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Our Caregiver's e-Mall is filling up with great stores and a growing number of items just in time for the holidays. Whether you browse and find a book or tape to help you with caregiving, or come across a wonderful gift for a friend or family member, the e-Mall can be your source for easy shopping and gift-giving.

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Posted: April 27, 2005

Professional Caregiving

Update on Alzheimer's Disease -- Steps We Can Take

There is new research that enlightens us further on ways to minimize the onset of dementia, in as much as we have control at all.

We know there are approximately 15 years of slow, latent brain plaque development prior to the onset of dementia symptoms that insidiously increase, finally warranting a medical evaluation. When diagnoses are made, symptoms have usually been evident, often only in retrospect, for two years on average. Denial is a strong force, and when the beginnings of functional lapses begin to show, we often assign them to overwork, poor sleep or nutrition, stress, or depression, when in fact they are the hallmark signs of early stage dementia-memory loss, word finding disturbance, and skill loss.

The development of diffuse plaques in the initial decade of the disease is one of much study in the neurosciences -- if the plaque can be managed, stopped or minimized, would that then extend the time a person could go before symptoms appear?  One would suppose so, but the science is extraordinarily complex.

Here is a simplified version of a very complex process: plaques are a collection of sticky amyloid proteins that have been snipped from the neuron at a particular point -- the beta juncture -- which causes the protein to collect in dense deposits, disrupting the work of the neurons.  Their job is to communicate with one another to carry out metabolic and repair tasks.  If the enzymes that snip the protein can be trained to separate at a different spot, the fragment then is chemically soluable and easer to clear, minimizing the collection of sticky deposits that create plaque.

Drugs

Aricept, Exelon and Reminyl are therapies that reduce the acetylocholine neurotransmitter deficit that is the end result of the plaques and tangles, the condition that in an autopsy points to an Alzheimer's diagnosis.

There are also cerebral electrical signals that become damaged and the drug Memantine, or Namenda, is used for this condition.

Alzheimer's can be caused by both genetic and environmental factors, and there are some steps that we can take to at least strengthen our brain health in as much as we are able to influence it. 

A Johns Hopkins neuroscientist, Ann Morrison, Ph.D, who has studied dementia for more than 20 years, suggests a few steps that she subscribes to:

Exercise

Exercise for our brain health?  The answer is yes, based on two new studies (Karstein, March 2005 and Sisodia, March 2005), that found that genetically identical mice, pre-disposed for Alzheimer's disease, had very different outcomes when placed in environments, one with no stimulation and the other enriched stimulation. They ate the same food and water, but one group had running wheels and colored tubes to crawl through, and the other group had just the food, water and no other stimulation.  Again, both sets of mice would eventually succumb to Alzheimer's disease, but the group in the enriched, more physically and mentally challenging environment had 50% fewer amyloid deposits in their brains than their couch potato twins!

This research means all kinds of exercise and mental stimulation should be offered throughout the aging delivery service continuum --   to entice all people in our care and their caregivers (and us, too!), to partake in mental and physical exercise regularly, even if it means offering bonuses or freebies to those who do. Enrich the environment and we can have considerable impact on delaying the symptoms of Alzheimer's.

Vitamins

New findings have corroborated the recommendation to take Vitamin E and C daily to decrease the risk of AD. This is only a preventative measure as research has not shown that Vitamin E slows the progression of Alzheimer's disease.

Diet

This is bad news for salmon, mackerel and sardines, but we should all be consuming these fish for their Omega 3 and Omega 6 fatty acids which keep the lipids in our brains healthier and suppler. Low fat, low salt, lower caloric intake and reduced glucose sugars are the recommendations for improving one's brain health.  Reducing high glucose levels caused by processed and sugary foods will keep insulin levels lower, which maintains our brain's vascular health when kept at a low, stable place. Arteries that are occluded and brittle cannot maintain a healthy blood flow that is necessary for good circulation.

So not only for our figures, or the upcoming swim suit season, or even our general physical health, should these steps be followed, but to maintain our brain health as an ongoing effort to delay the symptoms of dementia, even if we are pre-disposed to contract the disease.

_____

Sylvia Nissenboim is a licensed clinical social worker and who has been working in the field of adult day services in the St. Louis area. She is the director of four adult care and enrichment centers for the American Red Cross and also operates a personal and professional coaching firm, LifeWork Transitions, specializing in caregiving concerns, adult day care management and other aging services, such as virtual coaching and family care giving support groups. She co-authored The Positive Interactions Program, is a national speaker, and has served as president of the Missouri Adult Day Care Association and as a member of the Missouri Governor's Advisory Council on Aging..

© 2005 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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