Study links seniors' loneliness to higher risk of dementia

Loneliness may put people at risk of an Alzheimer's-like dementia, a study reported Monday.
"People who described themselves as lonely were twice as likely to develop dementia," says researcher Robert Wilson of the Rush University Medical Center in Chicago.



Source USA Today

By Kathleen Fackelmann, USA TODAY


Loneliness may put people at risk of an Alzheimer's-like dementia, a study reported Monday.
"People who described themselves as lonely were twice as likely to develop dementia," says researcher Robert Wilson of the Rush University Medical Center in Chicago.

Other studies have found that people who are unmarried and socially isolated are at higher risk for dementia, including Alzheimer's. But this study is one of the first to show a link between loneliness — or the feelings of disconnection from other people — and a higher risk of developing dementia late in life, says Laurel Coleman, a spokeswoman for the Alzheimer's Association and a geriatrician in Portland, Maine.

Wilson and his colleagues studied 823 people who were about 80 years old and had no sign of dementia at the start of the study. The team gave the recruits a loneliness quiz and tested them annually for signs of memory loss and confusion, two key signs of dementia and Alzheimer's.

During the four-year study, 76 people developed an Alzheimer's-like dementia, Wilson says. The risk of developing dementia increased about 51% for each one-point increase on the loneliness scale. People with the highest scores had 2.1 times the risk of developing dementia, a group of conditions that destroy brain cells and lead to mental confusion. Alzheimer's is the most common form of dementia.

Autopsies were performed on 90 people who died during the study. The researchers found no link between loneliness and the development of the abnormal brain deposits that are the hallmark of Alzheimer's.

That finding suggests loneliness might be triggering dementia through a novel mechanism — one that doesn't lead to a brain riddled with deposits, Wilson says.

One theory is that people who are lonely over long periods of time might have higher levels of damaging stress hormones. The elevated stress hormones might lead to an accelerated aging of the brain — and perhaps to dementia, Wilson says.

Other research suggests lonely people are at risk of other health problems such as cancer and high blood pressure, says John Cacioppo of the University of Chicago. Still, he says, the new finding, which appears in February's Archives of General Psychiatry, must be verified by additional research.

The findings didn't change much when the team factored in markers of social isolation, such as infrequent participation in social events. That means that people who have a small number of good friends might be better off than those with a busy social schedule but chronic feelings of loneliness, Wilson says.

But lonely people often benefit from signing up for a new class or activity, Coleman says. Research shows that such activities might protect aging brain cells. And seniors who are out and about are more likely to make new friends, which might lessen feelings of loneliness, she says.

The CareGiver Blog

Robert T DeMarco

The Alzheimer's Reading Room

AllAmerican Senior Care Weblog

Senior CareElder CareCareGiver Alzheimer’sDementia CareGiver

Health and wellnessWeblog

New Drug Alzhemed Stops Alzheimer's In Tracks

The drug -- called Alzhemed -- attacks Amyloid Peptide - the molecule that causes Alzheimer's.

Paul Aisen, M.D.: "I think it is tremendously significant."

An early study showed Alzhemed stabilized the disease in nearly half of patients. Now, more than 1,000 are being followed.



Source ABC7


Nearly five-million Americans are living with Alzheimer's disease. Drugs on the market can treat the symptoms -- but not one goes after what causes it. Now, researchers are on the brink of a huge breakthrough with a drug that targets the cause and could stop the disease in its tracks.

Frances Goldstein: "I like to paint -- a lot."

Jacobo, her husband of 45 years, loves watching her mind at work. Frances has Alzheimer's disease -- diagnosed eight years ago at age 56.

Jacobo Goldstein, Wife has Alzheimer's: "For the first nine months, I couldn't tell her the word Alzheimer's because I was afraid, you know, that she might go into tremendous shock."

Instead, Frances fought back. For three years, she's been in a study testing a drug that could change her prognosis. Current Alzheimer's drugs target the symptoms of the disease...like memory loss and emotional problems. Well this new drug is taking a more direct approach.

Paul Aisen, M.D., Alzheimer's Specialist: "This drug is attacking the cause of Alzheimer's disease. If it works, it will change the course of the disease and that will represent a real breakthrough."

