Archives for April 2013

Alzheimer’s Caregiver Information and Support Resources in the U.S.

(HBO) The following list of caregiver resources is provided by the HBO Alzheimer’s Project.


 

National Institute on Aging, National Institutes of Health

Alzheimer’s Disease Education and Referral (ADEAR) Center National Institute on Aging

P.O. Box 8250, Silver Spring, MD 20907-8250

1-800-438-4380 (toll-free)

This service of the National Institute on Aging (NIA) offers information and publications on diagnosis, treatment, patient care, caregiver needs, long-term care, education and training, and research related to Alzheimer’s disease. Staff members answer telephones, emails, and written requests, and make referrals to local and national resources. The ADEAR website offers free, online publications in English and Spanish; email alerts, and online Connections newsletter registration; an AD clinical trials database; the AD Library database; and a listing of the NIA’s Alzheimer’s Disease research centers around the United States and more.

Alzheimer's Association

Alzheimer’s Association

225 North Michigan Avenue, Suite 1700

Chicago, IL 60601-7633

1-800-272-3900 (toll-free)

The Alzheimer’s Association is the leading voluntary health organization in Alzheimer’s care, support, and research. The Alzheimer’s Association delivers education, support, and services for people diagnosed with Alzheimer’s, their families, caregivers, healthcare professionals, and the general public. Programs delivered at the nationwide level include a 24-hour helpline for information and referrals, online education and assistance at www.alz.org, housing- and care-finder services, an identification program designed to address wandering and return people home safely, and nationwide campaigns about the warning signs of Alzheimer’s, risk reduction, and the effects of Alzheimer’s on the brain. A network of local Chapters sponsors support groups and educational programs, and offers referrals to local resources and services. A wide variety of online and print publications and videos are also available. The Association is the leading non-profit funder of Alzheimer research.

Information and Support Resources

AARP

AARP

601 E Street NW

Washington, DC 20049

1-888-687-2277

With a membership of 40 million, AARP is the largest nonprofit, nonpartisan membership organization that helps people age 50 and older to improve the quality of their lives. AARP’s mission is to enhance the quality of life for all as we age, leading positive social change and delivering value to members through information, advocacy, and service. The website provides information about Alzheimer’s disease, caregiving, driver safety, checklists for choosing an assisted living center or nursing home, and many other topics of interest to older people and their families.

Administration on Aging Alzheimer's Resource Room

Administration on Aging Alzheimer’s Resource Room

U.S. Department of Health and Human Services

The mission of the Administration on Aging (AoA) is to help elderly individuals maintain their dignity and independence in their homes and communities through comprehensive, coordinated, and cost effective systems of long-term care, and livable communities across the U.S.

The Dana Foundation

The Dana Foundation

212-223-4040

The Dana Foundation is a private philanthropic organization with particular interests in neuroscience, immunology, and arts education. It supports the Dana Alliance, a nonprofit organization of more than 280 leading neuroscientists committed to advancing public awareness about the progress and benefits of brain research, and the Dana Press, which publishes books and, on dana.org, free online and print resources on the brain, immunology, and arts education.

Medline Plus

Medline Plus

U.S. National Library of Medicine

U.S. Department of Health and Human Services

MedlinePlus brings together the resources of the world’s largest medical library, The National Library of Medicine, in a format designed for the general public. There are directories, a medical encyclopedia and a medical dictionary, easy-to-understand tutorials on common conditions, tests, and treatments, health information in Spanish, extensive information on prescription and nonprescription drugs, health information from the media, and links to clinical trials.

Caregiving Support and Services

Children of Aging Parents

Children of Aging Parents

800-227-7294 (toll-free)

This nonprofit organization provides information and referrals for nursing homes, retirement communities, elder-law attorneys, adult day-care centers, insurance providers, respite care, assisted living centers, support groups, and State and county agencies. It also offers fact sheets, a newsletter, and conferences and workshops.

Eldercare Locator

Eldercare Locator

1-800-677-1116 (toll-free)

The Eldercare Locator is a nationwide service helping older adults and their caregivers locate local support and resources. It is a public service of the Administration on Aging, U.S. Department of Health and Human Services.

Family Caregiver Alliance

Family Caregiver Alliance

1-800-445-8106 (toll-free)

The Family Caregiver Alliance is a nonprofit organization that offers support services and information for people caring for adults with AD, stroke, traumatic brain injuries, and other cognitive disorders.

