Monthly Archives: July 2013

Decline in Dementia in Europe

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There was an interesting New York Times article this week about the lower rate of dementia in two recent European studies.

I hadn’t planned on sharing the article as it is more about Alzheimer’s than any of the non-AD dementias in our group, but the PBS NewsHour had a very nice interview tonight (July 17, 2013) on this news.  The PBS NewsHour interviewed Dr. Murali Doraiswamy, an Alzheimer’s researcher at Duke University, who was mentioned in the rate of dementia article below.

The PBS NewsHour segment is only seven minutes.  You can find a link to the segment plus a transcript here:

www.pbs.org/newshour/bb/health/july-dec13/dementia_07-17.html

(When I was watching the NewsHour live, the lead-in video showed Dr. Adam Boxer at UCSF.  But today’s segment was not about UCSF research.)

On the NewsHour, Dr. Doraiswamy noted that:

“We have to differentiate is the risk vs. the total numbers.  The total numbers of Alzheimer’s disease are going to climb upwards quite dramatically because older age and the rising number of people who live into their 70s, and 80s and 90s is a huge risk factor for Alzheimer’s.  But within each generation, what we’re seeing is a given person’s risk for developing Alzheimer’s might actually reduce and go down.”

Plus, Dr. Doraiswamy surmised that the decline in dementia was probably due to decline in vascular dementia “because we now have better ways to treat cardiovascular disease.”

Here’s a link to the New York Times article on these research findings:

www.nytimes.com/2013/07/17/health/study-finds-dip-in-dementia-rates.html

Dementia Rate Is Found to Drop Sharply, as Forecast
By Gina Kolata
New York Times
Published: July 16, 2013

Robin

 

 

 

“6 Mind Hacks That Keep Stress In Check”

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I’ve been taking a mindfulness-based stress reduction class at Palo Alto Medical Clinic, so the topic of using your mind to change your perception is of interest to me these days.  I thought this was a good, short article on six things you can do to keep “stress in check.”

The six stress management techniques include:

  • Be mindful of how you label things.
  • Erase and replace.
  • Use your imagination.
  • Look at your life as a movie.
  • Revisit what’s valuable.
  • Stop by a graveyard.

I especially liked “Look at your life as a movie.”  Here’s what the author has to say about this technique:

Look at your life as a movie.
You’re the director — you get to decide which events become catastrophe, and which don’t make the cut. This is a practice that involves stepping away. “Be the watcher rather than the reactor,” [Lauren E. Miller, author and stress expert] instructs. Look at a stressful moment as if it’s on screen — imagine the scene that initially caused you to feel stressed, and imagine your reaction to it. There’s a lot you can do with this power. You can add props (have the people who are making you feel threatened wear clown costumes, for example). You can make the aggressive characters in your life physically smaller, and decide that your voice is louder than all of the supporting actors of your life’s movie. Looking at a problem from this angle will remind you that you’re in control.

Here’s a link to the full article:

www.huffingtonpost.com/2013/07/16/stress-relief-tips-get-out-of-your-head_n_3562190.html

6 Mind Hacks That Keep Stress In Check (Really!)
The Huffington Post
By Kate Bratskeir
Posted: 07/16/2013 8:18 am EDT

Robin

 

 

“When Aggression Follows Dementia” (NYT 7-12-13)

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This post may be of interest to those dealing with dementia — all of the LBD caregivers, the majority of PSP caregivers, and some unknown percentage of CBD caregivers.  (Presumably no MSA caregiver is dealing with dementia.)

This article from Friday’s (July 12, 2013) “New Old Age” blog in the New York Times points out that a “sizable minority” of those with dementia — nearly 29 percent, according to a German study — have physically aggressive behavior.

Approaches mentioned in the article include:

  • placement in a suitable care facility
  • treatment of pain, infection, and depression
  • using “behavioral approaches to soothe aggressive responses,” such as letting the person with dementia have his/her way (and not arguing over tasks)
  • reduce stimulation in the environment
  • “adapt the way you communicate”
  • medication (the need for which should be re-assessed every so often)

Here’s a link to the article:

newoldage.blogs.nytimes.com/2013/07/12/when-aggression-follows-dementia/

The New Old Age: Caring and Coping 
New York Times
When Aggression Follows Dementia
By Paula Span
July 12, 2013, 4:38 pm

Robin

PSP on “The Doctors” (3 minutes), CBD and MSA mentioned (7-11-13)

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This email will mostly be of interest to the PSP folks, and maybe of passing interest to the CBD and MSA folks.

Local support group member Phil Myers sent me this info today.

Patricia Richardson, the actress who was on a show called “Home Improvement,” is the national spokesperson for CurePSP.  She was on “The Doctors” today (July 11, 2013).  “The Doctors” had segments today with actresses who played mothers on TV shows.

She talked about PSP, which is a disease her father had.  She mentioned CBD and MSA.  She said that the only person with PSP that we’ve heard of is Dudley Moore, and she said that Johnny Cash had MSA.  (I thought that the MSA community did NOT think Johnny Cash had MSA.)

When describing PSP, she said that it was a tauopathy, like traumatic brain injury that returning vets get and like football players.  I’m not aware that TBI injuries in war zones are connected with the protein tau.  Certainly, chronic traumatic encephalopathy (CTE) is a tauopathy that many athletes have been found to have on post-mortem brain examination.  CTE is caused in some way by repeated head trauma.

