Diverse Approaches to Alzheimer's Therapies Continue to Show Progress at ICAD

clipped from alzheimersreadingroom.blogspot.com A lot of good and encouraging news continues to come out of this week's Alzheimer's Association International Conference on Alzheimer's Disease 2008. --18-Month Data from an Extension of a Pivotal Trial of Dimebon in Alzheimer's --First U.S. Double-Blind Phase II Clinical Trial of IVIg (Immunotherapy) in Alzheimer's --Phase II Immunotherapy Trial with LY2062430 in Mild to Moderate Alzheimer's --Antidementia Drugs Contribute to Longer Life in People with Alzheimer's Read More......

Abnormal Thyroid Levels Can Increase Risk For Alzheimer’s Disease in Women

A year or so ago I first read about hyperthyroidism and its connection to Alzheimer's disease and dementia. I asked our doctor to check my mother. He termed the results as suspicious and prescribed a drug for her thyroid. After about two months my mother started smiling more and laughing. Was it the drug? I'll never know for certain. Buy, my belief is it does help. If you have a loved one suffering from an early stage of Alzheimer's or dementia I suggest you get the thyroid checked.

clipped from www.healthnews.com Thyroid disease, resulting from either low or high thyrotropin levels, has been found to be associated with an increased risk of Alzheimer's disease in women only. Thyrotropin is a hormone that affects thyroid gland function and thyroid hormone levels. When a patient has low levels of the hormone, the condition is known as hypothyroidism, while a patient having high levels is referred to as having hyperthyroidism. Both conditions are recognized causes of reversible dementia based on previous studies. In fact, routine screening of serum thyrotropin levels is included in evaluation of patients with suspected dementia. However, the effects of a normally functioning thyroid gland on the brain's cognitive abilities have not been made clear. It is not known whether thyroid function affects Alzheimer's or if it is Alzheimer's that affects thyroid function.

New Research Shows That People With Better Physical Fitness Have Less Brain Atrophy in Alzheimer's

I have been writing about Alzheimer's and exercise on the Alzheimer's Reading Room blog for years. I believe that exercise is a key component in fighting off the devastating effects of Alzheimer's on my mother--now 92 years old.

Exercising in a gym also gives my mother an added boost by keeping her socialized. Most days my mother goes kicking and screaming to the gym. On the way out she has a smile on her face, better balance while walking, and I feel like we are fighting the good fight.

I should mention that I am also getting some obvious benefits. If you are predisposed to Alzheimer's by birth you really need to incorporate Alzheimer's into your daily return.

clipped from www.alz.org People with early Alzheimer’s disease who had better fitness ratings had less atrophy in key brain areas associated with memory, according to research reported today at the 2008 Alzheimer's Association International Conference on Alzheimer’s Disease (ICAD 2008) in Chicago. This is the first time that MRI brain imaging has been used to demonstrate the connection between cardiorespiratory fitness and Alzheimer’s-related brain changes in the hippocampus, an area of the brain important for memory and spatial navigation. In Alzheimer's, the hippocampus is one of the first regions of the brain to suffer damage. "We found that, in early-stage Alzheimer’s, cardiorespiratory fitness is correlated with regional brain volumes in key areas affected by the disease," said Honea. "This suggests that maintaining cardiorespiratory fitness may positively modify Alzheimer’s-related brain atrophy."

Health Benefits of Pets

I know first hand how a cat can benefit a person suffering from dementia or Alzheimer's. Also, see the article below from HealthCentral.com for more about the benefits of pets in assisted living facilities.

clipped from www.cdc.gov Most households in the United States have at least one pet. Why do people have pets? There are many reasons. Some of the health benefits of pets are listed below. Pets can decrease your: Blood pressure Cholesterol levels Triglyceride levels Feelings of loneliness Pets can increase your: Opportunities for exercise and outdoor activities Opportunities for socialization Health Benefits of Pet-Ownership Strengthens Human-Animal Bond The American Veterinary Medical Association (AVMA) issued a statement supporting the health benefits of animal companionship for people. Health Benefits of Animals The Delta Society provides abstracts, articles, and bibliographies on the health benefits of animals to people. Health Benefits of Pets, NIH

Pet Doors Opening at Assisted Living Centers

This is an excellent article that I read at HealthCentral.com. I know from first hand experience about the wonderful effect a cat can have on a person suffering from dementia or Alzheimer's. Just watching this effect can bring you joy and happiness.