Medicare.gov/Caregiver

Medicare.gov/Caregiver Centers for Medicare and Medicaid Services (CMS)

U.S. Department of Health and Human Services

This website, designed to help caregivers navigate Medicare, addresses topics such as how to enroll, how to file a claim, help with billing, comparing facilities, getting in-home services, ways to pay for nursing homes, and planning for long-term care, getting legal help and a caregiving exchange.

National Academy of Elder Law Attorneys (NAELA)

National Academy of Elder Law Attorneys (NAELA)

703-942-5711

The National Academy of Elder Law Attorneys is a nonprofit association that assists lawyers, bar organizations, and others who work with older clients and their families. The Academy provides a resource of information, education, networking, and assistance to those who deal with the many specialized issues involved with legal services to seniors and people with special needs.

National Family Caregivers Association

National Family Caregivers Association

1-800-896-3650 (toll-free)

The National Family Caregivers Association helps educate and support people who care for loved ones with chronic illness, disability, or the frailties of old age. The Association offers an online library of information and educational materials, workshops, and other resources.

NCCNHR: The National Consumer Voice for Quality Long-Term Care

NCCNHR: The National Consumer Voice for Quality Long-Term Care

NCCNHR is a nonprofit, 501(c)(3) organization founded in 1975 to protect the rights, safety, and dignity of America’s long-term care residents. In 2007, the organization changed its name from the National Citizen’s Coalition for Nursing Home Reform (NCCNHR) to reflect its increasing involvement in assisted living, board and care facilities, and home and community based alternatives. For over thirty years, NCCNHR has worked with its members to carry out its mission to inform, educate and empower consumers; support citizen groups and ombudsman programs to be effective advocates for residents; promote best practices in care delivery and the enforcement of quality standards.

Caring Connections

Caring Connections

1-800-658-8898 (toll-free)

Caring Connections is a program of the National Hospice and Palliative Care Organization, a nonprofit organization that works to enhance the quality of life for people who are terminally ill. It provides information, resources, and referrals to local hospice services, and offers publications and online resources.

Well Spouse Association

Well Spouse Association

1-800-838-0879 (toll-free)

The nonprofit Well Spouse Association gives support to spouses and partners of people who are chronically ill and/or disabled. It offers support groups and a newsletter.

Research and Clinical Trials

Alzheimer's Disease Cooperative Study

Alzheimer’s Disease Cooperative Study

858-622-5880

The Alzheimer’s Disease Cooperative Study (ADCS) is a cooperative agreement between NIA and the University of California, San Diego, to advance research in the development of drugs to treat AD. The ADCS is a consortium of medical research centers and clinics working to develop clinical trials of medicines to treat behavioral symptoms of AD, improve cognition, slow the rate of decline caused by AD, delay the onset of AD, or prevent the disease altogether. The ADCS also develops new and more reliable ways to evaluate patients enrolled in clinical trials.

Alzheimer's Drug Discovery Foundation (ADDF)

Alzheimer’s Drug Discovery Foundation (ADDF)

The ADDF is an affiliated public charity of the Institute for the Study of Aging, funding drug discovery research for Alzheimer’s disease, related dementias, and cognitive aging.

Alzheimer Research Forum

Alzheimer Research Forum

The Alzheimer Research Forum is an online scientific community dedicated to understanding Alzheimer’s disease and related disorders. Established as an independent not-for-profit, the website reports on the latest scientific findings, creates and maintains public databases of essential research data and reagents, and produces forums to promote debate, speed the dissemination of new ideas, and break down barriers across the numerous disciplines that can contribute to the global effort to cure Alzheimer disease.

American Health Assistance Foundation

American Health Assistance Foundation

1-800-437-AHAF

The American Health Assistance Foundation (AHAF) is a nonprofit organization that funds research seeking cures for Alzheimer’s disease, age-related macular degeneration and glaucoma, and provides the public with information about risk factors, the latest research, treatments, risk reduction through healthy lifestyles, and ways to cope with the effects of these diseases.

ClinicalTrials.gov

ClinicalTrials.gov

ClinicalTrials.gov is an online registry of federally and privately supported clinical trials and studies conducted in the United States and around the world. Users can search for clinical trials and find information about each trial’s purpose, who may participate, locations, and phone numbers for more details.

