Scientists continue to unravel the complex brain changes involved in the onset and progression of Alzheimer’s disease. It seems likely that damage to the brain starts a decade or more before memory and other cognitive problems appear. During this preclinical stage of Alzheimer’s disease, people seem to be symptom-free, but toxic changes are taking place in the brain.

Damage occurring in the brain of someone with Alzheimer’s disease begins to show itself in very early clinical signs and symptoms. For most people with Alzheimer’s—those who have the late-onset variety—symptoms first appear in their mid-60s. Signs of early-onset Alzheimer’s begin between a person’s 30s and mid-60s.

The first symptoms of Alzheimer’s vary from person to person. Memory problems are typically one of the first signs of cognitive impairment related to Alzheimer’s disease. Decline in non-memory aspects of cognition, such as word-finding, vision/spatial issues, and impaired reasoning or judgment, may also signal the very early stages of Alzheimer’s disease. And some people may be diagnosed with mild cognitive impairment. As the disease progresses, people experience greater memory loss and other cognitive difficulties.

Alzheimer’s disease progresses in several stages: preclinical, mild (sometimes called early-stage), moderate, and severe (sometimes called late-stage).

Signs of Mild Alzheimer’s Disease
In mild Alzheimer’s disease, a person may seem to be healthy but has more and more trouble making sense of the world around him or her. The realization that something is wrong often comes gradually to the person and his or her family.

Problems can include:
• Memory loss
• Poor judgment leading to bad decisions
• Loss of spontaneity and sense of initiative
• Taking longer to complete normal daily tasks
• Repeating questions
• Trouble handling money and paying bills
• Wandering and getting lost
• Losing things or misplacing them in odd places
• Mood and personality changes
• Increased anxiety and/or aggression

Alzheimer’s disease is often diagnosed at this stage.

Signs of Moderate Alzheimer’s Disease
In this stage, more intensive supervision and care become necessary, which can be difficult for many spouses and families.

Symptoms may include:

• Increased memory loss and confusion
• Inability to learn new things
• Difficulty with language and problems with reading, writing, and working with numbers
• Difficulty organizing thoughts and thinking logically
• Shortened attention span
• Problems coping with new situations
• Difficulty carrying out multistep tasks, such as getting dressed
• Problems recognizing family and friends
• Hallucinations, delusions, and paranoia
• Impulsive behaviour such as undressing at inappropriate times or places or using vulgar language
• Inappropriate outbursts of anger
• Restlessness, agitation, anxiety, tearfulness, wandering—especially in the late afternoon or evening
• Repetitive statements or movement, occasional muscle twitches

Signs of Severe Alzheimer’s Disease

People with severe Alzheimer’s cannot communicate and are completely dependent on others for their care. Near the end, the person may be in bed most or all of the time as the body shuts down.

Their symptoms often include:
• Inability to communicate
• Weight loss
• Seizures
• Skin infections
• Difficulty swallowing
• Groaning, moaning, or grunting
• Increased sleeping
• Loss of bowel and bladder control

A common cause of death for people with Alzheimer’s disease is aspiration pneumonia. This type of pneumonia develops when a person cannot swallow properly and takes food or liquids into the lungs instead of air.

There is currently no cure for Alzheimer’s, though there are medicines that can treat the symptoms of the disease.

Article courtesy of the National Institute of Aging.
https://www.nia.nih.gov

By Judith Graham | September 1st, 2017

After making it through the maelstrom of middle age, many adults find themselves approaching older age wondering, “What will give purpose to my life?” now that the kids have flown the nest and retirement is in the cards.

How they answer the question can have significant implications for their health.

Over the past two decades, dozens of studies have shown that seniors with a sense of purpose in life are less likely to develop Alzheimer’s disease, mild cognitive impairment, disabilities, heart attacks or strokes, and more likely to live longer than people without this kind of underlying motivation.

Now, a new report in JAMA Psychiatry adds to this body of evidence by showing that older adults with a higher sense of purpose tend to retain strong hand grips and walking speeds — key indicators of how rapidly people are aging.

Why would a psychological construct (“I feel that I have goals and something to live for”) have this kind of impact? Seniors with a sense of purpose may be more physically active and take better care of their health, some research suggests. Also, they may be less susceptible to stress, which can fuel dangerous inflammation.

“Purposeful individuals tend to be less reactive to stressors and more engaged, generally, in their daily lives, which can promote cognitive and physical health,” said Patrick Hill, an assistant professor of psychological and brain sciences at Washington University in St. Louis who wasn’t associated with the study.