Follow the link in the clip to read the entire article. It is a good read.

clipped from www.healthcentral.com When the elderly woman first arrived at Brooke Grove Retirement Village in Sandy Spring, Md., some of the staffers were skeptical when they saw she had brought her cat along. The woman, in the early stages of dementia, "floated in and out," according to Jackie Carson, the assisted living administrator at Brooke Grove, a center specializing in Alzheimer's care. Staffers had to help the woman remember to feed the cat, and some were initially resentful, saying their job was to care for people, not animals, she added. But slowly, the staff came around, when they saw all the benefits that the cat conferred on the residents, Carson, a registered nurse, said.

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I’ve learned about long-term care’s reality, thanks to Mom

This is an excellent read. Paul R. Willging was involved in long-term care policy development at the highest levels for more than 20 years but he really learned what it is all about when he to find long term care for his mother.

You can read the entire article by following the link in the clip.

clipped from www.ltlmagazine.com You’d think I’d know it all by now. But let me tell you, nothing brings the real issues of long-term care home in a more compelling fashion than confronting them personally. As I write this piece, I’ve just returned from Minnesota, where multiple siblings and I spent a fascinating, frustrating, and educational week seeking an appropriate long-term care community for Mom.

Which Drugs Do — And Don’t — Increase Fall Risks for the Elderly

clipped from blogs.wsj.com Falls are the leading cause of injury deaths for people 65 and older, and they’re the most frequent reason for trauma admissions among the elderly, according to the Centers of Disease Control and Prevention. Drugs ranging from sleeping pills to painkillers can make people woozy, confused or interfere with balance. To cut the risk of falls, the UNC researchers are focusing on the options among nine groups of medicines. For a look at the best and worst choices by category, see the appendices to the study in the June issue of the American Journal of Geriatric Pharmacotherapy. The basic problem is that patients — and even their physicians — are unlikely to be aware of all the side effects that common medicines can have, Susan Blalock, an associate professor at UNC’s pharmacy school, told us.

Study: Regular walking nearly halves elderly disability risk

Older adults can decrease their risk of disability and increase their likelihood of maintaining independence by 41 percent by participating in a walking exercise program, according to a new University of Georgia study.

Study: Regular walking nearly halves elderly disability risk

Older adults can decrease their risk of disability and increase their likelihood of maintaining independence by 41 percent by participating in a walking exercise program, according to a new University of Georgia study.

The study, which appears in the current issue of the Journal of Geriatric Physical Therapy, also found that walking program participants increased their peak aerobic capacity by 19 percent when compared to a control group and increased their physical function by 25 percent.

“In the past decade, researchers have focused on the benefits of strength training in maintaining independence, but until now we didn’t have good evidence using an objective performance measure that a walking program would improve physical functioning,” said study co-author M. Elaine Cress, professor of kinesiology and researcher in the UGA Institute of Gerontology. “Our study found that walking offers tremendous health benefits that can help older adults stay independent.”

The researchers randomly assigned 26 low-income adults aged 60 and older to either a walking exercise group, which met three times a week for four months, or a nutrition education control group. Initially, the group would walk for 10 minutes continually. As the weeks progressed, they increased their walking time to 40 continuous minutes. Each session began with a 10-minute warm-up and ended with a 10-minute cool-down that included balance and flexibility exercises.

Trudy Moore-Harrison, the lead author of the study and a former UGA doctoral student, explained that the researchers focused their study on low-income individuals because people with fewer financial resources are less likely to be physically active and are more likely to have chronic health conditions and lack health care coverage. Moore-Harrison added that walking doesn’t require any special equipment other than a pair of comfortable shoes, which makes it a simple and low-cost way for people to become active. Moore-Harrison supervised the group, but the researchers said that motivated community members could lead similar groups across the country.

Getting people to stick with exercise programs can be notoriously difficult, but the researchers found that every single member of the group stayed with the program for its four-month duration. “People really enjoyed the program,” said Moore-Harrison, now a post-doctoral fellow at the University of North Carolina Charlotte. “It gave them an opportunity to make new friends and get to know their neighbors.”

