Titled “Understanding the Person with Dementia: How to Communicate Effectively,” it was presented by Susan Stone who is with AFDC and does outreach and education. Susan is an excellent communicator herself and interacts with the audience extremely well. I want to share some of her thoughts in this article and I will continue next month.

Because communication is only 7% verbal and the rest nonverbal, it is important to not limit your communication to just words. People with Alzheimer’s prefer not to talk on the phone and initiating phone calls is difficult. They have difficulty keeping up with conversation and may not understand your words. Their attention span is limited and they may have trouble finding the correct word. Furthermore, they may pick up only every three to four words.

For example, the conversation may sound like this:

___ WANT ___  ___  ___ GET ___  ___  ___ TAKE ___  ___  ___ . WE ___  ___  ___ APPOINTMENT ___  ___  ___  ___ WE ___  ___  ___ BEFORE ___  ___  ___ HOME.

NOW ___  ___ HURRY.

Here is the entire message:

I WANT you to GET up now and TAKE a good shower. WE have a doctor’s APPOINTMENT at 11:00 and WE can have LUNCH before we go HOME.

NOW please just HURRY!

Getting angry and adding a sharp tone of voice is not going to make this message any easier for the AD person to decipher. Here are some suggestions Susan offered:

• Restating key words will help.

• Give one direction at a time.

• No rushing – time does not mean anything to an AD person.

Here are further suggestions repeating just the key words.

• Get up. (Offer your hand).

• Shower.

This is all the person needs to know at this point. They don’t really need to know about the appointment and having lunch is too far in the future to mention it now. You want them to take a shower and all they might remember is having lunch.

More suggestions will be coming next month. I hope this gives some understanding as to why communication is so challenging for those with dementia.

According to Wikipedia, MCI is a brain-function syndrome involving the onset and evolution of cognitive impairments beyond those expected based on the age and education of the individual, but which are not significant enough to interfere with their daily activities. It is often found to be a transitional stage between normal aging and dementia.

For this investigation, they turned to the Mayo Clinic Study on Aging, an ongoing, population-based cohort study in Olmsted County, Minnesota. The analysis involved 1233 nondemented participants aged from 70 to 89 years; 1070 patients were cognitively normal, and 163 had MCI.

The subjects noted the amount of calories they ate or drank in a food questionnaire. They were divided into three equal groups based on their daily caloric consumption.

• One-third consumed between 600 and 1,526 calories per day.
• One-third consumed between 1,526 and 2,143 calories per day.
• One-third consumed between 2,143 and 6,000 calories per day.

The analyses were adjusted for history of stroke, diabetes, amount of education, and other factors that can affect risk of memory loss. The risk for the highest calorie group was nearly double that of the lower calorie group. There was no noticeable difference in risk for the middle group.

According to Geda, the findings should be considered preliminary. However, consuming in moderation is a good idea for other medical reasons as well.

The co-authors of the study include Ronald C. Petersen, MD, Fellow of the American Academy of Neurology, and other investigators of the Mayo Clinic Study of Aging in Rochester, Minn.

Several people sent me e-mail about this interview and since then I’ve been researching various Web sites as well as checking out local retail outlets for coconut oil. Health food stores and specialty supermarkets carry coconut oil in capsule form, although you may be able to find some health food stores carrying the actual oil (I was pleased to find it in a health food store in my area). However, with experts recommending between two and three tablespoons of coconut oil daily for prevention of AD and up to five tablespoons for AD and with each capsule having only about 500 to 1000 mg of oil (each tablespoon is equal to about 15 grams), you would need at least 15 capsules to get one tablespoon. Taking 45 to 75 capsules a day would be quite costly and ill advised.

One of the top producers of coconut oil is the Philippines so I visited a local Filipino market in southern California that was recommended by a Filipino acquaintance who uses coconut oil. It is recommended that you start slowly, and thus far I’ve used about a teaspoon in my morning oatmeal. (I’m trying to get used to greasy oatmeal). I’ve also tried substituting the olive oil in my salad with the coconut oil (the taste did not agree with me). Finally, I substituted one tablespoon of coconut oil for butter and syrup on my pancakes and that was by far the tastiest option. But since I don’t eat pancakes every day, I continued to experiment and now I find that adding coconut oil to a small amount of coffee or tea works well.

