacent areas of the lower brain stem appear to be involved.

Dr. Bradley Boeve, a professor of neurology at the Mayo Clinic and a leading expert on the condition, has published multiple studies. One in 2007 appeared in Brain: A Journal of Neurology, and said his data "suggest that many patients with 'idiopathic' (REM behavior disorder) are actually exhibiting an early clinical manifestation of an evolving neurodegenerative disorder." The next year, Canadian researchers wrote about the link with Parkinson's disease. In March 2010, a scientist in Paris wrote about the disorder and how it can precede by severel years the development of Lewy body dementia. Korean scientists had similar findings in their research in February 2010.

More about Lewy body dementia.

More on the subject from the American Family Physician.

Author Fawn Germer: Why Alzheimer's is the Long Goodbye

2010-04-14T18:58:00.004-04:00

Author Fawn Germer writes about "Why They Call it The Long Goodbye" on the Huffington Post. Those of us with a loved one in the grasp of this dreadful disease can probably relate to her words:

I wonder what it is like for her, trapped in so much nothingness. Does she feel the slowness of time passing? What is she thinking? Is she thinking anything? Is she fighting to stay alive, or is she too lost to let go? I am so confused. I hurt for her.

Read all of Germer's essay.

Certain food combinations may reduce Alzheimer's

2010-04-12T16:00:00.004-04:00

People who eat salad dressing, fish, nuts, poultry and certain fruits and vegetables--and fewer high-fat dairy products, red meats and butter--appear less likely to develop Alzheimer's disease, say scientists in the June 2010 issue of Archives of Neurology.

More and more epidemiological research links diet to dementia, showing associations with saturated fatty acids, monounsaturated fatty acids, omega-3 fatty acids, omega-6 fatty acids, vitamin E, vitamin B12 and folate.

Columbia University Medical Center's Yian Gu lead a study of 2,148 older adults (age 65 and older) without dementia living in New York. Participants provided information about their diets and were assessed for the development of dementia every 1.5 years for an average of four years. During the follow-up, 253 individuals developed Alzheimer’s disease.

Researchers found one dietary pattern that was significantly associated with a reduced risk of the disease:

* High intakes of salad dressing, nuts, fish, tomatoes, poultry, fruits and cruciferous and dark and green leafy vegetables

* Low intakes of high-fat dairy, red meat, organ meat and butter.

The combination of nutrients in the low-risk dietary pattern reflect multiple pathways in the development of Alzheimer’s disease, the authors note. “For example, vitamin B12 and folate are homocysteine-related vitamins that may have an impact on Alzheimer’s disease via their ability of reducing circulating homocysteine levels; vitamin E might prevent Alzheimer’s disease via its strong antioxidant effect; and fatty acids may be related to dementia and cognitive function through atherosclerosis, thrombosis or inflammation via an effect on brain development and membrane functioning or via accumulation of beta-amyloid,” they write.

Modern Love: 'Sweetest at the End' essay in The New York Times

2010-04-11T19:28:00.006-04:00

Of course Elinor Lipman's essay in The New York Times' "Modern Love" column caught my eye. Some promotional type summarized: "Dementia turns an elegant man into a gregarious child."

That elegant man was her husband, Bob, whom she was married to for 30-plus years. Bob, who was a radiologist. Bob, who was 57 when his wife and grown son noticed something was amiss.

I read to where she described "the cruel disease that felled him was frontotemporal lobe dementia--rare, untreatable and fatal, and one that often turns its victims into violent, angry and inappropriate versions of their normal selves."

My Dad has become those things. Sadly. Predictably. Just like the neurologist who saw him in October 2008 said he would. Violent at times, angry at times, inappropriate at times. But still, often, himself. My aunt visits, and he pulls out her chair like the gentleman he's always been.

Elinor writes that FTD would "change and diminish" her husband, and then kill him three years and eight months after the first signs of trouble. Eventually, his language was whittled to a four-word answer to everything: "I'm a happy guy," he would say.

Which of course makes me wonder about my Dad's final words. His voice still has his chipper, inviting tone, though the words he says no longer plug into conversation. Will they encapsulate his life in some way? Have a double meaning? Be humorous? Make any sense at all?

Read Elinor's essay.

An educational look at your brain

2010-04-09T19:54:00.005-04:00

The Alzheimer's Association offers this 16-slide educational tour of the brain.

It's worth checking out.

How else would you know how much your brain weighs? (3 pounds.)

Or what percentage of your body's fuel and oxygen your brain uses when you think hard? (Up to 50 percent.)

Or the chief type of cell that Alzheimer's destroys? (Neurons, or nerve cells.) Turns out, the adult brain contains about 100 billion of these, with branches that connect at more than 100 trillion points. Scientists call this dense, branching network--pictured above--a "neuron forest."

New York considers expanding "Amber Alert" to seniors with Alzheimers, dementia

2010-04-09T19:22:00.006-04:00

New York's governor wants to expand the "Amber Alert" system, created to mobilize the public and law enforcement in the search for a missing child, to include missing adults with Alzheimer's.

