Thursday, January 29, 2009

Developing Diabetes Prior to Senior Citizen Years Increases Risk of Alzheimer's


A new study published in the January 2009 issue of Diabetes indicates that those suffering from diabetes have a significantly greater risk of suffering from dementia and Alzheimer's. Those who develop diabetes in middle age are at the greatest risk.

This study confirms how important it is to maintain a healthy lifestyle in order to reduce the risk of dementia late in life.

Wednesday, January 28, 2009

Unemployed Might get Medicaid


House Democrats are quietly working on a new temporary entitlement that would allow workers getting unemployment checks to qualify for Medicaid. If it becomes law, the bill would temporarily allow unemployed workers to qualify for Medicaid regardless of their income or assets. This entitlement would be attached to the stimulus bill now working its way through Congress.

Relief Seen for Jobless and States in Health Care Plan


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Monday, January 26, 2009

Resveratrol Clinical Trials


Yesterday, I posted an article about Resveratrol, Fountain Of Youth In A Wine Rx? The catalyst for the article was a segment I saw on 60 minutes. The article received quite a few hits here on the Alzheimer's Reading Room and more than 400 hits on one of my companion blogs. The form of the drug, Resveratrol, that I was referring to is being developed by Sirtris Pharmaceutical, a Cambridge, Mass research company.
SRT501, a formulation of resveratrol with roughly five times higher bioavailability than the chemical alone
According to the scientist on 60 minutes the drug they are testing is in an early stage and still about five years away from being an available product.

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Sunday, January 25, 2009

Fountain Of Youth In A Wine Rx?


Alzheimer's caregivers and those predisposed to Alzheimer's by birth are likely to be hearing about the new drug resveratrol. The so-called (by me)---Fountain of Youth drug.

Sirtris, a Cambridge, Mass research company is developing resveratrol-based drugs that they believe zero-in on the longevity gene. These drugs are designed to slow down aging. Basically turning a 90 year old into a 60 year old. The also claim it could ward off diseases like Alzheimer's, diabetes, and cancer.

Thursday, January 22, 2009

CHANGE FOR THE COUNTRY = CHANGE FOR THE BIDENS


I received this email and press release from Interim HealthCare. The release contains a list of useful questions you could ask when seeking caregiver services. I know from personal experience, and the number of emails I receive, that this can be an overwhelming task.

I am not affiliated with Interim HealthCare and I am not receiving any compensation for this article. I am always willing to post good information that I believe is helpful to caregivers.
With the recent news that Joe Biden’s mother will continue living in Delaware, the family must decide how to ensure that she continues receiving the care she needs. This is a dilemma faced by many families in the U.S. Below are some tips from Interim HealthCare, a leading national organization that provides medical staffing and home care services to seniors, to help adult children make decisions about healthcare with their elderly parents.

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CHANGE FOR THE COUNTRY = CHANGE FOR THE BIDENS

Vice President’s Family Faces Same Decision as Millions:

How to Care for Mom?

Sunrise, Fla. -- While Michelle Obama’s mother, Marian Robinson, moves into the White House to help with childcare, Joe Biden’s sprightly mother, Jean, is in for some life changes of her own. Ms. Biden, who is in her early nineties, has lived with her son and his family at their Delaware home for years. With Joe Biden moving to Washington, D.C. to take on the demanding job of Vice President, the family has decided that Ms. Biden will remain in Delaware. They will face additional transition as they determine how to continue providing her with care that meets her needs.

The Bidens are the most visible example of a life-changing decision that millions of families must make each year. For many, the sensitive topic of how to care for an aging parent can be daunting, with no clear roadmap on how to make the best decision.

One thing is clear: the worst thing to do is to deny the need or avoid the discussion. “If you wait until your parent is having a health crisis, you are forced to make crucial decisions without the benefit of research or interviews with prospective caregivers – maybe not even reliable information about your parent’s health conditions or medications,” says Kathleen Gilmartin, President and CEO of Interim HealthCare (www.interimhealthcare.com), a leading provider of health care personnel at all skill levels in all settings. “The sooner you open dialogue with your parent, the easier the transition will be for them and for you.”

Gilmartin has personal experience providing care for seniors: she cared for her grandmother in her home, and also used home health services to help provide long-distance care for her father and mother. She offers some advice for families who want to provide the best possible care for their aging parent:

If your parent only requires assistance with light tasks like grocery shopping, transportation, or housekeeping, tap informal networks, like family, faith community and neighbors, first. However, it’s important to recognize when their needs outpace the resources. If the parent has ongoing health problems, or cannot cope with daily tasks such as meal preparation, bathing, dressing, or has difficulty with taking medication, professional home care should be considered.

Ask for recommendations from people you know and trust who have used home care providers. Consult your family doctor, hospital discharge department, local Council on Aging or the National Association of Home Care & Hospice (www.nahc.org).

