Wednesday, August 3, 2016

Can we Broaden the Conversation to the Benefit of All?


The question is: what can we do to raise the level of awareness for all forms of Dementia, that would also include Alzheimer's?

Can we, as Americans and U.S. policymakers, do what the World Health Organization and others in the global health community do? Refer more broadly and inclusively to the issues of Dementia that include: Alzheimer's; Vascular; Mixed; Lewy body; Frontotemporal; Chronic Traumatic Encephalopathy (CTE); Traumatic Brain Injury; Wernicke-Korsakoff Syndrome; Creutzfeldt Jakob Disease; HIV-AIDS, and others, rather than narrow-casting most all of our words, government plans, and efforts mainly just around Alzheimer's?

When we do, those living with Alzheimer's disease (AD) will benefit as will the huge number of people that have Dementia, but not necessarily AD. Because it's better to do so, policymakers talk about cancer, heart disease, diabetes and other major pressing health worries mainly in the broadest terms, but when it comes to Dementia... most only know of AD, and often don't understand how Dementia and AD relate to one another. If AD alone is considered the 6th leading cause of death in America, just imagine what happens when you nearly double the numbers to include all forms of Dementia... it's place in American health priorities will rise even faster.

Dementia is an epidemic both nationally and globally. By seeking to be more inclusive, rather than less inclusive, we shine a brighter light on millions more cases of Dementia, as well as the needs of those living with it, their care partners, and the greater costs for families. When it comes to funding research as well as creating better person-centered care plans for insurers to cover and consider (including Medicare and Medicaid)... when we speak more openly of the larger numbers affected... it puts an additional premium on the rewards for finding medical cures and supporting non-medical innovations to deal with all forms of Dementia.

Whether you're a dyed in the wool blue supporter, a red supporter, or somewhere else on the political continuum, please take the time to Know Dementia and "see more purple." Actively demand of your civil servants that all forms of Dementia take the larger stage together for the purposes of research, concern and care.

- Kevin Jameson, DrHC,
President of the Dementia Society of America

#dementia #abetterwayforwward #seemorepurple #knowdementia​ #theatlanticdnc

This post is the result of a meeting and subsequent Q&A held during the Democratic National Convention in Philadelphia, PA on Monday July 25th, 2016. At approximately the 1 hour mark into this forum, the Dementia Society of America was honored to have the opportunity to ask a question of Teresa Osborne, Secretary of the PA Dept of Aging, as well as Carol Lippa, Prof. of Neurology at Drexel Univ. (panel moderated by Steve Clemons, Wash. Editor at Large of The Atlantic). Click here to see the video of the entire session.

Friday, July 22, 2016

Curing Disease: More Insight Instead of Mere Effort




Curing disease correlates with insight, not blind effort. There is an eternal trade-off between insight and effort. If we think carefully, understand the problem, and plan, then effort is minimized. If (as too often happens) we think carelessly, misunderstand the problem, and rely on hope instead of planning, then effort is not only maximized, but is usually a complete waste. Lacking insight, we foolishly flush both money and effort down the drain. In the case of clinical trials for Alzheimer’s disease – and in fact, all age-related diseases – this is precisely the case.

The major problem is a na├»ve complaisance that we already understand aging pathology. If there was a single concept that is key to all of aging, it is the notion that everything in our organs, in our tissues, and in our cells is dynamically and actively in flux, rather than being a set of organs, tissues, cells, and molecules that statically and passively deteriorate. Aging isn’t just entropy; aging is entropy with insufficient biological response. Senescent cells no longer keep up with entropy, while young cells manage entropy quite handily. At the tissue level, the best example might be bone. We don’t form just bone and then leave it to the mercy of entropy, rather we continually recycle bony tissue throughout our lives – although more-and-more slowly as our osteocytes lose telomere length. This is equally true at the molecular level, for example the collagen and elastin molecules in our skin. We don’t finish forming collagen and elastin in our youth and then leave it to the vagaries of entropy, rather we continually recycle collagen and elastin molecules throughout our lives, although more-and-more slowly as our skin cells lose telomere length. Aging is not a process in which a fixed amount of bone, collagen, or elastin gradually erodes, denatures, or becomes damaged. Rather, aging is a process in which the rate of recycling of bone, collagen, or elastin gradually slows down as our shortening telomeres alter gene expression, slowing the rate of molecular turnover, and allowing damage to get ahead of the game. We don’t age because we are damaged, we age because cells with shortening telomeres no longer keep up with the damage.

The same is true not only of biological aging as a general process, but equally true of every age-related disease specifically. Vascular disease is not a disease in which our arteries are a static tissue that gradually gives way to an erosive entropy, but an active and dynamic set of cells that gradually slow their turnover of critical cellular components, culminating in the failure of endothelial cell function, the increasing pathology of the subendothelial layer, and the clinical outcomes of myocardial infarction, stroke, and a dozen other medical problems. Merely treating cholesterol, blood pressure, and hundreds of other specific pathological findings does nothing to reset the epigenetic changes that lie upstream and that cause those myriad changes. Small wonder that we fail to change the course of arterial disease if our only interventions are merely “stents and statins”.