Under the governor's proposal, the same system now used to disseminate missing child alerts to police agencies, broadcast networks, Thruway service areas, lottery terminals, airports and bus terminals would be deployed when adults at particular risk go missing. His bill is intended for adults who have a mental disability, cognitive disorder or physical disability that prevents them from assisting in their own recovery, as well as missing adults who have disappeared under circumstances that indicate they are in imminent danger of harm, such as those were abducted or who are suicidal.

The CNY Alzheimer's Association supports such a change, and points to cases like that of Frank Wlosinski that could have been helped by such an alert system. The group's chief operating officer, Cathy James, told news channel 9 that Amber Alerts in the first 24 hours can make a big difference. "An alert can go out, and information and search and rescue can start immediately."

Eleven other states already have similar programs, called Silver Alerts. U.S. Senator Charles E. Schumer last fall introduced a bill to integrate such systems nationwide.

Read the story from news channel 9 WSYR.com

Read Paterson's bill.

Big money going toward new therapies for FTD

2010-04-07T19:53:00.008-04:00

Three scientists will receive $1.2 million in research grants over four years to help accelerate the development of novel therapies for Frontotemporal Dementias. The money comes from the Alzheimer's Drug Discovery Foundation and the Association for Frontotemporal Dementias.

"This year's recipients are all engaged in the type of research that offers both caregivers and patients the optimism they need to face the chalenges of living with FTD," Phil Lovett, a foundation board member and research liaison, said in a news release.

Recipients include:

* Dr. Philip Van Damme of Leuven University in Belgium.

Recently he was involved in research published in the Annals of Neurology that examined mutations that lead to a loss of progranulin, or PGRN, in a "considerable portion" of frontotemporal lobar degeneration.

* Einar M. Sigurdsson, Ph.D., of New York University School of Medicine.

His recent work in the journal, Current Alzheimer Research explains the challenge of getting immunotherapies that target the amyloid-beta peptide in Alzheimer's disease ready for clinical trials.

* W. Haung Yu, Ph.D., of The Taub Institute of Columbia University Medical Center.

The Journal of Neuroscience recently featured work from Yu about protein processing at the cellular/molecular level.

Think you have memory loss? That could predict dementia

2010-04-06T18:43:00.007-04:00

Believing that your memory is failing may actually be a predictor of a diagnosis of dementia or Alzheimer's disease, according to some fascinating German research in the April issue of the Archives of General Psychiatry.

Researchers from the Department of Psychiatry at the University of Bonn say their work--involving 2,415 subjects--helps describe Alzheimer's as a three-stage clinical manifestation. First there is subjective memory impairment. Then mild cognitive impairment. And then dementia.

"The concept of mild cognitive impairment as a predementia manifestation of Alzheimer's disease is substantiated by studies providing biologic evidence for the presence of Alzheimer's disease in patients with mild cognitive impairment," writes lead author, Dr. Frank Jessen. "However, Alzheimer's disease-related pathologic changes in the brain evolve several years before the onset of mild cognitive impairment."

He says subjective memory impairment, or believing you have memory loss, may be a clinical manifestation of Alzheimer's disease. In his study, patients who started out with subjective memory impairment and who went on to have mild cognitive impairment 18 months later had almost 10 times the risk of any dementia at three years, and almost 20 times the risk of Alzheimer's disease--compared to patients without subjective memory impairment.

Read the MedPage Today story.

Read the Doctor's Guide article.

Read the abstract in the Archives of General Psychiatry.

Exercise may protect some people from dementia

2010-04-05T21:14:00.004-04:00

How much of an effect can exercise have on slowing cognitive decline? Some studies have already demonstrated benefit. Several others are underway, designed to find out. (One even looks expressly at Zumba.) The exercise, by the way, does not need to be a strenuous cardio workout. Some researchers suggest activities such as gardening, tai chi and walking.

Read my article on LiveStrong.com

Check out these 26 studies that look at exercise and dementia. Would you or someone you love qualify to enroll?

Is dementia an occupational hazard for football players? California lawsuit is a test case

2010-04-05T20:43:00.005-04:00

The NFL could face $100 million or more in liability if the league is found responsible for dementia claims by retired players. One worker's compensation claim filed on behalf of Ralph Wenzel in California recently is considered a test case, reports the New York Times.

Ronald G. Feenberg of Los Angeles, Wenzel's lawyer, likened football head trauma to asbestos exposure: a workplace danger whose effects can take 20 to 40 years to manifest. “Medical science has recently put those puzzle pieces together — that hitting your head over and over on the football field causes certain conditions,” Feenberg told the newspaper. “All of these hits could have injured Ralph Wenzel’s spine. But they didn’t. They injured his brain.”

Read the complete story.

Read about the football-dementia connection.

Read a New York Times article about how women are leading the way in the NFL fight about the impact of head trauma.

Happy 69th birthday to my Dad

2010-04-03T16:09:00.011-04:00

I can't recall missing one of my Dad's birthdays since my adulthood. Growing up, we celebrated his special day the way we did everyone in the family. The birthday person got to choose their favorite restaurant, and we had homemade cake at home. Once I was out of the house, the milestones were celebrated via U.S. Postal Service--a small gift and a carefully selected card.

