CAREGIVER: STRESSED OUT? ADVICE TO HELP YOU COPE

Sometimes, the pressure of caring for someone who is elderly or who has a chronic illness can lead to stress and a condition called "Caregiver Burnout." To prevent this, it's essential to know how to manage your stress.

WHAT IS STRESS?

Stress is a reaction to changes that require you to adjust or respond. Our bodies are designed to feel stress and react to it. Not always a bad thing, stress keeps us alert and ready to escape danger.

It's not always possible to avoid change or the situations that can cause stress; as a result, you can begin to feel overwhelmed and unable to cope. When it persists, stress can affect the body's immune system, leading to illness. The key to coping with stress is to identify the causes of stress in your life, then learn healthy ways to deal with them. It's important to remember that stress comes from how you respond to stressful events. Therefore, you have some control over stress and how it affects you.

WHAT CAUSES STRESS?

Stress can be caused by anything that requires you to adjust to a change in your environment. Your body reacts to these changes with physical, mental, and emotional responses. We all have our own ways of coping with change, so the causes of stress can be different for each person. Becoming a caregiver is a common source of stress for many people.

When you are not sure of the exact cause of your stress, it may be helpful to know the warning signs. Once you can identify these signs, you can learn how your body responds. Then you can take appropriate steps to reduce the stress.

WHAT ARE THE WARNING SIGNS OF STRESS?

Your body sends out physical, emotional, and behavioural warning signs of stress.

Emotional Warning Signs:
• Anger
• Inability to concentrate
• Unproductive worry
• Sadness
• Frequent mood swings

Physical Warning Signs:
• Stooped posture
• Sweaty palms
• Tension headaches
• Neck pain
• Chronic back pain
• Chronic fatigue
• Weight gain or loss
• Problems with sleep

Behavioural Warning Signs:
• Over-reacting
• Acting on impulse
• Using alcohol or drugs
• Withdrawing from relationships
• Changing jobs often

What Can I Do to Reduce Stress in My Life?

Finding ways to reduce stress will help lessen the long-term emotional and physical toll of care-giving. Tips for managing stress include:
• Keep a positive attitude. Believe in yourself.
• Accept that there are events you cannot control.
• Be assertive instead of aggressive. "Assert" your feelings, opinions, or beliefs instead of becoming angry, combative, or passive.
• Learn to relax.
• Exercise regularly. Your body can fight stress better when it is fit.
• Stop smoking.
• Limit yourself to moderate alcohol and caffeine intake.
• Set realistic goals and expectations.
• Get enough rest and sleep. Your body needs time to recover from stressful events.
• Don't rely on alcohol or drugs to reduce stress.
• Learn to use stress management techniques and coping mechanisms, such as deep breathing or guided imagery.

Coping Mechanisms:

Most people don't have a plan for coping with stress. Fortunately, there are a number of techniques that you can use to help deal with stress, such as:

• Two-minute relaxation - Switch your thoughts to yourself and your breathing. Take a few deep breaths, exhaling slowly. Mentally scan your body. Notice areas that feel tense or cramped. Quickly loosen up these areas. Let go of as much tension as you can. Rotate your head in a smooth, circular motion once or twice. (Stop any movements that cause pain.) Roll your shoulders forward and backward several times. Let all of your muscles completely relax. Recall a pleasant thought for a few seconds. Take another deep breath and exhale slowly. You should feel relaxed.
• Mind relaxation - Close your eyes. Breathe normally through your nose. As you exhale, silently say to yourself the word "one," a short word such as "peaceful," or a short phrase such as "I feel quiet." Continue for 10 minutes. If your mind wanders, gently remind yourself to think about your breathing and your chosen word or phrase. Let your breathing become slow and steady.
• Deep breathing relaxation - Imagine a spot just below your navel. Breathe into that spot, and fill your abdomen with air. Let the air fill you from the abdomen up, then let it out, like deflating a balloon. With every long, slow breath out, you should feel more relaxed.
• Guided imagery - Guided imagery is a meditative technique that involves focusing on a particular sensory image to create a specific physical reaction. Guided imagery (also called guided meditation) is a form of mind-body therapy that can bring about deep relaxation and positive focus, the state of mind and body most conducive to healing. Guided imagery also can be used to release tension, anxiety, and stress.
• Biofeedback - Biofeedback helps a person learn stress-reduction skills by providing precise, immediate information about muscle tension, heart rate, and other vital signs as a person attempts to relax. It is used to learn total body relaxation and also to gain control over certain physiological functions that cause tension and physical pain.
• Behavioural changes - Changing certain thought patterns and behaviours can help you better manage difficult situations and stress. Examples include checking your assumptions, sharing your expectations with others, being assertive, exercising and eating healthy, focusing on positive relationships, forgiving, communicating feelings, listening, and rewarding yourself and others.