Interview several reputable, credentialed providers:

  • Do they answer your questions thoroughly and offer to have a nurse or social worker speak with you?
  • How do they evaluate the needs of new clients?
  • How do they evaluate the changing needs of existing clients as they age?
  • How do they hire and supervise their employees?
  • How do they review and assess their employees’ performance?
  • Do they allow their caregivers to accept cash? If they do, this is a warning sign.
  • Will they be able to check your insurance to determine your coverage?
  • If you are providing long-distance care, do they offer technology like client Internet portals and telemonitoring of your parent’s condition (such as temperature and blood pressure)?
  •  Tools like these provide consistent, objective data on your parent’s status.
Selection of a home care service is a beginning, not an end. “Home care is not a one-size-fits-all-solution -- it’s an ongoing relationship that needs to respond to your loved one’s changing needs over time,” Gilmartin said. “Staying involved helps ensure the right care from the right person with the right skills and personality.”

Gilmartin advises establishing clear expectations and ongoing, open communication between the patient, family and provider. She feels it is the provider’s responsibility to give answers that are simple and clear, and to anticipate and provide recommendations to address changing needs that accompany aging. Gilmartin said, “We’re all working towards the same goal: golden years that are enjoyable for all. So many of our patients have given so much, it is a pleasure to be able to give back.”

Interim HealthCare offers an online assessment quiz to help people know when to consider a change in living arrangements: https://www.interimhealthcare.com/homestyle/assessment/.

Founded in 1966, Interim HealthCare is the nation’s oldest proprietary national organization providing health care personnel at all skill levels in all settings. Through a national network of more than 300 locally owned and operated franchise offices, Interim HealthCare provides diverse services including community based home car and health care staffing. Interim employs more than 75,000 health care workers and provides services to approximately 50,000 people each day. For more information, visit www.interimhealthcare.com

Indiana Senate committee OKs Silver Alert system


Previously, I wrote asking for support of the Silver Alert initiative in the Indiana state legislature. Good news--the senate committee committee voted in favor of the proposed bill. If you want to weigh in and help insure the bill becomes a law go here to find out how to do it.
The death of 91-year-old Clifford E. "Jack" Obenchain has prompted lawmakers to propose creating a public alert system like the one used when children are missing.
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Obenchain was missing two weeks before he was found dead in a Northern Indiana creek, many counties away from home.
Support the Silver Alert system in your state. With our help we might be able to insure that situations like that described in the story below stop happening.

Indiana Senate committee OKs Silver Alert system

Under the program, stations would broadcast bulletins on adults who are in danger
By Bruce C. Smith
bruce.smith@indystar.com

The death of 91-year-old Clifford E. "Jack" Obenchain has prompted lawmakers to propose creating a public alert system like the one used when children are missing.

A state Senate committee voted Wednesday in favor of establishing a Silver Alert system. Similar to Amber Alerts, Silver Alerts would be issued by police, voluntarily broadcast by TV and radio stations and posted on Web sites when an adult is believed to be in danger.

Obenchain apparently suffered a series of mini-strokes while driving in Indianapolis in December 2007. Disoriented, Obenchain then drove as far as Ohio, apparently unable to find his way home. The Pittsboro man was stopped once by an Ohio policeman but sent on his way with driving instructions.

Obenchain was missing two weeks before he was found dead in a Northern Indiana creek, many counties away from home.

"At least we were fortunate to have found him. Many families don't even get that," said Nancy Boggs-Bray, Brownsburg, Obenchain's granddaughter. "After Grandpa died, we asked the legislators from our area if something could be done so this wouldn't happen to any other families."

At least 10 other states have created versions of the Silver Alert.

On Wednesday, members of the Senate Committee on Health and Provider Services voted 7-0 in support of Senate Bill 307, introduced by Sen. Patricia L. Miller, R-Indianapolis. The measure now goes to the full Senate for action.

In a hearing on the bill last week, law enforcement agencies expressed concerns that creating a Silver Alert might hurt the effectiveness of the Amber Alert system.

One reason Amber Alerts have been so effective is that only a handful are issued each year -- three in Indiana in 2008, according to police.

But a lobbyist for seniors and families of missing adults said the need for a Silver Alert will increase as baby boomers age.

More than 115,000 Hoosiers have been diagnosed with the memory-robbing Alzheimer's disease, which can cause adults to wander from caregivers, according to the Alzheimer's Association of Indiana.

"Thousands of Hoosiers now suffer from Alzheimer's, and it has been estimated as many as 60 percent may wander away from home at some point," Miller said.

"Regardless of age, all life is valuable, and the state should use every available resource to find Hoosiers in danger -- especially our young and aged."


Wednesday, January 21, 2009

Exercise and Socialize to Fight off the Risks of Alzheimer's and Dementia


A new study being circulating all over the Internet indicates that:
having a calm and outgoing personality in combination with a socially active lifestyle may decrease the risk of developing dementia.
This differs slightly from earlier studies that indicated:
chronic stress can affect parts of the brain, such as the hippocampus, and possibly leading to dementia.
My own experience with my mother and other Alzheimer's sufferers indicates that exercise and socialization makes a big difference in daily behavior and ability to function effectively. So, its not hard for me to jump to the conclusion that exercise and socialization keep the brain strong and actually help improve the brain and its functioning.