The researchers measured the aerobic capacity of the participants using a treadmill test and found that while the control group saw an 9 percent decline in aerobic capacity over the four-month study period, the aerobic capacity of the walking group increased by 19 percent over the same time period.

“Aerobic capacity is really the engine that we draw upon for doing the things we want to do, whether it’s cleaning up around the house or running a marathon,” Cress said. “By increasing their aerobic capacity, the walking group was better able to perform their daily tasks and had more energy left over for recreational activities, like going out dancing.”

The researchers assessed health status and bodily pain through questionnaires and examined disability by measuring performance on factors such as balance and walking. Physical functioning was measured through both questionnaires and through tests that measured how well the volunteers performed daily activities such as climbing a flight of stairs and putting on and removing a jacket.

The researchers found that physical function increased by 25 percent in the walking exercise group, compared to a decrease of 1 percent in the control group. And while the control group saw their risk of disability increase over the four-month period, the walking exercise group saw their disability risk go from 66 percent to 25 percent – a decrease of 41 percent in just four months.

“We know that walking is good for you, but too many people still aren’t doing it,” Moore-Harrison said. “This study shows that just walking on a regular basis can make a huge impact on quality of life.”

The research was supported by the UGA Institute of Gerontology Seed Grant, the Northeast Georgia Area Agency on Aging and the Georgia Gerontology Consortium Seed Grant. The research was done in cooperation with the Athens Housing Authority.


Sam Fahmy, 706/542-5361, sfahmy@uga.edu

M. Elaine Cress, 706/542-2202, mecress@uga.edu; Trudy Moore-Harrison, 704/687-6030, tlmoore2@uncc.edu


The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease and Memory Loss in Later Life

Portable Device Provides Quick, Inexpensive Detection of Early Alzheimer’s

This is really exciting news. A new device developed by the Georgia Institute of Technology and Emory University may allow patients to take a ten minute test that gauges reaction time and memory to measure mild cognitive impairment (MCA), often the earliest stage of Alzheimer's.

The test is inexpensive and could be administered as part of a routine yearly checkup at a doctor's office.

Watch the video at the Woodruff Health Sciences Center



Portable Device Provides Quick, Inexpensive Detection of Early Alzheimer’s

The latest medications can delay the onset of Alzheimer’s disease but none are able to reverse its devastating effects. This limitation often makes early detection the key to Alzheimer’s patients maintaining a good quality of life for as long as possible.

Now, a new device developed by the Georgia Institute of Technology and Emory University may allow patients to take a brief, inexpensive test that could be administered as part of a routine yearly checkup at a doctor’s office to detect mild cognitive impairment (MCI) — often the earliest stage of Alzheimer’s. The device is expected to be commercialized later this year.

Current assessment tests capable of detecting early Alzheimer’s typically are taken with a pen and paper or at a computer terminal and last about an hour and a half. They must be given by a trained technician in a quiet environment, because any distractions can influence the patient’s score and reduce the test’s effectiveness. Because of their length and expense, the tests are not used as regular screening tools and typically are given only after there is obvious cognitive impairment such as forgetfulness or unsafe behavior.

“Families usually wait until their mom or dad does something somewhat dangerous, like forgetting to take their medications or getting lost, before bringing them in for testing. At that point, the patient has already lost a significant portion of their cognitive function,” said David Wright, MD, who helped develop the device. Wright is assistant professor of emergency medicine in Emory University School of Medicine and co-director of the Emory Emergency Medicine Research Center. “With this device, we might be able to pick up impairment well before those serious symptoms occur and start patients on medications that could delay those symptoms.”

The Georgia Tech and Emory device, called DETECT, gives individuals a roughly ten-minute test designed to gauge reaction time and memory — functions that, when impaired, are associated with the earliest stages of Alzheimer’s disease. The test is a specially modified, shortened version of the traditional pen and paper test and could be given repeatedly by doctors to evaluate any changes in cognitive functions.

“We really envision this to be part of the normal preventative care a patient receives from a general practitioner,” said Michelle LaPlaca, Ph.D., one of the creators of the device and an associate professor in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University. “It would be part of a regular preventative medicine exam much like a PSA test or EKG (Electrocardiogram), serving as a cognitive impairment vital sign of sorts.”