There was a graphic that came up when she talked that said 5 out of 100,000 people have PSP.  Ms. Richardson made the point that only one in three are diagnosed with PSP.  PSP is as common as ALS or Lou Gehrig’s Disease but people have heard of ALS.

Here’s a link to “The Doctors” webpage on today’s segment about health secrets from TV moms:

www.thedoctorstv.com/main/show_synopsis/1255?section=synopsis

On that webpage, scroll down to find a summary of info on PSP and a link to three short clips — 90-second PSP overview, 90-second comparison of PSP and Parkinson’s, and 50-second caregiver advice from Patricia Richardson.

I’ve copied the info from “The Doctors” website on PSP below.  (The details on the “synopsis” page were not all discussed in the segment with Patricia Richardson.)

Robin

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www.thedoctorstv.com/main/show_synopsis/1255?section=synopsis

Patricia Richardson on PSP Awareness
As the Home Improvement mom America could relate to, actress Patricia Richardson went from the TV limelight to being a national spokesperson for Cure PSP — an organization combating a rare and often misdiagnosed brain disease that claimed the life of her father and fuels her fight to find a cure.

“He probably had the disease [for] five or six years before we knew he did,” Patricia says. “We’re only really catching 1 in probably 3 people with it.”

PSP, or progressive supranuclear palsy, is a degenerative neurological disorder that causes abnormal movement, similar to that of Parkinson’s disease. People suffering from PSP develop sluggish body movement and stiffness, as well as balance problems and difficulty with eye and neck motility. PSP is caused by an inability to process natural waste from the cells in the brain. Most people can process this waste but for those with PSP, the waste remains in the brain and creates a protein that attacks the brain cells. Oftentimes, people are misdiagnosed with Parkinson’s and prescribed medication. If the medication proves ineffective, it signals that PSP may be the cause, as opposed to other brain diseases.

Approximately 5 people in every 100,000 will develop PSP, but only a third are diagnosed. Unfortunately, an official diagnosis usually occurs after death, when doctors can examine the brain during an autopsy to verify if the proteins that cause PSP are present. The best living diagnosis is if patients are not reacting well to their Parkinson’s medication. PSP usually develops in people in their 50s and 60s — not in the later years. The disease tends to last between five and 10 years, before patients die from related health complications, such as aspirational pneumonia and brain ulcers. Researchers speculate that there may be a genetic component to PSP, but the specific gene has yet to be identified.

(Note:  there’s a short ad before these video clips)

PSP Symptoms:
http://www.thedoctorstv.com/videolib/init/9405
This video is just over 3 minutes.  Caregiving and PSP are first raised about 1:33.  CBD and MSA are mentioned shortly thereafter.

PSP Explained:
http://www.thedoctorstv.com/videolib/init/9406
This clip is about a minute and a half.  It features Dr. Carlos Portera-Cailliau.  PSP is compared to Parkinson’s Disease.

Patricia Richardson’s Advice for Caregivers
http://www.thedoctorstv.com/videolib/init/9407
This clip is about 50 seconds long.  Patricia Richardson advises people to get into a patient advocacy group.  Caregivers are told to take care of themselves.  

Short Description of LBD (Northwestern Univ)

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Quite awhile ago, Dr. Brad Boeve, an expert in LBD, PSP, and CBD from Mayo Rochester, recommended Northwestern University’s website on primary progressive aphasia (PPA).  I was looking at the site for someone today.

Northwestern’s website has a very short webpage on LBD (Lewy Body Dementia) as well.  Looks like it hasn’t been updated in over a year.

I’m copying the webpage on LBD below because I think there can be value in short webpages that can easily be shared with friends, family, care facilities, and aides.

Robin

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brain.northwestern.edu/dementia/otherdementia/lbd.html

Lewy Body Dementia (LBD)

Overview

Lewy Body Dementia (LBD) is a disease that is related to Parkinson Disease, but has significant involvement of memory and thinking as well.

Symptoms

Like Parkinson Disease, people with LBD get slowed movements, stooped unsteady shuffling gait, loss of facial expression, and tendency to fall. Additionally, people with LBD also develop significant changes to memory and thinking. Commonly, they will have major fluctuations in their attention and awareness, which can last for significant periods of the day, or can be momentary. This may manifest as staring spells, spending most of the day sitting or sleeping, or difficulty following events. Oftentimes, the types of thinking changes will look like psychiatric disease like major depression, odd false beliefs (delusions) or seeing things that are not there (visual hallucinations).

Progression

Over time, both the movement and cognitive symptoms get worse. These symptoms tend to develop slowly, but somewhat quicker than in dementia of the Alzheimer type. Rarely, the symptoms may develop extremely rapidly.

Late in the course, people may develop problems with injuries from falls, immobility, or swallowing problems.

Diagnosis and Treatment

How it’s diagnosed
LBD is diagnosed based on the signs and symptoms above by a qualified doctor. Oftentimes, an MRI and basic bloodwork is done to make sure that there are no other explanations for the symptoms.

Medications
The movement problems in LBD can be treated with Parkinson Disease medication, such as carbidopa-levodopa. Depression and motivation problems may respond to antidepressants. Antipsychotic medications such as quetiapine can help behavior, psychiatric problems such as delusions and hallucinations, and with agitation, but can also worsen movements, so need to be used with caution. Alzheimer’s medications such as donepezil seem to help with the fluctuations in many with LBD.

Non-pharmacological interventions

Supportive treatment for problems with behavior, swallowing, speech and communication, falls and mobility are available. Many people with LBD benefit immensely from occupational therapy, physical therapy, and speech therapy.

This page last updated Jun 19, 2012