This year, I sent a card. I doubt he will understand who it is from. He probably will not realize today is his birthday. But I sent it just in case. What if the frontal temporal lobe dementia that's got him in its grip gives him a good day? Some days are, after all, better than others.

My Dad didn't age until dementia took over, in 2008. He always looked younger than he really was. In this picture, he is 64. He is standing infront of the little clinic in Jacksboro, Texas where he was born. At the time, his family lived in nearby Archer City, (home, too, to author Larry McMurtry.)It was important to my Dad that we travel back to Archer City on Fourth of July weekend every five years for a family reunion that pulls together kin from all over the United States.

When we were there in 2005, we stayed at the Spur Hotel, at the intersection bearing the city's single stoplight, checked out the still-in-renovation Royal Theater, and looked through all of McMurtry's book stores. (Even running into McMurtry, himself, in one of them.) We ate at the Dairy Queen, even though the city boasted a brand new Sonic. Dad showed us the rodeo yards, and the house where he grew up. We visited the cemetery where our ancestors are buried. And we toured the Archer County Museum and Jail, a sandstone building from 1910. A docent warned us to be on the lookout for rattlesnakes as we showed ourselves around the property and climbed to the third floor to see the hanging gallows.

Dad enjoyed showing his grandchildren his roots. And I'm glad he got to revisit them, himself, for one last time.

Magnet can alter our moral compass, neuroscientists show

2010-04-02T07:07:00.008-04:00

Our moods may waver, but most of us are very confident and consistent in making moral judgements. That's why neuroscientists at the Massachusetts Institute of Technology in Cambridge, Mass. were surprised to find those judgments could be altered, easily and significantly, by placing a magnet near the temporal parietal junction of the brain.

"It's one thing to 'know' that we'll find morality in the brain," researcher Liane Young told the New York Daily News. "It's another to 'knock out' that brain area and change people's moral judgments."

The temporal parietal junction is active when people are asked to make moral judgments that require them to think about the intentions of others, something called "theory of mind." One example would be figuring out what a hunter was thinking if he shoots his friend while on a hunting trip: Was he secretly jealous, or did he mistake his friend for a duck?

The researchers, led by Rebecca Saxe, MIT assistant professor of brain and cognitive sciences, used a non-invasive method called transcranial magnetic stimulation to apply a magnetic field to a small area of the skull (on the scalp) to create weak electric currents that stop nearby brain cells from firing normally for a while. Their work appears in the Proceedings of the National Academy of Sciences.

Read the New York Daily News story.

Read the story in Medical News Today.

Remembering a parent with Alzheimer's

2010-03-31T07:15:00.005-04:00

Sue Wronsky writes in the newspaper supplement I edit, "Healthy CNY" about her mother and Alzheimer's disease:

I don't recall the last "normal" conversation I had with my mother.

One of her many caregivers during her 11-year battle with Alzheimer's disease, I vividly remember our time together during the last years of her life. As it happens, the most recent memories of moments spent with this amazing woman - who had once been a world traveler, an advertising executive, a teacher, a Eucharistic minister, a military wife, an avid reader, a sister, a friend, a mother of seven and grandmother of 11 - were of feeding her lunches the consistency of baby food, giving her sponge baths, and trying to settle her unquiet thoughts by speaking softly in her ear as if she was a scared child....

Continue reading her essay (and see a picture of her mother)

"Cognitive shop" blends exercise, diet, socializing to ensure brain health

2010-03-30T19:20:00.011-04:00

Can a combination of physical exercise, a Mediterrainean diet, music therapy, social interaction and cognitive challenges stave off Alzheimer's disease?

A new project--the Cognitive Fitness and Innovative Therapies--is trying to determine if the onset of the disease can be delayed, perhaps indefinitely. It focuses on dementia as preventable, which is so much nicer than thinking of dementia as inevitable.

"By the time someone walks in my door with symptoms of the disease, it's too late," Dr. Kenneth S. Kosik told the Wall Street Journal. He is co-director of the Neuroscience Research Institute at the University of California, Santa Barbara. He says people should start efforts to prevent the disease in their 50s.

Alzheimer's, a progressive brain disorder that accounts for the majority of dementia cases, affects some 5.3 million Americans. Doctors don't know for sure what causes it, but genetics and age likely play a role.

Lots of research has connected exercise to an improvement in cognition, some showing a protective effect and some showing that cognitive declines can be slowed.

Read the Wall Street Journal article.

Read the abstract from Archives of Internal Medicine about "Resistance Training and Executive Function" from January 2010.

What is the hippocampus? And why should we care?

2010-03-29T22:27:00.008-04:00

My Dad was dating the woman he would marry when the Lancet published research in 1985 about how "the decline of all higher cognitive functions in senile dementia of the Alzheimer type is attributable to histopathological changes in the hippocampal formation."

Twenty-three years later, the year his wife got him settled into Silverado Senior Living, research still focused on the hippocampus, deep in the brain. It seems a larger hippocampus may protect people from the effects of Alzheimer's disease-related brain changes, "an exciting area of research," according to Professor Clive Ballard, director of research for the Alzheimer's Society in London.