Monday, January 19, 2009

Help make the Silver Alert Program Happen in Indiana


Three bills are on the table in the Indiana House and Senate that would help locate missing Alzheimer's patients but the proposal does not come without opposition.
Imagine this: someone you love is lost. To make matters worse it is unlikely they will be able to find their way home without help. They might be gone for days, they might die from exposure or worse.
According to the Alzheimer's Association, over a hundred thousand Hoosiers have Alzheimer's and over 60 percent of them will at some point wander away from their home.
You can do something to help make this legislation a reality.
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If you live in Indiana call the office of your local representative. To identify your state legislator go here. You can find the name and contact information by entering your zip code.

If you live outside Indiana but want to show your support consider contacting State Rep. Dennis T. Avery. Mr. Avery introduced House Bill 1029, legislation that creates a 'silver alert' system to help locate aging seniors who have wandered away from their homes. You can get Representative Avery's contact information here.

I know everyone is busy. But, now you have the opportunity to make a real difference. Imagine for a moment that you played a role in helping this legislation pass. Then imagine your role in saving the life of someone suffering from Alzheimer's that is lost and in danger. Imagine.

Indiana Legislator to Propose Silver Alert




Thursday, January 15, 2009

Does Drinking Coffee Really Reduce Alzheimer's Risk?


The study found that coffee drinkers at midlife had lower risk for dementia and AD later in life compared to those drinking no or only little coffee. The lowest risk (65% decreased) was found among moderate coffee drinkers (drinking 3-5 cups of coffee/day). Adjustments for various confounders did not change the results.


By Bob DeMarco
Alzheimer's Reading Room


It seems there is big buzz about a new study that indicates drinking 3-5 cups of coffee a day might help ward off Alzheimer's disease.

I actually wrote briefly about this back in April. The lead researcher on the this newly released , Miia Kivipelto said:
"Middle-aged people who drank between three and five cups of coffee a day lowered their risk of developing dementia and Alzheimer's disease by between 60 and 65 percent later in life,"

Tuesday, January 13, 2009

Dial 211 When Alzheimer's or Dementia Strike


As the Alzheimer's Reading Room continues to grow, I am starting to receive direct emails asking me for help and advice.

I know from personal experience the overwhelming feeling of stress that comes with a diagnosis of dementia or Alzheimer's. Never having experienced dementia, in any way, I just didn't know where to turn or what to do. To make matters worse, my mother lived more than 1000 miles away from me. It took me almost a year to get my feet on the ground.

Over time I am going to rewrite and organize all of the information I learned into one article. Today, I want to familiarize you with 2-1-1.
In many states, dialing “211” provides individuals and families in need with a shortcut through what may be a bewildering maze of health and human service agencies’ phone numbers. By simply dialing 211, those in need of assistance are referred, and sometimes connected, to appropriate agencies and community organizations.


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Here is the link to discover if 211 is available to you. Go here and put in your zip code or city to determine if the service is available to you.

In many states, dialing “211” provides individuals and families in need with a shortcut through what may be a bewildering maze of health and human service agencies’ phone numbers. By simply dialing 211, those in need of assistance are referred, and sometimes connected, to appropriate agencies and community organizations.

211 works like 911. Calls to 211 are routed by the local telephone company to a local or regional calling center. The 211 center’s referral specialists will ask questions to determine needs and possible sources of help.

  • Specialists can access databases of resources available from private and public health and human service agencies
  • Match the callers’ needs to available resources
  • Link or refer callers directly to an agency or organization that can help.


211 can be dialed in any health or family emergency. Much like 911, 211 can be an emergency service resource.

Available services vary widely by city and county. There may be services in your area that are very difficult to identify and find. I found that sometimes a foundation will fund a program for seniors in a single zipcode. Services like these often help with things like cleaning, bathing, food preparation or meals, or offer relief so you can go to the store or bank. Often they provide this service free of charge. You really need to dig deep to find these services. After a year of digging and looking I identified an service unknown that was less than a mile away.

Once you start looking for help, dig deep, you will be wonderfully surprised when that very special person "pops-up" and gives you more information or help than you could every imagine.

When the overwhelming feelings come remember one thing--you are not alone. I had to learn this on my own but I now know it is true.


Gene Variant May Hike Women's Risk of Alzheimer's


Scientists have discovered a gene variant on the X chromosome that appears to increase the risk of developing Alzheimer's disease. The scientists uncovered a strong association between a mutation on the PCDH11X gene and Alzheimer's disease.

For the study, Dr. Steven Younkin and his colleagues scanned hundreds of thousands of genes in 844 people with Alzheimer's disease and 1,255 healthy people who served as "controls."

Women with two copies of the gene had a 75 percent increased risk for Alzheimer's. Women with only one copy of the gene had a 26 percent increased risk, while men with one copy had an 18 percent increased risk.