But what is purpose, really? And how can it be cultivated?

Anne Newman, a 69-year-old who splits her time between Hartsdale, north of New York City, and Delray Beach, Fla., said she’s been asking herself this “on a minute-by-minute basis” since closing her psychotherapy practice late last year.

Building and maintaining a career became a primary driver in her life after Newman raised two daughters and went back to work at age 48. As a therapist, “I really loved helping people make changes in their lives that put them in a different, better position,” she said.

Things became difficult when Newman’s husband, Joseph, moved to Florida and she started commuting back and forth from New York. Over time, the travel took a toll, and Newman decided she didn’t want a long-distance marriage. So, she began winding down her practice and thinking about her next chapter.

Experts advise that people seeking a sense of purpose consider spending more time on activities they enjoy or using work skills in a new way. Newman loves drawing and photography. She has investigated work and volunteer opportunities in Florida, but nothing has grabbed her just yet.

“Not knowing what’s going to take the place of work in my life — it feels horrible, like I’m floundering,” she admitted, in a phone interview.

I didn’t ask myself did I have a larger purpose in life — I asked myself what gives meaning to my life.

Barry Dym
Many people go through a period of trial and error after retirement and don’t find what they’re looking for right away, said Dr. Dilip Jeste, senior associate dean for healthy aging and senior care at the University of California-San Diego. “This doesn’t happen overnight.”

“People don’t like to talk about their discomfort because they think it’s unusual. And yet, everybody thinks about this existential question at this time of life: ‘What are we here for?’” he noted.

Newman’s focus has been on getting “involved in something other than personal satisfaction — something larger than myself.” But that may be overreaching.

“I think people can get a sense of purpose from very simple things: from taking care of a pet, working in the garden or being kind to a neighbor,” said Patricia Boyle, a leading researcher in this field and professor of behavioral sciences at the Rush Alzheimer’s Disease Center at Rush University Medical Center in Chicago.

“Even small goals can help motivate someone to keep going,” she continued. “Purpose can involve a larger goal, but it’s not a requirement.”

Older adults often discover a sense of purpose from taking care of grandchildren, volunteering, becoming involved in community service work or religion, she said. “A purpose in life can arise from learning a new thing, accomplishing a new goal, working together with other people or making new social connections when others are lost,” she said.

Tara Gruenewald’s research highlights how important it is for older adults to feel they play a valuable role in the life of others.

“I think what we often lose as we age into older adulthood is not a desire to contribute meaningfully to others but the opportunity to do so,” said Gruenewald, chair of the department of psychology at California’s Crean College of Health and Behavioral Sciences at Chapman University. Her research has found that people who perceive themselves as being useful had a stronger feeling of well-being and were less likely to become disabled and die than those who didn’t see themselves this way.

“In midlife, we contribute to others partly because it’s demanded of us in work and in our social relationships,” Gruenewald said. “As we grow older, we have to seek out opportunities to contribute and give to others.”

Some researchers try to tease out distinctions between having a sense of purpose and finding meaning in life; others don’t. “Practically, I think there’s a lot of overlap,” Boyle said.

After Barry Dym, 75, retired a year ago from a long career as an organizational consultant and a marriage and family therapist, he said, “I didn’t ask myself did I have a larger purpose in life — I asked myself what gives meaning to my life.”

Answering that question wasn’t difficult; certain themes had defined choices he’d made throughout his life. “What gives meaning to me is helping people. Trying to have an impact. Working with people very closely and helping them become much better at what they do,” Dym said in a phone conversation from his home in Lexington, Mass.

In retirement, he’s carrying that forward by mentoring several people with whom he has a professional and personal relationship, bringing together groups of people to talk about aging, and starting a blog. Recently, he said, he wrote about discovering that he feels freer now to “explore who I am, where I came from and what meaning things have to me than at any other point of my life.”

And therein lies a dilemma. “I feel of two minds about purpose in older age,” Dym said. “In some ways, I’d like to just shuck off that sense of having to do something to be a good person, and just relax. And in other ways, I feel deeply fulfilled by the things I do.”

Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation.

By Jacqueline Ahearn | August 27th, 2019

A new study has examined the dementia prevention benefits of social activity in 50 and 60 year olds, finding that a robust social calendar during these years may play an important role in staving off dementia.