It's not that any of this knowledge or experimentation could help my Dad now, or even back in 1985, that I find myself wondering about this structure, this region, this whatever-it-is piece of the brain. It's the purple area in this drawing provided by Dr. Jim Phelps, an Oregon psychiatrist. This is a slice image, looking deep in the temporal lobe, which is above and infront of the ear on either side of the head.

He explains that the hippocampus--part of the innermost fold of the temporal lobe--is instrumental in helping us store memories. And, he gives three reasons why we should care about it:

1. This part of the brain appears to be absolutely necessary for making new memories. Alzheimer's disease affects the hippocampus first and severely, which is why memory (or the ability to make new ones) is usually the first thing to start to falter in Alzheimer's.

2. The hippocampus appears to shrink in severe mental illnesses, including severe depression and schizophrenia.

3. Estrogen has a direct effect on the hippocampus. Research on the role of estrogen in preventing Alzheimer's is underway.

So this is what we know now. We can only imagine what we'll know another 23 years from now.

ScienceDaily report from 2006 on the size of the hippocampus as it relates to Alzheimer's disease

He reminds me of my Dad

2010-03-27T15:11:00.011-04:00

I see my Dad in my memories now. He's so far gone, mentally, and so far away, physically, that memories are pretty much all that is left. Then one day, I came across Bruce Bane's blog. And, somehow, this stranger's words make me feel closer to my Dad.

Bruce Bane writes the "Living with Dementia" blog. He has the same diagnosis as my father: Frontotemporal lobe Dementia. He is a writer, a poet.

The first post is from Jan. 19, 2010. It's titled "After Church:"

Too many faces
Too many voices
Like a thundering waterfall
Falling on me
And I can’t remember how to swim

This must be how my Dad felt, when we took him to restaurants, amusement parks, anywhere lots of people were gathered.

Bruce writes about the challenge of just thinking, and I imagine my father could identify:

I start to remember something
But it retreats into the distance
Around a corner, out of reach, lost in the mist

He writes about seeing himself in the mirror, something most certainly my father did and, likely, experienced similarly:

The man in the mirror must be me
But there’s something unfamiliar about him
Something I can’t describe
I recognize him, I know him, but only in part
And then I understand
I know him only in part because that’s how I know myself
I am growing more and more unfamiliar with myself

My father's sense of humor would appreciate Bruce's observation of a "positive" about dementia--that of being able to see the same movie twice, three times, even four, and each time experiencing it like it was the first time.

It makes me sad to think about my Dad's situation, to try to understand what he's going through. (I used to say "what he's suffering," but a friend convinced me how that word may not be precise.) Because he's going through this, I feel it my responsibility to try to understand. Bruce helps me do that, even if he chokes me up at the same time.

"I know what I want to say, but can’t seem to get it out," Bruce writes, and I think how awful that must be.

"Gradually it feels like I’m becoming less of who I am," he writes, and I cringe, thinking how apt a description.

Bruce's blog is like messages from my Dad. They are heart-warming and at once heart-breaking. "There will come a day when I will wake up without wondering, without being tempted by feelings," Bruce writes, "the day when dementia is no longer just a part of me, but all of me.”

Read Bruce Bane's blog for yourself.

If there were a test for dementia, would you take it?

2010-03-27T13:52:00.007-04:00

Especially if Alzheimer's disease "runs in the family," we listen when scientists talk of ways to predict who will develop such a dreadful disease. We've heard more about the brain than we care to, with its tau proteins and plaques and neurofibrillary tangles. Of course brain research is teaching us about the causes of dementia, and maybe it will eventually lead to methods of prevention or treatment. Will those advances come in time for us? For our children?

Earlier this year, research in the Neurobiology of Aging Journal explained how elevated levels of phosphorylated tau231 in cerebrospinal fluid may be used to diagnose a healthy person who will develop Alzheimer's disease. Researchers from New York University's School of Medicine said the levels could predict future memory decline and the loss of brain gray matter in the medial temporal lobe--a key memory center.

"Our research results show for the first time that elevated levels of P-tau 231 in normal individuals can predict memory decline and accompanying brain atrophy," said lead author Dr. Lidia Glodzik, an assistant research professor in the Department of Psychiatry at the school's Center for Brain Health and Center of Excellence on Brain Aging. "Our findings suggest that P-tau231 has the potential to be an important diagnostic tool in the pre-symptomatic stages of Alzheimer's disease."

Which is great.

Or at least, potentially, a great advance.

It's quite a ways off. When I go for my physical in a couple of weeks, I won't be able to ask my doctor to run this test and then...know. But there's a good chance something like this will be available if not in my lifetime, certainly within the lifetimes of my children.

We know what Alzheimer's and dementia do to the ones we love. We know how the diseases take them from us long before their bodies fail, leaving bits of their spirit and personality glimmering--only every now and then--in their eyes. One merciful aspect of the disease may be that our loved ones did NOT know what was happening to them until it already was. By the time symptoms of memory failure became evident, hopefully, they were too far gone to notice. What appears to us as suffering may be, to them, just the way life is.

Science may wind up changing that for us.

We may have the option of learning way before symptoms emerge whether dementia is part of our future. So, what if it is? What then?

Read the story in ScienceDaily.