"To me, the fact that it's X-linked is intriguing because of the fact that there are more women than men with Alzheimer's disease," he said.


Gene Variant May Hike Women's Risk of Alzheimer's




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Bob DeMarco is the editor of the Alzheimer's Reading Room and an Alzheimer's caregiver. Bob has written more than 1,300 articles with more than 9,000 links on the Internet. Bob resides in Delray Beach, FL.

Original content Bob DeMarco, the Alzheimer's Reading Room


Monday, January 12, 2009

Obama's big idea: Digital health records


If you are a caregiver my guess is that you have filled out a lot of paperwork. Every time you go to a new doctor or specialist you get a hand full of forms to fill out. Need a medical procedure or test--fill out the forms. If you are like me you probably noticed that most of these forms are standardized and ask the same questions over and over. It never stops amazing me how antiquated our medical system is in the year 2009.

The issues around digitizing medical health records will be high cost, the difficulty of moving from legacy systems to new computer software, and privacy.
Change won't come easily despite the enormous benefits that will be reaped by patients, doctors, and government.


I have written many times about the importance of selecting the "right" personal physician. It took us four changes before we got it right.

It turns out that our personal physician successfully installed a new computerized system that is completely paperless. When we visit he enters all the information directly into a computer. Want to know the last time you had a chest X-ray and the result? Our doctor hits a couple of buttons and there is the information right at his finger tips.

A few months ago I was worried that my mother was getting pneumonia. I called the doctor and he worked us in in a couple of hours. After checking her out he was also worried. He sent us across the hall for a chest X-ray. By the time we walked back to his office he was viewing her X-ray and was able to tell us my mother was not suffering from pneumonia. However he was concerned with the results. He gave her a shot and prescribed a very strong antibiotic. No waiting a day or two for the results of the X-ray; and an, immediate diagnosis and treatment. In cases like this immediate treatment makes a big difference in the eventual outcome.

I cannot tell you how reassuring and uplifting the use of modern technology can be. It really gives you confidence that you are getting the best treatment available; and more importantly, a quick diagnosis that leads to immediate treatment means no worrying for days at a time while you wait for test results. In the future results will come back fast and the follow-up care will be more immediate. Have you ever sat around for a week wondering, what if?

My doctor proved that the transition to the digital age can be made. I am sure doctors will resist at first. Purchasing and installing the hardware and software will cut into their profit in the short term. And, they will need to learn how to use the technology and get comfortable using the new computer software.

Once they install an efficient computer system good things will happen. First, their productivity will be increased and they will be able to see patients on schedule. Second, it will allow them in cases like I described above to deliver immediate medical treatment and advice . In the past we would have made at least one additional visit to the doctors office and the treatment would have been delayed. Third, when necessary, it will allow doctors' to view recent medical tests online and do away with the need for faxing and delivery of these documents. This will bring additional costs benefits across the entire medical system and lead to major savings to insurers like Medicare. Less duplication and waste means lower costs.

By adopting modern day technology everyone will see lower costs, increased profits, and a more efficient use of time. Patients and caregivers will spend less time running back and forth to the doctor and the doctors' office will be running more efficiently. This will result in less time lost at work and less money spent on things like--gasoline.

All of this is a good thing.

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Obama's big idea: Digital health records

President-elect wants to computerize the nation's health care records in five years. But the plan comes with a hefty price tag, and specialized labor is scarce.

By David Goldman
NEW YORK (CNNMoney.com) -- President-elect Barack Obama, as part of the effort to revive the economy, has proposed a massive effort to modernize health care by making all health records standardized and electronic.

Here's the audacious plan: Computerize all health records within five years. The quality of health care for all Americans gets a big boost, and costs decline.

Sounds good. But it won't be easy.

In fact, many hurdles stand in the way. Only about 8% of the nation's 5,000 hospitals and 17% of its 800,000 physicians currently use the kind of common computerized record-keeping systems that Obama envisions for the whole nation. And some experts say that serious concerns about patient privacy must be addressed first. Finally, the country suffers a dearth of skilled workers necessary to build and implement the necessary technology.

"The hard part of this is that we can't just drop a computer on every doctor's desk," said Dr. David Brailer, former National Coordinator for Health Information Technology, who served as President Bush'shealth information czar from 2004 to 2006. "Getting electronic records up and running is a very technical task."

It also won't come cheap. Independent studies from Harvard, RAND and the Commonwealth Fund have shown that such a plan could cost at least $75 billion to $100 billion over the ten years they think the hospitals would need to implement program.

That's a huge amount of money -- since the total cost of the stimulus plan is estimated to cost about $800 billion, the health care initiative would be one of the priciest parts to the plan.

The biggest cost will be paying and training the labor force needed to create the network. Luis Castillo, senior vice president of Siemens Healthcare, a company that designs health care technology, said the laborers will have the extremely difficult task of designing a a system that "thinks like a physician."

"Doctors cannot spend hours and hours learning a new system," said Castillo. "It needs to be a ubiquitous, 'anytime, anywhere' solution that has easily accessible data in a simple-to-use Web-based application."