The portable test runs patients through a battery of visual and auditory stimuli such as pictures and words that assess cognitive abilities relative to age, gauging reaction time and memory capabilities. Its software can track cognitive capabilities — and decline — year to year during annual appointments. And because the device blocks outside sound and light from the patient’s environment, it can be administered in virtually any setting, providing more consistent results.

Preliminary analysis of the first 100 patients of a 400 person clinical study being conducted at Emory’s Wesley Woods Center has shown that the 10 minute DETECT test has similar accuracy as the 90 minute ‘Gold Standard’ pen and paper test.

With millions of baby boomers easing into late adulthood, the number of patients with Alzheimer’s is expected to skyrocket over the next few decades. More than 24 million people worldwide are currently thought to have Alzheimer’s disease and by 2040, an estimated 81 million people worldwide are expected to develop the disease.

To give these millions of potential Alzheimer’s sufferers a chance to slow the disease’s advance before serious symptoms set in, doctors need an inexpensive and easy-to- administer test to detect and track the cognitive decline associated with the early stages of the disease.

The DETECT device is designed to be administered while a patient is still healthy, tracking any abnormal decreases in the patient’s cognitive performance over time. If a patient’s performance declines outside the normal range, the patient would then undergo additional testing and care from a neurologist, neuropsychologist or other specialist.

The DETECT system includes an LCD display in a visor with an onboard dedicated computer, noise reduction headphones and an input device (controller). The display projects the visual aspect of the test, the headphones provide the verbal instructions and the controller records the wearer’s response.

DETECT’s creators have formed a company, called Zenda Technologies (www.zendatech.com), to commercialize the device for MCI, as well as other conditions. Georgia Tech and Emory researchers are exploring other types of cognitive impairment such as Attention Deficit/Hyperactivity Disorder (ADHD) that could be picked up by DETECT. A version of the system designed to detect mild concussions on the sidelines of a football game, during other high-impact sports or on a battlefield, is still being tested.

The research was funded with a grant from the Wallace H. Coulter Foundation and support from the Georgia Research Alliance through Georgia Tech’s VentureLab.

Dr. Wright and Dr. LaPlaca have an equity interest in Zenda Technologies. In addition, Dr. Wright and Dr. LaPlaca are inventors on a patent application covering the DETECT technology, and may receive royalties or fees through the license agreement. Emory, Georgia Tech, Dr. Wright, and Dr. LaPlaca may benefit financially if Zenda Technologies is successful in marketing the DETECT device. Dr. Wright’s relationship with Zenda Technologies has been reviewed and approved by Emory in accordance with its policies on conflicts of interest.

For more information:
Megan McRainey
Georgia Institute of Technology
Media Relations
404-894-6016
megan.mcrainey@icpa.gatech.edu

Jennifer Johnson
Emory University, Woodruff Health Sciences Center
404-727-5696 office, 404-227-3683 cell
jennifer.johnson@emory.edu

Here is more information.

Detecting Declining Minds

The Alzheimer's Action Plan: The Experts' Guide to the Best Diagnosis and Treatment for Memory Problems

Intel Receives FDA Market Clearance on In-Home Medical Device for Management of Health Conditions

This is an important new product and brings state of the art technology to patients that are chronically ill or in need of constant care giving. I beleive this could become an important tool for caregivers. For those who must work it could certainly provide some piece of mind and allow them to keep their loved one at home rather then have them institutionalized.

As time goes on this new technology will likely come down in price and overall cost. With the cost of gasoline rising it might also replace some visits to the doctor's office. The potential market for this device is huge, so if it is accepted in the marketplace it will become a valuable tool.

Here is a snippet from the press release. You can read more by following the link in the clip.

clipped from www.intel.com Intel Corporation today announced the receipt of 510(k) market clearance from the U.S. Food and Drug Administration (FDA) on Intel's personal health system, the Intel® Health Guide, a care management tool for healthcare professionals who manage patients with chronic conditions. The Intel Health Guide enables caregivers to provide their patients with more personalized care at home, while also engaging and empowering patients to take a more active and positive role in their own care. The Intel Health Guide is a comprehensive solution, combining an in-home patient device, as well as an online interface allowing clinicians to monitor patients and remotely manage care. The solution offers interactive tools for personalized care management and integrates vital sign collection, patient reminders, multimedia educational content and feedback and communications tools such as video conferencing and e-mail.

