Can that morning cup of coffee actually help prevent Alzheimer’s disease?

A new report from the Institute on Scientific Information on Coffee in Europe offers a balanced look at the science behind coffee and caffeine, and finds no clear evidence whether coffee can actually help prevent neurodegenerative disease.

A news release about the reports offers up the tantalizing suggestion that a “lifelong regular intake of coffee may have protective effect related to cognitive decline and neurodegenerative conditions.”

But the report itself is more cautious. It notes that research into the connection between coffee consumption and Alzheimer’s disease actually shows varied results, with many studies suggesting that a lifelong intake of coffee/caffeine is associated with a reduced risk of developing Alzheimer’s while others were unable to prove clear causation.

The report does say, however, that a review in 2018 suggested that more than 75 percent of the research supports the opinion that caffeine has a favorable effect against cognitive decline and Alzheimer’s.

The Institute on Scientific Information on Coffee is funded by six of Europe’s major European coffee companies: illycaffè, Jacobs Douwe Egberts, Lavazza, Nestlé, Paulig, and Tchibo.

Diet Vs Coffee

Coffee, like wine or chocolate, is often making headlines for new studies that tout its health benefits: from boosting your cognitive function to improving your gut health. Past research has examined how coffee may protect against Alzheimer’s and Parkinson’s disease.

However, Elisabeth Rothenberg, an associate professor at the Department of Food and Meal Science at Kristianstad University in Sweden and an author of the latest report, notes that the scientific consensus is much clearer when it comes to the impact of diet on neurodegenerative conditions.

Rothenberg writes that nutrition research currently focuses more on the impact of overall food choices rather than particular nutrients or individual food items in maintaining good health. She says that the most well-documented dietary impact comes from the Mediterranean diets. Those are heavy on plant-based foods including fruits, vegetables, seeds, grains and olive oil, and they avoid saturated fats, animal-derived proteins and refined sugars.

“Positive associations between Mediterranean dietary patterns and better cognitive scores and a lower risk of Alzheimer’s Diseases have been shown,” Rothenberg says. “Although results vary, a majority of studies suggest that closer adherence to a Mediterranean style diet is associated with a lower risk for cognitive decline, probably acting by modifying pathways related to a more general aging process.”

If your aging parents need help to stay safe and healthy, you might be unsure about how to handle the situation.

Figuring out their needs, understanding the options, and making decisions can feel overwhelming.

Focusing on something concrete helps you feel more in control of the situation.

Use these 7 steps to turn the vague problem of “my aging parents need help” into a practical, realistic plan to help mom or dad be as healthy and happy as possible.

1. Assess your parent’s needs

Caring for a parent can feel overwhelming because you’re not sure exactly what needs to be done.

To solve that problem, take a step back to understand how much help your parent needs with everyday life.

Think about 8 key areas:

• Family support
• Home safety
• Medical needs
• Cognitive health
• Mobility
• Personal hygiene
• Meal preparation
• Social interaction

How much support are they already getting in each category and how much help do they realistically need to stay safe and healthy?

Write everything down in a caregiving notebook so you can keep track of their needs and figure out what services are needed.

For example, let’s say your dad is managing diabetes and heart disease, has no other family nearby, is fairly isolated in a rural area, and hates to cook for himself. Plus, you live across the country. So, he’ll need help with medication management, transportation, and meals.

You could hire a driver for doctor’s appointments and errands, set up grocery or meal deliveries, and hire an in-home caregiver to prepare meals and make sure he’s taking his medicine.

2. Think about your own needs and abilities

Everyone is in a different place in their lives.

Before you make the assumption that you can take care of all your parent’s needs by yourself, stop and think about your own situation and abilities.

• Does your health allow you to physically care for someone?
• Do you live close enough to visit as often as needed?
• Would you want to live with them, either in their house or yours?
• Do you have the kind of relationship that allows you to spend a lot of time together without creating a lot of negative feelings on either side?
• Do you have the personality to provide the type of care they need?
• Are you willing to learn how to provide that care?

We want our parents to be safe and healthy. And it’s not selfish or heartless if you’re not the best person to personally provide that care.

By looking out for their health and safety and arranging the help they’ll need, you’re still being a supportive and caring child.

It’s best to make an honest assessment early in the process so you don’t get yourself into a situation that’s not sustainable.

If you take on too much and burn out physically or emotionally, you won’t be able to help your parent or yourself.

3. Include your parent in the process

Nobody wants to lose control of their life, especially someone who’s already concerned about losing independence.

That’s why it’s so important to involve your parent as much as possible when you’re planning for their care. This helps them see you more as a partner rather than someone who’s swooping in to make changes.