The drug -- called Alzhemed -- attacks Amyloid Peptide - the molecule that causes Alzheimer's. In mice, watch as the drug clears the molecule from the brain.

Paul Aisen, M.D.: "I think it is tremendously significant."

An early study showed Alzhemed stabilized the disease in nearly half of patients. Now, more than 1,000 are being followed.

Paul Aisen, M.D.: "If the phase three study confirms that the drug is effective, we will have a way of slowing the progression of Alzheimer's disease for the first time."

Frances takes Alzhemed twice a day.

Jacobo Goldstein: "I don't know where we would be if it wasn't for this. We have no idea. I know what she does now. If we can stay the way we are, we would be forever grateful."

With hope in hand, Frances continues to make every day and every painting count.

To date, more than 600 patients have completed one year of treatment on the medication. The study is scheduled to be complete soon. More than 70 centers across the United States and Canada are taking part. Side effects of the drug have been minimal and primarily include mild gastrointestinal symptoms.

Copyright 2007, ABC7/KGO-TV/DT.

Caring for the Caregivers

Group meetings help those coping with dementia in a loved one.

Caring for the Caregivers

By Elizabeth Cooney
TELEGRAM & GAZETTE
ecooney@telegram.com

WORCESTER— You came to the right place, the group told the silver-haired woman who had just joined them.

She took her seat on one of the 14 armchairs fanning out from the fireplace at Dodge Park Rest Home. Twice a month, people caring for loved ones with Alzheimer’s disease meet to share supper, stories, strategies and support. Across the hall, their relatives can have a meal and take part in an activity while the two-hour session unfolds.

The new arrival, who didn’t want her name used in the newspaper, told the group why she came.


“I don’t think I know how to handle the situation with dementia,” she said about her husband’s disease, diagnosed 10 years ago. “I lose my temper a lot and I get exasperated. I know I’m not handling things well, not for him and not for myself.”

Everyone in the room struggles with anger, frustration, fear and sorrow, said Deanne Weissflog, who was sitting next to her. While the men and women were all caring for relatives in different stages of dementia or Alzheimer’s, they all know the difficult road they are traveling.

And that includes Nafie Saba-Shapazian, executive director of Dodge Park and its Day Club, and Don Kemp, who helps her lead the sessions for caregivers.

Ms. Saba-Shapazian, a registered nurse, is responsible for Dodge Park’s 60 residents. Mr. Kemp, a rehabilitation counselor, took care of his father when he had Alzheimer’s.

They all know dementia and Alzheimer’s are insidious diseases, stealing up on people and their families. Only after the fact do bizarre behaviors and odd lapses make sense, sometimes after working lives and financial security are in a shambles. Alzheimer’s affects about 4.5 million Americans. There are some medications that stall the chronic, progressive disease, but there is no cure.

At the meeting, Betty Belevick read from an article in a business magazine about drugs in the pipeline. It might be too late for their loved ones in the grips of Alzheimer’s, but maybe it could help their children, Donna Haran said. There has been progress, not just in medications, Jeanette Rosa-Brady, support group coordinator of the Alzheimer’s Association’s Massachusetts chapter, said in an interview. She is not involved with the Dodge Park group.When she started training support group leaders in 1992, not as much was known about the disease, she said.

“People are able to access information much more readily now with the Internet,” she said. “That wasn’t there when I started. There weren’t medications to treat Alzheimer’s and there wasn’t a lot we knew from research about how to manage home safety or understand what someone with Alzheimer’s perceives.”

The Dodge Park group members talked about how to stay in the moment with the patients. For Ms. Haran, that meant not fighting with her husband when he headed for the snow blower at the first flake. Instead, she told him it was out of gas.

Distraction can work, as can humor.

The worst can be those moments of lucidity when Alzheimer’s patients recognize their plight.

Barbara Gould said her husband retired when he couldn’t face going to work once he knew he wasn’t doing it properly.

“All of a sudden he couldn’t count the money in his pocket,” she said. “That was humiliating for such a proud man. He was quick with numbers, like a calculator.”