Dementia prevention is an increasingly studied field, from studies covering what medications to avoid taking to the role stress plays in raising dementia risk. This recent study, undertaken by researchers at University College London, looked at the role of social activity in preventing dementia.

“[O]ne in three cases [of dementia] are potentially preventable,” said Dr. Andrew Sommerlad (UCL Psychiatry), the study’s lead author. “We’ve found that social contact, in middle age and late life, appears to lower the risk of dementia.”

The finding emphasizes the importance of meaningful community connections throughout a person’s lifetime, but especially as a person grows older. Reducing isolation and loneliness appears to be a critically important step in dementia prevention. Among the study’s most significant findings is that, even after accounting for factors such as education, employment, marital status and socioeconomic status, someone who saw friends almost daily at age 60 was 12 percent less likely to develop dementia than someone who only saw one or two friends every few months. This increased social contact was also linked to general cognitive measures.

The research team used data from the Whitehall II study, which tracked the frequency of social contact among 10,228 participants between 1985 and 2013. The same participants also completed cognitive testing from 1997 onwards, and researchers then studied electronic health records up until 2017 to see if any participants were diagnosed with dementia. Previous studies have found a link between social contact and dementia risk, but did not have as long of a follow-up time.

These findings are significant in developing a clinical understanding of dementia, as well as to understanding how to prevent it. The findings will require further study, including more inquiry into whether social isolation is truly a risk factor for dementia. However, the authors of the study and U.K. health officials are encouraging individuals to get out into the sunshine more often with family and friends.

According to Fiona Carragher, Chief Policy and Research Officer at Alzheimer’s Society, “The Government’s recent emphasis on health prevention is a welcome opportunity to reduce the risk of dementia across society.”

By Christine Barba | August 15th, 2019

In a new study, researchers rejuvenated older brain cells so that they acted like younger cells — at least, in rats.

The team of researchers from the Wellcome-MRC Cambridge Stem Cell Institute at the University of Cambridge wanted to see whether it’s possible to make older brain cells act youthful again.

Can We Trick Brain Stem Cells into Becoming More Youthful?

As we become older, our muscles and joints may become rigid, affecting mobility. In this study, researchers found that even our brains become stiff as we age, leading to brain stem cell dysfunction.

The scientists examined young and aging rat brains to learn how brain stiffening impacts oligodendrocyte progenitor cells (OPCs), located in the central nervous system.

In a healthy brain, OPCs help the brain function and regenerate myelin, a fatty substance that coats our nerves. Previously, researchers found that damaged myelin and OPC cell death cause conditions like cerebral palsy and multiple sclerosis (MS). As people become older, these cells often become less functional.

To see whether they could change the course of a loss of function in aging OPCs, the researchers transplanted OPCs from aging rats into younger rats’ softer brains. After the transplant, the cells started acting like more youthful, healthy cells.

The researchers also focused on a protein known as Piezo1, which tells a cell whether the surrounding area is soft or stiff. They created materials that had different levels of stiffness — reflecting either a young or older brain — then studied how the stem cells functioned when they believed they were in a younger brain.

“When we removed Piezo1 from the surface of aged brain stem cells, we were able to trick the cells into perceiving a soft surrounding environment, even when they were growing on the stiff material,” said Professor Robin Franklin, who co-led the research with Dr. Chalut. “What’s more, we were able to delete Piezo1 in the OPCs within the aged rat brains, which lead to the cells becoming rejuvenated and once again able to assume their normal regenerative function.”

Better Treatments for Neurodegenerative Diseases

The researchers believe their findings could help them better understand how aging works, and how to improve treatments for neurodegenerative conditions.

“We were fascinated to see that when we grew young, functioning rat brain stem cells on the stiff material, the cells became dysfunctional and lost their ability to regenerate, and in fact began to function like aged cells. What was especially interesting, however, was that when the old brain cells were grown on the soft material, they began to function like young cells — in other words, they were rejuvenated,” said Dr. Kevin Chalut, who co-led the research.

In addition, they hope the study paves the way for additional research on how to restore damage in the brain.

“The Cambridge team’s discoveries on how brain stem cells age and how this process might be reversed have important implications for future treatment, because it gives us a new target to address issues associated with aging and MS, including how to potentially regain lost function in the brain,” said Dr. Susan Kohlhaas, Director of Research at the MS Society, who funded part of the research.

