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

"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

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

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

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

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

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

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

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

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

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

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

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?

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

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

"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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.