But highly skilled health information technology professionals are as rare as they come, and many IT workers will need to be trained as health technology experts.

Early government estimates showed about 212,000 jobs could be created from this program, but Brailer said there simply aren't that many Americans who are qualified.

Furthermore, ensuring the privacy of patients' records in a nationalized computer network will be tricky. There are obvious concerns about hackers and system failures. And new online health record systems, such as Google Health are not currently subject to the Health Insurance Portability and Accountability Act, the national health privacy law.

"HIPAA was never intended for the digital age, because the laws never anticipated the emergence of Web-based records," said Brailer. "Congress can pass one of numerous policy proposals for change, it's just a question if they have the will to do that."

Jobs and savings for the future
The Obama transition operation declined a request to elaborate on Obama's proposal. The president-elect said Thursday in a speech on the economy thatthe benefits of a modernized national health record system go beyond just cost savings.

"This will cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests," said Obama. "It just won't save billions of dollars and thousands of jobs -- it will save lives by reducing the deadly but preventable medical errors that pervade our health care system," he added.

Still, compared to the $2 trillion a year that the industry spends, the$100 billion experts say it may cost to implement Obama's planis a drop in the bucket.

"We must reduce waste to become more efficient" said Brailer.

The savings of such a plan could be substantial. Brailer estimates that a fully computerized health record system could save the industry $200 billion to $300 billion a year.

That could ultimately slow the rapid rise of health care premiums, which have cut into Americans' paychecks. While wages are rising at a rate of around 3% a year, health care costs are growing at about three times that rate.

"Obama's support for electronic medical records is one of the key efforts of health reform that actually will deliver lower costs for hard-working American families," said Larry McNeely, a health care advocate at U.S. Public Interest Research Group. "Long-term savings can't happen unless we have 21st century health information technology."

Massachusetts has developed a plan to fully computerize records at its 14,000 physicians' offices by 2012 and its 63 hospitals by 2014. After a pilot program, the state legislature estimates it will cost about $340 million to build the statewide computer system, with a cost of about $2 million per hospital.

"[Obama's] timeframe is very ambitious, but there is a need to be able to track data on patients and talk across providers and health care systems," said Dr. JudyAnn Bigby, Secretary of Health and Human Services for Massachusetts. "The program will allow for greater patient safety."

Some say some of the hard work has begun. The Bush administration laid much of the groundwork for the program, leading to several pilot programs in a handful of states, as well as a standardization of medical records.

"The whole structure has already been developed," said Stephen Schoenbaum, executive director of The Commonwealth Fund's commission on a high performance health system. "It's feasible to at least make a lot of progress on this in the next five years."

Find this article at:
http://money.cnn.com/2009/01/12/technology/stimulus_health_care/?postversion=2009011204

Obama's big idea: Digital health records


Aricept is not an Antipsychotic Medication


I noticed Google is being searched with these keywords: is Aricept an anti psychotic drug. I am not surprised. I pointed out in two recent articles:

Anti-psychotic drugs raise risk of death in Alzheimer's patients' 

and

Studies show that anti psychotic medications can be harmful to Alzheimer's patients'


that a poorly written headline--

Alzheimer's drugs double death risk in elderly

might lead to the idea that drugs like Aricept and Namenda are anti-psychotic medications. Aricept is not an anti psychotic medication. Donepezil marketed under the trade name Aricept is a centrally acting reversible acetylcholinesterase inhibitor.

I borrowed this directly from the official
Aricept website: HOW ARICEPT Is Thought to Work

When someone has Alzheimer's disease, nerve cells and vital chemicals in the brain are lost over time. This occurs in parts of the brain that are key to memory and other mental processes. One such chemical is called acetylcholine. This chemical helps carry messages from nerve cell to nerve cell in the brain. Alzheimer's may impair thinking and memory by disrupting these messages between cells.

It is thought that ARICEPT may help reduce the breakdown of acetylcholine, allowing more of this important chemical to remain in the brain.

If you are interested you can read more about cholinesterase inhibitors here.

PCDH11X gene


Researchers at Mayo Clinic have discovered the first gender-linked susceptibility gene for late-onset Alzheimer's disease.

In the Jan. 11 online edition of Nature Genetics, they report the results of their two-stage genome-wide association study of patients with Alzheimer's disease. The research showed that women who inherited two copies of a variant in the PCDH11X gene, found on the X chromosome, are at considerably greater risk of developing Alzheimer's disease.

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Saturday, January 10, 2009

HBO and Maria Shriver to Tackle Alzheimer's in Documentary Series


Maria Shriver is an executive producer of this series. More on the Alzheimer's Project at the Alzheimer's Reading Room.

The Memory Loss Tapes takes an intimate look at seven individuals living with Alzheimer’s, seeking to introduce a new understanding by sharing the devastating experience of memory loss from the point of view of the person with the disease.

Grandpa, Do You Know Who I Am? With Maria Shriver is geared toward children and young teens coping with a grandparent’s illness, and presents vignettes that can help a child understand and deal with a relative’s gradual decline into Alzheimer’s.