Bruce Fife, ND, author of Stop Alzheimer’s Now!: How to Prevent & Reverse Dementia, Parkinson’s, ALS, Multiple Sclerosis & Other Neurodegenerative Disorders cautions that proper diet is also a necessary component. Simply adding coconut oil to the diet will produce disappointing results. He says that the fundamental problem associated with Alzheimer’s disease is the inability of the brain to effectively utilize glucose, or blood sugar, to produce energy. The brain then needs another source of energy and this comes in the form of ketone bodies produced in the liver. Medium chain triglycerides (MCTs) like coconut oil are converted into ketones in the body.

There are different methods of producing coconut oil. According to Tropical Traditions, a producer of coconut oil, “Virgin Coconut Oil can only be achieved by using fresh coconut meat or what is called non-copra. Chemicals and high heating are not used in further refining, since the natural, pure coconut oil is very stable with a shelf life of several years. There are currently two main processes of manufacturing Virgin Coconut Oil:

1. Quick drying of fresh coconut meat which is then used to press out the oil. Using this method, the coconut meat is quick dried, and the oil is then pressed out via mechanical means. This is the most common type of “Virgin” or “Extra Virgin” (see below) coconut oil sold in the market today that you will find in stores. It is mass-produced.

2. Wet-milling. With this method the oil is extracted from fresh coconut meat without drying first. “Coconut milk” is expressed first by pressing. The oil is then further separated from the water. Methods which can be used to separate the oil from the water include boiling, fermentation, refrigeration, enzymes and mechanical centrifuge.

Currently there is no known medication to prevent or stop Alzheimer’s disease. Coconut oil offers hope for this disease affecting 5.4 million Americans. Should you decide to try it, let me know how you’re ingesting it.

The cognitive activities included:

• Reading books
• Writing for pleasure
• Doing crossword puzzles
• Playing board games or cards
• Playing musical instruments
• Participating in organized group discussions

Physical activities included:

• Playing tennis or golf
• Swimming
• Bicycling
• Dancing
• Walking for exercise
• Doing housework
• Participating in group exercises

Today, almost everything you read suggests that physical activity plays an important role in maintaining your brain as well as your heart. In this study, however, almost none of the physical activities appeared to offer any protection against dementia. This study specifically looked at whether or not there were ways to reduce the risk of dementia and the only physical activity to offer protection against dementia was frequent dancing!

Here are some of the results:

Dancing frequently – 76% – the greatest risk reduction of any activity studied, cognitive or physical.
Doing crossword puzzles at least four days per week – 47%
Reading – 35%
Bicycling and swimming – 0% reduced risk
Playing golf – 0%

The researchers believe that the dancers are more resistant to the effects of dementia as a result of having greater cognitive reserve and increased complexity of neuronal synapses. Like education, participation in some leisure activities lowers the risk of dementia by improving cognitive reserve. They also said we need to keep as many of those paths active as we can while also generating new paths to maintain the complexity of our neuronal synapses.

More recently, Science Daily reported in 2010 that two recent studies conducted by University of Missouri researchers found that participation in dance-based therapy can improve balance and gait in older adults. Improved functionality among seniors can decrease their risk of falling and reduce costly injuries.

I love line dancing and I attend classes when my schedule permits. This video is a link to one of the sessions and as you can see, not everyone learns at the same pace, but everyone has a lot of fun. Eventually,we all get it. The short Asian woman in green in the back row is 80 years old. What an inspiration. Now that I know the huge benefit of dancing, I will definitely want to continue.

1.  Focus on the events of the day in order from arising in the morning until you go to sleep. The good news is that you will fall asleep long before you reach the end of the day.

2.  During the process, visualize each step of the day.  The process should include all activities, conversations, thoughts and individuals met during the day.  It might be seen as a video recording of the day played back only in your brain.  Focus on details.