Nor is Alzheimer’s a disease in which beta amyloid and tau proteins passively accumulate over time as they become denatured, resulting in neuronal death and cognitive failure. Alzheimer’s is a disease in which the turnover – the binding, the uptake, the degradation, and the replacement – of key molecules gradually slows down with telomere shortening, culminating in the failure of both glial cell and neuron function, the accumulation of plaques and tangles, and ending finally in a profound human tragedy. The cause is the change in gene expression, not the more obvious plaques and tangles.

Our lack of insight, even when we exert Herculean efforts – enormous clinical trials, immense amounts of funding, and years of work – is striking for a complete failure of every clinical trial aimed at Alzheimer’s disease. Naively, we target beta amyloid, tau proteins, phosphodiesterase, immune responses, and growth factors, without ever understanding the subtle upstream causes of these obvious downstream effects. Aging, aging diseases, and especially Alzheimer’s disease are not amenable to mere well-intended efforts. Without insight, our funding, our time, and our exertions are useless. Worse yet, that same funding time, and exertion could be used quite effectively, if used intelligently. If our target is to cure the diseases of aging, then we don’t need more effort, but more thought. However well-intentioned, however much investment, however many grants, and however many clinical trials, all will be wasted unless we understand the aging process. Aging is not a passive accumulation of damage, but an active process in which damage accumulates because cells change their patterns of gene expression, patterns which can be reset. Curing Alzheimer’s requires insight and intelligence, not naive hope and wasted effort.

#alzheimers #dementia #telomerase #research

Contributing Author: Dr. Michael Fossel earned both his PhD and MD from Stanford University, where he taught neurobiology and research methods. Winner of a National Science Foundation fellowship, he was a clinical professor of medicine for almost three decades, the executive director of the American Aging Association, and the founding editor of Rejuvenation Research. In 1996, he wrote the first book on the telomerase theory of aging, Reversing Human Aging, describing the medical aspects of extending human telomeres, reversing aging, and curing age-related disease. In 2004, he authored the magisterial academic textbook, Cells, Aging, and Human Disease, and in 2011, he coauthored The Immortality Edge, a bestselling discussion of the potential for extending the human lifespan. He currently teaches The Biology of Aging at Grand Valley State University.

The world's foremost expert on the clinical use of telomerase for age-related diseases, Michael has lectured at the National Institute for Health and the Smithsonian Institute, and continues to lecture at universities, institutes, and conferences throughout the world. He has appeared on Good Morning America, ABC 20/20, NBC Extra, Fox Network, CNN, BBC, Discovery Channel, and regularly on NPR. He is currently working to bring telomerase to human trials for Alzheimer’s disease.


The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org


Sunday, June 12, 2016

The Creative Spirit and Music


Music connects people to their life history and culture. Music transports people back to happy and sad places such as having attended a concert with friends or as a reminder of a long-gone relative.

Listening to or making music is a wonderful way for you and your loved-one to get a mini-vacation from illness as well as to stimulate conversation different from what he or she had for breakfast.

Clinical case studies show when people who have dementia listen to the music of their youth they become animated and may tap their feet to the rhythm or sing. Music therapists say that music therapy improves mood and behavior as well as lessens reliance on behavior-modifying medications.

Research shows that active involvement is more beneficial than listening to music. Singing and playing music, especially when preparing for a performance, improves focus, attention and memory. Opportunities to socialize and, perhaps even more importantly, share with others, is another important benefit of active participation.

Most people have positive reactions to the popular music of their youth or the kinds of music that reflect their taste and preferences. Therefore don’t assume the person in your care will want to hear Glenn Miller or Bing Crosby. Baby Boomers may prefer Elvis Presley, Buddy Holly, the Beatles or the Rolling Stones. Some people may favor classical music, jazz, or opera.

There are many simple ways to bring music into your loved-one’s life. At home you can download music from the internet and watch or listen to broadcast performances. Together, you can sing, play a music instrument, or use bells, sticks, and homemade drums to create a home-style rhythm band. Consider inviting family members, friends as well as other caregivers and their loved-ones to participate in a jam-session. Serve coffee and cookies and you have an event!

It’s always a nice break to take excursions outside of the home. Combining an early afternoon concert with lunch or an early supper is another way to enjoy a day and enrich a relationship. You can find local and sometimes no-cost events in the calendar section of your local newspaper. Community orchestras and choral groups often give public performances. Senior centers are another place where you can find performances as well as music classes your loved-one might enjoy.

Many non-profit organizations, such as the Dementia Society of America, sponsor music programs designed especially for people who have dementia and other disabilities. An internet search is an easy way to find music programs and performances in the community where your loved-one lives.

Janet Yagoda Shagam, PhD, is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” Available through Amazon.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

Creating a Dementia-Friendly Home


The words “house” and “home” aren’t the same. For most people, the word “house” produces a mental image of a building. In contrast, the word “home” stimulates an array of complex feelings.

“Home” may bring back memories of a mother’s cooking, the view from a childhood tree house, the sound of children playing, and the feel of a loved-one’s kiss. For nearly everyone, home is more than four walls and a roof. Home is memory, personal history, and a bountiful source of comfort.