Momentum in Science is a two-part, state-of-science odyssey that takes viewers inside the laboratories and clinics of 25 leading physicians, revealing some of the most cutting-edge Alzheimer research advances.

Caregivers is a collection of five family portraits that illustrate caring for the different stages of Alzheimer’s disease.

Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The blog contains more than 2,390 articles with more than 272,100 links on the Internet. Bob resides in Delray Beach, FL.


More from the Alzheimer's Reading Room

Friday, January 9, 2009

Studies show that Antipsychotic Medications can be Harmful to Alzheimer's patients'


By Bob DeMarco
Alzheimer's Reading Room

The hot buzz on the Internet today is about the misuse of anti psychotic drugs to treat Alzheimer's. 

The use of antipsychotic drugs to "control" difficult behavior, agitation, outbursts and sometimes combative behavior of dementia and Alzheimer's patients is soaring. Sales of newer antipsychotics like Risperdal, Seroquel and Zyprexa have more than tripled to $14 billion, up from $4 billion in 2000, according to currently available statistics. Most of this increase can be traced to prescriptions in nursing homes. Current estimates indicate that about one-third of all nursing home patients have been given antipsychotic drugs. Yikes.

There are at least seventeen studies of elderly people with dementia that compared patients taking an anitpsychotic drug with those taking a placebo. These studies indicate that patients taking the drugs die at a rate almost two times the rate of patients taking the placebo over the course of the study.

Thursday, January 8, 2009

Antipsychotic Drugs raise Risk of Death in Alzheimer's Patients


The Associated Press just released an article titled,  Alzheimer's drugs double death risk in elderly.  Whoever wrote the headline for the story did a very poor job. The article is actually about anti-psychotic drugs that are often misused to treat Alzheimer's sufferers. The headline could give the impression that the article is about frequently presecribed Alzheimer's drugs like Aricept and Namenda.
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The misuse of anti-psychotic drugs to treat Alzheimer's patients is an important issue and I wrote about it some time ago. The issue is important because these medications are missused by physicians and in nursing homes. The Food and Drug Administration warned doctors in 2005 that some anti-psychotic drugs could increase the risk of death when given to older patients in nursing homes. In spite of this, the drugs are still being widely prescribed. An estimated 30% to 60% of nursing home patients in the USA are given the drugs, and many of these patients have Alzheimer's. This practice is done to sedate older people and keep them under control. The rationale is that the patients are "difficult". This is horrifying.

This newly released study,  being published in the journal Lancet Neurology,  found that after two years, 46 percent of Alzheimer's patients taking anti-psychotics were alive, versus 71 percent of those not on the drugs.
"Would I want to take a drug that slightly reduced my aggression but doubled my risk of dying? I'm not sure I would," said Clive Ballard, the lead author of this new study
The FDA approved the anti-psychotic drugs for the treatment of schizophrenia, not Alzheimer's, says P. Murali Doraiswamy, chief of biological psychiatry at Duke University Medical Center. The medications do help certain people. If there's no other way to stop an Alzheimer's patient from acting out a dangerous delusion, then a prescription for an anti-psychotic can be a blessing, Doraiswamy says.

"But a lot of doctors don't realize how powerful these drugs are," Doraiswamy says. "They should be used only as a last resort."
Also see,

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

where I discuss how hypothyroidism can present as dementia and

Overuse Of Antipsychotics Among Nursing Home Residents With Dementia

where I discussed this issue and how it related to my mother and her treatment by a personal physician.

Alzheimer's drugs double death risk in elderly

The Associated Press

Anti-psychotic drugs commonly used to treat Alzheimer's disease may double a patient's chance of dying within a few years, suggests a new study that adds to concerns already known about such medications.

"For the vast majority of Alzheimer's patients, taking these drugs is probably not a worthwhile risk," said Clive Ballard, the paper's lead author, of the Wolfson Centre for Age-Related Diseases at King's College London.

"Would I want to take a drug that slightly reduced my aggression but doubled my risk of dying? I'm not sure I would," Ballard said.

The research was published Friday in the medical journal, Lancet Neurology.

Alzheimer's disease is the most common cause of dementia and causes symptoms including aggression, delusions and hallucinations. Previous studies have shown anti-psychotic drugs, which can help control the aggression and hallucinations for a few months raise the risk of death in older patients with dementia. There are other side effects, including respiratory problems and stroke.

Ballard and colleagues followed 165 patients aged 67 to 100 years with moderate to severe Alzheimer's disease from 2001 to 2004 in Britain. Half continued taking their anti-psychotic drugs, which included Risperdal, Thorazine and Stelazine. The other half got placebos.

Of the 83 receiving drugs, 39 were dead after a year. Of the 82 taking fake pills, 27 were dead after a year. Most deaths in both groups were due to pneumonia.

After two years, 46 percent of Alzheimer's patients taking the anti-psychotics were alive, versus 71 percent of those not on the drugs. After three years, only 30 percent of patients on the drugs were alive, versus 59 percent of those not taking drugs.