They’re likely to be resistant in the beginning, so it will probably take multiple conversations. As long as they’re not in immediate danger, try not to force changes too quickly.

A helpful approach is to start with less intrusive approaches and increase the level of help as you go.

Unless it’s an emergency situation, get them used to accepting help by focusing on 1 or 2 critical needs. After that, slowly add on until they’re getting all the help they truly need.

4. Understand the financial situation

No matter what, caring for an older adult will cost money. It’s a good strategy to estimate future costs so you’ll be prepared.

Think about the medical care they’re likely to need, the cost of their potential living situation (like assisted living vs moving in with you), and everyday costs like food, caregiving supplies, home safety modifications, etc.

Once you have an idea of their financial position, you’ll know if they’ll be able to afford the care they need or if they’ll need financial help.

You may want to consult an elder law attorney or financial planner to help you plan ahead.

5. Take care of home safety basics

Safety hazards in the house add up over time, making it easier for older adults to trip, fall, or hurt themselves.

Preventing falls will go a long way to keeping your parent independent for as long as possible.

Simple fixes include:

• Making sure all floors and walkways are clear of clutter, cords, and rugs
• Adding grab bars in the bathroom and stair railings throughout
• Updating lights so all rooms are bright and switches are easily accessible
• Ensuring all appliances work well and are within easy reach
• Minimizing the need to use step-stools or bend down low

For more suggestions, check out this handy room-by-room home safety modification guide.

6. Make sure communication is simple and accessible

Another thing that keeps your parent safe is the ability to easily call for help and keep in touch with family and friends.

On top of being a safety hazard, isolation and loneliness have a serious negative effect on overall health.

Make sure their phone is easy to use and easily accessible. For some, keeping a simple mobile phone with pre-programmed numbers in their pocket is reassuring and easier to get to.

Or, if your parent is open to the idea, consider a wearable medical alert device.

7. Explore available aging care options

Even after breaking down the steps, caring for your parent can be an overwhelming responsibility.

Fortunately, there are many aging care options and helpful resources you can rely on.

• Geriatric care managers– they can act as consultants to guide you or they can manage all aspects of caring for your parent. Their experience could save you time, money, and headaches down the road.
• In-home caregiving help– whether you hire privately or go through a home care agency, hired caregivers take care of seniors in their home.
• Assisted living communities– if your parent isn’t able to live on their own or needs 24/7 care, assisted living and other senior housing options might be the right choice.
• Geriatricians (geriatric doctors)– they specialize in caring for seniors and have more experience treating people with multiple chronic health conditions, dementia, and other conditions that primarily affect older adults

Article courtesy of the DailyCaring Editorial Team                                                                                                                                                                                                                                                

Both Parkinson’s disease and dementia were ravaging the brain and behavior of actor Robin Williams before his death, but at the time, he didn’t realize he had the latter.

Despite the fact that the signs of this combination can be confusing, the double diagnosis of Parkinson’s and dementia impacts a large number of people. Of the one million people who have Parkinson’s in the U.S., 50 to 80 percent may have dementia—either as a result of Parkinson’s pathology, or separately.

Robin Williams’ widow, Susan, wrote an editorial published in Neurology that was addressed to neurologists after his death. In it, she shared what it was like seeing her husband experience both Parkinson’s disease and Lewy body dementia firsthand.

“My hope is that it will help you understand your patients along with their spouses and caregivers a little more,” Susan wrote.

Williams was first diagnosed with Parkinson’s disease, which at first seemed to provide some answers for his out-of-character symptoms.

But it wasn’t until after his death that an autopsy revealed he had been in the later stages of Lewy body dementia—a common form of dementia characterized by deposits of Lewy body proteins in the brain, which can impact physical movement, mood, memory and behavior.

“I will never know the true depth of his suffering, nor just how hard he was fighting,” Susan wrote. “But from where I stood, I saw the bravest man in the world playing the hardest role of his life.”

If you or a loved one are concerned about having either of these diseases and want to learn more about their effects on the brain, here are the most important things you should know.

The pathologies are different, but many of the symptoms can be similar

“We do know that the pathology is quite different” between Parkinson’s and dementia, said Dr. Odinachi Oguh, a neurologist at the Cleveland Clinic Lou Ruvo Center for Brain Health. “But the processes in which memory is impacted in both diseases is about the same.”

“From the pathology standpoint, both diseases are characterized by a neurodegenerative process,” Oguh said. “The neurodegeneration results in abnormal accumulation of protein, which builds up and becomes toxic to the brain.”