One woman who, like many in the room, is caring for not one but two relatives — a parent and a spouse — with Alzheimer’s, said putting her husband in a nursing home was harder for her to get through than his death. Another woman said she had promised her aunt to keep her at home as long a she possibly could. Because her relatives disagree with her vow, she said, they don’t help her with the care.

Some of the people the caregivers spoke about were elderly, but some were just in their 50s when they began to fail. Many of the caregivers in the group are still working full time, fraying when demands tear them apart.

Russ Varney said he hasn’t taken a vacation in the three years since his mother became ill. He lives in Boston, works in Wellesley and takes care of his mother in Worcester. He’s exhausted pretty much all the time.

At 89, she is in perfect health — except for her dementia. She attends a day program most weekdays, as did other relatives of group members. He was cleaning her bathroom one recent weekend when he realized he couldn’t recall the last time he did the bathroom in his own house.

He recommended respite care, just to recharge.

That sounds good, but it’s not so easily done. First, the caregivers have to get over the guilt they feel when they turn their attention to themselves for a change, said Ms. Rosa-Brady of the Alzheimer’s Association. They feel guilt that they didn’t notice the disease sooner, or that they still enjoy things they used to do together, or that they get angry.

“People feel guilty that they are not doing a better job,” she said. “Any support group can dispel that right away. There’s no such thing as a perfect caregiver. You’re a human being.”

And human beings need rest. Ms. Saba-Shapazian tells them they can’t give good care if they don’t take care of themselves.

There’s even a study from the National Institutes of Health published in November that showed caregivers significantly improved their own quality of life and their loved ones’ when they were visited by people trained in stress management and problem-solving techniques and had support groups to call on.

While the Dodge Park group members talked about their trials, they never forgot the patients, saying how painful it must be for them, both in the early stages when they know they are declining and later when they are afraid and can’t be calmed.

Ms. Haran’s husband asked her one morning, when he didn’t know if he should get up, “What life is this, when I don’t know if it’s morning or night?”

Deanne’s mother was frightened, asking her, “What’s going to happen to me?”

Heads nodded as she said that.

“The strength from the people in this room is very encouraging,” Ms. Haran said.

Ms. Rosa-Brady said that’s the constant in support groups.

“You can read about Alzheimer’s on the Internet all you want. You will find information that is useful but all of us need to sit down and talk to other people who are doing the same thing you are,” she said. “You can read all you want, but that’s not going to dispel the feeling that you are the only person in the world this is happening to.”

That’s what the newcomer heard.

“It’s not easy being the ones who are left, trying to keep your head afloat. But here there’s camaraderie, compassion and understanding,” June Shack told her. “This is the right place to be.”

Comment on this story at www.telegram.com. Send an e-mail to Elizabeth Cooney at ecooney@telegram.com.






The CareGiver Blog
Robert T DeMarco
The Alzheimer's Reading Room
AllAmerican Senior Care Weblog Senior CareElder CareCareGiver Alzheimer'sDementia CareGiver
Health and wellnessWeblog

The Seven Stages of Alzheimer's

Experts have documented common patterns of symptom progression that occur in many individuals with Alzheimer’s disease and developed several methods of “staging” based on these patterns.





Source Alzheimer's Association

The Seven Stages of Alzheimer's

Staging systems provide useful frames of reference for understanding how the disease may unfold and for making future plans. But it is important to note that not everyone will experience the same symptoms or progress at the same rate. People with Alzheimer’s live an average of 8 years after diagnosis, but may survive anywhere from 3 to 20 years.

The framework for this section is a system that outlines key symptoms characterizing seven stages ranging from unimpaired function to very severe cognitive decline. This framework is based on a system developed by Barry Reisberg, M.D., Clinical Director of the New York University School of Medicine’s Silberstein Aging and Dementia Research Center.

Within this framework, we have noted which stages correspond to the widely used concepts of mild, moderate, moderately severe and severe Alzheimer’s disease. We have also noted which stages fall within the more general divisions of early-stage, mid-stage and late-stage categories.

Stage 1:
No impairment (normal function)


Unimpaired individuals experience no memory problems and none are evident to a health care professional during a medical interview.


Stage 2:
Very mild cognitive decline (may be normal age-related changes or earliest signs of Alzheimer's disease.


Individuals may feel as if they have memory 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.


