In my previous post, I talked about using the Alzheimer’s Association as our benchmark for determining the stages of Alzheimer’s disease. In Stage 1 there is no evidence of Alzheimer’s disease as determined by a medical interview.

Stage 2 of Alzheimer’s disease shows very mild cognitive decline. At this point, it could be just the normal “senior moments” or it could be the earliest sign of Alzheimer’s disease. According to the Alzheimer’s Association:

Individuals may feel as if they have memory loss and lapses, especially in forgetting familiar words or names or the location of keys, eyeglasses or other everyday objects. But these problems are not evident during a medical examination or apparent to friends, family or co-workers.

Personally, it seems as though most of my conversations with my senior friends which lasts longer than a few minutes are sporadically sprinkled with “senior moments.” As far as I know, these are not friends that have any particular problems like coping with grief, abuse and addiction, anxiety disorders, or sleep problems that could affect their memory.

One day my husband and I were taking a walk in the neighborhood and it took us half the length of the walk to remember the the names of a family that used to live in our cul-de-sac. That family has since moved into a bigger house down the street. The next time we took the same walk, we had forgotten their names again and this time we never did come up with all of the names. Generally, between the two of us, we do manage to come up with all of their names. Thank goodness for a neighborhood directory. Perhaps we won’t forget on the next walk. We laugh about it, but at the same time, that thought of Alzheimer’s disease always crosses my mind.

How about you? If you’re in that situation, does Alzheimer’s disease ever cross your mind?

Depending on the source, some say there are seven (7) stages of Alzheimer’s disease while others say there are three (3). The Alzheimer’s Association says that there are seven (7) stages of Alzheimer’s disease. I will cover each stage of Alzheimer’s in separate posts.

Stage 1, according to the Alzheimer’s Association, is No Impairment (normal function). No evidence is apparent to a health care professional during a medical interview. In my post on What is Alzheimer’s Disease? I mentioned three ways that doctors determine how a diagnosis is made –

1. Lab tests
2. Neuropsychological testing (extensive assessment of thinking and memory skills)
3. Brain scans

Apparently, Stage 1 only involves an interview since there is no evidence or reason for more extensive testing at this point. So why a Stage 1? If Stage 1 is normal functioning with no impairment, then it seems to me in order to determine a Stage 1, it is can only be determined AFTER a person has been diagnosed with Alzheimer’s disease. There is no abnormality in Stage 1. So after a person has been diagnosed, then we can go back and say this person with Alzheimer’s was in Stage 1.

On the other hand, it might be possible to detect a Stage 1 if you lived with someone or you know someone very well … a loved one whom you can detect mild memory loss or mild cognitive impairment or other signs and symptoms such as personality changes, all of which may indicate a future Alzheimer’s diagnosis. Or, if you personally feel that something is not right with your memory,  then you may possibly be in Stage 1 of Alzheimer’s disease, but Stage 1 means that you are still functioning normally. At this point, though, from a medical standpoint, an Alzheimer’s diagnosis is not possible. Other problems such as anxiety disorders, bipolar disorders, sleep problems, depression, or medications could also point to Alzheimer’s disease, but that would be conjecture at this time.

If you detect dementia, though, and if you are a future caregiver, you need to remember to most importantly take care of yourself. But it also gives you time to get things in order and prepare for the future. Through our continuous journey, I hope we can learn what to expect (even though each case is unique) and follow the Scout motto: “Be Prepared.”

Alzheimer's Association's E-News

The Alzheimer’s Association has a wonderful Web site packed with a wealth of information. I came across the video below because I signed up to get their weekly E-News and you can click here to sign up as well. It is a one-page update on advances in Alzheimer’s disease care, research, events and a brain-builder puzzle. Although the information is invaluable, it can be overwhelming to those not familiar with navigating Web sites. Additionally, symptoms may be similar, but no two people will experience Alzheimer’s disease in exactly the same way.

The video below reminds us that no one is immune to Alzheimer’s disease and Alzheimer’s is a family disease. The statistics are staggering — every 70 seconds in the United States, someone is diagnosed with Alzheimer’s.  Wow! Imagine being diagnosed with Alzheimer’s disease. The Alzheimer’s diagnosis may not surprise you because you may have suspected cognitive decline, but nevertheless, it is a shock to you and your family to receive the news. This can lead to many problems including depression in older adults, anxiety disorder, personality changes, bipolar disorder, and mental health problems, to name a few. Along the journey, although there is no known cure, I will certainly be looking for tips for getting better.