A dementia-friendly home is one that provides both emotional and physical comfort and safety. Family photographs, the worn but still comfortable chair, an ancient radio, and a hugely-ugly coffee mug – are all remnants of a life-well lived. While you may consider them clutter, your loved-one finds enjoyment and pleasure in their presence. The chair may remind him or her of having once read bedtime stories to you and your siblings. The radio might encourage conversation about the days when people listened to baseball games. And what does the hugely ugly coffee mug contribute to a dementia-friendly home? It doesn’t matter, the mug isn’t yours.

Creating a physically safe environment for your loved-one requires sensitivity, practicality and acknowledgement of his or her capabilities. It is more likely your loved-one will accept the changes to his or her personal space if you describe the installation of bathroom handrails as an “update” and the new automatic tea kettle as a “gift.”

As a first step, assess your loved-one’s home for areas and objects of potential danger. Examples of simple changes include installing automatic shut-off timers on appliances such as the toaster oven. Replace the overhead microwave oven with a countertop model. Remove tripping hazards and improve household lighting. Adjust the thermostat on the hot water heater to a lower temperature. Install handrails in the bathroom. Use safety locks on the cabinets that contain toxic cleaning supplies. Remove locks to prevent your loved-one from becoming entrapped in the bathroom or bedroom.

Another approach to creating a dementia-safe home is to learn about the new assistive technologies that help disabled people live at home for as long as is possible. Smart phone apps as well as televideo and other kinds of monitoring systems can let you know if your loved-one is as active as expected, has left a certain area, or if an appliance has not been turned on or off. There are smart phone apps that can remind your loved-one to take his or medication, give verbal instructions on how to use an appliance, find misplaced items, as well as keep track of day and time.

Good intentions aside, creating a dementia-friendly home for your loved-one takes insight and experience. Your internet browser and the key words -- home, safety, assessment, and dementia--will link you to many excellent on-line resources.

Another option is to have an eldercare home safety consultant inspect your loved-one’s home. Taking into consideration your loved-one’s capabilities, he or she will inform you of needed improvements. The safety consultant can also suggest where to buy home-safety equipment and, if need be, people to install such things as bathroom handrails. Use your internet browser and the key words--eldercare home safety consultant--plus the location where you loved-one lives to find locally-conveniently home safety services.

A dementia-friendly home is one that respects your loved-one’s dignity, while at the same time, and an illusion of independence.

Janet Yagoda Shagam, PhD, is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” Available through Amazon.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org


Learn to Play an Instrument

Music is incredibly important for enhancing brain development. Numerous sources, including Time Magazine, have published articles extolling the value of learning to play an instrument, and how it can improve academic achievement, among other cognitive skills. 

The key is actively engaging in the instrument. When we look at our ability to excel at mathematics and develop psychomotor skills and manual dexterity, people who play music are simply better at these things than people who don’t.

Learning to play involves learning to read music, which is highly analytical and mathematical in nature. Playing the instrument involves motor neurons and many areas of the brain in the process as you learn to perform smoothly. Remembering the song, the arrangements, and the changes in tempo also taps into memory and cognitive ability.

There are also ‘brain balancing’ benefits through right-brain, left-brain stimulation. Playing music (or, even singing) with other people or in a band also improves interpersonal skills and team building. 

A professional drummer, after having participated in a brain training program here in 2014, signed a contract with a major country music band because his drumming skills had so dramatically improved. His improved mathematical skills, focus, and attention, as well as his improved ability to use his left (non-dominant) hand, allowed him to follow his dream.

The benefits of music also extend to perseverance; sticking to something worthwhile over time. Coordination, reading and comprehension skills, stress relief, and responsibility (i.e. taking care of your instruments) are all powerful ‘side-effects’ of playing music. Self-expression can also be improved. There are some that struggle with their ability to communicate through words, and music can be their vehicle for communication.

Some woodwind and brass instruments will help improve your breathing and oxygen levels. Even if you’ve never played an instrument before, it’s never too late to learn. 

Contributor Author: Dr. Michael Trayford is a Board Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For more information, please visit www.ApexBrainCenters.com/memory.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org


Make Your Bed


On the surface, the idea of making your bed might seem mundane. However, there are significant benefits to making your bed each morning. Many successful organizations, including the military and Psychology Today, have looked at the benefits that making your bed has for the brain.

It’s something that a lot of people often leave behind. You wake up, the room is dark, you take a quick shower, and go about your day. Then you come home at night and you see a big pile of blankets and sheets right in the middle of the bed and you accept that it still needs to be made. Sometimes it can even be a little bit stressful to not have your bed made when all you want to do is go to sleep.


There is mounting evidence to support the fact that making the bed in the morning contributes towards making a person happier and more successful. A recent online survey of 68,000 people, which is a fairly substantial base of people, found that 59% of people don’t make their beds and 27% do. The remaining 12% were people that have someone else, like a housekeeper, make their bed for them.


