Tag Archives: Alzheimer’s

Alzheimer’s Dementia and 90 + study reveal the new data on Alzheimer’s.

Alzheimers-diseaseThis article on Alzheimer’s and  and related 60 minutes show are devoted to follow up of a study at UC Irvine that followed retrospectively a neighborhood of 14, 000 people.   Living to 90 and beyond – click here UCI mind and related articles and links   The sixty minute summary of the 90 + research reveals that activity, social connection, matter even if just in little however constant bursts.   UC Irvine is studying a senior community where they have a distinct group of fourteen thousand senior citizens that completed a survey a decade ago. They are attempting to look retrospectively exactly what took place to them.  

No surprises smoking cigarettes are bad and workout in moderation is good.

But this is a good research to give you hope. 15 minutes of light cumulative workout or walking made a difference, and came to a head at 45 minutes. They also noted that the exercise does not need to be continuous. Keep in mind the study is watching those who are left so the results are tilted to healthy seniors.  

Being overweight is better than underweight.

Kept in mind that while they saw that being overweight was good they cautioned that was not morbidly obese. We can add that when you are obese you likewise have more muscle and the extra muscle is more vital than the fat is bad to give you much better function, flexibility, immune system etc. Being any underweight likewise may suggest other condition. Exactly what we also have to be clear is being 20 % over weight is ok it is much better not to be actually obese. As all of us understand everything in small amounts.  

Exactly what was interesting to these researchers was that Alzheimer’s is not as typical as they believed.

While the researchers for decades have actually stated that Alzheimer’s condition is the most usual form of dementia that could not hold true. They are finding signs that little strokes in even more usual and Alzheimer’s illness is less usual.   Add in typical people have plaques and tangles and there was no CT or imaging machines to find little strokes in the early days of defining Alzheimer’s illness. Therefore one can see that Alzheimer’s is over identified. Vascular illness is common and is the leading cause of death without a doubt so of course that affects intellectual condition as well.  

Alzheimer’s Disease or Dementia or other labels can be misleading

  I don’t like  these labels because there are no good therapies. Obviously, general avoidance is needed in all cases. The fact is no matter what sort of dementia you have all dementia labels will considerably impact your life.  Alzheimer’s dementia or multi infarct or little stoke dementia the problems are comparable. How will you get the assistance you need. Family caregivers and a family style care group are the very best responses.   caregiver-teamIn addition I like to re-focus readers on getting the best household care group and care setting possible as you begin to need any quantity of assistance for any reason to ensure the best care and life style possible for you as you age and need more care.  

Vitamins did not help however alcohol did correlate with longer life expectancy.

They found many things. Vitamins in their group did not help you age much better however drinking a little alcohol of any kind did seem to make you live longer. While that seems like information I wish to know if the reason alcohol helped was due to individuals who consume alcohol had more free time to enjoy a glass of wine and were somehow more relaxed instead of the drinking per se? Those problems are vital in all research studies however are often specifically omitted in a control group. Considering that those big, typical, however hard to study things are hard to measure, specify, study and differ extensively they cannot study them. How do you quantify the amount of joy, joy, or despair? What is the scale one would use to compare the quantity of depression? Similarly money and relationships are hard to study. While you may believe income is simple to study it is not. While IRS reported income is another tangible part of income financial success consisting of possessions, household resources, back up properties, household income, expenditures, relative income and way of life are all much tougher to obtain sincere answers to. While researches do include some details that your physician can make use of to work up a treatment plan for you research studies are not the last word.  

Exactly what is missing in this and all medical research studies?

The research studies are not the final word and no study states exactly what any one person should do given their social, financial, other medical and psychological wellness concerns dictate.   The doctor who understands you and all of those “other” social, financial, numerous complex and overlapping other clinical issues, that make you a human being uses that data and treats you with time, works day in and day out with you, to try those suggestions out on you and keeps track of the responses and all the time is stabilizing the many adverse effects and threats against the advantage you and the physician are seeing. That is old fashioned art of medicine. The flow sheets, and over specialized care system do not have connection of care and follow up of exactly what works consisting of all the realities that a lot of research studies swelling into the control group and implies do not matter like social supports, psychological hygiene, multiple complex other clinical problems, and financial issues. That is why clinical medicine is an art.   doctors

Alzheimer’s and wellness research summary.

Excellent research to view on 60 minutes and UC Irvine site.  Unfortunately there is no easy answer and the observations are just that, general associations however they are in not near to perfect by themselves in treating an individual. The effect of each differs with each person, their social and medical conditions and obviously the financial supports.   Related Links Distinguishing ‘senior moments’ from Alzheimer’s   Thanks for reading, commenting and Likes / Shares Dr Shawn McGivney

Alzheimer’s Disease Treatment. – Pills

In this section we talk about Alzheimer’s disease treatment and focus on the medications.