Access the full study here. 

brainhealth

By Lecia Bushak | August 14th, 2019

Frequently napping during the day may be a sign of fatigue or growing older, but a new study suggests it may also be a warning sign of Alzheimer’s disease. The study, out of UC San Francisco, found that sleeping too much during the day — especially if there are no sleeping problems at night — could be a sign that the beginning of Alzheimer’s may be impacting the part of the brain associated with staying awake.

The study found that tau protein tangles may be responsible for impacting these brain regions associated with wakefulness and contributing to degeneration, rather than amyloid protein, which was previously assumed.

“Our work showed definitive evidence that the brain areas promoting wakefulness degenerate due to accumulation of tau — not amyloid protein — from the very earliest stages of the disease,” Dr. Lea Grinberg, senior author of the study, said in a press release.

Tau Accumulation in the Brain’s ‘Wakefulness Center’

The study examined the brains of 13 deceased Alzheimer’s patients, as well as the brains of seven healthy controls. The researchers analyzed the brain regions that were responsible for wakefulness, including the locus coeruleus, lateral hypothalamic area and tuberomammillary nucleus. The same brain regions are also associated with narcolepsy, a disorder involving excessive sleepiness during the day.

The researchers found a good deal of tau protein buildup in all of these wakefulness brain regions, with some losing up to 75 percent of their neurons.

“It’s remarkable because it’s not just a single brain nucleus that’s degenerating, but the whole wakefulness-promoting network,” lead author Jun Oh, a Grinberg lab research associate, said in the press release. “Crucially this means that the brain has no way to compensate because all of these functionally related cell types are being destroyed at the same time.”

The researchers concluded that there needs to be a greater focus on how tau protein accumulates in brain regions in the earlier stages, rather than amyloid protein, as this may contribute to early stages of Alzheimer’s disease.

Alzheimer’s and Sleep

This isn’t the first study to link disrupted sleeping to Alzheimer’s disease. Past research has shown that excessive daytime napping was associated with Alzheimer’s and a greater build-up of beta-amyloid, a compound that disrupts communication between neurons and destroys them over time. A study published earlier this year also pinpointed an increase in accumulated tau protein in brains of people who experienced less deep sleep.

Disrupted or deprived sleep, as well as poor sleep hygiene, can have a huge effect on your brain. Getting a good night’s sleep is responsible for clearing beta-amyloid; and not getting enough has been linked to an increase in beta-amyloid, according to the National Institutes of Health (NIH). Whether disrupted sleep contributes to Alzheimer’s or Alzheimer’s causes disrupted sleep will have to be the subject of further research.

by the DailyCaring Editorial Team

A trip to the hospital emergency room is especially stressful for seniors with Alzheimer’s or dementia.

Hospitals are noisy, confusing environments that are full of strange people, bright lights, and reflective surfaces. Even worse, your older adult isn’t feeling well or is in pain and they’re getting touched, prodded, and poked.

All of this can lead to agitation, delirium, aggression, worsening of dementia symptoms, and other challenging behaviours.

But there are ways to make the situation less disorienting for your older adult. Reducing their fear and confusion helps them stay calm and cooperate with the doctors and nurses treating them.

1. Bring a copy of important documents

In addition to your older adult’s medical aid information, bring all essential legal and medical documents. This can include Power of Attorney, DNR, advance directive / living will, and any other documents necessary for your older adult’s situation.

2. Have their basic medical info written down

In the ER, the staff will likely ask for your older adult’s:

• Basic information – height, weight, etc.
• Brief medical history – past surgeries, need for hearing aids, significant health conditions, etc.
• Current list of medications – include vitamins and supplements

Having this information written down saves you from trying to recall important information like when they had that surgery, when they were diagnosed with a specific health condition, or how many milligrams of a specific medication they’re taking.

3. Be proactive and tell staff that your older adult has dementia and why that’s significant

Many people working in hospitals don’t understand how dementia can affect behaviour and communication. Typically, there is little to no training for the staff to teach them how to treat someone with dementia. Calmly tell anyone who interacts with your older adult that your older adult has dementia and briefly name the top symptoms they need to be aware of.

Make it clear that your requests aren’t just “nice to have,” but they will help avoid unnecessary (and time-consuming) conflicts brought on by dementia agitation.

For example, you could say, “my mother has dementia and that makes it very difficult for her to communicate. I can keep her from getting too anxious or upset by translating your questions so you can find out what you need to know. Getting worked up can cause her to try to run away or start screaming in fear. Please let me keep her calm and cooperative to make things easier for you.”