Alzheimer’s, for example, affects memory areas of the brain, which include the temporal lobes, as well as the memory center, or hippocampus. Parkinson’s, meanwhile, starts in the basal ganglia part of the brain, and as the disease progresses, it can also affect the memory center, resulting in forgetfulness, an early sign of Alzheimer’s or other forms of dementia.

There’s a spectrum of pathologies

Scientists have been examining this link—and how the two diseases often overlap—for some time, but still aren’t completely certain how they contribute to one another. As a result, physicians sometimes group the diseases into different combinations when making diagnoses.

Dementia in Parkinson’s patients can present itself in varying forms. In some cases, the Parkinson’s pathology can trigger the dementia pathology—a situation that results in what’s known as Parkinson’s disease dementia, says Dr. Aaron Ritter, Director of the Clinical Research Program at the Cleveland Clinic Lou Ruvo Center for Brain Health.

“A substantial subset of folks with Parkinson’s who live long enough, will develop [Parkinson’s disease] dementia,” Ritter said. “It’s separate from Alzheimer’s, but it’s likely related to Parkinson’s pathology, a sort of spreading of Parkinson’s.”

In other cases, patients may develop a form of dementia like Alzheimer’s separately from their Parkinson’s disease, though this isn’t visible until after death, through an autopsy.

Many people with Parkinson’s may also develop Lewy body dementia shortly after their diagnosis. “When you have Parkinson’s, and see cognitive decline—or things like hallucinations and delusions—up to a year after your Parkinson’s diagnosis, you may have Lewy body dementia,” Oguh said.

Ultimately, Ritter said, scientists are beginning to accept that there’s likely a wide spectrum of different pathologies that can develop in each individual. Studying those is the goal of the COBRE study at the Cleveland Clinic, which Ritter works on.

“Being able to study and acknowledge that there’s a spectrum of different pathologies in different people’s brains is how we’re approaching it,” Ritter said. “We’re going through genetic, inflammatory, cognitive data; as well as clinical data like head traumas, medications and family history, to see if we can differentiate [pathologies in Parkinson’s and dementia]. We’re trying to get a very deep-dive into what may shape an individual’s aging process [in the brain].”

Not everyone with Parkinson’s will develop dementia

Despite the fact that the pathology of Parkinson’s disease can trigger the development of different types of dementia, not everyone with Parkinson’s will develop dementia. About 30 percent of people with Parkinson’s will actually not develop dementia at all, as stated by the National Parkinson Foundation.

However, “the vast majority of people with Parkinson’s may experience some form of cognitive impairment over time,” the foundation says.

See a doctor if you’re noticing symptoms beyond Parkinson’s

Sometimes the mood or memory changes a person experiences cannot entirely be explained just by Parkinson’s. If this is the case, “the caregiver should explore other diagnoses, because if something cannot be explained by Parkinson’s, there’s certainly a risk of it being dementia,” Oguh said.

She added that some signs to look for include increased memory and behavioral problems, like mood swings, anxiety or depression. Psychiatric behaviors, like hallucinations, delusions or paranoia, cannot just be explained by Parkinson’s, and are more likely to be caused by a form of dementia like Lewy body dementia.

Oguh urged caregivers to be aware of changing symptoms like these.

“I think sometimes family members are able to realize [the symptoms] sooner than the patient,” Oguh said. “Often the patient might lack insight as to what is happening. I would encourage family members to seek expert opinion and treatment options.”

There’s no cure for the diseases, but some therapies may help

Certain drugs, like cholinesterase inhibitors and antipsychotic medications, are prescribed as treatment for people with Parkinson’s and dementia. And lifestyle changes—from improved diet, sleep, exercise and socializing—have been shown to have beneficial effects on patients with these diseases.

Oguh noted she hopes that improved treatments that will help some of the emotional and behavioral problems in these patients will be on the horizon soon.

“I’m hoping that with the new advances in medication, we’ll be able to control [Parkinson’s and dementia] better,” Oguh said. “I believe there will be better medication to improve cognition in patients, and that that will be seen in the next five to 10 years.”

Those ‘senior moments’ may creep up on you as you get older, but how can you tell if slips in memory are a normal part of ageing or a sign of something else?

By Kate Corr

Could this be you? You keep forgetting where you’ve placed your keys, you walk around the supermarket trying to remember the one thing you went in there to get, or you walk upstairs…then rack your brain trying to remember why you went up. Everyone has moments like this and they’re usually nothing to worry about. But it’s still useful to know what to look out for in case these senior moments do become a little more serious.

SPOT IT: Normal forgetfulness

What happens: As we get older, our brains change making it harder for us to dredge up certain facts or memories that were stored there. This can mean it might take us longer to learn or recall information, though most of the time whatever you seem to have forgotten will come back to you – eventually!