National Cell Repository for Alzheimer's Disease (NCRAD)

National Cell Repository for Alzheimer’s Disease (NCRAD)

1-800-526-2839 (toll-free)

NCRAD is a national NIA-funded resource where clinical information and genetic material (DNA) can be stored from individuals with Alzheimer’s disease as well as from individuals without any symptoms of memory loss or dementia. NCRAD is part of a new effort to help researchers identify the genes that play a role in the development of Alzheimer’s disease. Contact NCRAD for information about ongoing AD genetics studies.

Professional Organizations

American Academy of Neurology

American Academy of Neurology

1-800-879-1960

The American Academy of Neurology (AAN), a professional association of more than 21,000 neurologists and neuroscience professionals, is dedicated to providing the best possible care for patients with disorders of the brain and nervous system, such as Alzheimer’s disease. In addition, the AAN Foundation raises money to fund vital research to help prevent, treat, and cure hundreds of neurologic disorders. The AAN Foundation also produces educational materials, including TheBrainMatters.org, a trusted one-stop resource to help those with neurologic disorders and their loved ones better understand common disorders of the brain, including Alzheimer’s disease. The AAN also publishes educational materials such as: the free patient magazine Neurology Now®, updates from its medical journal Neurology®, and AAN Guidelines that summarize research on diagnosing and providing treatment options for people with Alzheimer’s disease and their families.

Society for Neuroscience

Society for Neuroscience

202-962-4000

The Society for Neuroscience (SfN) is a nonprofit membership organization of scientists and physicians who study the brain and nervous system. The Society also promotes public information and general education about the nature of scientific discoveries and the results and implications of the latest neuroscience research, and produces a variety of publications, including a monthly newsletter and a primer on the brain and nervous system.

Citation

http://www.hbo.com/alzheimers/get-help.html

© 2015 Home Box Office, Inc. All Rights Reserved.

 

Obesity in the Elderly is Related to Late Onset Alzheimer’s Disease

Alzheimer Dis Assoc Disord. Author manuscript; available in PMC 2013 April 1.

Alzheimer Dis Assoc Disord. 2012 April; 26(2): 101–105.  doi:  10.1097/WAD.0b013e318222f0d4

Central obesity in the elderly is related to late onset Alzheimer’s disease

JA Luchsinger, MD, MPH, D Cheng, MPH, MX Tang, PhD, N Schupf, PhD, and R Mayeux, MD

Abstract

The evidence relating obesity measured with body mass index (BMI) in the elderly to late onset Alzheimer’ disease (LOAD) is conflicting. Central obesity in middle age is related to a higher risk of LOAD, but data in the elderly are lacking. We explored whether measures of central obesity, waist circumference (WC), and waist to hip ratio (WHR) were better predictors of LOAD compared to BMI in the elderly.

Participants were 1459 persons aged 65 years and older without dementia at baseline, with follow-up, and with anthropometric data from a longitudinal study of aging in New York City. Proportional Hazards regression was used for multivariable analyses relating BMI, WC, and WHR to LOAD. There were 145 cases of AD in 5,734 person-years of follow-up.

Only WHR was related to higher LOAD risk (HR of the 4th quartile compared to the first =2.5; 95% CI = 1.3, 4.7) after adjustment for age, sex, education, ethnic group, APOE-ε4, type 2 diabetes, hypertension, non-HDL cholesterol, HDL cholesterol and stroke. Measures of central obesity, particularly WHR, are better predictors of cardiovascular outcomes compared to BMI.

Our results support the notion that central obesity is related to a higher risk of late onset Alzheimer’ disease.

Citation

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3358415/

National Center for Biotechnology Information, U.S. National Library of Medicine

 

How to Assemble a Caregiving Team

(Fisher Center for Alzheimer’s Research Foundation) Whether it’s driving mom to the doctor, doing dad’s laundry, or providing 24/7 care to an aging relative, many Americans these days are familiar with the rigors of caring for a loved one. According to the Family Caregiver Alliance, 78 percent of adults in the U.S. who receive long-term care at home get all their care from family and friends, mostly wives and adult daughters.

For the caregivers, the task can be overwhelming. Studies show that caregivers are prone to depression, stress and anxiety. They’re also more vulnerable to high blood pressure, poorer immune function and an increased risk of dying.