In future posts, I will be writing about stages of Alzheimer’s disease and the problems each stage brings. In this way, we can prepare for coping with the disease.

Check out this video from the Alzheimer’s Association.

In my previous post, I wrote about focusing on the caregiver. If you’re not physically and mentally healthy, finding the strength to take care of an Alzheimer’s disease (AD) patient is a monumental challenge. Even if you are in the best of health, I know it’s still difficult, but at least you’re healthy and can think more clearly. Recently, the Alzheimer’s Association in my area sent me a request to renew my 2010 Champion membership — i.e., please send more money.  Attached to this request was a list — 10 Symptoms of Caregiver Stress. I was happy to see the focus on the caregiver. Here are the symptoms of caregiver stress.

1. DENIAL about the disease and its effects on the person who has been diagnosed. “I know Mom’s going to get better.”
2. ANGER at the person with Alzheimer’s or others that no effective treatments or cures currently exist and that people don’t understand what’s going on. “If he asks me that question one more time, I’ll scream.”
3. SOCIAL WITHDRAWAL from friends and activities that once brought pleasure. “I don’t care about getting together with the neighbors anymore.”
4. ANXIETY about facing another day and what the future holds. “What happens when he needs more care than I can provide?”
5. DEPRESSION begins to affect the ability to cope. “I don’t care anymore.”
6. EXHAUSTION makes it nearly impossible to complete necessary daily tasks. “I’m too tired for this.”
7. SLEEPLESSNESS caused by a never-ending list of concerns. “What if she wanders out of the house or falls and hurts herself?”
8. IRRITABILITY leads to moodiness and triggers negative responses and reactions. “Leave me alone!”
9. LACK OF CONCENTRATION makes it difficult to perform familiar tasks. “I was so busy, I forgot we had an appointment.”
10. HEALTH PROBLEMS begin to take their toll, both mentally and physically. “I can’t remember the last time I felt good.”

The Alzheimer’s Association offers a brochure that tells you how to manage caregiver stress and how to be a healthy caregiver. Click here to obtain the brochure. The Alzheimer’s Association has a toll-free number should you wish to speak with someone. 1.800.272.3900. I wish you the best. Please take care.

Alzheimer’s disease (AD) is generally associated with people over 60. Many adult children find themselves in reverse roles taking care of their parents. Those whose mother or father has AD or any other debilitating disease find themselves in an extremely stressful situation. In this post, I want to focus on the health of the caregiver. The loss of sleep and the worry over the well-being of the AD patient can take its toll over time.

Abhishek Agarwal in his article on Caretaker’s Health – Taking Care Of Yourself Is Part Of A Caretaker’s Job! says that caring for an elderly person can be both immensely satisfying and overwhelming. He states, “It is equally important for the caregiver to take care of himself if he so badly wants to take care of his loved ones.”

Caregiver burnout can include the following and it is important to get help:

• Guilt that there are other things to care for in the caretaker’s life besides the parent
• Decline in health, including change of attitude
• Lack of sleep and appetite
• Nervous breakdown

Virginia J. Duffy, Ph.D., a psychiatric nurse practitioner in her article, Beating Burnout In Helping Professionals, has the following recommendations for professionals, but it can certainly apply to individual caretakers as well:

• Take care of you, it will relieve some of your stress and allow you to better take care of others
• Try understanding and treating yourself with the same care you give your patients
• Allow yourself to say no
• Recognize and allow your own feelings
• Practice stress reduction techniques (exercise, relaxation, meditation, distraction)

Personally, I think if you can select just one of the stress reduction techniques in a short burst, say, just five minutes of meditation a couple of times a day and capture the gratitude of the moment, you can give yourself a gift. For anyone reading this blog who has a friend with Alzheimer’s disease and you’re not comfortable alone with the patient, perhaps you can just make sure that the AD patient is safe while the primary caretaker just takes a few minutes for him/herself in another room.

I wish you all the best in this new year. It’s so difficult when we know that Alzheimer’s disease is not reversible, but let this be the year that the focus is on the caregiver, too. You owe it to yourself to be strong because it requires strength to care for others.

As we come to the end of 2009, I think it’s fair to say that there’s hope and progress in the field of Alzheimer’s disease (AD) research. Each year, the Alzheimer’s Association sponsors the International Conference on Alzheimer’s Disease (ICAD). The 2009 conference was held in Vienna, Austria and drew close to 3,800 international attendees. The purpose of the conference was to share the latest ideas, thoughts, and theories in dementia science. Next year’s meeting will be held in Honolulu, Hawaii.

