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Sleep: The Brain’s Washer?

It turns out our mothers were on to something when they told us to get to bed, and we would feel better in the morning.  Now there is the science to back that up.  And it may even have something to contribute to the Alzheimer’s field.

A paper published in Science this week provides direct experimental evidence that the mouse brain cleans itself during sleep, by expanding channels between neurons that allow an influx of cerebrospinal fluid. The fluid flushes out neurotoxic waste products, such as amyloid proteins, which accumulate as plaques in Alzheimer’s disease, twice as fast when mice are sleeping as when they are awake.

Promising news, especially in the field of Alzheimer’s research.  See the study article in the Journal Science.

 

 

 

September is World Alzheimer’s Month

 

 

September is World Alzheimer’s Month – Just a Few Facts

For the second year, September is proclaimed World Alzheimer’s Month, an international campaign to raise awareness and challenge stigma.  Worldwide, dementia, of which Alzheimer’s is the most common form, claims 7.7 million new cases per year.  The World Health Organization estimates that by the year 2050, more than 115 million people throughout the world will have dementia.  The most recent statistics from 2010 indicate there are currently 35.6 million people worldwide with a form of dementia.  International studies make it clear that dementia occurs in every country of the world.  Dementia affects 1 in 20 people over the age of 65 and 1 in 5 over the age of 80.

Global Costs are Devastating

Caregivers understand the devastating personal and financial impact to an elder with Alzheimer’s, as well as to the impact to the family.  But globally, the World Health Organization, in 2010, estimated the total societal cost of dementia as $604 billion (US$), or 1% of the worldwide gross domestic product (GDP).

G8 Countries to Unite for a Global Solution

On 11 December 2013, Prime Minister David Cameron of the UK will host a G8 Summit to make the fight against dementia a coordinated global effort.  It is great to see this taking on more of a priority among our world leaders.  For the rest of us, we can take action too.  The above video gives some ideas, and hopefully will inspire at least one person to take a step toward bringing more attention to this devastating disease.

Communicating with a Person with Dementia

Keep Tone, Clarity and Goals in Mind

Because of the cognitive changes with Alzheimer’s and other dementias, communication is often challenging.  Dementia is a broad term that refers to a decline in mental ability significant enough to interfere with daily life.  Of all the dementias, Alzheimer’s disease is the most common (60 – 80% of all cases), and of the estimated 5 million Americans with Alzheimer’s disease, the majority are age 65 or over.

Herewith some tips caregivers can use to help communication go a little smoother.  These tips were recently presented by the Gerontological Society of America, in their publication “Communicating with Older Adults” (2012).

·         Maintain a positive communicative tone when speaking with an older adult with dementia.  Older adults with dementia remain able to understand the tone of communication.  Thus, a soft tone with a patient manner can be helpful in reducing problem behaviors like agitation.

·         Avoid speaking slowly to older adults with dementia.  Speaking slowly with older adults with dementia only makes it more difficult for them to remember all the words said before they can comprehend the whole sentence.  Instead, maintain your regular rate of speech, and focus on intonation and enunciation.

·         Pose different types of questions according to your conversational goals.  Depending on your goal – gathering information or encouraging conversation, do the following:

For gathering information, use closed-ended or yes/no questions such as “Would you like iced tea or water?” or “Are you tired?”

For encouraging conversation, use open-ended questions such as “What show would you like to watch?

·        Simplify sentences by using “right-branching” sentences.  What does this mean?  In right branching statements, the main clause is followed by the subordinate clause.  For example, “Get in the car and we will go to the store.”  This is the preferred and simpler statement vs. “If you want to go to the store, get in the car” (a left branching statement).  The left branching sentence requires the listener hold the information of the first clause (subordinate) in order to understand the full sentence.  This places a strain on the individual’s working memory.

·        Use verbatim repetition or paraphrase sentences to facilitate comprehension.  This step is often what we do naturally when we know the individual with whom we are speaking does not comprehend what we are saying.  By repeating, we reinforce what was said, aiding in the memory trace of the original message.  When we paraphrase, we revise our original sentence by removing the confusing word or words and substituting them with more understandable words.  An example of paraphrasing would be changing a sentence from “Tomorrow, when I return from the airport, I will go grocery shopping,” to “Tomorrow I will go grocery shopping

Do I Have Dementia?

You may have wondered this yourself.

I hear this question fairly frequently.  I have been in many situations where someone who is young (under age 60), will question whether the memory lapses they sometimes have are a sign of early stage dementia or Alzheimer’s.  Perhaps they sometimes lose their train of thought mid sentence.  Or know someone’s face but cannot remember their name.  Or become overwhelmed with too many of life’s details.  Well, the Alzheimer’s Association has a simple chart that may help us with sorting this question out for ourselves.  I use it here, in hopes that it allows someone to understand that some of these moments are just age related.  Here it is in summary:

Signs of Alzheimer’s

Typical age-related changes

Poor judgment and decision making Making a bad decision once in a while
Inability to manage a budget Missing a monthly payment
Losing track of the date or the season Forgetting which day it is and remembering later
Difficulty having a conversation Sometimes forgetting which word to use
Misplacing things and being unable to retrace steps to find them Losing things from time to time

This is a pretty handy chart.  And more information is available at www.alz.org.  Of course if you think you or someone you love has symptoms that are more on the left side of the chart, by all means see a physician for an evaluation.  It is never too soon.

To Care with Dignity

Earlier this month I attended a professional conference with many of my fellow GCM colleagues. We were fortunate to have as a speaker, David Troxel, co-author, with Virginia Bell, of the Best Friends Approach to Alzheimer’s Care. This was the second time in the last ten years I have heard him speak, and both times I have gained insight and new ideas for helping my caregiving families and hired caregivers in their caregiving role. Mr. Troxel, who advocates and teaches of a dignified approach to caregiving, pointed out several things: we can address behaviors by looking at the environment; hugs are better than drugs; and to bring out the best in persons with Alzheimer’s Disease or dementia, the number one focus should be on socialization. Included in socialization would be creative activities, conversation, using the life story, exercise (twice daily!), music, purposeful learning and growth, laughter, animals, and being outside. Pictures are a great way to tell a story, and he used USA Today as a good example of a periodical with lots of pictures. The tools for engaging someone with dementia are all around us. We just need to look around the house.

The Heroes Among Us

“It attacks rich and poor, white-collar and blue, and women and men, without regard to party. A degenerative disease, it steadily robs its victims of memory, judgment and dignity, leaves them unable to care for themselves and destroys their brain and their identity — often depleting their caregivers and families both emotionally and financially.”

The above quote, from “The Age of Alzheimer’s,” an October 27, 2010 New York Times article by Sandra Day O’Connor, Stanley Prusiner and Ken Dychtwald,  succinctly spells out the nature of Alzheimer’s disease.  Alzheimer’s can find anyone.  And though great research is taking place, we have not yet found a response that will either postpone or altogether eliminate the disease.  The above article makes a clear statement about what can be done to progress further and faster.

The folks who know this issue firsthand are those who perform the heroic work as caregivers.  This month, as National Alzheimer’s Awareness Month, and National Caregiver’s Month, is a tribute to those who live with the disease, and those, who day after day, honor them by caring for them.  These are the heroes among us.