Mental Test Spots Alzheimer's Risk

Interesting article well worth reading.

The Everyday Cognition instrument consists of 39 questions to be answered by people who know the patient well.

Mental Test Spots Alzheimer's Risk

A new questionnaire may help in both diagnosing older adults facing dementia and also in identifying individuals who need help with daily living.

The Everyday Cognition instrument consists of 39 questions to be answered by people who know the patient well.

"There have been a number of studies that show that people with mild cognitive impairment who have functional problems in addition to performing poorly on neuropsychological testing are more likely to progress in the near future," said study author Sarah Tomaszewski Farias, an assistant professor of neurology at the University of California, Davis, Medical Center in Sacramento. "One of our hopes is that this instrument will be able to help identify very early on those people at increased risk for developing Alzheimer's disease."

That would help both patients and family members prepare for what lies ahead and identify patients who need to be more closely monitored.

In addition, Farias said, the test would also help identify "people who are having [functional] problems so that we know who needs help and who doesn't."

"What's nice about this is that it is designed to pick up very early memory problems, and it's an entirely caregiver-based survey," said Dr. Scott Turner, incoming director of the Memory Disorders Program at Georgetown University Medical Center, in Washington, D.C. "This is something the caregiver can fill out, while the practitioner is looking at the patient. It could be used for screening, for diagnosis and for drug development, if you want to look for some proof that your drug is having some effect, so it has a lot of potential uses."

"They want something that they could use to ask a family member about the potential patient's everyday functioning to see if that's sensitive to picking up the likelihood of dementia early on," added Dr. Gary J. Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York City.

The findings were published in the July issue of Neuropsychology.

Existing neuropsychological tests tend to be very abstract. For the last 40 years, these tests have looked at two categories: so-called "basic" activities (such as grooming, feeding, dressing), which are affected in later stages of dementia, and "instrumental" activities of daily living (such as managing medication, finances, cooking, driving).

"I was interested in understanding how our neuropsychology tests translated into everyday problems, how our cognitive tests . . . translate into everyday problems that a person is experiencing and that a caregiver is concerned about," Farias explained.

Farias and her colleagues divided everyday functioning into seven cognitive "domains:" memory, language, semantic or factual knowledge, visual and spatial abilities, planning, organization and divided attention.

An original list of 138 items was eventually culled to 39, which was then tested in 576 older adults: 174 of whom were cognitively normal, 126 who had mild cognitive impairment (MCI), and 276 who had been diagnosed with dementia.

"Informants" (people who had known the patient for an average of almost 45 years) provided details on whether the patient could remember shopping items without a list, reading a map, balancing the checkbook, and cooking or working and talking at the same time.

Not only did the instrument confirm established diagnoses, it was also able to distinguish people with MCI from those with full-blown dementia, meaning it was able to pick up on subtle differences in function.

The results also weren't highly influenced by occupation and education levels, as are existing tests.

"This is really the first step in development the instrument," Farias said. "What we're really interested in doing is to track people over time to get a better understanding of the early signs of functional impairment."

The Alzheimer's Action Plan: The Experts' Guide to the Best Diagnosis and Treatment for Memory Problems

With Alzheimer's, the Caregiver Is a Patient, Too

This is an interesting and thought provoking article.

"What we're seeing is that Alzheimer's is not a typical disease model," she says, "precisely because the health and well-being of the caretaker is affected as well as the patient. I know when I assume the care of an Alzheimer's patient, I am also caring for the caregiver."

With Alzheimer's, the Caregiver Is a Patient, Too

Alzheimer's Disease and other forms of dementia do not affect just the patient. These diseases gradually rob patients of memory and other intellectual abilities, leaving them unable to perform routine tasks. As the disease continues to destroy brain cells, patients increasingly depend on family members or others to carry out simple tasks like shopping and getting dressed. Ultimately, most patients will need complete care, adding to the caregivers burden.

Alzheimer's disease is the most common form of dementia, affecting up to 4 million Americans - and untold millions of family members and others who care for them. Physicians now recognize that Alzheimer's caregivers themselves often require care and attention, says Diana R. Kerwin, MD, Medical College of Wisconsin Assistant Professor of Medicine in the Division of Geriatrics and Gerontology.