By recognizing your warning signs and taking steps to reduce the stress in your life, you should be able to cope more easily with the pressures of being a caregiver.

(Source: WebMD - http://www.webmd.com/healthy-aging/caregiving-insights/handle-stress)

HEART DISORDER ALZHEIMER'S LINK

A common heart disorder has been linked to a raised risk of Alzheimer's disease by US researchers.

Atrial fibrillation causes the heart to beat chaotically, increasing the risk of blood clots and, if the condition is left untreated, stroke.

It has previously been linked to some types of dementia - but not Alzheimer's, the most common form.

The study based on more than 37,000 patients found atrial fibrillation patients under the age of 70 had a 187% greater risk of all types of dementia compared with the general population.

But their specific risk of Alzheimer's disease was also up - by 130%. However, the overall risk of Alzheimer's for all patients remained low.

The Researchers said previous studies have shown that patients with atrial fibrillation are at higher risk for some types of dementia, including vascular dementia. But to their knowledge, this is the first large-population study to clearly show that having atrial fibrillation puts patients at greater risk for developing Alzheimer's disease.

Alzheimer's, which accounts for up to 80% of all dementia cases, is known to be linked to age and genetics.

It has long been suspected that poor heart health may also play a role.

Various Theories

The Researchers said more research was needed to explain why atrial fibrillation may raise the risk of Alzheimer's.

They put forward several theories for a possible link. They suspect atrial fibrillation damages the small blood vessels, potentially reducing blood flow to the brain.

Alternatively, the condition is linked to tiny micro-strokes, the damage from which may accumulate over time, making Alzheimer's more likely.

Thirdly, atrial fibrillation is associated with a general increase in inflammation throughout the body, again a possible risk factor for Alzheimer's.

Now that they've established this link, their focus will be to see if early treatment of atrial fibrillation can prevent dementia or the development of Alzheimer's disease.

Rebecca Wood, Chief Executive of the Alzheimer's Research Trust, said: "If research helps us understand the relationship between the two conditions, we will be in a better position to develop desperately needed new treatments."

"We can all lower our dementia risk by maintaining a balanced diet and taking regular exercise, which is also good advice for protecting your heart."

Alasdair Little, cardiac nurse at the British Heart Foundation, said: "This is an interesting study which adds weight to previous data indicating a link between atrial fibrillation - a common disturbance of heart rhythm - and dementia.

"The risk factors for heart disease and dementia are very similar so it is not surprising that in some people they co-exist.

"Further research into both conditions is needed to understand whether there is a causal link between the two."

Details of the study were presented to the Heart Rhythm Society in Boston.

(Source: BBC NEWS, 15 May 2009: http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/8051800.stm)

WARNING SIGNS : A NEW TEST TO PREDICT ALZHEIMER'S

Researchers at the University of California, San Francisco (UCSF), and the University of Pittsburgh have developed the first screening tool that can help predict whether elderly patients are at low, moderate or high risk of developing dementia. The new test takes into account characteristic risk factors for dementia, including advanced age and the presence of genes associated with Alzheimer's, but also relies on lesser-known contributors such as patients' body weight and alcohol-drinking habits.

Detecting the earliest signs of memory loss and dementia - the broader category of age-related conditions of mental decline, up to 80% of which are Alzheimer's - has always been a major goal of researchers. While there is no cure for Alzheimer's, the earlier patients are diagnosed, the sooner they can make lifestyle changes that may help slow the progression of the neurodegenerative disorder. But so far, no test has proven dependable enough to help patients predict their true risk; even the presence of genes known to be associated with Alzheimer's does not reliably lead to the disease.