Or, “my father has dementia and he may become very agitated if you approach him quickly or speak loudly. He will be calm and cooperative if you could please move slowly and speak softly. I appreciate it and it will save everyone a lot of time and headache.” You may also want to ask to dim harsh lighting while waiting or to be moved to a quieter area – all to help keep your older adult calm.

4. Bring another person to help you

You will need to provide information and answer questions, especially when you first arrive. If possible, ask a family member or friend to go with you or meet you in the ER. They can sit with your older adult to help them feel calm and secure and you can focus on communicating important information to the hospital staff.

5. Advocate for your older adult and provide accurate information

Someone with dementia often can’t or won’t accurately report symptoms or pain. They also may not remember what happened or why they need to be in the hospital. You’ll need to speak on their behalf so they get the correct treatment. Jot down a few notes so you can briefly describe the symptoms and events that caused the visit. Having notes to look at helps you keep things brief and makes sure you don’t forget an important piece of information. While you’re in the hospital, keep taking notes if you notice expressions of pain or changes in their symptoms so you can update doctors and nurses.

6. Stick by your older adult’s side

As much as you can, stay close to your older adult. You’re the only familiar face in this confusing environment and having you near will be calming. Staying close also means that you can keep an eye on your older adult’s symptoms and needs. You’ll know right away if they’re in pain, need a bedpan, need a drink of water, or if their symptoms change. That means you can accurately report their needs and your observations to hospital staff.

7. Stay calm and positive to reduce challenging behaviour

People with dementia often pick up on body language. Even though this is a tough and scary situation, do your best to stay calm and focus on the positive. That will help your older adult feel calm and safe, which helps minimize challenging behaviour.

8. Help your older adult understand what’s happening

Being in an unfamiliar hospital environment can be disorienting and confusing to someone with dementia. They may ask why you’re there or ask to go home. To help reassure them, you could say something simple like “we’re in the hospital because you fell down and got hurt.” Then, if possible, distract them with a pleasant activity.

9. Ease a long wait with comforting activities

Often, going to the emergency room means waiting for hours if the situation isn’t immediately lifethreatening. Depending on the specific situation, it may help to bring a simple, calming activity to give your older adult something positive to focus on and help them stay busy while they wait for treatment or tests. This could be a box of tissues to fold or fiddle with, a deck of cards to shuffle and arrange, a photo album to look at, or a fidget quilt. Others may be comforted by a therapeutic doll, stuffed animal, weighted lap blanket, or a sensory toy. Some older adults may enjoy listening to their favourite music or having you read to them.

Please take seven minutes out of your day to watch Leaving Alzheimer’s Behind, a Being Patient short documentary.

Peter Berry is a person from the United Kingdom who has been diagnosed with early-onset Alzheimer’s. An avid cyclist, Peter remarked during our interview that when he gets on his bicycle, he leaves Alzheimer’s behind.

We hope that this video serves as a reminder that if you are diagnosed with Alzheimer’s, you still have the ability to take control of the disease.

By Christine Barba | June 13th, 2019

We’ve all looked for our sunglasses only to discover they’re sitting on top of our head or turned off the stove before leaving the house for vacation, then run back inside to double check that it’s really off. While researchers say it’s normal to become forgetful from time-to-time, recent studies have pinpointed some early Alzheimer’s symptoms that could indicate you may be on a path towards diagnosis.

An Inability to Recognize Your Own Forgetfulness

Researchers found those who aren’t phased by bouts of forgetfulness are more likely to develop or have Alzheimer’s

A study found that consistently worrying about our memory—think rushing to WebMD every day to determine whether or not occasionally forgetting the route to a friend’s house means we’re destined to develop Alzheimer’s—is a sign that we may have a lower risk of receiving an Alzheimer’s diagnosis. The study found that forgetting your own forgetfulness is more concerning and could be an early sign of dementia.

According to the study, Alzheimer’s patients often have anosognosia, or a lack of awareness of early Alzheimer’s symptoms. After surveying nearly 500 participants and their loved ones, the scientists found that those who didn’t notice they were struggling with their memory were three times more likely to get dementia within the next few years. These participants also had more amyloid in their brains, the toxic protein that many scientists think leads to Alzheimer’s symptoms.