The task is especially daunting if the care recipient suffers from Alzheimer’s disease—not just because the disease can be so challenging, but also because the responsibilities can last for years.

“When you’re dealing with someone with Alzheimer’s, you’re going to be doing it for a long time,” says Donna Schempp, program director for the FCA in San Francisco.

“Most people with Alzheimer’s have had it for 3 to 5 years before diagnosis and will have it for 5 to 20 years after diagnosis. When people start being a caregiver for someone with dementia, they often don’t think about the long haul.”

Taking a team approach to the task is essential for the caregiver to preserve her own well-being.

“If you don’t get help in caregiving, it’s going to hurt you,” Schempp says. “It’s going to hurt your body. It’s going to hurt your mental health. It’s going to hurt your spiritual health.”

To make matters worse, long-term caregiving often results in isolation for the caregiver.

“You’ll be surprised at how quickly you can become isolated from family and friends,” says Linda Rhodes, Ph.D., former secretary of aging for the state of Pennsylvania and author of Caregiving as Your Parents Age. Studies have found that the longer someone is a caregiver, the more cut off from others they become.

The only way to reduce the impact is to find others to pitch in.

“Having help eases the burden,” Schempp says. “And you don’t have to be in crisis before you look for help. You should get help along the way before a crisis happens.”

What’s Stopping You?

Many caregivers have a hard time asking for help. They may identify themselves as “The Caregiver” and have difficulty sharing that role with others. Or they may be perfectionists who think others won’t take care of mom the way they would.

“You’ll start to feel that it’s easier to just do things yourself, or your parent will become so dependent upon you that he or she never wants you to leave,” Rhodes says.

Some caregivers slip into the role so gradually that they don’t even think of themselves as caregivers. What starts out as making occasional meals for mom turns into a daily grind that involves doctor visits, grocery shopping and medication management.

It’s possible too, that some caregivers know they need help, but are unaware of the resources available to them in the community, or that they’re so immersed in the day-to-day duties that they don’t have time to seek help.

Many other caregivers simply have trouble accepting help from others.

“Caregivers seem to have difficulty asking for help for the person they are caring for and even for themselves,” says Marion Somers, Ph.D., author of Elder Care Made Easier.

What many caregivers fail to realize is that if they don’t care for themselves—and lighten the burden—there may be no one around to care for their loved one.

“It’s not surprising that many caregivers pass on before the person they are caring for does,” Schempp says.

To get in the practice of accepting help, Schempp recommends having a list of specific tasks that you need done—and keeping that handy.

“If someone asks, ‘Is there anything I can do?’ you need to learn to say yes,” Schempp says.

“And if you have that list, you can say, ‘Yes, I need someone to walk the dog, or I need someone to stay with him while I get my hair cut.’ The key is to be specific and to have a list of things for people, so they can pick the things that suit them.”

Schempp says many people actually enjoy helping out.

“People offering help actually feel good when they do something good for someone,” she says.

Identifying Helpers

If no one is offering any help, it’s time for you to take a more proactive approach to lining up a caregiving team. Start by identifying the tasks you need help with. Is it paying bills? Preparing meals? Driving to doctor appointments? Bathing and hygiene? After you know what needs to be done, it will be easier to identify the right people for the job.

When you’re looking for help, here are several resources to consider:

  • Family members. Turning to siblings is only natural if the person you’re looking after is a parent. Though you may be the lead caregiver, it’s critical to let others know that they need to play a role, too, even if it’s sending money, so you can put mom in adult day care a couple hours a week, or making phone calls to arrange dad’s appointments. But don’t forget other relatives, such as your spouse, children, aunts, uncles and cousins.
  • Friends and neighbors. Depending on the relationships you have, friends and neighbors can be another viable source of help. And while you may not ask a neighbor to do dad’s taxes, you might feel comfortable asking her to watch your kids while you run your mom to the doctor’s. Whatever you do, be clear about what you need them to do and how long you’ll need that help, Somers says. “People are more likely to lend a hand if the role and time commitment are both clearly defined,” she says.
  • Community organizations. Many communities have service groups set up specifically to help caregivers. The ElderCare Locator, sponsored by the Area Agencies on Aging, is one place to start. Another: Lotsa Helping Hands. You can also get information from local churches, senior centers, and government agencies. Once you start looking, you may find a whole network of services available to help.
  • Hired help. If you have the resources, you may consider hiring people to be part of your caregiving team. Hired help might include a geriatric care manager, who can help you plan and orchestrate your relative’s care, especially if you’re trying to do this long distance. You might also considering hiring a home health aide, house cleaning service, a handyman, lawn care or transportation services.
  • Support groups. Whether it’s in person or online, a support group should be part of any caregiver’s team—not so much for the recipient, but for the caregiver herself. A support group can serve as a place for you to vent your frustrations, ask questions about specific challenges and get information about community resources. Look for support groups through your local hospital’s community education program, Rhodes suggests. You can also find groups through health associations. Also, check www.ALZTalk.org and your local Alzheimer’s Association chapter.
  • Respite care. Most caregivers eventually need a break from the rigors of caregiving. That’s when you should find someone to provide respite care. Whether it’s a couple of hours a week at an adult day care or a weekend break provided by your sister, the goal is to give you time away from your duties to recharge.