They also found that 71% of the bed makers consider themselves to be generally happy with their lives. 62% of non-bed makers admitted to being generally unhappy. Of course these results can vary by the life circumstances of the individual. It can extend to their job satisfaction, owning a home, exercising regularly, proper diet, feeling well rested. These things are all associated with people that fix their beds every day.


There is basis behind fixing your bed each morning. What happens is you wake up and right away you’re training your brain to do a task and attend to an activity that makes you feel good. As a result, you start your day with a sense of accomplishment. This sets the tone for the rest of your day and carries over to completing other tasks. It is the start of the snow ball effect that encourages you to keep a proactive attitude throughout the rest of your day.


When you stop and think about it, it only takes a couple of minutes in the morning to stop and make your bed. Start developing the habit, stick with it, and see what happens. I guarantee, it will help to start your day off on the right foot, because it’s the little things that make a difference.



Contributor Author: Dr. Michael Trayford is a Board Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For more information, please visit www.ApexBrainCenters.com/memory.


The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

Sunday, June 5, 2016

Memory Loss and Family History


Late stage Dementia can create an inability retell certain personal and family histories. Dementia might make long-held treasured memories slow and difficult to retrieve, or they morph into something different than how you remember them.

Research shows that people who have a terminal illness, desire opportunities to give as well as to receive. Compiling a family’s history through recordings and other activities is a gift the person who has dementia can give to his or her family.


Together, family members and their loved-one can explore the treasure trove of stored photographs and other memorabilia. With or without the assistance of a professional videographer, audio and video recordings give another perspective about the people and events that molded your loved-one’s life and perhaps influenced yours as well.


Before getting started, it is important to consider the permanence and availability of electronically-stored photographs and audio and video recordings. Floppy discs and hard discs have been obsolete for many years. Compact discs (CDs) and hard drives are quickly becoming phased out - and there is no reason to assume that cloud computing will last forever.


Probably the best solution, in addition to electronic storage, is to make hard (paper) copies of photographs, scanned memorabilia, and transcripts of audio recordings. With the help of online self-publishing services you can design a beautiful book that contains selected images, transcripts and commentary.


Some ideas:

1. Video record your loved-one as he or she tours their home or another meaningful location. Ask “tell me about questions” to get the stories associated with framed photographs, a chipped and repaired vase, or a lovely rose garden. Encourage further discussion by asking logical follow-up questions. And above all – listen!!
2. Record your loved one as he or she recalls various events such as a particularly exciting fishing trip, your birth, or having fought in the Vietnam War.
3. Create a memory box that contains small objects plus a few sentences that describes the significance of each item. Have your loved-one write memory “tweets” on slips of paper. Memory Tweets might be something like “Make my steaks medium rare and my eggs over-easy, “or “I remember the day you were born. The sun was shining and I was the happiest person alive.” 


Janet Yagoda Shagam, PhD, is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” Available through Amazon.



The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

Notes:
1. KE Steinhauser, et. al. “In Search of a Good Death: Observations of Patients, Families, and Providers,” http://www.eutanasia.ws/hemeroteca/t377.pdf (accessed May 2, 2016)

Medical Records


Many of us, when unable to answer simple questions about the medications we take, promise ourselves to make a list before our next appointment. We know it’s important, but we never seem to get around to doing so. Besides, we are quite sure our prescription history is already a part of our medical history file.

However, your doctor may not know about the prescriptions you have received from other clinicians, or if you take dietary supplements such as vitamins or alternative medicine herbals such as echinacea. Conversely, an emergency room doctor or another clinician may not easy access to your medical records.


Keeping a current record of all the medications your loved-one takes is especially important when dementia is part of the equation. People who have dementia may see physicians that, in addition to his or her family doctor, include a geriatrician, a neurologist or a psychiatrist. It’s also quite likely the person who has dementia will require evaluation and treatment for conditions unrelated to his or her dementia diagnosis. In addition, with the progression of dementia, memory loss and other disabilities, makes it imperative that a family member or other caregiver have access to the medication list.


As a first step, make a complete list of the medications, supplements, and any herbals your loved-one may use. The list, in the form of a table, should include the following information: the name of the medication, the daily dosage, the prescription number, the pharmacy contact information, the prescribing clinician’s name and contact information, as well as the location of the medication in your loved-one’s place of residence. You might also want to jot down a few words about any side effects, you or other people may have noticed.

As a second step, and on a need-to-know basis, a hard copy of the compiled information should be available to other family members as well as to other caregivers responsible for your loved one’s care. Place another paper copy in a folder or a three-ring binder and leave it by the telephone. The folder, in addition to the medication list, should also contain other important names and numbers such as the contact information for your loved-one’s doctors, as well as for the local hospital, ambulance service and emergency room.


Create a file on your computer hard-drive that contains the all information you need to oversee your loved one’s care. Doing so will make it easy to update your loved-one’s medical records. 

Do keep in mind that only certain people should have access to your loved-one’s Medicare, health insurance and credit card information as well as other types of confidential information. Doing so will help to prevent financial abuse and identity theft.

And while you are at it – this is a good time to finally get around to tabulating your medications and other types of personally important information!



Janet Yagoda Shagam, PhD, is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” Available through Amazon.


