The Alzheimer’s Association has a booklet called, Maintain Your Brain, and subtitled — there is growing evidence that lifestyle can affect your brain health. You can obtain this 16-page online booklet by clicking here. If you want a quick summary, the 10 ways to maintain your brain discussed are:

1. Head first
   Good health starts with your brain. It’s one of the most vital body organs, and it needs care and maintenance.
2. Take brain health to heart
   What’s good for the heart is good for the brain. Do something every day to prevent heart disease, high blood pressure, diabetes and stroke — all of which can increase your risk of Alzheimer’s.
3. Your numbers count
   Keep your body weight, blood pressure, cholesterol and blood sugar levels within recommended ranges.
   
4. Feed your brain
   Eat less fat and more antioxidant-rich foods.
5. Work your body
   Physical exercise keeps the blood flowing and may encourage new brain cells. Do what you can — like walking 30 minutes a day — to keep both body and mind active.
6. Jog your mind
   Keeping your brain active and engaged increases its vitality and builds reserves of brain cells and connections. Read, write, play games, learn new things, do crossword puzzles.
7. Connect with others
   Leisure activities that combine physical, mental and social elements may be most likely to prevent dementia. Be social, converse, volunteer, join a club or take a class.
8. Heads up! Protect your brain
   Take precautions against head injuries. Use your car seat belts, unclutter your house to avoid falls, and wear a helmet when cycling or in-line skating.
9. Use your head
   Avoid unhealthy habits. Don’t smoke, drink excessive alcohol or use street drugs.
10. Think ahead — start today!
    You can do something today to protect your tomorrow.

In September 2008, the International Journal of Geriatric Psychiatry published an interesting article: Smell test predicts performance on delayed recall memory test in elderly with depression. Who would’ve thought that a smell test might be a tool to forecast cognitive impairment. But it turns out that the elderly, particularly those diagnosed with depression, have an increased risk for cognitive dysfunction and dementia.

According to sensonics.com, Sensonics, Inc. tests can be used to detect smell loss but cannot be used alone to diagnose disease. Smell and taste monitor the intake into the body of all nutrients and airborne chemicals required for life.

Here is an abstract of the study that was done.

Purpose

To assess the validity of the CC-SIT (Cross-Cultural Smell Identification Test) as a screening test for cognitive impairment in elderly with depression.

Methods

Forty-one patients, aged 60 and over, were assessed with the CC-SIT and CVLT (California Verbal Learning Test) after three months of treatment of a Major Depressive Episode (DSM-IV) at the Day Hospital for Depression, Baycrest. Patients already diagnosed with dementia, or other psychiatric and neurological disorders, were excluded. Receiver Operating Characteristics (ROC) analysis was applied to assess the CC-SIT’s accuracy in identifying individuals with impairment (2 SD below the mean for age and education or less) on CVLT delayed recall trials.

Results

Forty-one patients (33 women and eight men) were assessed. Mean age was 76.8 (SD: 6.5), mean HRSD scores before treatment was 22.0 (SD: 5.1). Nine patients had impairment on CVLT delayed recall measures. The area under the ROC curve was 0.776 (95% CI = 0.617-0.936).

Conclusions

Our results support the use of the CC-SIT as a screening tool for cognitive impairment among elderly with depression as an indicator for the need of a comprehensive neuropsychological evaluation. Replication with larger samples is necessary. Copyright © 2008 John Wiley & Sons, Ltd.

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.

Freddi Donner

Guest blogger and caregiver, Freddi Donner, shares a poignant remembrance about her mother.

My mom died around noon on December 31st, 1999. She hated New Year’s and I think she decided just to skip the hyped up transition to 2000. Her journey through Alzheimer’s was more difficult for me and my sisters than for her. Of course, she was VERY angry when we told her about her diagnosis and thought my sister and I were so cruel for telling her. As her journey progressed, I began to study the disease. Knowing the “7 stages”, or that there were stages at all, helped me understand what was happening.

We moved her to assisted living for her safety. It was not long after that date she had to be moved to the locked floor. This is when she became childlike. “I have just come back from New Orleans!”, she shares one day. “Mom, why didn’t you let me know? I would have gone with you!” She shared the events of her trip that had an uncanny agenda of a trip she took in her 20’s.

Mom taught me through her journey that imagination is more fun than reality, so let’s just play there. My roles changed as the visits continued (her mom, her sister, an aid, her daughter) but the stories got more entertaining. “I got married last week” was my favorite! She had actually “taken” to one of the male aids who worked the midnight shift. I guess they spent a LOT of time together, because that is who she “married”.  I honestly believe that my mom had more fun in the midst of the Alzheimer’s disease than she had in real life. She loved life and got to relive all her favorite memories and recreate the life she really wanted. God bless her.

Freddi Donner
Unlock your possibilities
for better health and more wealth
E-mail: freddi@forhealthandbalance.com
Co-Chair, Health and Wellness Committee
Dulles Regional Chamber
_______________________
www.nikken.com/freddi
www.forhealthandbalance.com
NEW: www.livewellvirginia.org

Continuing my highlights of Alzheimer’s Care with Dignity by Frank Fuerst, in today’s post I list 6 caregiver products that Fuerst considers specifically helpful for people with dementia. You may be able to get them free or at a reduced cost. Ask your contacts such as members of your support group or see if it’s a Medicare-qualified item.

Consult his guide for a complete list, but the following are those that solved major physical and psychological challenges for him. Having gotten them sooner he feels would’ve prevented a good deal of stress.