“You have a right to take care of yourself, laugh, keep up your interests and not allow caregiving to consume you,” Rhodes says.

Citation

https://www.alzinfo.org/articles/assemble-caregiving-team/

By Winnie Yu

Copyright © 2016 Fisher Center for Alzheimer’s Research Foundation

 

8 Ways to Help Your Aging Parents

(Psych Central) As they age, our parents might need more help. But you might not know exactly how to lend a hand or even where to start. Plus, what do you do if your parents balk at your attempts to assist them?

While every situation is unique, Christina Steinorth, MFT, a psychotherapist and author of Cue Cards for Life: Thoughtful Tips for Better Relationships, offered her suggestions for helping aging parents.

1. Empathize with your parents.

Sometimes you might be taken aback by your parents’ frustration, moody behavior or neediness. In fact, on some days, they might be downright unpleasant to be around. But it’s important to be empathetic and understand where they’re coming from. According to Steinorth, “Aging is a series of losses — loss of employment, health and energy, friends, mobility, and independence.” Consider how you’d feel if you were in their situation, she said.

2. Call them regularly.

When Steinorth was researching her master’s thesis, the number one thing aging parents wanted from their kids was simply to hear from them. She suggested setting a reminder on your phone to check in with your parents and see how they’re doing.

3. Get other family involved.

When helping your parents, don’t take on all the responsibility yourself, unless you have to, Steinorth said. For instance, she knows of one family who emails updates to each other any time a sibling visits their parents. This not only provides information on their parents’ health and current situation, but it also makes it easier to coordinate visits and share responsibilities, she said.

Communication among family members also is key when parents need financial help. “Sometimes siblings will help offset expenses by giving your parents a little bit of money every month — they just need to know what the financial need is in order to be able to make the decision to help,” Steinorth said. (She also suggested seeing a financial advisor who specializes in elder care issues to discuss your options.)

4. Seek out potential problems.

Walk around your parents’ home, and scrutinize the surroundings for any necessary repairs or changes. For instance, look out for uneven flooring, handrails and well-lit hallways and stairs, she said. Also, check if essential items are within reach and emergency contact information is next to the phone. If something major requires repair, find out if your state offers low-interest loans to seniors, Steinorth added. She suggested visiting this website for more information.

5. Advocate for them.

If your parent has an illness, make sure both of you have a good grasp of what that means and what treatment entails. For instance, know the medications they’re taking and when they’re supposed to be taken. If you’re accompanying them to appointments, ask questions, and take notes, she said.

6. Encourage them to be active.

Many aging parents tend to be isolated, because they stop driving, get tired easily or have hearing or vision loss, Steinorth said. She stressed the importance of helping parents stay both socially and physically active.

“Talk to them about their friends, senior groups, and church or synagogue members. Find out what parks, the library, museums, nearby universities, and community centers offer in the way of organized activities.”

Physical activity is key for improving mood, endurance, balance and strength and delaying cognitive decline, she said. For instance, aging parents can walk, or participate in exercise programs for seniors.

7. Help them downsize without being bossy.

When helping your parents downsize, don’t tell them what they should and shouldn’t keep or toss anything unless you have their permission, she said. “Realize that your parents have many memories and treasure things that remind them of relatives and happy events — these are specific to the individual and just because you don’t see the value in certain items, doesn’t mean your parent shares your view.”