Stage 3:
Mild cognitive decline

Early-stage Alzheimer's can be diagnosed in some, but not all, individuals with these symptoms:



Friends, family or co-workers begin to notice deficiencies. Problems with memory or concentration may be measurable in clinical testing or discernible during a detailed medical interview. Common difficulties include:

Word- or name-finding problems noticeable to family or close associates.

Decreased ability to remember names when introduced to new people.

Performance issues in social or work settings noticeable to family, friends or co-workers.

Reading a passage and retaining little material.

Losing or misplacing a valuable object.

Decline in ability to plan or organize.


Stage 4:
Moderate cognitive decline
(Mild or early-stage Alzheimer's disease)


At this stage, a careful medical interview detects clear-cut deficiencies in the following areas:

Decreased knowledge of recent occasions or current events.

Impaired ability to perform challenging mental arithmetic-for example, to count backward from 75 by 7s.

Decreased capacity to perform complex tasks, such as planning dinner for guests, paying bills and managing finances.

Reduced memory of personal history.

The affected individual may seem subdued and withdrawn, especially in socially or mentally challenging situations.


Stage 5:
Moderately severe cognitive decline
(Moderate or mid-stage Alzheimer's disease)


Major gaps in memory and deficits in cognitive function emerge. Some assistance with day-to-day activities becomes essential. At this stage, individuals may:

Be unable during a medical interview to recall such important details as their current address, their telephone number or the name of the college or high school from which they graduated.

Become confused about where they are or about the date, day of the week or season.

Have trouble with less challenging mental arithmetic; for example, counting backward from 40 by 4s or from 20 by 2s.

Need help choosing proper clothing for the season or the occasion.

Usually retain substantial knowledge about themselves and know their own name and the names of their spouse or children.

Usually require no assistance with eating or using the toilet.


Stage 6:
Severe cognitive decline
(Moderately severe or mid-stage Alzheimer's disease)


Memory difficulties continue to worsen, significant personality changes may emerge and affected individuals need extensive help with customary daily activities. At this stage, individuals may:

Lose most awareness of recent experiences and events as well as of their surroundings.

Recollect their personal history imperfectly, although they generally recall their own name.

Occasionally forget the name of their spouse or primary caregiver but generally can distinguish familiar from unfamiliar faces.

Need help getting dressed properly; without supervision, may make such errors as putting pajamas over daytime clothes or shoes on wrong feet.

Experience disruption of their normal sleep/waking cycle.

Need help with handling details of toileting (flushing toilet, wiping and disposing of tissue properly).

Have increasing episodes of urinary or fecal incontinence.

Experience significant personality changes and behavioral symptoms, including suspiciousness and delusions (for example, believing that their caregiver is an impostor); hallucinations (seeing or hearing things that are not really there); or compulsive, repetitive behaviors such as hand-wringing or tissue shredding.

Tend to wander and become lost.


Stage 7:
Very severe cognitive decline
(Severe or late-stage Alzheimer's disease)


This is the final stage of the disease when individuals lose the ability to respond to their environment, the ability to speak and, ultimately, the ability to control movement.

Frequently individuals lose their capacity for recognizable speech, although words or phrases may occasionally be uttered.

Individuals need help with eating and toileting and there is general incontinence of urine.

Individuals lose the ability to walk without assistance, then the ability to sit without support, the ability to smile, and the ability to hold their head up. Reflexes become abnormal and muscles grow rigid. Swallowing is impaired.

The CareGiver Blog

Robert T DeMarco

The Alzheimer's Reading Room

AllAmerican Senior Care Weblog

Senior CareElder CareCareGiver Alzheimer’sDementia CareGiver

Health and wellnessWeblog

Loneliness and Alzheimer's Linked

"People who are lonely are twice as likely to develop Alzheimer's disease, a large US study has suggested."

Read this article at The Senior Reading Room

Huperzine A in Alzheimer's Disease-The Clinical Trial

"The Huperzine A in Alzheimer's Disease clinical trial is currently open and recruiting patients. This is a Phase II clinical trial."

Read about the study including requirements and available locations at The Alzheimer's Reading Room: Huperzine A in Alzheimer's Disease-The Clinical Trial.