Read the story in The Medical News.

The abstract in the Neurobiology of Aging.

Wandering--and coming to rest

2010-03-23T19:27:00.006-04:00

He looks like anybody's grandpa, this former Syracuse firefighter, striken with dementia and missing from home since Jan. 2. Here it is two and a half months later, and police report finding a body on the shore of Onondaga Lake.

The body found is clothed the same way Frank Wlosinski was clothed the afternoon he went missing. Even though identifications have not been made, my heart weeps for this man's family.

While a missing child is "every parent's worst nightmare," I imagine that a missing parent, with Alzheimer's, becomes a grown child's. How can the worry NOT consume every moment? To know that Dad/Brother/Grandpa is out there, somewhere, wandering and lost and afraid?

Hopefully, the discovery of this man's body brings his family some sense of relief that he is, finally, home.

Memory, thinking skills deteriorate long before dementia diagnosis, study shows

2010-03-23T18:21:00.008-04:00

Memory and thinking skills seem to deteriorate rapidly among people who go on to be diagnosed with Alzheimer's disease--compared to those who are aging normally--says a study in the journal Neurology.

Researchers from Rush University Medical Center in Chicago followed 1,168 older adults, all of whom, at the beginning of the study, did not have dementia. After a mean of five to six years, participants had a detailed clinical evaluation, and 614 were found to have no cognitive impairment, 395 had mild cognitive impairment, and 149 had Alzheimer’s disease. Participants then completed brief cognitive testing at 3-year intervals. Compared with the "no cognitive impairment" group, the annual rate of cognitive decline was increased more than twofold in those with mild cognitive impairment--and more than fourfold in those with Alzheimer’s disease. The results did not vary by race, sex, or age.

"These results show that we need to pay attention to this time before Alzheimer's disease is diagnosed, when people are just starting to have problems forgetting things," lead author Robert S. Wilson, of Rush University Medical Center in Chicago, said in a news release from the American Academy of Neurology.

What the study may be telling us is that by the time of an actual diagnosis, dementia may have progressed into final stages, the disease present (though in a far less debilitating form) for many years.

Read the U.S. News & World Report story.

Read the news release from Rush University Medical Center.

The full text in Neurology (incurs a cost of $20)

Drop blood pressure, drop dementia risk?

2010-03-21T20:22:00.010-04:00

One more reason to control your blood pressure: reduce your risk of dementia. Maybe.

A recent Associated Press story says controlling blood pressure may be the best protection yet known against dementia. Scientists are saying that high blood pressure seems to create scarring in the brain as early as the middle ages, which leads to later development of Alzheimer's disease and other dementias.

"If you look ... for things that we can prevent that lead to cognitive decline in the elderly, hypertension is at the top of the list," Dr. Walter Koroshetz, deputy director of the National Institute of Neurological Disorders and Stroke, told The Associated Press. He said studies soon will get underway to see if people with hypertension can benefit from dropping blood pressure rates even lower than currently recommended.

Recent research has looked at MRI scans in women 65 and older, finding that those with worse blood pressure had higher volumes of "white matter damage," according to a study published in the Journal of Clinical Hypertension. Another study in the journal Stroke by researchers from Johns Hopkins University tracked 983 people starting in middle age for 15 years. It found that the longer people spent with uncontrolled high blood pressure, the more white matter damage they accumulated.

Certainly high blood pressure, alone, does not predict the development of dementia. But the National Institutes of Health plans to begin enrolling people this fall for a study called SPRINT, the Systolic Blood Pressure Intervention Trial. It's designed to look at heart and kidney health, but participants--7,500 people age 55 and older with hypertension--will also be screened for dementia. The question is whether taking agressive steps to lower systolic blood pressure below 120 will prove healthier than the current guidelines.

"We have a number of effective and safe medications to lower blood pressure," Dr. Lawrence Fine told HealthDay. He is chief of the clinical applications and prevention branch in the division of cardiovascular sciences at the National Heart, Lung, and Blood Institute. "For the average person right now, the recommendation is a blood pressure of 140/90 or lower. SPRINT will compare that with a goal of 120 as the top number. Will the rate of dementia for people in the lower-goal arm be lower than standard?"

Music may make older minds more resilient

2010-03-18T19:51:00.006-04:00

Taylor Bredberg is an ardent fan of the indie band Grizzly Bear and the TV series "Lost," an amateur filmmaker and a doodler of figures that bring to mind Tim Burton's kinetic grostesques.

But if those interests make him a pretty normal teenager, Bredberg's eight-year relationship with the piano may have made him a little more unusual: He is a kid with the attention span of an anesthesiologist, the persistence and discipline of an Olympic athlete and the emotional range of an artist....

That is the start of Melissa Healy's recent Los Angeles Times story about the Effect of Music on Cognitive Function

She goes on to explain that researchers who study the link between music-making and cognitive performance want to learn how music can impact academic skills. And that means studying kids from a wider range of family environments and offering music lessons.

Dr. Antonio Damasio, director of USC's Brain and Creativity Institute, told the newspaper that even if music did little more than lift our spirits, it would be a powerful force in maintaining physical and mental health. The pleasure that results from listening to music we love stimulates the release of neural growth factors that promote the vigor, growth and replacement of brain cells--which may help keep older minds healthy, active and resilient against injury and illness.

