Oct 25, 2011

Mood, cognition and sleep patterns improve in Alzheimer's patients after cataract surgery

There could be a reason why your loved one is moody, mean, or not sleeping. This is only one of many.

By Bob DeMarco
Alzheimer's Reading Room

This research caught my attention because there is a tendency on the part of doctors and caregivers to assume because the person is old, or because the person is suffering from dementia there is no real purpose in treating all conditions and illnesses.

More than one doctor has tried to discourage me from getting Dotty a diagnostic test or treatment based on her age and condition.

The usual logic and reasoning, she's old. Once you add in dementia there is a tendency to believe it really won't make a difference.

If you want to know the truth I find this upsetting.

In one specific incidence I couldn't get what I wanted from a doctor. So I walked in and asked to talk to his boss, the head doctor. I was discouraged from doing so. I insisted.

Finally, they "sloughed me off" to the office manager. By the time the office manager called me in "to find out" what I wanted everyone of my senses had been activated. I also had the steely, I mean business look in my eyes.

I don't like to verbally abuse people, and I don't like to yell. What I will usually do when I want my way is to "allude" to what I am intending to do if I don't get my way.

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In other words, I won't make a direct "threat"; instead, I'll let the person read between the lines. This is a necessary step I must take. Why? Because once "war" is declared, I can't turn back.

At first, the office manager tried to tell me how it was going to be impossible to talk to the "head honcho doctor" because he was so very busy. So I said to her, maybe you would like to consider this.

The "this" more or less was the indirect threat that I was fully prepared to "make their lives miserable"; and, I was smart enough to do it. I don't like to be underestimated in situations like this one.

In under five minutes, the head honcho was sitting across the desk from me.

I told him what I wanted for Dotty and how I wanted her to be treated. He started to hem and haw. When he stopped, I sat right up on the edge of my chair, looked him right in the "eye" and told him what was going to happen if I didn't get my way.

Guess what he said? He said, "the wheel that squeaks the loudest gets what they want". Keep in mind I never raised my voice, in fact, when I get that look, my voice actually goes down and I talk slower.

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And now to my point.

I learned over and over "the wheel that squeaks the loudest gets its way". However, my translation goes like this, "you have to know your rights when it comes to the medical system".

Don't fool yourself.

The entire systems is under orders from the healthcare companies to delay expensive procedures, or to try to avoid them.

In the case of Dotty, I don't care if she gets to be 110. If she gets cataracts or needs a procedure and there is little or no downside, she will be getting it and no one is going to tell me "she is old".

My motto, treat Dotty the same way I would treat myself, only better.

Take a look at the report on research below. Are you getting a thorough eye check up for your loved one every year? Are you getting a complete physical and stress test every year? Thyroid checked every year?

Don't be lazy and don't be dumb.

There could be a reason why your loved one is moody, mean, or not sleeping.

Like it or not, if you are the "chosen ONE", the dementia caregiver, it is up to you make sure no stone goes unturned. Alzheimer's patients for the most part cannot tell you something is wrong as the disease progresses.

Enough with the lecture already.

Start squeaking, and make sure you look under ever rock.

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Mood, cognition and sleep patterns improve in Alzheimer's patients after cataract surgery

Brigitte Girard
Researchers at Tenon Hospital, Paris, France, found that patients with mild Alzheimer's disease whose vision improved after cataract surgery also showed improvement in cognitive ability, mood, sleep patterns and other behaviors. Lead researcher Brigitte Girard, MD, will discuss her team's results today at the American Academy of Ophthalmology's 2011 Annual Meeting.

This is the first study to specifically assess whether cataract surgery could benefit Alzheimer's patients, although earlier research had shown that poor vision is related to impaired mood and thinking skills in older people and that cataract surgery could improve their quality of life. Thirty-eight patients, average age 85 and all exhibiting mild dementia due to Alzheimer's disease, completed Dr. Girard's study. All participants had debilitating cataract in at least one eye and were appropriately treated with standard cataract surgery and implantation of intraocular lenses, which replace the eyes' natural lenses in order to provide vision correction. After surgery, distance and near vision improved dramatically in all but one of the Alzheimer's patients.

A neuropsychologist assessed the Alzheimer's patients for mood and depression, behavior, ability to function independently, and cognitive abilities at one month before and three months after cataract surgery. Cognitive status, the ability to perceive, understand and respond appropriately to one's surroundings, improved in 25 percent of patients. Depression was relieved in many of them, and the level of improvement was similar to what commonly occurs after cataract surgery in elderly people who do not have dementia. No changes were found in patients' level of autonomy, that is, their ability to function independently.

Sleep patterns improved and night time behavior problems decreased in most study patients. Other studies have shown that when cataracts are removed, levels of the sleep-regulating hormone melatonin become normalized. Dr. Girard notes that this may have been a key factor in the Alzheimer's patients' improved sleep patterns.

"We wanted to learn whether significant vision improvement would result in positive mood and behavior changes, or might instead upset these patients' fragile coping strategies," said Dr. Girard. "In future studies we intend to learn what factors, specifically, led to the positive effects we found, so that we can boost the quality of life for Alzheimer's patients, their families and caregivers."
The 115th Annual Meeting of the American Academy of Ophthalmology is in session October 23 through 25 at the Orange County Convention Center in Orlando, Fla. It is the world's largest, most comprehensive ophthalmic education conference.

About the American Academy of Ophthalmology

The American Academy of Ophthalmology is the world's largest association of eye physicians and surgeons — Eye M.D.s — with more than 30,000 members worldwide.

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Original content Bob DeMarco, the Alzheimer's Reading Room