3.  Initially, the mind video will be playing in fast forward.  It will be difficult to pick out the small details such as thinking over your today list or looking in the mirror while brushing one’s teeth.  In addition, scenes may jump out of sequence from morning to afternoon and then back to getting out of bed.  However, your goal is to play the video in sequence.

4.  As you continue the exercise several days in a row, you should begin to see some differences.  That which was once a just big chunk of time will begin to develop into fully visualized scenes, which include people, conversations, room decor, signs and thoughts.  Details will become clearer.

5.  It should become a daily challenge to remember more of the day.  You will become more aware of the things you normally would have done without much thought.  Since you know you must recall, your focus changes.  You are using brain cells not previously harnessed.  While the nighttime exercises may be a cure for insomnia, the daytime exercises help you to focus, improve your memory, and lower the chances of developing dementia.

By improving one’s daytime focus and recalling events of the day, it is possible for people to avoid memory loss and dementia.  Additionally, these activities can help with insomnia.

The ideas in this article are adapted from a blog on how to become a better chess player, but certainly seem appropriate for anyone concerned with dementia and having problems with memory and focus.

http://www.mychessblog.com/one-simple-mental-exercise-to-improve-your-mind-power/

Souvenaid has a unique mixture of nutrients that work by stimulating the connections between nerves, also known as synapses. Losing these connections is what many experts think is responsible for losing memory in Alzheimer’s patients.  Studies demonstrate that the nutrients in Souvenaid can help grow new synapses in the brain. People taking Souvenaid daily over three months had improved scores on memory tests.

Scheltens is cautiously optimistic about the new findings. More research needs to be done before any conclusions can be drawn, but he thinks it is a step in the right direction.

Souvenir II was completed at  27 centers in six countries in Europe to see if the effects from Souvenir I would last for eight weeks. This study used additional measures to test for recall and also measured brain activity. Of 259 subjects, over 91% finished the study.

Memory was tested at the beginning, at 12 weeks, and at 24 weeks. The composite score was gotten from the Rey Audtiory Verbal Test which tests instant recall, delayed memory, and recognition. The Wechlser Scale which tested verbal association was also used.

Over the 24 weeks, the total scores from the Souvenaid group were much higher than those from the control group. Besides just looking at memory scores, they are attempting to analyze the electroencephalogram and magnetoencephalogram data, which may help figure out the influence  Souveniad has on synapse building in patients with Alzehimer’s disease and dementia.

CTAD is sponsored by the University of California, San Diego School of Medicine and the European Alzheimer’s Disease Consortium (EADC).

According to Tone Oderud, a research scientist at SINTEF, the elderly are being excluded from social media today. The user interface is too advanced for many of them. Oderud is working in a multidisciplinary research team to develop a web-based communications application which is simple enough to enable even people with dementia to use it. The goal is to create a simpler and more secure everyday life for elderly and senile people, their relatives and personnel in the community care services.

Furthermore, research scientists believe that contact through social media can improve the quality of health and life for the great numbers of elderly and those with dementia in our society. At the same time, this can ease the burden on therapists and caregivers.

Testing of other web-based communications systems have already been started. They include a “digital diary” and “scrapbook” with personal photos, newspaper cuttings, and other online information. Oderud says that both of these improved communication between both relatives and the community care services in an informal but valuable way.

The article states that the tests showed that constant, simple contact between relatives and the support services improved everybody’s security and at the same time it reduced the time the caregivers needed to follow up concerned relatives. This holds great potential in all fields of caregiving.

A prototype is currently being tested in the city of Drammen in southern Norway.

You’ve seen the staggering figures. There are already more than 5 million Americans diagnosed with Alzheimer’s disease and by 2050 as many as 16 million Americans will have the disease. Will you be counted in that figure? Let’s do all we can to take care of ourselves and to support the Alzheimer’s Association to eliminate this awful disease.

The researchers reported at the Alzheimer’s Association International Conference (AAIC) 2011 that the proportion of worldwide and United States (US) Alzheimer’s cases could be attributed to seven key risk factors:

Altogether, the seven possible modifiable risk factors contributed to 50% of cases of Alzheimer’s worldwide while in the US, the number is 54%. Researchers were similarly surprised that factors such as smoking and physical inactivity contribute to a large quantity of cases compared to cardiovascular disease. However, this also suggests that simple changes in lifestyle such as regular physical activity and stopping smoking could have a drastic impact on the cases of Alzheimer’s disease over time.