8. Help them create a memory book.

It’s common for seniors to experience short-term memory problems, according to Steinorth. Reminiscing might help. She suggested creating a scrapbook for your parents, filled with photos and names of the people, places and pets from their past. If you have time, work on the scrapbook together, she added.

What To Do When Parents Don’t Want Help

It’s not uncommon for parents to refuse their kids’ help. Try to have this conversation before your parents need immediate assistance, Steinorth said. If they’re not open to your help right now, over time, they might change their minds, she said.

Another approach is to ask others to intervene. For instance, you might ask your siblings, close relatives or even their doctor to talk to your parents, she said. “Sometimes hearing the need for additional help from an outside source can help your parents really hear what is being said and therefore may also make them more open to your help.”

Finally, if your parents are a danger to themselves or others and still refuse your help, contact the department of social services to step in, Steinorth said. Be prepared for your parents to be upset with you. But their anger will probably dissipate, she said, because they’ll be less emotional and understand you had their best interests and safety in mind (and in your heart).

Citation

By MARGARITA TARTAKOVSKY, M.S., Associate Editor

http://psychcentral.com/blog/archives/2013/04/20/8-ways-to-help-your-aging-parents/

Tartakovsky, M. (2013). 8 Ways to Help Your Aging Parents. Psych Central. Retrieved on April 23, 2013, from http://psychcentral.com/blog/archives/2013/04/20/8-ways-to-help-your-aging-parents/

Copyright © 1995-2016 Psych Central.

 

Efficacy of Naproxen, Celecoxib for the Prevention of Alzheimer’s Disease

Alzheimers Dement. 2013 Nov;9(6):714-23. doi: 10.1016/j.jalz.2012.11.012. Epub 2013 Apr 3.

Results of a follow-up study to the randomized Alzheimer’s Disease Anti-inflammatory Prevention Trial (ADAPT).

Alzheimer’s Disease Anti-inflammatory Prevention Trial Research Group.

Collaborators (88)

Abstract

Objectives

The Alzheimer’s Disease Anti-inflammatory Prevention Trial Follow-up Study (ADAPT-FS) was designed to evaluate the efficacy of naproxen and celecoxib for the primary prevention of Alzheimer’s disease (AD) several years after cessation of treatment in ADAPT.

Methods

ADAPT was a randomized, double-masked, multicenter scientific trial of naproxen or celecoxib vs placebo (1:1:1.5 project ratio) at six U.S.-based totally clinics. The trial enrolled 2528 folks between 2001 and 2004. treatments had been discontinued in December 2004 and individuals were monitored continuously unless 2007. In 2010 and 2011, ADAPT-FS screened 1537 contributors by way of telephone and, if indicated, examined them in particular person using standardized scientific assessments. the primary outcome was time to prognosis of ad. demise index searches were carried out for individuals now not located.

Results

Eighty-9 additional advert situations have been identified (24 celecoxib, 25 naproxen, and forty placebo) yielding a complete of 161 events (48 [6.6% of randomized participants] celecoxib, 43 [6.0%] naproxen, and 70 [6.5%] placebo) across ADAPT and ADAPT-FS. Adjusted hazard ratios (HRs) comparing every remedy with placebo confirmed no total reduction in chance of ad: HR celecoxib vs placebo, 1.03 (ninety five% self assurance interval [CI], zero.72-1.50; P = .86); HR naproxen vs placebo, zero.ninety two (ninety five% CI, 0.62-1.35; P = .66). there were 349 deaths (110 [15.2%] celecoxib, ninety six [13.4%] naproxen, and 143 [13.2%] placebo). chance of loss of life used to be identical for thenaproxen- and placebo-assigned teams (HR, zero.ninety nine; ninety five% CI, zero.seventy six-1.28; P = .93) and moderately higher for celecoxib in comparison with the placebo-assigned staff (HR, 1.15; 95% CI, 0.ninety-1.48; P = .27).

Conclusions

These results obtained all through a observe-up of roughly 7 years (which included a median of lower than 1.5 years of remedy) do not beef up the speculation that celecoxib or naproxen stop advert in adults with a domestic historical past of dementia.

Citation

 

Late-Life Depression, Mild Cognitive Impairment, and Dementia

JAMA Neurol. 2013 Mar 1;70(3):374-82.

Late-life depression, mild cognitive impairment, and dementia.