Drugs given to up to 60 percent of patients
In the United Kingdom and the United States, guidelines advise doctors to use anti-psychotic drugs cautiously and temporarily. But in many nursing homes in Europe and North America, up to 60 percent of patients with dementia are routinely given the drugs for one to two years.

"The drug regimen for any person with Alzheimer's needs to be personalized," said William Thies of the Alzheimer's Association in the U.S. Thies was not connected to the study. "At some points, some people will be better off with no medication."

Simon Lovestone of the Institute of Psychiatry at King's College in London said psychiatrists should try environmental or behavioral therapies instead of anti-psychotics.

Experts aren't sure how the anti-psychotics increase patients' risk of dying. But they think the drugs could be damaging to the brain and their sedative effects make patients less able to exercise and more susceptible to deadly infections.

The study was paid for by the U.K. Alzheimer's Research Trust. Ballard reported receiving grants from various pharmaceutical companies which make drugs used to treat Alzheimer's patients.

Copyright 2008 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
URL: http://www.msnbc.msn.com/id/28566249/

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Bob DeMarco is the editor of the Alzheimer's Reading Room and an Alzheimer's caregiver. Bob has written more than 1,050 articles with more than 8,000 links on the Internet. Bob resides in Delray Beach, FL.

Original content Bob DeMarco, the Alzheimer's Reading Room


Wednesday, January 7, 2009

Can Clioquinol Stop Alzheimer's?


A buzz is starting to move around the Internet about Clioquinol. The drug Clioquinol (klye oh KWIN all) has been available for 80 years. Currently, Clioquinol topical cream is prescribed as an antifungal and antibacterial medication. Clioquinol topical prevents fungus from growing on your skin. Clioquinol has also been used in the past to treat diarrhea and other gastrointestinal disorders. The drug was taken off the market in several countries in the 1960's when 10,000 Japanese suffered from an epidemic of subacute myelo-optic neuropathy (SMON).

A poorly written press release out of Canada's McGill University starts with this paragraph:
Recent animal studies have shown that clioquinol – an 80-year old drug once used to treat diarrhea and other gastrointestinal disorders – can reverse the progression of Alzheimer’s, Parkinson’s and Huntington’s diseases. Scientists, however, had a variety of theories to attempt to explain how a single compound could have such similar effects on three unrelated neurodegenerative disorders.
There is no explanation of the above and there are no further mentions of Alzheimer’s, Parkinson’s and Huntington’s diseases in the release.

The advance online edition of the study was published in Oct. 2008 in the Journal of Biological Chemistry.

I cannot find anything of any real substance about this on the internet. I should mention that you can obtain Clioquinol from a chemical wholesaler.

It does sound interesting, so I'll continue to search for additional information.

Old gastrointestinal drug slows aging, McGill researchers say

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Pet Scans Show Brain Aging


UCLA scientists are using an innovative brain-scan technology along with patient-specific information on Alzheimer's disease risk, to help diagnose brain aging, often before symptoms appear.

"Combining key patient information with a brain scan may give us better predictive power in targeting those who may benefit from early interventions, as well as help test how well treatments are working". Dr. Gary Small, a professor at the Semel Institute for Neuroscience and Human Behavior at UCLA.

This science is interesting because additional research shows that early detection of Alzheimer's often results in better treatment outcomes.
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Assessment technique lets scientists see brain aging before symptoms appear


Approach combines PET scans with information on patients' Alzheimer's risk

UCLA scientists have used innovative brain-scan technology developed at UCLA, along with patient-specific information on Alzheimer's disease risk, to help diagnose brain aging, often before symptoms appear. Published in the January issue of Archives of General Psychiatry, their study may offer a more accurate method for tracking brain aging.

Researchers used positron emission tomography (PET), which allows "a window into the brain" of living people and specifically reveals plaques and tangles, the hallmarks of neurodegeneration. The PET scans were complemented by information on patients' age and congnitive status and a genetic profile.

"Combining key patient information with a brain scan may give us better predictive power in targeting those who may benefit from early interventions, as well as help test how well treatments are working," said study author Dr. Gary Small, who holds UCLA's Parlow-Solomon Chair on Aging and is a professor at the Semel Institute for Neuroscience and Human Behavior at UCLA.

Scientists took PET brain scans of 76 non-demented volunteers after they had been intravenously injected with a new chemical marker called FDDNP, which binds to plaque and tangle deposits in the brain. Researchers were then able to pinpoint where these abnormal protein deposits were accumulating.

They reported that older age correlated with higher concentrations of FDDNP in the medial and lateral temporal regions of the brain, areas involved with memory, where plaques and tangles usually collect. The average age of study volunteers was 67.

Thirty-four of the 76 volunteers carried the APOE-4 gene allele, which heightens the risk for developing Alzheimer's disease. This group demonstrated higher FDDNP levels in the frontal region of the brain, also involved in memory, than study participants without allele.