Watch Damasio's presentation on art and emotions. (56-minute video.)

Dementia epidemic coming among people over age 90

2010-03-17T07:04:00.010-04:00

The oldest old are the fastest growing segment of the US population, and dementia rates among them "threatens to become an epidemic with enormous public health impact," says a neurology scientist at the University of California, Irvine.

The World Health Organization has said dementia affects up to 10 percent of the North American population age 65 and older, and that Alzheimer's disease accounts for two-thirds of those cases.

Maria Corrada-Bravo writes in the Archives of Neurology that dementia incidence increases exponentially beyond age 90. The increase is almost 13 percent per year in the 90- to 94-year-old age group, 21 percent per year in the 95- to 99-year-old age group, and almost 41 percent per year in those over age 100.

"Our findings show dementia incidence rates almost double every five years in those 90 and older," Corrada-Bravo says.

Previous work has estimated America has 2 million people ages 90 and older. That number is expected to reach 8.7 million by 2050, making the oldest-old the fastest growing segment of the U.S. population.

The study appears in the February issue of Annals of Neurology. You can also read a report about the study in Science Daily.

Contemplations over the loss of a pet

2010-03-15T22:00:00.006-04:00

One of our guinea pigs died today. I raced home from work but missed her last breath by a few minutes. She was about 6 1/2, which is a little longer than the expected lifespan of a guinea pig.

I remember when she joined our family.

My Dad was visiting over the summer of 2004 and while he was here, he got my son (7 at the time) his birthday gift from Grandma and Grandpa: two guinea pigs.

My Dad had grown up in the country, so he was comfortable with rodents. He told many stories about his mother warily opening dresser drawers, fearful of what rodent (or other creature) he might have stashed in there for safekeeping. He set up the cage and bedding with my son and helped him get acquainted with the new little guinea pigs who would become part of our family.

Eventually Allison provided my son with what he describes as the best day of his life. He came home from school to find three baby guinea pigs in her cage. (We had noticed she had been getting rather fat.)

Lately we noticed she had been getting rather frail. My son came home from school today to find her unable to stand. By telephone, he described her limpness, and her legs that were shaking. "Hold her," I coached him. "Let her feel you touching her. Pet her, and love on her."

I arrived home to find him in tears. She was gone. And he felt awful about how she had gone: right there, with him holding her.

I thought about how lucky she was. "Actually," I told my son, "of all the ways there are to die, the way she went is probably the best."

And then I wondered if--prayed that--his Grandpa would be so lucky.

Examining the football-dementia connection

2010-03-15T18:41:00.018-04:00

A study that came out in fall 2009 was important because it showed that NFL players suffer dementia at rates vastly higher than those of the general population--including 19 times the normal rate for men ages 30 to 49. It was the first "evidence" showing what the NFL had long denied: that of cognitive decline among its players.

The study was from the University of Michigan Institute for Social Research. Researchers surveyed 1,063 retired players and found that incidence of heart disease was lower, but incidence of arthritis was higher. Noting study limitations, they also found a significantly higher incidence of dementia.

Here's the New York Times story about the study, and a followup story criticizing the study.

Here's a copy of the study.

"We conducted some interviews with a 'proxy reporter,' generally the wife, of some players who are unable to answer for themselves. We did not administer cognitive tests and did not conduct neurological examinations. The only information we collected about dementia was to ask the respondent (or proxy) if they had ever been diagnosed with dementia, Alzheimer’s disease, or other memory-related disease. Diseases of memory are rare, but NFL retirees report higher rates," wrote researchers David R. Weir, James S. Jackson and Amanda Sonnega. The incidence of dementia among American men over age 50 is 1.2 percent. Among retired NFL players over age 50, it was 6.1 percent.

The study raises questions about the connection between concussion and dementia.

When I heard about the NFL study, I thought of my Dad. The place where he lives now--Silverado Senior Living--is the place the NFL has contracted with to provide care to former players and their families who suffer Alzheimer's, Parkinson's or other forms of memory impairment.

What would Dad say about this dementia blog?

2010-03-14T20:18:00.006-04:00

Would Dad mind that I mention him, that I post his picture on this DementiAwareness blog? That question nags at me.

My father was always very proud of my work as a journalist. And I enjoyed, when he came to visit, that he could open the daily newspaper and read articles written by his daughter. But those stories weren't about me, or him. They did not publicize our family.

This blog sort of does.

It's too late to ask my Dad how he feels about, well, pretty much anything. We can't trust much of what he says (he often says he's hungry just after finishing a meal) so I have to imagine what his response would be, based on the 44 years I've known him. Would he be proud of my work? Or embarassed of the content and its occasional reference to him? Would he feel shame?

My father never sought publicity, at least not for himself. But he was willing to promote certain causes. When I was little, he posed for a magazine cover during the energy crisis, bundled in a blanket for a story about energy conservation.

He was a lover of science, too, and when he watched TV, it was often a documentary or educational program. I remember watching Mutual of Omaha's Wild Kingdom with Marlin Perkins together every week growing up.