Richard E, Reitz C, Honig LH, Schupf N, Tang MX, Manly JJ, Mayeux R, Devanand D, Luchsinger JA.

Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.

Abstract

Objective

To evaluate the association of late-life depression with mild cognitive impairment (MCI) and dementia in a multiethnic community cohort.

Design and Setting

A cohort study was conducted in Northern Manhattan, New York, New York.

Participants

A total of 2160 community-dwelling Medicare recipients aged 65 years or older were included in the study.

Methods

Depression was assessed using the 10-item version of the Center for Epidemiological Studies Depression scale (CES-D) and defined by a CES-D score of 4 or more. We used logistic regression for cross-sectional association analyses and proportional hazards regression for longitudinal analyses.

Outcome Measures

Mild cognitive impairment dementia, and progression from MCI to dementia were the main outcome measures. We also used subcategories of MCI (amnestic and nonamnestic), and dementia (probable Alzheimer disease and vascular dementia, including possible Alzheimer disease with stroke).

Results

Baseline depression was associated with prevalent MCI (odds ratio, 1.4; 95% CI, 1.1-1.9) and dementia (2.2; 1.6-3.1). Baseline depression was associated with an increased risk of incident dementia (hazard ratio [HR], 1.7; 95% CI, 1.2-2.3) but not with incident MCI (0.9; 0.7-1.2). Persons with MCI and coexisting depression at baseline had a higher risk of progression to dementia (HR, 2.0; 95% CI, 1.2-3.4), especially vascular dementia (4.3; 1.1-17.0), but not Alzheimer disease (1.9; 1.0-3.6).

Conclusion

The association of depression with prevalent MCI and with progression from MCI to dementia, but not with incident MCI, suggests that depression accompanies cognitive impairment but does not precede it.

Citation

 

Art and Music Therapy for Alzheimer’s Disease

(WebMD) There is no known cure for Alzheimer’s disease. There are, however, many ways to treat symptoms and problems associated with the disease. Some Alzheimer’s treatments involve medications. Others are non-medical Alzheimer’s therapies like art, music, and more. The goal of an Alzheimer’s therapy is to help the person maintain a better quality of life.

Alzheimer’s therapies that draw on individual interests through structured activities can be beneficial. Which therapies might work best for your loved one with Alzheimer’s disease? Start to answer this question by thinking about his or her past hobbies or passions. Talk with the doctor as well, who may have more suggestions and resources for using these therapies effectively for Alzheimer’s disease.

Music Therapy for Alzheimer’s Disease

Music therapy has many benefits for Alzheimer’s disease. It may help by:

  • Soothing an agitated person
  • Sparking memories
  • Engaging the mind even in the disease’s later stages
  • Improving eating in some cases

Here are some tips for using music therapy to help your loved one:

  1. Golden oldies spark memories. Songs from the person’s youth often spark the most memories. In the later stages of Alzheimer’s disease, you may have to go back to songs learned in childhood. Encourage sing-a-longs. Try using a karaoke machine.
  2. Toe-tapping beats stimulate activity. Up-tempo dance tunes can help stimulate both mental and physical activity in Alzheimer’s patients. Encourage dancing, if possible.
  3. Easy listening can be soothing. Soothing music can help ease the anxietyand frustration felt by many people with Alzheimer’s disease. For example, lullabies at bedtime can help your loved one get into bed and fall asleep.

A person with Alzheimer’s disease may not be able to verbally communicate their likes and dislikes. Rely on other clues such as facial expressions to help you learn which songs are a hit and which aren’t. Ask friends or relatives for suggestions about the types of music or particular songs the person used to enjoy.

Art Therapy for Alzheimer’s Disease

Painting, drawing, and other forms of art therapy can help people with Alzheimer’s disease express themselves. Expression through art can become especially important as a person’s ability to communicate through words deteriorates.

Here’s how to get your loved one engaged in art therapy:

  1. Picture the past. Encourage a project that tells a story or evokes a memory. The project can be something that you can talk about together, both while the work is in progress and after it is finished.
  2. Free form. Keep instructions to a minimum to avoid confusion and frustration. Then, step out of the way as the work takes shape. If necessary, get things started by painting the first few brush strokes yourself to remind your loved one how it is done. Don’t forget that the picture is done when the person says it’s done, whether you think so or not.
  3. Don’t be a critic. If you don’t care for the colors chosen, keep it to yourself! Positive feedback and questions that encourage interaction are the best contributions you can make.

