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

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

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

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

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

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

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

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

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

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?

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

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

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

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

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

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?

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

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?

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

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

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?

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?"