To date, the only other major screening tool for Alzheimer's was developed by Finnish scientists in 2006. However, that screen is targeted toward a younger population and designed to identify the highest-risk individuals in midlife. But considering how many factors may intervene between midlife and the 60s - the decade in which Alzheimer's typically sets in - Deborah Barnes, a Professor of Psychiatry at UCSF, says she wanted to develop a screen for the older population more likely to be at immediate risk of the disease.

"It's important to figure out who is at high risk and low risk, so that as we develop tools for prevention, we can try to target our prevention efforts at people with the highest risk for developing dementia," says Barnes, Lead Author of the new report published today in the Journal Neurology.

Barnes and her colleagues studied 3,375 patients age 65 years or older who were enrolled in a study analyzing heart disease and cognition. Researchers recorded which of the patients developed dementia in the six-year study period, then isolated the risk factors that appeared to make dementia more likely. Many factors were considered: age, genetic risk factors, mental health status, depression, physical fitness, alcohol consumption, fine motor skills and social support. In the end, only a handful of factors, arranged on a 15-point scale, emerged as being highly predictive of dementia.

Volunteers who scored eight points or higher on the index - which includes older age, worse cognitive function, some heart disease risk factors and the presence of genes linked to Alzheimer's - were at high risk of developing dementia within six years; 56% of these high scorers showed serious mental decline by the end of the study period. Of those scoring lower on the index, deemed at moderate or low risk, 23% were diagnosed with dementia.

Many of the risk factors included in the new screen are familiar: advanced age and the presence of Alzheimer's genes (which are associated with the growth of fatty plaques and tangles in the brain that gum up neural connections), for example, have long been clearly linked to dementia. Even heart disease risk factors are somewhat expected, since recent studies show that the same conditions that boost the risk of heart attack, such as high cholesterol, hypertension and atherosclerosis, may also raise the risk of dementia; the theory is that whatever is causing fat deposits in heart vessels may also contribute to fat and protein deposits in the Alzheimer's brain.

But some of the elements in the index were more surprising. The research team found, for instance, that patients who were underweight, did not drink alcohol and took longer to put on and button a shirt were also at high risk for dementia. Barnes speculates that fine motor skills, such as those required to button a shirt, may be one of the first things to suffer as neural connections in the brain succumb to dementia. As for the alcohol connection, she suggests that people who drink alcohol may simply be healthier overall and therefore less vulnerable than others to mental decline. "It's possible that someone who is still enjoying a glass of wine each day is in better health," Barnes says.

But she warns that it's too early to encourage elderly patients to start drinking in order to stave off senior moments. "Since alcohol is contraindicated with so many medications today, sicker people who are taking medications may have had to cut alcohol out," she says.

Still, the screening tool may be extremely useful in prompting high-risk people to start doing whatever they can to protect themselves from future memory loss. "This study has taken a number of earlier findings on risk factors and combined them into a fairly impressive predictor of risk," says Dr. Ralph Nixon, vice chair of the Medical and Scientific Advisory Council for the Alzheimer's Association. The new index accurately predicts dementia in 81% of cases. (The midlife tool predicts dementia accurately 78% of the time.)

So, what should high scorers do? For one, they can build a rich social network of friends and family, and engage aggressively in ways that challenge their mental as well as physical capabilities. "I truly believe that a lifestyle that incorporates greater socialization and greater use of the mind is what is most important for reducing risk of Alzheimer's," says Nixon, who is also Director of the Center of Excellence on Brain Aging at New York University Langone Medical Center. And if this screen can inform more people about their risk of developing dementia - and encourage younger folks to start taking precautions early - perhaps they will be able to prevent the disorder from occurring in the first place.


(Source: Time, May 14, 2009)
http://news.yahoo.com/s/time/20090514/hl_time/08599189803400/print

DELIRIUM EPISODES COULD HASTEN ALZHEIMER'S-LINKED DECLINE

The delirium sometimes experienced by people with Alzheimer's who are hospitalized might accelerate their cognitive decline, a new study shows.

Researchers found that people with Alzheimer's who had an episode of delirium while in the hospital had a rate of cognitive decline that was three times faster than that of those who didn't experience delirium.

"From a clinical standpoint, this study suggests that over 12 months, patients with AD [Alzheimer's disease] who become delirious experience the equivalent of an 18-month decline compared to those who do not experience delirium," the study's authors wrote.