Other Alzheimer’s Disease Therapies

Other therapies can help enrich the life of a person with Alzheimer’s disease. Which therapies work best depends on the needs of  the individual.

  • Massage. This hands-on therapy may help in two ways. It can ease agitation and may improve sleep.
  • Pet therapy. People who used to enjoy being with pets may find contact with them enriching or soothing. Match the pet to the person’s needs. For example, a person who can walk may enjoy visiting with a dog. A person who is less mobile may enjoy petting a cat.
  • Previous hobbies. Pursuing hobbies or interests that used to be familiar can help a person with Alzheimer’s feel more stable about their lives. Consider gardening, cooking, or any other activity that the person used to enjoy. Try to work these activities into the person’s daily routines.
Citation

SOURCES: Alzheimer’s Association. Fisher Center for Alzheimer’s Research Foundation.

http://www.webmd.com/alzheimers/alzheimers-therapies-music-art-more?page=1

Reviewed by Jon Glass on March 13, 2012

© 2012 WebMD, LLC. All rights reserved.

 

Health Information on the Web: Finding Reliable Information

(American Academy of Family Physicians) It’s an old warning that is especially true for health-related information you find on the World Wide Web:

“Don’t believe everything you read.”

The Web can be a great resource when you want to learn about a specific disease or health condition. You can also find tips on staying healthy. But among the millions of websites that offer health-related information, there are many that present myths and half-truths as if they are facts.

To avoid unreliable health information when you’re surfing the Web, ask yourself the following questions:

Where Did This Information Come From?

Any website that provides health-related information should tell you the information’s source. See if you can find answers to the following questions:

  • Who wrote this information? Keep in mind that many health-related websites post information that comes from other sources. If the person or organization that runs the website didn’t write the information, the original source should be clearly stated.
  • If a health care professional didn’t write the information, was it reviewed by a doctor or another medical expert?
  • If the information contains any statistics, do the numbers come from a reliable source?
  • Does something on the webiste appear to be someone’s opinion rather than a fact? If so, is the opinion from a qualified person or organization (such as a doctor or medical organization)?

How Current is This Information?

Health information is constantly changing. For example, researchers continue to learn new things about various diseases and their treatments. You should know whether the health-related information you’re reading is up-to-date. Many Web pages will post the date on which the page was last reviewed or updated. You can usually find this date at the very bottom of the page. If this date isn’t included, check to see whether the page has a copyright line. This tells you when the information was originally written. If the page you’re reading hasn’t been reviewed in the past year, look for more recently updated information.

Remember

Information that you find on a website does not replace your doctor’s advice. Your doctor is the best person to answer questions about your personal health. If you read something on the Web that doesn’t agree with what your doctor has told you, ask him or her about it.

Who is Responsible for the Content of the Website?

Before you believe any health-related information you find on the Web, find out who is responsible for information on the site. The easiest way to do this is to look at the site’s home page. If the home page doesn’t tell you who publishes the site, look for a link that says “About us” or “About this site.” Often, this link will be at the bottom of the home page. Clicking on this link will usually take you to a page that explains what person or organization is responsible for the information on the site.

Websites published by an organization. Health-related websites may be published by the U.S. government (.gov), a nonprofit organization (.org) or a college or university (.edu). These sites may be the most reliable sources of health information because they’re usually not supported by for-profit companies, such as drug or insurance companies. However, you still need to find out where these sites get their information.

Sites with .com Web addresses may represent a specific company or be published by a company that uses the Web to sell products or services. These are called commercial sites. Commercial sites can offer useful and accurate information. You may want to be more careful about believing the information you read on these sites, though. The information may not be fair and accurate if the company that pays for the site has something to gain from it. It’s a good idea to double-check information you read on commercial websites.

Websites published by an individual. Websites published by individuals may offer support and advice about coping with certain conditions and their treatments. These sites can contain reliable and useful information. However, it’s very important to double-check health information you see on a website published by an individual. While many of these sites contain good information, some may contain myths or rumors.

Other Organizations

Citation

http://familydoctor.org/familydoctor/en/healthcare-management/self-care/health-information-on-the-web-finding-reliable-information.html

Written by familydoctor.org editorial staff

Copyright © American Academy of Family Physicians