The Alzheimer’s Association reported the following highlights from ICAD 2009:

DHA Drug Trial

An 18-month study in people with mild to moderate Alzheimer’s did not support the routine use of DHA, an omega 3 fatty acid. Meanwhile, a six-month study was conducted in healthy older people to see DHA’s effect on “age related cognitive decline.” This trial showed a positive result on one test of memory and learning.

These two studies — and other recent Alzheimer therapy trials — raise the possibility that treatments must be given early in the Alzheimer’s process for them to be truly effective.

Phase III Alzheimer’s Drug Raises Level of a Toxic Protein

Recent evidence suggests that the drug Dimebon may improve cognitive function in people with mild to moderate Alzheimer’s. However, researchers found that treatment with Dimebon cause an increase in beta amyloid in mouse models of Alzheimer’s. Beta amyloid is a protein that is the main constituent of plaques found in the brains of people with Alzheimer’s.

This result is highly unexpected as most Alzheimer drugs are tested for how much they can lower beta amyloid levels.

Heart Healthy May Reduce Risk of Cognitive Decline

Scientists at ICAD 2009 reported that following the Dietary Approaches to Stop Hypertension diet — or DASH diet — was associated with higher scores for cognitive functioning. The researchers found that four food categories from the diet plan — whole grains, vegetables, low-fat dairy foods, and nuts and beans — may offer benefits for cognition in late life. We cannot yet confidently say how much of these foods to include in one’s diet to experience some benefit.

To all of my readers, thank you for stopping by and may you all have a safe and very healthy and Happy New Year! Together we will continue the journey to learn about and conquer Alzheimer’s disease!

Earlier this year in my other blog, I wrote about ways to boost your brain power. It was a simple list of seven things that might help counteract age-related changes in the brain and perhaps stave off Alzheimer’s disease (AD). One was to play Sudoku. You may be a pro at Sudoku or you may be a beginner like me or somewhere in-between. In any case, Web Sudoku is an amazing Web site where you can find Sukoku for every level from easy to evil. You can download the puzzles as well. The best part? They have a cool button that says, “How Am I Doing?” so if you really need to find out if you’re on the right track, you could, let’s say, cheat, no, I meant get some assistance. Click here.

According to Wikipedia, Sudoku was popularized in 1986 by the Japanese puzzle company Nikoli, under the name Sudoku, meaning single number. It became an international hit in 2005.

With this being the week of Christmas and all the hustle and bustle, it would be refreshing to stop for a few minutes and work on a puzzle. Interested in playing with someone else? Check out the two-player Sudoku Combat.

From AboutAlz.com, Happy Holidays! Although many of you are facing the challenges of Alzheimer’s disease, know someone who is, or is a caretaker, I ask you to take care of yourself as your health is the greatest gift you can give to yourself and to those you love. I leave you with this question: If health were your top priority, what would you be doing differently today? If your answer is, “I have no time,” what one tiny change can you make?

Located in Fairfax, Virginia, the Alzheimer’s Family Day Center (AFDC) is the only adult day health center in the Washington, DC metro area for adults with Alzheimer’s disease in the mid to late stages of Alzheimer’s and other related dementia. For those in the early stages, the Social Club meets for a half-day once a week. Founded in 1984 by visionary Dr. Lin Noyes Simon, AFDC just celebrated its 25th anniversary. As a founding director of the first and only dementia-specific day-care center in Northern Virginia, Dr. Simon turned a concept of care into a viable nonprofit business that increases the quality of life for people with dementia and their families.

Alzheimer's Family Day Center

Part of the mission of this organization is education. They offer training programs for caregivers and they practice and improve the skills and techniques in their programs. They also offer classes for caregivers on many aspects including medical, legal, financial, community resources, how to build coping skills.

The Alzheimer’s Family Day Center is a full care facility providing breakfast, lunch, and two snacks each day. Additionally medical services and transportation are provided. They can accommodate up to 34 participants with a 1:4 staff ratio. Fees cover 40% of their budget; fund raising and grants cover the rest. Scholarships are provided for those that cannot afford the fees. Level II care for the middle stages of Alzheimer’s and runs from $730 to $1533 per month, depending on the number of days the client attends. Level III care for late stage dementia ranges from $830 to $1743 per month.

On the day I visited, the group was actively engaged in a game. One aide was seated right outside of the restrooms ready to assist while another sat right outside of the game room also ready to assist. Another staff member was cleaning the bright dining room. It’s a very pleasant facility with an upbeat staff.