According to calculations, a 10% decrease in all the risk factors could halt 1.1 million cases of Alzheimer’s worldwide as well as 184,000 cases in America. Take note that a reduction of 25% in all the risk factors could halt more than three million cases of Alzheimer’s in the world and 492,000 cases in America.

In the study conducted by Deborah Barnes,  Associate Professor of Psychiatry at the University of California – San Francisco and  San Francisco and Mental Health Research PI at the Veterans Affair Medical Center at San Francisco, she reports that what mattered was the common risk factors in the population. She adds that the study’s focus was how the risk factors were common within the population. In the US alone, a third of the population leads a sedentary lifestyle. A large quantity of cases could be attributed to physical inactivity. Smoking similarly contributed to a large number of cases.

According to Barnes, the estimates offer a valuable assumption – that there is a direct relationship between the studied risk factors as well as Alzheimer’s disease. The next step is to do an intervention to discover if changing such risk factors will decrease the risk of Alzheimer’s. The results of the study are to be published on the Lancet Neurology online.

Related articles

• Mathematical Model of Alzheimer’s Disease Risk (aboutalz.com)

Previous research has seen a slew of potential changeable risk factors for the disease such as physical activity levels, diet and mental stimulation. However, it is unclear if changing such a lifestyle-based risk factors could result in lesser Alzheimer’s disease risk.

Scientists utilized mathematical modeling in order to compute the percentage of the disease that might be attributed to mid-life hypertension, diabetes, smoking, mid-life obesity, low educational attainment, depression as well as physical inactivity. According to researchers, such estimates provide a critical assumption that is yet to be proven (that there is a direct relationship between the examined risk factors as well as Alzheimer’s disease and that changing the risk factors could decrease the risk of Alzheimer’s).

In a study presented at 2011 AAIC, researchers are looking at the characteristics of old adults who kept their cognitive normal function in order to build a “cognitive resilient aging” index. Their objective is to know a group of factors which predict one’s cognitive stability later in life to be used in research trials and clinical practice.

William Thies, PhD, is the Chief Medical and Scientific Officer of the Alzheimer’s Association. According to him, Alzheimer’s disease and lifestyle is a worldwide emergency. We need to increase the discovery of ways to prevent and detect it as soon as possible. He adds that estimated costs of worldwide dementia is US$604 billion. In the US alone, the cost is US$183 billion.

Deaths related to Alzheimer’s disease are increasing. Meanwhile, those from other types of disease are decreasing. Take note that Alzheimer’s is in the top 10 causes of death in the US which could not be cured, prevented or be slowed down.

In the 2010 World Alzheimer Report produced by Alzheimer’s Disease International, dementia is significantly affecting the world’s social care and health system. Plus, dementia costs are about to soar. According to Thies, the Alzheimer’s Association – in behalf of those who are suffering with such a devastating disease as well as their families including the tons of researchers present in the conference – is calling for an unprecedented worldwide collaboration to further understand, treat and diagnose the disease with the objective of eliminating this global epidemic.

Meanwhile, Associate Professor of Psychiatry at San Francisco’s University of California, San Francisco and Mental Health Research PI at the Veterans Affair Medical Center at San Francisco, Deborah Barnes, PhD, MPH, as well as colleagues, utilized mathematical models to compute PARs or “population attributable risks” for possibly modifiable risk factors for Alzheimer’s disease to show the possible impact of risk factor decrease on the prevalence of Alzheimer’s in the US and the world.

PARs are utilized to estimate the number of cases of a specific disease which are possibly attributable to or necessitated by numerous risk factors. PARs usually consider the strength of the connection between the risk factors of the disease as well as the commonality of the risk factors.

They discovered that almost half of Alzheimer’s disease risks are attributed to changeable risk factors. Altogether, seven risk factors (to be discussed in the next post) are seen to contribute to as many as 17 million cases of Alzheimer’s disease and lifestyle worldwide and almost 3 million cases in America.