Aricept and Namenda

Pills like Aricept, (Donezepil), Namenda and Exelon might assist if you have an extremely pure case of very early age Alzheimer’s which tends to have fewer co morbid concerns that need to be considered. alzheimers-disease-pillsTacrine ( Cognex) Tacrine (Cognex) was the first of this course however had a lot of adverse effects it never became a basic treatment. Then when Aricept was presented with less adverse effects and adverse effects like stress and anxiety that were more challenging to see and different form the process of dementia it became popular as an expect the therapy of Alzheimer’s illness. In fact, one has to be careful when studying the advantages observed from all of these medicines to confirm that they are assisting.

Exelon Patch, Exelon

Other medicines in this course include galantamine (Razadyne – formerly referred to as Reminyl), rivastigmine (Exelon). They also prevent the enzyme acetylcholinesterase that damages acetylcholine and consequently enhance the concentration of acetylcholine in the blood and tissues.

Remember pills are just a small part of Alzheimer’s Disease Treatment.

Aricept  , Exelon Patch   http://www.aricept.com/ http://www.webmd.com/drugs/drug-14335-Aricept+Oral.aspx?drugid=14335&drugname=Aricept+Oral, http://en.wikipedia.org/wiki/Exelon

Namenda XR

Memantine is a oral medication for treating patients with Alzheimer’s disease. Other medications made use of for Alzheimer’s disease affect acetylcholine, among the neurotransmitter chemicals that afferent neuron in the brain use to communicate with one another. Memantine’s impacts are independent of acetylcholine and acetylcholinesterase. Glutamate is the main excitatory neurotransmitter in the brain. It is thought that too much excitement of afferent neuron by glutamate may be responsible for the degeneration of nerves that occurs in some neurological diseases such as Alzheimer’s condition. Like other neurotransmitters, glutamate is produced and released by afferent neuron in the brain. The launched glutamate then travels to close-by nerve cells where it attaches to a receptor on the surface of the cells called the N-methyl-D-aspartate (NMDA) receptor. Memantine blocks this receptor and therefore lowers the results of glutamate. It is assumed that by obstructing the NMDA receptor and the results of glutamate, memantine might secure afferent neuron from excess stimulation by glutamate. Typically physicians incorporate Namenda with other medications but the advantages of this strategy need to be recorded by the care team who see the client regularly. We applaud more research however want to focus on our belief that the most cost effective and best treatment plans are not pill based however caregiver and individuals based. http://en.wikipedia.org/wiki/Memantine

Pills Pale in Alzheimer’s Treatment efficacy compared to People

While physicians typically do not concern themselves with stabilizing costs total in a homeowners care strategy one ought to consider if the $50-100 / mo co pay might be better spent by paying to have a friend take that person out for lunch once a week or spending for a more skilled and socially linked caregiver. Be sure to follow our blog and read the next part in Alzheimer’s Disease Tips.  Alzheimer’s Disease Treatment Caregivers and Behavioral therapy   Check out Tender Loving Care Senior Residence as an example of superior treatment through continuity of care. Thanks for the Like and Share Dr Shawn McGivney  

Alzheimers Disease diagnostic criteria

While the requirements for diagnosing Alzheimers disease have been upgraded and now attempt to concentrate on identifying phases of senile dementia of the Alzheimer’s type (SDAT) in fact that is really subjective. For example if they have mild memory loss that is early, even more amnesia that is affecting their life more that is moderate and when advanced, after a long 10 year course of decline then they call it severe. Virtually talking,  that is very little aid.

doctor-patient-team

Alzheimers Disease Diagnostic Criteria

  Another mainly unstudied issue is the truth that plaques and tangles which are thought to be so important in at least early beginning Alzheimer’s Disease before 60 yrs old are confused when you include the reality that before the 1980’s and the introduction of CT of the head was started it was not used to include what in fact is a a lot more likely cause of cognitive loss which is small strokes. These can be called TIA, micro-vascular finding, or UBO’s on MRI. What we do understand is that it is way to very early to say what Alzheimer’s is and is not and how to separate out and quantify just how much of each part of aging that is influencing each of these Alzheimer’s cases.

New Alzheimer’s diagnostic criteria.

We applaud  this study effort and keep in mind a strategy to establish a tracer so we can in fact follow the plaques and tangles to lastly attempt to associate amount and sort of plaques and tangles which is the first step to in fact find Alzheimer’s and then establish treatments. Without that are reacting to drugs and since plaques and tangles are so typical in normal brains the rest is much less scientifically and reproducible.  

Missing diagnostic elements for Alzheimer’s disease

The diagnostic requirements are subjective and are complicated by constantly consisting of that “the signs and signs can not be due to any other issue.” In fact, older people have many concerns like poor balance, some quantity of dysphoria from numerous sorts of loss numerous verging on mild depression.