So I'm thinking that if he were in his right mind, my Dad would relish learning about frontotemporal lobe dementia. I think he could appreciate the mystery of the disease, if he weren't suffering from it so. I even think he would forgive me for sometimes referring to him in the past tense, even though he is still alive and, at least physically, well.

Hallucinations? Or deteriorating vision?

2010-03-13T20:55:00.006-05:00

What may seem like hallucinations in people with dementia may, in fact, be symptoms of deteriorating vision.

Howard Solomons, PhD, writes in this "Vision and Dementia" paper from 2005 about the way our eyes deteriorate as we age. People with Alzheimer's or dementia face those issues, plus they may face disturbances that originate in their brains, rather than their eyes. "That is, their problem can be having difficulty perceiving what they see rather than how sharply they see it," Solomons describes. "Problems most commonly occur in four areas – motion, depth, colour and contrast. Visual hallucinations have been reported to increase with loss of visual acuity in some Alzheimer’s patients."

It's something of which to be aware.

Teepa Snow, from the video above, trains caregivers and family members of dementia patients. Check out her Web site.

Simple new test can detect early dementia

2010-03-13T14:38:00.011-05:00

Sixty percent of Alzheimer's cases do not get diagnosed in primary care medical offices, which means missed opportunities to treat patients in the early stages of dementia.

A new Computerized Self Test, created by researchers from the University of Tennessee, could potentially bring a simple and inexpensive testing tool to family doctors and internists.

CST is a fitness test for the brain. It's a brief, interactive online test that assesses various impairments in the basic thinking functions that are affected by cognitive impairments and dementias including Alzheimer's. Researchers say it provides an objective way to determine what diseases may affect the patient, so providers can begin treatments that could blunt the effects of the disease.

“Early detection is at the forefront of the clinical effort in Alzheimer’s research, and application of instruments like CST in the primary care setting is of extreme importance,” Rex Cannon, an assistant professor in psychology, told Tennessee Today.

His work will be published in the April 2010 issue of the Journal of Alzheimer's Disease.

The study, "The Computerized Self-Test--an Interactive, Internet Accessible Cognitive Screening Test for Dementia"

The story from Tennessee Today, from the University of Tennessee, Knoxville.

Driving with early Alzheimer's even riskier than first believed

2010-03-12T20:33:00.009-05:00

Even with early dementia, research is now showing there's no safe time behind the wheel of a car.

"Alzheimer's disease affects memory and navigational skills. These impairments may lead to getting lost, which is a life-threatening problem. Family members and friends of individuals with dementia need to recognize these impairments as serious threats to safety for anyone who has dementia," Linda Hunt told HealthDay. She is an associate professor in the School of Occupational Therapy at Pacific University, Oregon, and author of a study published in the March-April issue of American Journal of Occupational Health.

The study focused on newspaper accounts of 207 Alzheimer's patients who went missing while driving. Thirty-two died, and 35 were found injured, according to the HealthDay article. Seventy had not been located at the time the data was analyzed. "Some had driven for almost two days and covered more than 1,700 miles while lost. Most had set off on routine trips to the post office, store or a relative's house," the article says.

Mom tried hiding the keys from Dad once it was clear he wasn't right. But of course one day he found them and took off in his car. She called me, fearful of what could happen. We weren't sure what to do. Would the police find him if we gave them the license plate number? Eventually Dad called saying he was at a gas station. Mom begged him to let her come get him, but he would have none of it. He said he would drive home. So again we fretted, waiting -- and were relieved beyond belief when he drove into his parking spot in the garage for what would be the last time.

Shortly after that, Dad's car went into the shop for repairs. It was gone for quite a long time. Long enough for him to get used to the idea that he could no longer drive.

Some of this advice from the National Safety Commission would not really apply to a person facing Alzheimer's or dementia, but some of it is useful if you're faced with taking the keys away from someone you love. This article -- "How to Determine Your Elderly Parent's Driving Ability" -- by Leonard Hansen at AgingCare.com may also be of help.

Putting a name on the feelings of loss before death

2010-03-12T19:48:00.012-05:00

A therapist / friend put a name on what I've been going through for almost two years, since it became clear that something was wrong with my Dad. She called it "anticipatory grief."

It's a feeling of loss before a death occurs.

Harriet Hodgson explains for the American Hospice Foundation how anticipatory grief "has been described as a 'normal process,' but life is far from normal if you're going through it. ... You may have bouts of crying, for example, a symptom that upsets you and those around you. You may hold back your tears because you have to be strong for your loved one. All through the day you have a choked feeling in your throat. Holding back tears takes lots of energy and, before long, you're exhausted."

Symptoms include: denial, mood swings, forgetfulness, disorganized and confused behavior, anger, depression, feeling disconnected and alone, anxiety and dread, weight loss or gain, sleep problems, nervous behavior and general fatigue.

Hodgson cites author Edward Myers' description of a slow decline as being like that of a glacier "massive and unstoppable, grinding you down," (as compared with a sudden death hitting more like an explosion.)