"We found that for many volunteers, the imaging scans reflected subtle brain changes, which take place before symptoms manifest," said Small, who is also director of the UCLA Center on Aging.

Small noted that the brain will try to compensate for any problems, which is why cognitive symptoms may not become apparent until much later.

"This type of scan offers an opportunity to see what is really going on in the brain," he said.

Another subset of the volunteers had mild cognitive impairment (MCI), a condition that increases the risk of developing Alzheimer's disease. These 36 volunteers had higher measures of FDDNP in the medial temporal brain regions than normal volunteers. Those who had both MCI and the APOE-4 gene had higher concentrations of FDDNP in the medial temporal brain regions than volunteers who had MCI but not APOE-4.

"We could see more advancing disease in those with mild cognitive impairment, who are already demonstrating some minimal symptoms," Small said. "Eventually, this imaging method, together with patient information like age, cognitive status and genetics, may help us better manage brain aging."

According to Small, in the future, brain aging may be controlled similarly to high cholesterol or high blood pressure. Patients would receive a brain scan and perhaps a genetic test to predict their risk. Medications and other interventions could be prescribed, if necessary, to prevent or delay future neurodegeneration, allowing doctors to protect a healthy brain before extensive damage occurs. The brain scans may also prove helpful in tracking the effectiveness of treatments.

PET, combined with the FDDNP probe, is the only imaging technology that offers a full profile of neurodegeneration that includes measures of both plaques and tangles — the physical evidence of Alzheimer's disease in the brain.

"The fact that we can see tau tangles as well as amyloid plaques is critically important in early detection of brain aging, since the tangles are the first abnormal proteins that appear in the brain, long before dementia is clinically obvious to the physician," said Dr. Jorge R. Barrio, a study author and professor of molecular and medical pharmacology at the David Geffen School of Medicine at UCLA.

Such subtleties allow more insight into how the plaques and tangles spread and ultimately how Alzheimer's disease may develop.

Currently, the new FDDNP-PET scans are used in a research setting, but clinical trials are in development to bring the technology to wider patient use.

The study was funded by both government and nonprofit agencies, including the National Institutes of Health, the U.S. Department of Energy, the Ahmanson Foundation, the Larry L. Hillblom Foundation and the Tamkin Foundation.

Additional UCLA authors include Prabha Siddarth, Ph.D.; Alison C. Burggren, Ph.D.; Linda M. Ercoli, Ph.D.; Karen J. Miller, Ph.D.; Dr. Helen Lavretsky; and Susan Y. Bookheimer, Ph.D, all from the UCLA Department of Psychiatry and Biobehavioral Sciences and the Semel Institute for Neuroscience and Human Behavior at UCLA; Vladimir Kepe, Ph.D.; S.C. Huang, Ph.D.; and Michael E. Phelps, Ph.D. from the UCLA Department of Molecular and Medical Pharmacology; and Paul M. Thompson, Ph.D., and Greg M. Cole, Ph.D., from the UCLA Department of Neurology.

UCLA is California's largest university, with an enrollment of nearly 38,000 undergraduate and graduate students. The UCLA College of Letters and Science and the university's 11 professional schools feature renowned faculty and offer more than 323 degree programs and majors. UCLA is a national and international leader in the breadth and quality of its academic, research, health care, cultural, continuing education and athletic programs. Four alumni and five faculty have been awarded the Nobel Prize.

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Original content Bob DeMarco, the Alzheimer's Reading Room

Monday, January 5, 2009

Early Onset Alzheimer's On The Rise


This is a well written article on the this topic and worth reading. Follow the link in the clip for more on early onset Alzheimer's and this trend.

"We're seeing more and more people in their 40s and especially in their 50s and early 60s with more serious memory problems than we've seen before. And many of them turn out to be Alzheimer's," said Dr. Constantine G. Lyketsos, chair of psychiatry at Johns Hopkins Bayview Medical Center.
He doesn't know why he is seeing more younger patients - it could be because baby boomers are pushing through this age group or there is a greater awareness of the disease. There aren't hard numbers, in part because Alzheimer's is notoriously difficult to identify, particularly in the middle-aged.

"I've heard it said that Alzheimer's kills the brain of the patient and the heart of the family," said Carol Wynne, a nurse practitioner who runs an Alzheimer's Association support group for families dealing with early-onset disease. "It's very hard to watch - and as a society, we aren't set up to deal with them."
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Friday, January 2, 2009

If it is not Alzheimer's, What is it?


While searching Google, I ran across an interesting article about Normal Pressure Hydrocephalus(NPH) on the ABC 7 website--San Francisco.

This article reminded me that when my mother was diagnosed with Alzheimer's my cousin Carole sent me an article about Normal Pressure Hydrocephalus(NPH). Of course, like many I was hoping this would turn out to be my mother's diagnosis rather than the dreaded Alzheimer's disease. It didn't turn out as I hoped but I still believe this is worth looking into as an alternative diagnosis.

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Thursday, January 1, 2009

Happy New Year


Happy New Year

Wishing each and everyone of you a wonderful new year.