Alzheimer’s disease and SDAT Resources

  Alzheimer’s research to define dementia is needed.  However, brain diseases are hard to study and mild alzheimers will be hard to distinguish from personality disorder and just mild mood disorders.  Unfortunately defining the stages of any process has wide variation and alzheimers disease stages are no different. Early senility, early-stage, early onset Alzheimer’s Disease or moderate alzheimers are issues. In severe stage alzheimers one of the biggest issues in treatment are the related delusions, paranoia that come with it. Foundations like alz.org and the Alzheimer’s association and all alzheimers research has value.  But right now and most likely forever, the best, most cost effective, treatment is finding the best care givers and care team you can.   National Institute of Neurological Disorders and Stroke   Family Style Alzheimer’s care.   IF YOU ENJOYED THIS POST – LIKE AND SHARE IT.   Dr Shawn McGivney      

What is Alzheimer’s Disease?

son-caregiver

Definition of Alzheimer’s Disease

Alzheimer’s disease is a neurological disorder where the death of brain cells triggers amnesia and cognitive decrease. A neurodegenerative sort of dementia, the condition begins moderate and gets gradually even worse.

Types of Dementia

Like all types of dementia, Alzheimer’s dissease is triggered by brain cell death. Alzheimer’s is a neurodegenerative condition, which means there is progressive brain cell death that occurs over a course of time. Obviously if that cell death is because of little strokes or low blood flow that is actually more of a stroke. Many times that distinction is difficult to make with subtle vascular occasions. That difference becomes an issue about the anticipated efficacy of the medicines that are focused on increasing acetyl choline in the brain like Donepezil (Brand Aricept). It is thought that increased concentrations of acetyl choline are responsible for the enhancement seen throughout therapy with donepezil.

Diagnostic confusion affects Alzheimer’s treatment.

One possible reason for the restricted impact over all of those given Aricept is that in fact they have strokes or a substantial part of vascular dementia which would not be expected to enhance.

Pathological Changes in Alzheimer’s

The total brain size reduces with Alzheimer’s – the cells has considerably less afferent neuron and connections. Nerve cells (neurons) in the brain. In Alzheimer’s, there are tiny ‘plaques’ and ‘tangles’ in between and within brain cells. While they can not be seen or tested in the living brain affected by Alzheimer’s disease, postmortem/autopsy will always show small additions in the nerve cells, called plaques and tangles:. Plaques are chosen from in between the dying cells in the brain – from the accumulation of a protein called beta-amyloid (you may hear the term “amyloid plaques”). The tangles are within the brain neurons – from a disintegration of another protein, called tau. While they think plaques and tangles are part of the picture it is yet unidentified how lots of plaques and tangles correlate with the quantity, kind, and degrees of amnesia, loss of adl’s, or any of a much broader array of signs and signs. Likewise it is extremely fascinating to note that most regular 80 year olds who die from other causes but who had no or little memory loss at age 80 have considerable varieties of plaques and tangles at autopsy. Therefore, it is very tough to measure and differentiate how many plaques per high powered field on a microscope cause an offered level of signs and symptoms in each individual patient. All of these make it difficult to accurately define Alzheimer disease and the stages of Alzheimers Disease. Education

 Alzheimer’s  Educational Resources

http://en.wikipedia.org/wiki/Alzheimers Alzheimer’s foundation of America Alzheimer’s Association   Thanks for the Like and Share Dr Shawn McGivney  

ALZHEIMER’S DISEASE LAS VEGAS: HOW WILL NEW ALZHEIMERS TEST HELP YOU?

Alzheimers-disease-kf

At-home test may help diagnose Alzheimer’s

NEW TEST TO DIAGNOSE ALZHEIMER’S.  4 pg test, with written questions to answer and drawings.   While this article brings up another new tool the doctor can use to prompt himself to ask a wide range of questions in the interview it is not new.   A doctor always uses interview questions coupled with history and medical exam to narrow down all causes of cognitive loss so I am not sure how new this is. Alzheimer’s is very difficult to diagnoses as a single pure entity and in fact most often Alzheimer’s overlaps a lot with many other things like Dementia, Parkinson’s, Neurological issues, wide based gait, and cns vascular disease to name some.  Indeed, aging and benign forgetfulness also is in there to complicate the diagnosis and all the life causes of poor mood as one ages and declines in function.  In fact, a depressed mood in many ways is “normal” when faced with the end of life and loss of your friends, own abilities, and prospects for the future.  To call all of this Alzheimer’s or anything to me is misleading and instead I would prefer we focus on the treatment of having the best, most consistent, care team possible to deal with all chronically ill people no matter what the label. I am also not sure how they will treat cognitive loss differently from how they do today if you find it.  The current meds Aricept, Namenda, Exelon are hit or miss at best.