Beth Erickson writes on the Strength for Caring caregiver Web site about the drawback to witnessing a loved one's slow demise. "As the loved one’s condition worsens, you may grieve with each downturn. You may experience feeling a sense of helplessness as your loved one fights for life. You may feel as if you are living with a pit in your stomach that won’t go away as you await death’s arrival."

I guess it's like anything else. There's value in learning what we can about the glacier, even if it is unstoppable. Knowing why we're ground down, knowing why we feel that pit in our stomachs can help us cope. Just knowing that what we're going through has a name -- anticipatory grieving -- reminds us we're not alone.

Genetic clue may help explain FTD risk

2010-03-11T20:05:00.009-05:00

A gene on chromosome 7 may increase a person's risk of developing frontotemporal lobe dementia, according to an international team of scientists writing in the journal, Nature Genetics. Their work compared the brains of 515 individuals with FTD with the brains of 2,509 healthy people.

"We found a specific genetic change that was associated with an increased risk of the disease," co-author Maria Grazia Spillantini, of the University of Cambridge, told the Telegraph. “A better understanding of how the gene is involved could identify a new approach to tackle this disease.”

The paper lists FTD as the second most common cause of presenile dementia, which is dementia occuring in people younger than age 65.

The BBC story.

The Telegraph story.

Read the journal abstract (to read the article incurs a fee.)

Things that strain our brains

2010-03-10T22:43:00.005-05:00

•Sleep deprivation
•Multitasking
•Stress
•Concussion
•Depression
•Some medications and sleep aids
•General anesthesia
•Failure to seek help if you notice difficulties such as loss of memory, inability to focus and make decisions, and a struggle to understand.

This list of eight comes from the Center for BrainHealth, at the University of Texas at Dallas. They are referenced in a story that Nancy Churnin wrote for The Dallas Morning News called "Human Brains Grow, Change and Can Heal Themselves."

Her article talks about plasticity and the benefits of brain physicals, (which cost $600.)

What is FTD?

2010-03-08T23:04:00.010-05:00

We had never heard of FTD before (other than the flower delivery service) when a doctor gave our family the diagnosis for our patriarch of frontotemporal lobe dementia. He said it was like Alzheimer's disease in some respects. But it was its own disease.

FTD actually refers to a group of rare neurological disorders that affect the frontal and temporal lobes of the brain, which control personality and social behavior, reasoning, movement, language, and some aspects of memory.

It often strikes people earlier than does Alzheimer's, developing as early as 35, (but most are diagnosed in their 50s and 60s.)

Doctors say that FTD makes up about 3 percent of all dementia cases.

The FTD Support Forum lists some of the diseases that get classified as FTD include Pick's Disease, FEDP-17, Supranuclear Palsy, Primary Progressive Aphasia and Corticobasal Degeneration.

It's not Alzheimer's

2010-03-06T18:52:00.008-05:00

Frontotemporal dementia (frontotemporal lobar degeneration) is an umbrella term for a diverse group of uncommon disorders that primarily affect the frontal and temporal lobes of the brain, the areas generally associated with personality, behavior and language, according to the Mayo Clinic definition page.

Here's what else it says:

In frontotemporal dementia, portions of the frontal and temporal lobes atrophy, or shrink. Signs and symptoms vary, depending upon the portion of the brain affected.

Some people with frontotemporal dementia undergo dramatic changes in their personality and become socially inappropriate, impulsive or emotionally blunted, while others lose the ability to use and understand language.

Frontotemporal dementia is often misdiagnosed as a psychiatric problem or as Alzheimer's disease. But frontotemporal dementia tends to occur at a younger age than does Alzheimer's disease, typically between the ages of 40 and 70.

Wear Purple Day is March 9 in Syracuse

2010-03-06T18:29:00.007-05:00

I plan to wear something purple on Tuesday, March9. It's a small way of raising awareness about Alzheimer's disease. (The "Wear Purple" day may happen on a different date in your community. Check with the Alzheimer's Association to find out.)

Organizers in Central New York also suggest changing the color of your email signature to purple for the day--and encouraging Facebook friends and Twitter followers to do the same. You could also sign up for a Memory Walk.

Introducing Amber Smith, medical journalist interested in dementia and Alzheimer's

2010-03-06T17:52:00.022-05:00

This is my Dad, who--like so many others--hovers between the here and the hereafter in a body gripped with dementia. It's a sad situation, one with which many of you can identify.

For 22 years, I've covered health and medicine in some capacity for The Post-Standard in Syracuse, NY. I'm a devoted and passionate journalist who likes learning, enjoys writing and feels grateful to play a role in helping to make sense of our often-confusing healthcare system.

My background includes training (and volunteering) as a paramedic until parenthood provided other things for me to do with my time. I also spent three years to obtain a master's degree in Health Services Management and Policy. For a while, I taught at Syracuse University's S.I. Newhouse School of Public Communications.

I'll blog here regularly, with news and information of interest to people affected by Frontotemporal Dementia (FTD) and Alzheimer's disease. Check back often. You can also follow me on Twitter, where I'll "tweet" each post.

Meanwhile, let me know if you've got a question related to dementia. I don't pretend to know everything, but I am pretty good at digging to find answers.

CBANMEP957TR

2010-03-05T13:18:00.000-05:00