"What we're seeing is that Alzheimer's is not a typical disease model," she says, "precisely because the health and well-being of the caretaker is affected as well as the patient. I know when I assume the care of an Alzheimer's patient, I am also caring for the caregiver."

Caregivers who accompany patients to the Froedtert Senior Health Program's Geriatric Evaluation Clinic, where Dr. Kerwin practices, are screened for "caregiver stress" and see a gerontologic nurse and social worker who will answer their questions, provide information and help create a plan for care of the patient. Caregivers are given a kit with information about support groups and community services, including adult day care, home care agencies, assisted living, skilled nursing facilities and respite care.

Stress, Depression Are Common
According to the Alzheimer's Association, more than 80% of Alzheimer caregivers report that they frequently experience high levels of stress, and nearly half say they suffer from depression. It's not difficult to see why.

The national Family Caregiver Alliance terms caregiver depression "one of today's all-too-silent health crises." The alliance estimates that caregiving spouses between the ages of 66 and 96 who are experiencing mental or emotional strain have a 63% higher risk of dying than people the same age who are not caregivers.

"Alzheimer's causes progressive memory loss, and in the later stages patients can develop behavior problems," Dr. Kerwin says. "It's distressing for the caregiver to suddenly have to cope with their loved one's anger, hallucinations, paranoia, aggression or inappropriate conduct in public. It's upsetting when, as the disease progresses, the patient no longer recognizes the spouse or loved one."

Caregivers often experience feelings of guilt, believing they are not doing enough to help, she adds. Spouses and adult children feel grief and loss, not unlike a death in the family - except that instead of being sudden, it's spread out over years. Alzheimer's is a progressively worsening disease, but the rate of progression from mild to advanced can vary widely, from three to 20 years. As Alzheimer's progresses, the loss of brain function itself will cause death unless the patient has one or more other serious illness.

When the Child Becomes the Parent
For an adult child who cares for a parent with dementia, taking on the role of caregiver is a role reversal and takes some adjustment. "It can be a difficult transition for a child to take on the role of 'parent' and decision-maker," Dr. Kerwin says. "The child often needs to be empowered to step in and begin caring for their ailing parent - making sure their parent takes his or her medication, for instance, or telling their parent they should not drive, and making difficult decisions about when the parent is no longer able to safely live alone."

Those caregivers are often already juggling multiple responsibilities with their own spouses, children and careers. In some cases, adult-child caregivers with siblings feel resentful if they must bear the brunt of their parent's care, Dr. Kerwin says. If the adult-child caregiver is the only sibling living in the same city as the parent he or she often feels isolated, overwhelmed and underappreciated.

And sometimes, whether the caregiver is a spouse or an adult sibling, out-of-town siblings or other family members who see the parent infrequently may think the caregiver is exaggerating the extent of the Alzheimer's patient's decline. The out-of-town family members may feel guilty about not being able to help from a distance, and when they do visit, they may criticize or ask to change the care their parent is receiving.

Caregivers are often fatigued from carrying out their new responsibilities, Dr. Kerwin says. "I see them neglecting their own health. It's not unusual for caregivers to suffer not only depression but also higher levels of hypertension. We recommend they have annual physicals, during which they should be sure to tell their primary care physician that they are caregivers. We also recommend they participate in support groups and learn about the community resources available."

Other concerns caregivers regularly express are loss of concentration due to their caregiving responsibilities and fear that they themselves might eventually get the disease.

Warning Signs for Caregivers What are some warning signs of caregiver stress? According to the Alzheimer's Association, they include:

Anger
Anxiety
Denial
Depression
Exhaustion
Health problems
Irritability
Lack of concentration
Sleeplessness
Social withdrawal

Caregivers who regularly experience these conditions should seek help from their physician, says the Alzheimer's Association.

Financial Strain Heightens Burden

In some families, the presence of Alzheimer's disease also brings financial problems that can add to stress and depression. Caregivers sometimes give up paying jobs for the unpaid one of caring for a loved one. They often find additional responsibilities are thrust on them, such as overseeing medications for their patient, knowing if or when the patient's care should be transferred to a nursing home, and taking on power of attorney duties along with living wills and advanced directives that specify whether terminal patients should undergo extreme measures to keep them alive.

The national Family Caregiver Alliance estimates that approximately 80% of the long-term care in the United States is provided without compensation, sometimes around the clock.