HERE IS WHAT WORKS AND HAS WORKED FOR ALL MEDICAL CARE AND ALZHEIMER’S CARE IF INDEED “ALZHEIMER’S” EVER EXISTS BY ITSELF WITHOUT OTHER MEDICAL, SOCIAL, FINANCIAL AND LIFE ISSUES.

The one treatment that works for all humans is caring and relationship building with the best care team you can find.  If you jump from one doctor to the next or the doctors don’t feel invested enough to stick with you as their / your treatment ideas are implemented and evolve you can imagine the care might be disjointed, incomplete and there by less effective.

Medicine is a process of trying various treatments and then following closely the response and adjusting those treatments.  People change, treatments change or evolve, and emotional health is all about relationships so that is the best and most cost effective treatment for all chronic disease and Alzheimer’s disease.

If you have a personal care team with a team leader or doctor who is active in sticking with you and willing to lead and make care decisions you can adjust to all diseases and emotional issues that arise.  Instead what we see is referral of the work and risk of the care and decision making to the next doctor.  In some ways that is kind of like warren buffets weapons of mass destruction and selling the toxic mortgages down the road to the next sucker but in this case we are hurting the humans and are passing along human suffering.  Homes are tangible products which in most cases are used and lived in and not decaying as a human being would which the service contract or mortgage is passed along.   In that case do not harm is the harm.  Being unwilling to make the diagnosis and try a treatment is more risky than not trying and just doing nothing or “no harm”.    You never know what will happen and what will change after you make the first choice of treatment to try that is why medicine is an art and clinical process and requires continuity of care and a steady relationship with the doctor to follow, adjust, and evolve your multiple level of treatments.  Even if your first treatment works you would not stop there but will add, adjust, modify treatment constantly.  There is no one flow sheet to follow.  All humans are complex beings and the choices in treatment are even more complex when you include the finance, social and emotional elements of those treatments.

 

Those who read my blog will recognize this quote that really sums up all medical and human caring:

“If you treat the disease you win or lose but if you treat the person you win NO MATTER WHAT THE OUTCOME.” Patch Adams, the movie Patch.

That last part is the key.  If the doctor and patient stick together, work together, in all care settings dealing with ALL PHYSICAL, MEDICAL, EMOTIONAL, SOCIAL, AND  COMPLEX OVERLAPPING LIFE ISSUES then you and those around you who care and are active in the care process are likely to feel  that they have made a difference and done the best possible in these difficult situations.  One might even say they feel good about whatever happens.

 

We all have the choice to choose our care setting and there by care team.  If you instead choose the insurance first then you really have no idea who or what care you will get.  Also if the doctor is the direct employee in practice of the insurance company and he has less or no expected interdependent relationship with the patient and their social system then it is likely both will act to protect themselves first and the care will be less consistent.  The patient might save money since that is all they can do and the doctor / representative of the insurance company might save time and pass the toxic risk / work of providing care, trying, making decisions to the next doctor.

GOOD NEWS!  WE ARE IN CONTROL.  WE CAN CHOOSE OUR CARE SETTING AND CARE TEAM!

We all can visit many care settings and choose the one we want to pay for.  If we have Medicaid or are on a government program we still can choose by visiting many providers of that care type and choosing one closest to our most frequent visitor and the best one.  We all need to make the time and take the time for this search when it comes.

I hope all are empowered by this.  You can choose!  All doctors and care settings are not the same.  Your control is by visiting many and choosing the best care team possible.  Indeed, in the end you might find it is cheaper to pay a fixed price than the bait and switch model of a relatively lower advertised cost for the room and then add ons for the care or assistance and medication management etc.

What do you think?  Share your views here.

Check out these fantastic Residential Care and Alzheimer’s Care Services.  Remember to consider all of these in your search for a care team since they all provide care —Residential care, Assisted Living, Home Care, Hospice Care, Dementia Care, Alzheimer’s Care, Memory Care and Nursing Homes all offer custodial care but what varies is the care team you choose when you choose any care setting.  Who is doing the day to day training, supervision, and support and hands-on management and who is doing the custodial care?   Look for the care team to get the best Assisted Living, Residential Care, Home Care, Retirement Community, Hospice Care, Dementia Care, Alzheimer’s Care and Memory Care in any care setting.  Look beyond the setting label and find out who you are getting before you buy.

Tender Loving Care Senior Residence – Or Tender Loving Care Senior Residential Care, Costa Brava  –

Educational video links

TLCSRLV youtube Channel.  Subscribe for free. Assisted Living and Residential Care Home Video Tour.   Assisted Living and Residential Care Home Testimonial    THANKS FOR LIKING AND SHARING  Dr Shawn McGivney