The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org


Repeat Names Three Times


Memorizing names can be a serious challenge for some people. The world is rife with all kinds of tricks for putting faces with names and the like. Most of them have various degrees of success. In a certain light, saying someone’s name three times during your first meeting can essentially be a type of brain game.

Most brain games are simple exercises to help your brain work better. Saying someone’s name three times is as much about memorization as it is about developing conversational skills and working on associations.


I must admit that I’m not the best when it comes to remembering names. I’ve tried a lot of different tips and tricks over the years and very few of them ever really helped.


Saying someone’s name three times is a simple brain games you can do when you meet people (and they will never know it). The goal is to be subtle about it. You don’t want to shake someone’s hand and simply rattle off their name three times.


What you want to do when you first meet somebody: at the first handshake you want to repeat their name. For example, if I was meeting someone named Jason for the first time I would say, “Hello Jason, how are you doing?”


As the introduction and conversation flows naturally, I follow up with opportunities. “So tell me Jason, where do you live?” So, at this point I’ve already said his name twice. My brain is getting used to that and it’s associating that person’s face, his demeanor and everything in that environment at that particular time.


Within the next minute or so, create another opportunity to use their name again. Something along the lines of “So Jason, how many kids do you have?”


Not only are you repeating their name to put it into your memory, but you’re also creating associations that are relevant to them (i.e. where they live and how many kids they have).


Of course, there are a lot of different topics you could touch on. Family, hobbies, where they live, or what they do for a living are all common topics that help you learn more about them and create memorable associations that will stick in your mind the next time you meet them.


With regular practice, I think you’ll find that you can get to know a lot about people in a relatively short period of time. This is especially helpful if you’re involved in any kind of networking or social groups, where you’re trying to learn as much as you can about someone in a short period of time.


The key is to drop their name into the conversation. As you say the name, really try to emphasize your focus on their face or their demeanor. This could also include finding a similarity to someone you know that has the same name.



Contributor Author: Dr. Michael Trayford is a Board Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For more information, please visit www.ApexBrainCenters.com/memory.


The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

Sleep, Establish and Routine


When it comes to sleep, establishing a routine is critical. Sleep-wake cycles are for the brain what your transmission is for your car. Further, sleep issues are often associated with dementia and may very well be a catalyst for dementia onset and severity.

In this day and age a lot of people are simply going to bed whenever they crash or whenever their kids or life demands allow them to crash. When they wake up, it’s rarely of their own accord. Instead they tend to wake up to loud alarm clocks blaring at them, somebody else waking them up or something else like the dog jumping on the bed.


Sleep routines are critically important for brain function and it can be as simple as setting a time to go to bed and a time to wake up, then sticking with it to make it a part of your regular routine. Establishing a routine helps your body find homeostasis with hormone production, regulating blood pressure, as well as other things like the glymphatic system which removes toxins from the brain while you sleep.


This is often easier said than done. Family life, career demands, pets and a lot of other distractions can make it challenging to establish a set sleep routine.


There’s no magic number for the number of hours you need to get each night, although 7-9 hours is a good rule of thumb. The brain needs a good solid two to three deep sleep cycles per night and you can’t do that if you’re only getting three or four hours of sleep per night.


The key is to listen to your body. Ideally you want to establish a sleep routine where you’re falling asleep easily at a set time and when you wake up in the morning you feel energized, alert and ready to face the day.

Some people might only need six hours of sleep while other people might need eight or even ten hours! There are some people that meditate quite regularly and the deep state training involved in the process means they may only require five or so hours of sleep each night.


Sleep science is constantly changing as research reveals more and more of the positive benefits of sleep and how to incorporate a positive sleep routine in your daily life.  What it boils down to is the routine that is best for you, your body and what makes you feel the most rested. 



Contributor Author: Dr. Michael Trayford is a Board Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For more information, please visit www.ApexBrainCenters.com/memory.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

Saturday, May 28, 2016

What Causes Dementia?


We don't know exactly. What actually causes dementia is a difficult question. There are an infinite number of factors that singly or in combination may increase risk for, or are associated with having dementia. To add to the mind-boggling complexity, each of us are the outcome of a unique collection of genes, lifestyle behaviors and environmental exposures.

Similar to the word “cancer” the word “dementia” is an umbrella term that includes many kinds of dementia. And again, similar to cancer, the dementias share certain characteristics such as memory loss, but also have ones specific to a particular type of dementia.  For example, Alzheimer disease tends to have a slow progression and vascular dementia tends to progress with bursts of increased disability.


In the case of early-onset Alzheimer disease, the answer might be less complicated than it is for other kinds of dementia. Scientists have identified genes that appear to cause the kind of dementia that strikes people younger than 65-years of age. People who have early-onset dementia genes can pass the trait on to their children. However, even these findings open the door to more questions. Do the early-onset genes actually cause the disease or do they increase risk to the extent that makes having early-onset dementia a given. Perhaps the relationship between genetics and this form of dementia involves other genes and factors, that in combination, cause early-onset dementia. 