Why: The hormones and proteins that repair brain cells and stimulate growth in the brain start to decline with age.

Typical symptoms:

• You occasionally (note occasionally!) forget where you left keys or glasses
• You sometimes forget an appointment
• You occasionally forget the details of a conversation (although you will remember the conversation itself)
• You have ‘tip of the tongue’ moments with words

But: This kind of forgetfulness caused by normal ageing is NOT the same as having significant memory loss.

SPOT IT: Memory Loss

What happens: This does exactly what it says on the tin – you struggle to remember things. However, while memory loss can be a symptom of more serious conditions that lead to dementia, it definitely isn’t a guaranteed sign.

Why: Memory loss can be a sign of other health conditions so it’s worth looking at your health more generally before assuming you have dementia.

Typical symptoms:

• You struggle to remember things on a daily basis
• You have memory loss accompanied by other symptoms such as tiredness, depression or weight loss.
• Your lifestyle choices – for example alcohol or drugs – are affecting your memory.

But: Memory loss is also one of the main symptoms of mild cognitive impairment (see below), so it’s wise not to ignore it.

SPOT IT: Mild Cognitive Impairment (MCI)

What happens: Sometimes described as a precursor or intermediate stage between normal ageing and dementia, mild cognitive impairment (MCI) causes memory problems that are noticeable, but are not interfering too much with everyday life in the way that dementia can.

Why: This is a grey area and the balance between forgetfulness, MCI and dementia is delicate. While having MCI can make it more likely you’ll go on to develop dementia it’s really important to remember that this certainly isn’t inevitable.

Typical symptoms:

• You frequently lose or misplace things
• You regularly forget conversations, appointments or events
• You have difficulty remembering the names of people you’ve just met
• You manage to carry on with normal life, but are reliant on notes and day planners.

But: The good news is that if MCI is spotted, it gives you time to prepare, plan ahead and have earlier access to drug treatments if (and only IF) dementia is eventually diagnosed.

SPOT IT: Dementia What happens: Someone with dementia may have similar symptoms to someone with mild cognitive impairment, the only difference is that they’ll be more noticeable, and could therefore impact more on everyday life.

Why: The move from having mild cognitive impairment to dementia can vary from person to person – some people plateau at quite a mild stage for several years.

Typical symptoms of dementia:

– Regularly struggle to remember recent events

– Find it hard to follow conversations or programmes on TV

– Forget the names of everyday objects

– Find that you repeat yourself or lose the thread of what you’re saying

– Get lost or disorientated in familiar places

But: If you’re worried about any of these symptoms, it’s definitely worth visiting your GP and finding out more. The sooner a dementia diagnosis is made, the easier it is to access the right sort of treatment and support

Other causes of memory loss:

• Depression
• Anxiety/Stress
• Insomnia
• Medications
• Vitamin Deficiency – B1 & B12 Alcohol and drug misuse
• Thyroid problems
• Head Injury
• Anaesthesia
• Neurological disease

Article courtesy of Alzheimers SA newsletter.

We were deeply touched by the recent interaction of one of our lovely residents and her little sheep. Ms JMK used to be a ballerina and a teacher and is now showing fairly advanced brain changes.

On this particular day, she was complaining about being cold. The little sheep is a microwaveable bean bag which she had on her hands and which she spent time hugging and kissing because he warmed her so nicely.

Ms JMK used to be a ballerina and a teacher and spent some time on this day with our CEO, Matron Painter, talking about her life over coffee and biscuits. They have become firm friends and often enjoy special coffee and cookie times while they chat.

A daily ritual for Ms JMK is to come for long hugs from Matron Painter and Sister Coram. This is a wonderful, affirming way that we are able to support her.

This was a great day for Ms JMK, and it was amazing to see how she lit up when she engaged with a little 1-year old visitor to Brenthurst and with one of our resident pet therapy dogs, Tyson. She is a special part of our Brenthurst family and we are so honoured to be able to travel this journey with her and to keep her truly connected, stimulated and engaged each day.

While forgetfulness and cognitive decline are the main defining symptoms of dementia or Alzheimer’s, the conditions are also often riddled with behavioral issues and aggression, which can be burdensome for both patients and caregivers.

Certain drugs, like antipsychotics, can be used to treat these behavioral issues, or at least ease them a bit. But a new meta-analysis examining 163 studies and over 23,000 people with dementia finds that drugs may not be the most effective treatment path.

Instead, the authors pinpoint more holistic activities—like spending time outdoors, or getting messages—as being better at alleviating aggression and agitation among patients.

