The American Journal of Alzheimer’s Disease and Other Dementias recently reported in an open-label pilot study that apple juice improved behavioral, but not cognitive symptoms in moderate-to-late Alzheimer’s disease patients. Although this was a very small study of only 21 institutionalized patients who drank two 4-ounce glasses of apple juice twice a day for a month, the study suggests that apple juice may be a useful nutritional supplement since, as Alzheimer’s disease (AD)  progresses, the mood of AD patients may decline as well. It may help ease the burden for caregivers.

The study said, “Caregivers reported an approximate 27% (P < .01) improvement in behavioral and psychotic symptoms associated with dementia as quantified by the Neuropsychiatric Inventory, with the largest changes in anxiety, agitation, and delusion.”

Exactly how apple juice might help remains unclear. It’s possible that the antioxidant nutrients in the apple juice reduces the oxidative damage to the brain tissue.

Since this was a very small study funded by the apple industry with no placebo, the conclusions need to be viewed with caution. However, given that apple juice is a healthy and inexpensive beverage, it would seem a positive thing for caregivers to try.

“Sundowning” or “sundowners syndrome” is a term that some say is unique to Alzheimer’s disease although there has not been a definitive conclusion. It is a behavior where sundowners become more demanding, upset, suspicious, and disoriented late in the day and especially after dark.

I was reading an issue of the Golden Gazette, a wonderful publication for seniors in Fairfax County, VA. In it, someone asked a question about her father who has Alzheimer’s disease and gets confused at night and doesn’t sleep well. As a result, she (as a caregiver) is finding it more and more difficult to get a good night’s rest.

The expert answering the question said that there is a tendency for individuals suffering from acute or chronic confusion to become more confused, restless and insecure late in the day, especially after dark. They may wander all night and it’s possible that they’ll see, hear, and believe things that aren’t real.

After staying up all night, of course, they doze off during the day. It appears that their biological clock is reversed. One theory according to wisegeek.com is that the constant daily mental processes for normal living can become overwhelming for the elderly during evening hours. They simply have too much incoming information and their restricted cognitive abilities become overloaded. The result is a period of irritability and negative thoughts.

Mayoclinic.com suggests that fatigue, low lighting, and increased shadows might be contributing factors as well. Suggestions include:

• Plan for activities and exposure to light during the day to encourage nighttime sleepiness.

• Limit caffeine and sugar to morning hours.

• Serve dinner early and offer a light snack before bedtime.

• Keep a night light on to reduce agitation that occurs when surroundings are dark or unfamiliar.

• In a strange or unfamiliar setting such as a hospital, bring familiar items such as photographs or a radio from home.

“Sundowning” or “sundowners syndrome” will definitely take a toll on the caregiver.  It is imperative that the caregiver seek help. The caregiver needs to take good care of him/herself first in order to be able to take care of others.

How is dementia different from Alzheimer’s disease? According to ezinearticles.com author Molly Shomer, she says that the term dementia seems to be preferred over Alzheimer’s disease possibly because of the less frightening connotation and that many are using the word interchangeably, but that is not correct. Dementia and Alzheimer’s are different.

Shomer says dementia is a symptom, just as pain is a symptom for something causing the pain. According to the National Institute of Neurological Disorders and Stroke, memory loss by itself does not mean you have dementia. People with dementia have serious problems with two or more brain functions, such as memory and language. Many different diseases can cause dementia, including Alzheimer’s disease and stroke. Drugs are available to treat some of these diseases. For a list of other dementias from the Fischer Center for Alzheimer’s Foundation, click here.

So the actual cause of dementia could be one of a myriad of things where cognitive abilities have been impaired. With dementia, it could simply be a temporary thing if the cause is treated. On the other hand, Alzheimer’s is an actual disease and the disease causes dementia. Many different diseases can cause dementia, including Alzheimer’s disease and stroke. Drugs are available to treat some of these diseases.

What we know about Alzheimer’s disease today, according to the Alzheimer’s Association, is that:

1. Alzheimer’s is a progressive and fatal brain disease.
2. Alzheimer’s is the most common form of dementia.
3. Alzheimer’s has no current cure.

In our next post next week, we will specifically look at how Alzheimer’s disease is defined. In the meantime, challenge your brain to something new as was discussed here.