"The responsibilities are vast," Dr. Kerwin notes. "It's important for caregivers to regularly take some time for themselves, away from their caring responsibilities."

Barbara Abel
HealthLink Contributing Writer

The Medical College's Center for Healthy Communities, along with the local non-profit organization Community Care for the Elderly Partnership, has developed a Caring for Caregivers Program to support Medicaid- and Medicare-eligible residents in the community who care for frail relatives, often those with dementia. For more information, contact Tovah H. Bates, PhD, Assistant Professor, Family & Community Medicine, at 414-456-4305, or Community Care for the Elderly at 414-385-6600.

For more information on this topic, see the HealthLink articles End-Stage Alzheimer's - the Long Goodbye and Current Research on Alzheimer's, Memory Loss, and Aging.


The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease and Memory Loss in Later Life

Assisted living costs for Alzheimer's patient is tax deductible

clipped from www.usatoday.com Q: My mother just went into an assisted living facility due to Alzheimer's. It costs over $4500 per month. Are any portion of these expenses tax deductible? Answer from AICPA member Kenneth J. Strauss: Sorry about your mother but the good news is that the entire $4,500 is fully tax deductible as a medical expense. The rules can get pretty complicated but it is clear that Alzheimer's disease is a severe cognitive impairment which is the threshold for determining if the taxpayer is entitled to a full medical deduction. Like all medical deductions the total amount of medical deductions is an itemized deduction. The medical expenses in excess of 7.5% of her adjusted gross income are deductible. Depending on how high her income is will determine the full tax benefit. This might be a year to take some extra money from her retirement account. If your mother does not have the resources and you or another family member is paying then you should see if your mom can qualify as a dependent.

Do Brain Games Helps?

There is a lot of controversy around brain games. Skeptics say, no they don't really help. Others believe they are of enormous help in keeping the brain sharp or helping those with Alzheimer's.

My mother plays Slingo on the computer. I believe it helps. If nothing else it keeps her brain active and I am always looking for ways to keep her brain working.

One thing for sure, it can't hurt. So I recommend games like Slingo.

Good article, read on....

clipped from abcnews.go.com "I was having memory problems just like everyone else has at my age," Goldberg explained. "Using these games has given me a dramatic improvement in my memory. I'm able to recall names, places and companies that I couldn't remember in the past. And it surprises me I can remember these things and it's given me much greater confidence."

The 10 Best Foods You Aren't Eating

I don't eat most of the foods on this list. But, after reading this article I might.

The article is full of explanations and reasons why these foods should be eaten. A lot of information that I was not in my awareness.

Definitely worth the time to read.

clipped from abcnews.go.com Guavas, beets and cinnamon are among the super-healthful foods that you should probably be getting more of in your diet.

5 Ways to Cut Risk of Type 2 Diabetes

This is an excellent and well written article. The tips apply to everyone and should be incorporated into daily life. Well worth the read.

clipped from abcnews.go.com More than 23 million Americans have diabetes, and up to a quarter of those do not even know they have it. A new report found that children are at greater risk of developing the disease.

Study points to dietary cocktail for Alzheimer's

This is the kind of science that really gets me excited.

clipped from web.mit.edu The combination of supplements, which contains three compounds normally found in the bloodstream, is now being tested in Alzheimer's patients. The cocktail has previously been shown to promote growth of new brain connections in rodents. "It may be possible to use this treatment to partially restore brain function in people with diseases that decrease the number of brain neurons, including, for example, Alzheimer's disease, Parkinson's, strokes and brain injuries. Of course, such speculations have to be tested in double-blind, placebo-controlled clinical trials," said Richard Wurtman, Cecil H. Green Distinguished Professor of Neuropharmacology and senior author of a paper on the new work. clipped from web.mit.edu

Family Conversation with Older Drivers

When the time comes for the elderly to stop driving they will do so only after "kicking and screaming all the way. If you find yourself in the position where you need to ask them to stop driving it will be one of the most difficult conversations you will ever face. Here are some tips on the following pages.

Preparing for a conversation

Successful family conversations begin with good preparation and caring communication. With sensitivity toward the feelings of older drivers, families can help the older driver make safe driving decisions and ensure peace of mind for the entire family.