Genetics may or may not play a role in the onset of other kinds of dementia. For example, approximately 15 to 40 percent of people who have frontotemporal lobe degeneration have a family history that includes at least one other relative who also has or had this kind of dementia. However, only 10 percent of these individuals have a form of the disease attributable to specific genes. This means that for 90 percent of cases, scientists have yet to discover genes that increase risk for having Frontotemporal lobe dementia. 


Although one cannot change their genetics, it is possible to reduce risk for dementia by modifying certain lifestyle behaviors. 


There are many lifestyle behaviors that appear to increase risk for dementia. Some of these include obesity, high blood pressure, smoking, diabetes, and lack of regular exercise. Social isolation, not having meaningful friendships, also appears to increase risk for dementia. Another risk factor is not having the mental stimulation that comes with acquiring new skills and knowledge. 


The good news is one can choose to reduce the likelihood of dementia by losing weight, eating a healthy diet, refrain from or stop smoking, exercising, as well as by attending community center activities or taking classes at a local college or university. 


Unlike behavioral changes, it’s difficult to impossible to avoid environmental risk factors. While one can make efforts to avoid environmental toxins such as second-hand smoke, it’s not possible to avoid to the fumes that come from car exhaust or from certain kinds of building materials. 


Over the past 50 years, there has been a dramatic change in the 10 leading causes for death. Deaths caused by acute infectious diseases and accidents have given way to lingering diseases such as cancer and dementia – both of which tend to occur later-in-life. Therefore, for many people, advanced age is their biggest risk factor for having dementia.



Janet Yagoda Shagam, PhD, is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” Available through Amazon.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

Money Does Matters


For many families, finances and the cost of dementia care can be one of their greatest worries. Families hope there are sufficient assets to meet the expenses for the next four to 10 years. According to a Care.com Usage and Attitude Family Caregiver survey, in 2014, over 50 percent of families spent more $5,000 per year to cover out-of-pocket expenses. The same survey reveals that seven percent of survey respondents report having spent more than $50,000 per year to cover the costs of their loved-one’s care.

Talking about personal finances is often difficult. To make these initial family discussions go as smoothly as possible, invite an elder-care lawyer, a financial advisor, or a geriatric care manager to guide discussion and offer their expertise. The goals of this and ensuing conversations are to define needs and expenses, and based on this information, develop a realistic financial plan. 


Dementia care is more than house utilities and groceries. Home expenses also include rent or mortgage payments, house maintenance, home and car insurance, as well as assorted federal, state and local taxes. Dementia care also involves the out-of-pocket deductibles and co-pays associated with the diagnostic procedures and treatments for dementia and any other medical conditions your loved-one may have. Do not overlook the expenses of such things as personal care supplies, equipment rental and purchases, adult day care and assisted living fees.


Sadly, circumstances may be one where your loved-one has neither the sufficient savings nor income to pay for the services he or she needs. 


What happens then? Sometimes families are able and willing to pay the difference--and sometimes not. Long-term care insurance is expensive, must be purchased well before need, and is not long-term in the sense of “forever care.” Often families must resort to state and federally-funded programs. 


Medicare, parts A, B, and D and most private insurance policies pay only for expenses not related to having dementia. However, your loved-one may be eligible for dementia coverage under one of several Medicare Special Needs Plans or “SNPs.”


There are other avenues worth exploring – all of which have specific eligibility requirements. Some of these are: Medicaid, a program that helps very low income people get the healthcare they need and the Program of All-Inclusive Care for the Elderly (PACE) that provides comprehensive medical services to Medicare and Medicaid enrollees. 

The United Stated Veterans Administration (VA) offers a broad range of services to help veterans who have dementia. To take advantage of the various VA programs and services, the veteran must be enrolled in the VA healthcare system. While the veteran does not have to have a service-related injury to receive dementia benefits, the veteran must have an honorable or a general discharge. 


Other strategies to supplement your loved-one’s income include a Home Equity Conversion Mortgage (reverse mortgage), the conversion of certain kinds of life insurance into long-term care insurance, as well as borrowing against the value of a life insurance policy. Disability insurance is another resource when dementia makes employment no longer possible.  


Community not-for-profit organizations offer many helpful services that can range from household repairs and yard maintenance to elder daycare programs and caregiver respite grants. Sliding scale fees are another not-for-profits feature. Therefore, your loved-one will have to meet eligibility criteria, to receive a reduced rate.



Janet Yagoda Shagam, PhD, is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” Available through Amazon.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

Understanding Behaviors and Emotions


Some people find the loved-one in their care almost seems like a stranger - perhaps morphing from a kind and helpful person to a combative and vulgar one. Other times, dementia seems to magnify personality traits. When this happens people often say, it’s my father only “more so.” 

Though difficult, do try to remember it is the disease and not the person who is responsible for these worrisome, and sometimes embarrassing, changes to his or her temperament. 


Dementia alters and destroys brain structures. The consequences of the damage include loses in the ability to accurately process and relay information. Another outcome is the inability to control emotions such as anger and censor impolite and socially inappropriate behaviors. Because of the progressive nature of dementia behavioral changes tend to worsen with time.