Drug Vs. Non-Drug Approaches

The researchers reviewed past studies that analyzed the efficacy of non-drug treatments for aggression in dementia. They found that being outside, getting massages and even music all showed positive benefits for reducing agitation and aggression in people with dementia—more so than antipsychotics.

Antipsychotics, like quetiapine and risperidone, are commonly prescribed to patients to help calm their aggressive behavior. But antipsychotics come with their own side effects, like an increased risk of stroke and falls. One recent study also found that antipsychotics were linked to a rise in hospitalizations among dementia patients.

The conclusion of the latest study was straightforward: “Nonpharmacologic interventions seemed to be more efficacious than pharmacologic interventions for reducing aggression and agitation in adults with dementia,” the authors wrote.

Outdoor activities in particular, like gardening, showed more efficacy in reducing physical aggression in dementia patients than antipsychotic medication. Physical touch, like massage and touch therapy, also showed to be a better alternative to drugs for treating verbal aggression.

Addressing the Root Cause of Aggression

But why do these seemingly simple non-drug approaches seem to work better? The authors believe it may have something to do with addressing the root cause of the aggressive behavior.

“Nonpharmacologic interventions may be efficacious because behaviour has meaning, which needs to be uncovered through multidisciplinary assessments and care that addresses underlying needs,” the authors wrote.

According to the Social Care Institute for Excellence, aggressive behavior in people with dementia can be thought of as a reaction rather than a symptom. Instead of assuming the person with dementia is being purposefully angry or aggressive, it’s important to understand that it’s more likely they are experiencing fear, discomfort or frustration in feeling unheard.

Figuring out the message behind a person’s aggressive behavior can help make it easier for caregivers to address it. Massaging a person’s hand, taking them outside for a walk, helping them feel more comfortable or changing their scenery could be good options in addressing their feelings.

Though the authors of the study recommend trying nonpharmacologic approaches to treat aggressive behavior, discussing it with a doctor first may be the best option. Some patients may require drugs, and some may benefit from a more comprehensive approach that uses both drug therapy and holistic activities.

In Tokyo, Japan, a restaurant aims to change stereotypes and raise awareness about dementia by hiring servers with the condition. Known as the Restaurant of Mistaken Orders, its goal is to create an open and welcoming community for people living with dementia and Alzheimer’s, and to help keep them integrated in society.

There are some 50 million people in the world living with dementia, according to the World Health Organization (WHO), and 10 million new cases occur each year. People with dementia, including those with Alzheimer’s, develop problems with memory and cognition throughout different stages that worsen with age.

Many people with dementia end up no longer working, living at home with full-time caregivers or in nursing homes. But there is some evidence that increased socializing and having a support system can be beneficial for patients. Community living environments also often help dementia patients avoid isolation and loneliness.

The idea for the restaurant stemmed from the desire to bring people with dementia together in a working community, and to spread awareness that the disease doesn’t have to prevent people from living life. In fact, the restaurant discovered that people with dementia wanted to work and stay busy.

“It started as a small trial event; a survey was conducted afterwards, and it was proven through numeric evidence that people with dementia worked vivaciously out of their free will, and customers also truly enjoyed the experience,” Tsutomu Hirakue, who was involved with the restaurant, told Being Patient. “[Discovering] that a fun space could be created even if a mistake occurred — or [even] enjoyed more when a mistake occurred — led to the participation of many corporations and local government organizations.”

Though some of the servers are prone to serving water twice or mixing up orders, customers laugh it off and simply enjoy the food they receive.

“Since dementia is a sensitive issue, there was a necessity to prove that [the restaurant could be] an event that is fun,” Hirakue said. “People feel at ease and smile from the bottom of their hearts regardless of having dementia or not.”

On its website, the Restaurant of Mistaken Orders notes that “All our servers are people living with dementia. However, rest assured that even if your order is mistaken, everything on our menu is delicious and one of a kind.”

The restaurant adds, “We hope this feeling of openness and understanding will spread across Japan, and through the world.”

Linda Freud produced the video and contributed to reporting for this article.

The attached CAREWORKERS RECOGNITION MEMORANDUM is to be handed to the DSD Portfolio Committee at the Parliament Building (Visitors Gate) at 12:00 on 1 October 2019 (International Older Persons day).

MEMORANDUM LINK

We would like to invite everybody who has a concern in this matter to join us in a Peaceful gathering for the day in the Western Cape. Organisations and Associations may send representatives and they may bring banners to indicate their support. We will arrange for press coverage in order to put pressure on the National Department DSD to recognise the industry partners in projects concerning our industry going forward.

Please let me know if you would be able to join us by 27 September 2019.

Kind regards

Annelie Terblanche

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.”