Start Early

If you start early you might find that convincing the person is easier over time.

Ideally, the first conversations about safe driving should occur long before driving becomes a problem. Early, occasional and candid conversations establish a pattern of open dialogue and allow time for the older adult to consider his or her driving skills and make appropriate modifications.

Here are some conversation openers:

“Health and safety first.”
When driving is placed within the larger context of other safety concerns, it may take the personal edge off the conversation.

“Driving isn’t what it used to be.”
Family members of any age can find common ground by talking about stressful road conditions. Restricting driving in order to compensate for worsening driving conditions makes sense for all drivers.

“Did you hear about the car accident in the news today?”
Use news reports to inform – not scare – older persons. Headline news about accidents that involve older and younger drivers can provide an opportunity to explore your family member’s attitudes about unfit drivers and the question of who can help them decide when to relinquish the keys.

“How did Granddad stop driving?”
This opener may provide an opportunity to reveal personal feelings about driving and family intervention.

Anticipate Reactions

Older drivers may express strong emotions when someone talks to them about their driving.

Older adults may agree with the assessment of their driving ability but feel depressed at the thought of relinquishing driving privileges.According to our survey:

* Nearly 1/4 of older adults reported feeling sad or depressed as a result of the conversation.
* Less than 10% reported responding with anger.

Older adults in poor health are more likely to have negative reactions. They may agree with the assessment of their driving ability but feel depressed at the thought of relinquishing driving privileges.

Negative reactions are often more about the message than the messenger. Older adults understand the implications of driving cessation:

* Fewer trips outside the home.
* Increased and permanent dependency on others for transportation.
* Becoming a burden to others.
* Fewer social opportunities.

Persuade the Driver

If an older driver doesn’t realize that his or her driving is a serious problem, it is necessary to have follow-up conversations with the driver, family members, doctors or law enforcement officials.

Here are some more direct appeals to help persuade a high-risk driver not to drive:

"Even if you were not at fault in a collision, you could be seriously injured or die." Regardless of who is at fault, older adults are more likely to be injured or killed because they have less capacity to endure the physical trauma of an accident. Pre-existing medical conditions may complicate recovery or result in death.

"I know you would feel terrible if someone was hurt when you were driving." Concern for others is often a stronger motivation than concern for self. In addition to physical harm to others, an accident can pose enormous financial and legal risks. Families should tactfully mention this possibility, but not dramatize the point.

"I'm afraid to let the grandchildren ride with you." An older relative may realize the degree of concern when family members will not ride with them. Protecting lives is more important than protecting feelings.

"Let's talk with your doctor about this." Blame the poor health, not the driver. Preferably, find out the doctor's opinion before suggesting this step. The doctor might not agree with the family's assessment nor want to assume the role of determining who should drive.

Discuss Alternatives

Effective conversations encourage future planning and show respect for the older adult’s ability to make appropriate decisions. When you observe the older person modifying his or her driving habits, use these opportunities to explore transportation options together to give the older adult time to adjust to them.

Here are suggestions of what to say:

"If you don't want to drive at night, we can arrange for someone to pick you up."
Commend the older driver for being cautious and help arrange transportation.

"Let's take the bus so we don't have to deal with the parking downtown."
Practice public transportation together before it becomes a necessity. And remember, public transportation may be difficult or impossible to use for some older adults with physical or cognitive difficulties. In these cases, families are often the first and only alternative transportation.

"You could save hundreds of dollars if you sold your car."

Insurance, maintenance, depreciation, and gasoline costs make owning and operating a car expensive. Even taxi services can be more economical.

This one of the most diffult tasks you will ever undertake. Good Luck!

Additional sources MIT and the Hartford



The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease and Memory Loss in Later Life

What I Wish I’d Done Differently

Been there, done that. An excellent article worth reading and passing along to friend.

I found out that one of the most important decision that can ever be made is the selection of an excellent personal physician. Are they still updating their education? This is one question I would ask. And the first thing I would recommend is asking questions.

clipped from newoldage.blogs.nytimes.com Looking back on the last few years of my mother’s life, with 20/20 hindsight and the belated knowledge that came from four years of reporting about aging for The New York Times, my single biggest mistake was not finding a doctor with expertise in geriatrics to quarterback her care and attend to the quality of her life, not merely its length.