Emotional blunting, or the inability to express verbal and non-verbal feelings, is another characteristic of having dementia. The inability to express needs and feelings can make people who have dementia angry, combative, and sometimes violent. Many people who have dementia experience depression. 


Dementia can also affect sexual behaviors in ways that are often unpredictable. Some people who have dementia cannot understand that it is impolite to touch or expose their private areas in public or make unwanted or inappropriate sexual advances.


There are many simple ways to reduce the incidents and intensity of these difficult-to-manage behaviors. However, first consider other reasons for your loved-one’s difficult behaviors. Drug interactions and side effects may intensify dementia symptoms, cause hallucinations, as well as intensify agitation and combativeness. Others explanations for uncharacteristic behaviors and emotions can include pain, fatigue, over stimulation, as well as other medical problems such as a bladder infection.


There are many strategies you can use to prevent or diffuse your loved-one’s outbursts. Perhaps the most important one is communication. Do not argue with your loved-one, remind them of what they have forgotten, or ask probing questions to assess their memory. Use supportive language to affirm you are listening, respecting his or her concerns, and responding in an appropriate manner. For example, it is better to respond to fearful, but unlikely true incident is to say, “I’ll look into it” rather than “don’t be silly.” Sometimes all it takes to is a calming hug or a kind and supportive touch.


Distraction and redirection is another useful way to diffuse anger or sexually aggressive behaviors. Give your loved-one a snack, go for a walk, point-out a pretty flower or talk about the weather.


Sometimes your loved-one’s behavior is more than you can handle. When this happens, calling the Crisis Intervention Team, rather than 911, may be the best option. The Crisis Intervention Team, (CIT), refers to the police officers in your community who have special training in how to manage a variety of behavioral, drug-related, and mental health crises. 


Having the CIT there to help with unmanageable or threatening behavior can prevent a difficult situation from escalating to something worse. The CIT can also accompany you and your loved-one to the medical facility. Be sure to include the phone number of your local CIT in your list of emergency phone numbers. 



Janet Yagoda Shagam, PhD, is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” Available through Amazon.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

What is Neuroplasticity?


Put simply, neuroplasticity is the brain’s ability to change and grow throughout time, dependent on its environment. The brain is a sensory driven organism. This means that it thrives and survives and functions based on the input it receives. The brain essentially is a relay station, the information coming in influences the information going out. 
So we want to make sure our brain is wired in the best way possible.

There is a brilliant quote from neuroscientist Santiago Ramon y Cajal that said, “Any man can, if he so desires, become the sculptor of his own brain.”


Cajal said that at the turn of the last century when most everything we knew about the brain came from head to toe physical examination. In fact, Cajal was one of the first people to really study brain cells under a microscope. The conventional wisdom at that time was that your brain was hardwired and what you had at birth was how your brain would be the rest of your life.


In recent years we have learned that the brain is capable of change. Neuroplasticity is the key concept for everything we talk about in regards to brain training.


The picnic game exercise is just one of many examples. The game is played with two or more people. It starts out by the first person saying something like “I’m going on a picnic and I’m bringing an apple,” or something that starts with the letter A. The second person says they’re going on a picnic and they’re going to bring an apple and something else that starts with the letter B. 


The game continues on with each person reciting the items in the list and then adding an item that starts with the next letter of the alphabet. When you expand it out through the alphabet and you get to the letter Z it can actually be rather complicated.


There are two points to this game – improvement in working memory and short term memory, which are very well connected. Short term memory is where you hold onto a piece of information for a brief period of time. If that information is worth committing to long term memory, it will be based on repetition or importance. Repetition is somewhat obvious where you do something over and over again until it becomes learned (e.g. playing a guitar).


Importance is related to something happening that has significant impact. For example, if someone was hit by a car in a hit and run accident and they got the license plate number as the car drove off.  

The picnic game exercises primarily working memory and secondarily, short term memory. Working memory helps you hold onto small amounts of information while you are attending to something else, and is often the first aspect of memory impaired in certain types of dementia. 


Contributor Author: Dr. Michael Trayford is a Board Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For more information, please visit www.ApexBrainCenters.com/memory.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

Get Moving


The phrase “Get moving” can mean something different for each of us. For some people it means getting up, walking on the treadmill, going for a bike ride or walking the dog. Unfortunately, for other people it means getting up, going to the bathroom and going back to the couch. So there is certainly a need to put this concept in perspective.

When it comes to proper brain function, movement is absolutely critical. Think about somebody you know that isn’t very mobile. They might be sedentary because they are bed ridden, have mobility issues or it might just be that they are plain lazy. Do their brains work as well as someone who is active, getting out and about all the time? 


The bottom line is that movement is essential for appropriate brain function. 


Chances are that you’ve heard the term “If you don’t use it, you lose it.”


The brain essentially is a relay station for sensory information. When we don’t have appropriate sensory information going into the brain from our muscles, joints, balance system and more, it starts to wear away and degenerate more rapidly than it should. In time it can cause the brain not to perform to its highest potential as you could imagine.  


The brain is stimulated by nerve fibers from several different sources. This includes senses like vision and hearing, as well as other sources. The nerve fibers that carry information from muscles and joints are by far the largest nerve fibers that supply the brain with the greatest amount of information. If you are inactive, you are cutting out your greatest amount of input to the brain. 