1. Bathroom transfer bench
2. Geriatric chair
3. Plastic runner
4. Hand-held shower
5. Stair lift
6. Wheelchair

A bathroom transfer bench is one where two legs remain inside of the tub with suction cups and two legs are outside of the tub.  It comes with a backrest. Since the person remains seated while bathing, a hand-held shower works well. (Hand-held showers work well for cleaning the tub as well).

A geriatric chair is like a wheelchair except that it is larger and more comfortable. Get one with a tray that can swing down and out of the way.

Plastic runners will help to keep your carpet in good condition in case of accidents. They have spikes on the bottom to hold it in place. Not all plastic runners are alike even though they may look alike. Since you need to walk on the runner, a softer plastic might be more  comfortable than a stiffer one. Use them in areas where there are likely to be accidents such as from the bed to the bathroom and in eating areas.

Stair lifts are expensive, but might still be a less costly alternative to other home alterations. Fuerst suggests that you check the Internet. One source is http://silvercross.com for more information. They also sell used equipment and will buy back equipment, but don’t expect to recover much of your purchase price.

Finally, wheelchairs are available everywhere, but if you’ve never ridden in one, they are not exactly comfortable. Be sure to add a cushion, preferably a high quality gel cushion as mentioned in this post.

Caregiving at a Glance

The Alzheimer’s Family Day Center has a wonderful booklet for Alzheimer’s disease caregivers called Caregiving at a Glance. It’s designed with tabs that you can simply slip your finger under and get to the information you need. Sample topics covered include:

• Sleeping
• Bathing
• Car and Home Safety
• Activities … What to do Between Meals
• Hostility and Aggression

On the topic of “Wandering,” for example, they suggest you register your loved one with the Safe Return program sponsored by the Alzheimer’s Association. You can call them toll-free at 1.888.572.8566 or on the Web at www.alz.org/safereturn.

“Troublesome Behaviors” is another section of this booklet. This covers a wide gamut, but they talk about things like screaming, repetitive phrases, or picking at clothes, tearing paper into tiny shreds, and other behaviors that develop in the middle to the late stages of the disease.

This wonderful resource is available at the Alzheimer’s Family Day Center by calling 703.204.4664 or e-mailing them at AFDC@alzheimersfdc@org.  The booklet is free – one copy per person. It was published with the permission of the Alzheimer’s Association. The project was supported, in part, by a grant from the Administration on Aging, Department of Health and Human Services, Washington, DC, 20201.

In this, the third of our series of breakthrough tests for Alzheimer’s disease, scientists at the University of California San Diego (UCSD), have developed a fast and accurate method for quantifying subtle, sub-regional brain volume loss using magnetic resonance imaging (MRI). This study promises to improve diagnosis and monitoring of Alzheimer’s disease (AD).

The techniques were applied to the dataset of the multi-institution Alzhiemer’s Disease Neuroimaging Initiative (ADNI). What the scientists at UCSD were able to demonstrate was that the sub-regional brain volume measurements outperform available measures for tracking the severity of AD, including widely used cognitive testing and measures of global brain-volume loss.

According to insciences.org, the new research shows that changes in the brain’s memory regions, in particular a region of the entorhinal cortex, offer sensitive measures of the early stages of the disease. According to Anders M. Dale, PhD, professor of neurosciences and radiology at the UC San Diego School of Medicine, who led the study, “Loss of volume in the hippocampus is a consistent finding when using MRI, and is a reliable predictor of cognitive decline. However, we have now developed and validated imaging biomarkers to not only track brain atrophy, but distinguish the early stages of Alzheimer’s disease from changes related to normal aging.”

The study’s co-author, James Brewer, MD, PhD, a neurologist and assistant professor in the Departments of Radiology and Neurosciences at UCSD adds that, “The technique is extremely powerful, because it allows a researcher to examine exactly how much brain-volume loss has occurred in each region of the brain, including cortical regions, where we know the bad proteins of Alzheimer’s disease build up.”

If a picture is worth a thousand words, here are serial MRI brain scans, taken six months apart, that show progression from mild cognitive impairment to Alzheimer’s disease with significant atrophy (blue) and ventricle enlargement (orange/red).

For more information, see “Analyzing Structural Brain Changes in Alzheimer’s Disease” at insciences.org.

Blanchette Rockefeller Neurosciences Institute

Today there are no reliable tests to determine conclusively if a person has Alzheimer’s disease (AD). However, there are several breakthrough tests on the horizon that have us hopeful that soon we may have an accurate test to diagnose Alzheimer’s disease. That’s a good thing. On an emotional level, though, sometimes I wonder if I really want to know. I prefer to not know and simply do all that I can to prevent it. (Click here for examples). There are several institutions and companies working on breakthrough tests and in this post I will cover what’s happening at the Blanchette Rockefeller Neurosciences Institute (BRNI) at West Virginia University and Inverness Medical Innovations.

At the Blanchette Rockefeller Neurosciences Institute (BRNI), the only non-profit independent institution in the world dedicated to the study of human memory and memory disorders, they located a biomarker that can be tested witout the invasive procedures previously required.  A biomarker is an objective, biological measure that is used to assess health or make a diagnosis of disease. The BRNI biomarker had a 98 percent level of accuracy in detecting AD. With the prick of a finger, it detects defective enzymes involved with memory function that are found in both brain and skin cells.

What is really exciting is that researchers discovered that low doses of the chemotherapy drug, bryostatin, reactivates the defective enzymes. It can actually rewire broken connections in the brain and restore memory! This means that it could be used to reverse the brain diseases. Clinical trials in people will start this year.