Similarly, Bill Burke, M.D., director of the Stead Family Memory Center at the Banner Alzheimer’s Institute said that when he worked in a memory disorders clinic, he was more concerned about patients who came into his clinic and told him that their spouse or children forced them to come than those who came in asking questions about their own memory problems.

“My rule of thumb was that if the person tells you they have memory problems, they almost certainly do not, and if they say they don’t have any memory problems and they’re in a memory clinic, then they have significant memory problems,” he said.

Burke said that your best baseline test for determining whether or not you have memory problems is your social network, or the people who know you best.

“You could do elaborate psychological testing and none of it is as effective as just asking someone who really knows the person whether they’re different than they were a year ago or there were things they could do a year ago that they can’t do now,” he said.

Having Trouble Finding the Right Words

Taking a long amount of time to think of the correct word could be an early Alzheimer’s symptom

Although we’ve all tried to think of a word that didn’t pop into our head until hours later, scientists have found that consistently being unable to find the right words could be an early Alzheimer’s symptom. Other early Alzheimer’s signs include frequently stopping in the middle of a sentence or starting a sentence, then forgetting what you planned to say, repeating the same story, or forgetting an object’s name (e.g. referring to your wallet as ‘the thing I put money in’).

Researchers from the University of Birmingham, the University of Kent and the University of California, Davis found that participants with mild cognitive impairment (MCI) who took a longer amount of time to come up with words were more likely to develop Alzheimer’s later on. Participants listened to descriptions like ‘a type of wood’ and researchers analyzed how long it took them to come up with a related description like ‘oak.’ Participants who were cognitively healthy or had MCI and answered more quickly did not develop Alzheimer’s within the next three years, while those with slower response times did.

Pam Montana, a former Intel executive who was diagnosed with Alzheimer’s, said her husband became increasingly concerned after they went on vacation together and she continued asking him the same question. She also began having difficulty remembering information she learned at team meetings.

“I found myself having a hard time grasping the information and keeping it in my head. That was new to me. I remember very clearly writing down word-for-word what was being said,” she noted.

More recently, researchers like Rhoda Au have been investigating how word choice or the way someone speaks could determine whether or not they’ll develop Alzheimer’s.

Difficulty Managing Your Finances

Successfully doing household finances, then suddenly being unable to complete them could also be an early Alzheimer’s symptom

Trouble doing simple mathematical problems could be an early Alzheimer’s symptom, according to arecent study by Duke University. Scientists said that if you have always struggled with math or another skill throughout your life, you should not be concerned. However, previously excelling at managing household finances, then being unable to navigate your checkbook is a cause for concern, the study authors said.

The researchers looked at nearly 250 participants between 55 and 90 years old who were cognitively healthy, had MCI or Alzheimer’s. After giving them financial tests and brain scans that analyzed how much beta-amyloid was in their brains, the researchers found that participants with more beta-amyloid plaques were more likely to have issues with tasks involving finances or balancing a checkbook.

While Gerda Saunders, a former mathematician, was diagnosed with vascular dementia, she also said that her mathematical capabilities were the first to go. Now, her husband manages their finances.

“I suddenly could not do a simple subtraction or addition problem because in the middle of the operation, I would switch from subtraction to addition without realizing I was doing that. I would find out the answer was wrong and then discovered that’s what I was doing. Even though I know that’s what I’m doing, I can’t do it right,” she said.

The National Institute on Aging (NIH) lists signs of money problems loved ones can look for if they believe their loved one may have Alzheimer’s: not paying or opening bills, various new charges on a credit card bill, purchasing odd new merchandise or if money goes missing from their loved one’s bank account.

Learn more about the seven stages of Alzheimer’s disease and the symptoms you or a loved one may experience at each stage here.

By Linda Freund | May 13th, 2019

Reading every day may reduce dementia risk, according to a study published in JAMA Psychiatry in July 2018.

Researchers at Hong Kong’s Elderly Health Centres tracked more than 15,000 people ages 65 and older for five years. All of the participants were dementia-free at the study’s conception.

Dementia risk was significantly lower among those who reported daily participation in intellectual activities, like reading books, magazines, and newspapers, as well as playing board games. The benefit was independent of other health problems, lifestyle factors (fruit and vegetable intake, exercise, smoking, etc.), demographics and socioeconomic status, according to researchers.

Research on the effects of brain-stimulating activities back up the memory-boosting benefits of reading. The 2013 study, published in the journal Neurology, found that life-long readers were better protected against Lewy bodies, amyloid burden, and tangles over the 6-year study. Reading into old age also reduced memory decline by more than 30 percent, compared to other forms of mental activity.