This will in turn reduce the efficiency of the output from the brain. This can manifest itself as physical problems, mental and emotional problems, cognitive and thinking problems, and memory decline. 


To stimulate the brain, you don’t need particularly intense activity. You can start out small. It might be going to the gym, taking a walk in the woods or on your streets. Just so long as you’re getting out there and getting moving.


Developing the habit of regular activity starts you building a foundation to explore other exercises and more intense activities that can have an even more significant positive impact on brain health.


Contributor Author: Dr. Michael Trayford is a Board Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For more information, please visit www.ApexBrainCenters.com/memory.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

Eat Your Breakfast


Eat your breakfast is one of those things we’ve all been told by our parents and even our grandparents. Of course, there is something to be said for the value of putting calories into your body each morning and the positive impact it has for the brain.

Unfortunately, what happens all too often is that people get caught up in their lives and sometimes give in to the temptation to skip breakfast. For some people it’s usually just a factor of being too busy. People are rushing out the door to get to work on time, drop off the kids or running late for an appointment.


There’s another segment of people that consciously choose to skip breakfast because they think it will help them lose weight. Their intuition tells them that skipping breakfast will give them a slimmer body shape, but, in fact, it’s actually working against them.


Several different things happen when you eat breakfast in the morning. One of the primary benefits is that it gets your metabolism started. It also sets the tone for the day.


Your brain needs a constant and steady source of fuel. It cannot store sugar, its primary source of fuel.


If you are going from say 8 o’clock at night until noon the next day without eating anything then the brain is without adequate fuel for most of that time. When this happens, the brain makes the inference that there isn’t adequate food available. When the brain goes into a state of crisis it starts to act to preserve its most valuable source of energy, which is fat.


The brain goes into a catabolic response, where it starts to break down protein structures and muscle mass in the body. Unfortunately, this is a very expensive process, which requires a lot of energy just to break down and use the protein. Not to mention, the accelerated loss of valuable muscle mass that tends to decline as we age anyhow.  

The end result is that your body stores fat while making you feel more sluggish. Most people, especially men will deposit fat around the midsection and the neck.

The bottom line is that it doesn’t take much to wake up five minutes earlier to grab something quick for breakfast. When you’re first developing the habit of eating breakfast, it doesn’t have to be a big meal. Getting your metabolism started and providing energy for the brain doesn’t require a lot of fuel.


Even something simple like eating a piece of fruit or a hard-boiled egg while you’re going out the door is better than nothing at all.



Contributor Author: Dr. Michael Trayford is a Board Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For more information, please visit www.ApexBrainCenters.com/memory.



The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

Friday, May 20, 2016

Dementia is Not a Specific Disease


Many people are under the impression that Alzheimer Disease (AD) and dementia are different conditions. In fact, AD is a type of dementia. In addition to AD, dementia also includes types such as vascular dementia, frontotemporal dementia, and dementia with Lewy bodies. 

Many people, particularly those who are very old, have mixed dementia or dementia that is caused by more than one kind of brain disease.


AD is currently considered the most common kind of dementia. Researchers estimate that as many as 5.5 million people living in the United States have this type of dementia.*


Although scientists have found various genetic and environmental factors that may increase the likelihood of having AD, age is the most important risk factor.


In the United States, about 1 out of every 20 men and women between the ages of 65 and 74 have AD.* The frequency for this disease nearly doubles every five years beyond age 65. Researchers believe that nearly half of all people older than 85 may be in various stages of the disease.


Vascular dementia, accounting for 12 to 20 percent of all dementias, is the second most common age-related dementia.* Unlike the gradual progression of AD, the onset of vascular dementia symptoms are often abrupt and may occur when a heart attack or a stroke dramatically reduces blood flow to or through the brain.


Vascular dementia can also have a slow progression. This happens when the accumulative damage of transient ischemic attacks - often called TIAs - cause many small areas of brain damage and, eventually, noticeable symptoms. The descriptive name “multi-infarct dementia” is the term healthcare providers use to describe this kind of vascular dementia. Multi-infarct dementia is the most common type of vascular dementia.


Each type of dementia has specific signs and symptoms. For example, memory loss, confusion, and difficulty in performing what was once familiar and easy tasks are early symptoms of AD. In contrast, the early symptoms of frontotemporal lobe degeneration (FTD) are poor coordination, tremors, and difficulty in using and understanding written and spoken the language. Memory loss is another aspect of FTD but occurs much later in the course of the disease. Ultimately, however, memory loss is a symptom that all forms of dementia have in common.


Examples of other types of dementia include dementia resulting from Traumatic Brain Injury (TBD); Wernicke-Korsakoff Syndrome (WKS); Normal Pressure Hydrocephalus (NPH); Chronic Traumatic Encephalopathy (CTE); Creutzfeldt-Jakob Disease (CJD), and others.



Janet Yagoda Shagam, Ph.D., is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” Available through Amazon.



The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse or guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

*https://www.alz.org/facts/downloads/facts_figures_2015.pdf (accessed May 5, 2016)