Nancy Dezan, Executive Director, said day care is not for everyone. People think that their loved ones won’t like it, but once they attend, they think it’s the greatest thing since sliced bread. She asked me why I thought my family never sent my father to day care. Well, they tried it, but my mother (as my father’s primary caretaker) felt it was so much work to prepare him to go out. Furthermore, they had to be ready when their transportation arrived. Nancy said this was a typical answer for many families.

To see how you can help, visit the AFDC Web site.

Nancy Dezan at Positive Aging Fair

I first heard Nancy Dezan speak about Alzheimer’s disease at the Positive Aging Fair in early fall. Her topic was “The Mind, Body & Spirit of Brain Health.” I heard her again speak on “Reducing Your Loss of Memory” at the Aging and Wellness Conference and Expo in McLean, Va, about a month later. Nancy is the dynamic Executive Director of the Alzheimer’s Family Day Center, the only adult day center in Northern Virginia devoted completely to the care of Alzheimer’s clients. She is an Alzheimer’s disease educator with an extensive background in Alzheimer’s and an excellent public speaker.

In her speeches, she assured us that forgetting a person’s name soon after being introduced is not a “senior” problem; it’s a problem of not concentrating. In normal aging, everything slows down; cognitive ability slows down around 40.

If you lost your keys every day, that is not necessarily a red flag. But if you don’t know what to do with the keys, that’s a red flag. Everyone with Alzheimer’s knows something is wrong and they feel vulnerable. Hence, they put keys in odd places like the freezer because they know that the keys are valuable, but since there’s no short-term memory, they can’t remember where or why they put it in the freezer.

She referred to the Nun Study which showed that nuns who were always exercising their brain fared the best, not necessarily those that were the most intelligent, because it sparked new neurons. She offered many tips on how to keep the brain healthy as well as the body. What is good for the normal person is good for one with Alzheimer’s as well. She mentioned four risk factors — blood pressure, cholesterol, obesity, and diabetes. High levels of stress can affect the brain and it is especially important for caregivers to reach out and ask for help.

In my next post, I will introduce you to the Alzheimer’s Family Day Care Center.

From the Mount Sinai School of Medicine on the Upper East Side of New York City comes exciting news that it is one of 12 sites nationwide participating in the first Phase 2 clinical trial to test gene therapy treatment for Alzheimer’s disease (AD). The study is the first multicenter neurosurgical intervention in Alzheimer’s research in the U.S. The Alzheimer’s Disease Cooperative Study (ADCS) is sponsoring the study through a grant from the National Institute on Aging (a part of the National Institutes of Health [NIH]) in association with Ceregene, Inc., which developed and will provide the active agent (CERE-110).

According to Mount Sinai’s press release:

The experimental treatment utilizes a viral-based gene transfer system, CERE-110, that makes Nerve Growth Factor (NGF), a naturally occurring protein that helps maintain nerve cell survival in the brain. CERE-110 has been previously studied in animals, where it reversed brain degeneration in aged monkeys and rats. For this study, CERE-110, will be injected by a neurosurgeon directly into the nucleus basalis of Meynert (NBM) of the brain, an area where neuronal death occurs in Alzheimer’s patients.

Mount Sinai Medical Center

In animal studies, NGF has been shown to support the survival and function of the neurons that deteriorate in Alzheimer’s patients. These neurons produce the chemical acetylcholine, which is important in memory and cognitive function. The hope is that improvement of this system’s function may lead to better memory performance in Alzheimer’s patients.

Participants in the Phase 2 study will be randomly placed into one of two treatment groups, with half receiving CERE-110 via neurosurgery and half receiving placebo surgery without any cranial injections. Once the study is completed, and if the results are promising, participants in the placebo group will be eligible to be treated with CERE-110. All participants will receive a thorough medical examination and cognitive testing. In addition, participants will be closely monitored by a team of physicians for the duration of the two-year study. Participants will also be encouraged to participate in long-term follow-up.

The Phase 1 study in Alzheimer’s patients was conducted at Rush University in Chicago and the University of California San Diego. Researchers observed increases in brain metabolism in several cortical regions of the brain at 6- and 12-month follow-up in some of the participants. With follow-up ranging from six months to more than four years post-treatment, there have been no side effects thought to be caused by CERE-110.

For more information from ADCS, click here. More information is also available at National Institute on Aging’s Alzheimer’s Disease Education and Referral Center (ADEAR). Click here.