Reading and Brain Health: It’s Never Too Late to Pick Up a Book

It’s never too late to start reading and reap the brain benefits. According to the Hong Kong study, even when individuals initiated a reading regimen later in life, the impact was still significant enough to delay or prevent dementia.

What About Reading After a Dementia Diagnosis?

“Don’t stop reading,” said Marina Guitart, a psychologist and coordinator of the Day Care Unit at Fundació ACE in Barcelona, Spain. Many people with dementia retain their ability to read, but may lose focus or are easily fatigued. They may quickly quit reading because of the effort involved in keeping the thread of the story.

“But reading every day helps preserve language and memory longer,” said Guitart.

The psychologist has several tips on how to encourage people with dementia to read regularly.

Key Tips for Caregivers and Families to Encourage Reading

(Source: Fundació ACE)

• Read alongside people with dementia.
• Choose reading materials wisely: Books with photos, clear, large text, and humor work best.
• When reading, write down notes about the plot for easy review.
• Make sure books and newspapers are accessible in the home.
• Write daily notes for those with dementia in short, clear handwriting.

This year, occupational therapists at Fundació ACE in Barcelona, Spain put these tips to use. The team initiated a group-reading activity at their drop-in centers for people with mild dementia.

“At first, our members were not capable of reading a whole book alone. Through this guided activity they have returned to enjoy reading,” said Guitart.

Every time members started a new reading session, an occupational therapist reviewed the plot to bring them up to speed and reduce any frustration. Maribel Vera, an occupational therapist at the Fundació ACE Day Care Unit, said this strategy can easily be replicated by family members and caregivers at home.

“While reading, it would be useful to write down notes in a notebook on the events that take place in the story, so that each time they pick up the book they can check the notes. This way, they will avoid the feeling of not knowing what they are reading, or losing the plot,” said Vera.

Guitart and Vera suggest selecting reading material that is most appropriate for each stage of dementia.

• For those with mild dementia, short novels, short stories or news articles are ideal.
• For the moderate phase, short poetry works better.
• As the disease enters its advanced stage, familiar proverbs resonate best. For example, “No man is an island” or “Fortune favors the bold.”

In the case of the Fundació Ace reading group, “we chose a short, easy-to-read novel with touches of humor,” Guitart said. This better engaged the members.

Which Books Are Best for People With Dementia?

In general, books that incorporate both pictures and related text can help readers retain focus longer, according to a 2016 study conducted at Essex Meadows Health Center in Essex Meadows Health Center, Essex, Connecticut, (EMHC).

“We discovered that interspersing clear, intriguing photographs reflecting the content of the corresponding page was instrumental in sustaining a reader’s focus,” wrote Dr. Peter S. Dixon and Speech-Language Pathologist Susan Ostrowski in a 2017 issue of iAdvance Senior Care.

The researchers proposed an ideal book format for dementia patients: Large margins, the main topic printed in bold, a photo, and 10-15 lines of text. This configuration resulted in less brain strain amongst the study’s participants which lead to longer reading times.

“The text, photo, and title drew from different areas of the mind and were synergistic in serving to focus and keep the reader’s attention,” Dixon and Ostrowski wrote.

The study’s two researchers went on the publish a book that matched these metrics to better serve people with dementia. The book is aptly titled “Book for People with Dementia: Masters of Comedy.”

Jump-starting a reading regimen for dementia patients may not be easy, but has tangible benefits at day’s end, according to Guitart. Despite a rough start, the Fundació Ace reading group eventually began to soar.

“Our members exchanged opinions and impressions of what they were reading, actively participated and enjoyed the company,” Guitart said.

Encouraged to pick up a book? What are some of your favorite things to read? Comment below.

People with dementia may experience problems with eating and drinking. There are many reasons this might happen. They might:

• forget to eat or drink
• experience difficulties preparing food or drinks
• have difficulty recognising food items
• have a change in appetite or taste

Eating a healthy and balanced diet is important for a person’s physical and mental health. Not eating and drinking enough can increase the risk of dehydration, weight loss, a urinary tract infection and constipation. These health problems can be particularly problematic for someone with dementia as they can increase confusion and the risks of delirium, and sometimes make the symptoms of dementia worse.

Helping a person with dementia to maintain a healthy diet can be difficult for the people caring for them. This leaflet aims to provide some positive tips on ways to help.

It’s important to consider the person’s likes and dislikes regarding food, however, tastes do change throughout our lives. These changes may be more pronounced for someone with dementia. They may find certain colours, textures or smells off-putting or sometimes eat certain foods they previously wouldn’t have. An increasingly sweet-tooth is common. This and other factors may make it more difficult for the person to stick to specific diets such as those for people with diabetes or coeliac disease, or those with religious or cultural needs.

Understanding the person’s previous relationship with food, as well as any cultural or religious reasons for avoiding particular food or drink, will
be useful.

Poor appetite and weight loss are quite common as dementia progresses. But there are also medical reasons why a person may have lost interest in food and drink, which your GP or perhaps your dentist could advise on. These include:

• depression, which can lead to poor appetite
• mouth pain and dental problems, which can lead to discomfort and a reluctance to eat or drink
• constipation, which can make a person feel full and nauseous
• infections or other physical illness

Setting the scene for mealtimes

A familiar, sociable environment can help a person with dementia to feel more comfortable eating and drinking. You could try:

• turning off noisy TVs and radios, or playing some soothing, familiar music
• being flexible about meal times, avoiding times when the person is tired or distressed
• giving the person lots of time to eat, so there is no rushing
• eating with the person, if they enjoy the social side of this. It might be encouraging for them to see you eating, but bear in mind some people may be self-conscious and embarrassed to eat in company
• making sure the room is well-lit and describing the food. This might help the person recognise the food they are eating more easily
• using plain coloured plates and cups so they can see the food easily. Specially adapted cutlery is available for people with dementia

Encouraging a person with dementia to eat

Involve the person by asking them what they would like to eat. If they struggle to decide, you could give them two options of simple things you know they like and can manage. If appropriate, you could involve them in the food preparation. You could try:

• offering something easy to eat, that you know the person likes
• giving the person small, regular portions rather than large meals
• being flexible: a person with a sweet tooth might like to eat their dessert first. You could add sweet condiments like ketchup or apple sauce to savoury food
• offering a small snack before a meal to see if that helps the person realise they are hungry
• using different tastes, smells and colours to stimulate the appetite

If someone with dementia is having difficulty swallowing, please seek the advice of a speech and language therapist before considering a diet of pureed or soft food, as this can lack nutrients. You should be able to request a referral from your GP. Your GP can advise you on food to offer while you wait for a referral, but it’s a good idea to keep offering food you know the person likes and can manage.

Encouraging a person with dementia to drink

A person with dementia may not always be able to recognise when they are thirsty, or they might not be able to communicate their thirst. But nevertheless, it is recommended to aim for about eight glasses of fluid per day. You could try:

• having a drink beside the person at all times
• adding a little flavoured squash if the person is not keen on water
• offering a choice of hot and cold drinks
• helping the person if they are struggling to pick up or hold a cup
• offering the person different shapes and sizes of cup
• finding out if they have a favourite mug they like to drink from

Stocking up and storing food

A person with dementia might need help keeping track of what food they have at home and storing food safely. You could try:

• storing food in ways that are easy to access and eat, such as pouring cereals into clear pots or cutting cheese into cubes
• buying frozen ready meals; but be mindful that the person might need help reheating frozen foods safely. You could put labels with clear cooking instructions on the top of the meal. You could put notes reminding the person that the meals are in the freezer on the freezer door
• checking the person’s cupboards and disposing of anything out of date

Weight gain or weight loss

Some of the eating and drinking issues associated with dementia can lead to weight loss. Pureed food is less nutritious, and people with dementia are at risk of malnutrition. In this instance, you could try:

• adding skimmed milk powder to whatever you are serving. Skimmed milk powder is available from most supermarkets
• mixing skimmed milk powder with milkshake powder, such as Nesquik. These are fortified with vitamins and mixing them creates a high nutrient drink

It is important to note that there is different nutrition and healthy eating advice for people with dementia. For most people, the standard advice is to follow a low fat, low sugar diet. But older people and those with dementia especially need higher nutrients.

People with frontotemporal dementia might be especially drawn to sweet things or starchy foods. If overeating or weight gain is an issue, you could try:

• serving food in a portion rather than bringing out the packet
• replacing sweet or high calorie foods with healthier alternatives such as fruit or low calorie jelly
• encouraging the person to become more active, by taking walks or swimming, or seated exercises for people with mobility issues
• storing food away from the person’s line of sight so they aren’t tempted