What might an 18-month decline in cognitive ability signify for the average person with Alzheimer's? That can vary depending upon the individual, according to Dr. Tamara D. Fong, an Instructor of Neurology at Harvard Medical School and the Study's Lead Author.

For example, someone who is mildly forgetful about the details of a conversation might not, 18 months later, be able to drive, balance a check book or recognize relatives not frequently seen.

But there was good news in the findings as well.

"Delirium is preventable, so we can actually design an intervention for a disease for which we have no cure at the present time," she said. Prevention strategies would probably involve multiple components, including such things as making sure people with Alzheimer's who are hospitalized have their glasses and hearing aides on so that they remain as oriented as possible and keeping them out of the hospital by foregoing elective surgeries.

Further training about delirium for hospital staff also might help. "Delirium is sometimes hard to diagnose and probably is under-recognized, even in a hospital setting," she said.

The study, published in the May 5 issue of Neurology, compared the speed of cognitive decline among 408 people with Alzheimer's, 72 of whom developed delirium during the course of their illness.

Delirium is a state of extreme confusion that occurs suddenly and can be short-lived or more long-term. It usually develops in the context of infections, hospital surgeries and medication changes.

This could put the value of elective surgery for people with Alzheimer's into question, she said, adding that further research might be needed to evaluate the risk/benefit ratio. Also, because surgery and anesthesia remain big risk factors for delirium, it might be better to rely on an epidural rather than general anesthesia for people with Alzheimer's who have hip replacement surgery.

Dr. Gary Kennedy, Director of Geriatric Psychiatry at Montefiore Medical Center in New York City, speculated that better control over anesthesia might boost the safety of elective surgeries for people with Alzheimer's. This implies that if you're especially vigilant about preventing delirium, maybe those elective hospitalizations are a bit safer after all.

Some sleep medications, antihistamines and antibiotics as well as anesthetics also have been associated with higher risk for delirium, Fong added.

Kennedy is hopeful that future research will look at the difference between people with Alzheimer's who are hospitalized for elective procedures, such as hip or knee replacement, and those who are hospitalized via the emergency room because of an illness. That distinction might help clarify what impact illness has on the development of delirium.

(Source: HealthDay News, May 6, 2009)

BRAIN SCANS SUPPORT COGNITIVE RESERVE THEORY FOR PREVENTING ALZHEIMER'S

Education may provide mental reserves that help to keep the brain agile into old age. Those are the findings of a new study from researchers at Washington University School of Medicine in St. Louis.

Other studies have shown similar correlations between years of education and risk of Alzheimer’s disease. But the current study suggested that even those individuals whose brains appeared “scarred” by Alzheimer’s could still be cognitively normal, especially if they had received more years of formal education.

The Researchers found that seniors with the most years of formal education scored higher on tests of memory, learning and thinking compared to those who spent the least time in school. In fact, many of the highly educated individuals who did well on the memory tests were shown by imaging tests to have the same kind of damage seen in the brains of those with Alzheimer’s disease. The findings were published in the Archives of Neurology, one of the medical journals from the American Medical Association.

The findings support the cognitive reserve theory, which refers to the brain’s ability to nurture healthy brain cells and connections between them. As people age, diseases like Alzheimer’s ravage the brain with the buildup of toxic proteins that form plaques and tangles. But according to the cognitive reserve theory, if enough healthy brain cells and brain cell connections remain, people can escape symptoms like memory loss and disordered thinking that are typical of Alzheimer’s disease.

Education is thought to boost cognitive reserve. Intellectual challenges to the brain early in life from schoolwork are thought to build brain cells and enrich the connections between them, effects that may be maintained into later years.

Earlier studies of normal aging have found that higher levels of educational attainment were associated with less cognitive and functional decline. And having few years of formal education has also been linked to an increased risk of Alzheimer’s. A study last year from Finland found, for example, that teenage dropouts were at higher risk of developing Alzheimer’s years later than those who got their diplomas and continued with further study.

Intellectually stimulating careers and hobbies, like learning a new language, playing a musical instrument or doing crossword puzzles or word games, build extra brainpower. Healthier brain cells and connections may help compensate for the rise in Alzhiemer’s-like brain changes that accompany normal aging.

What the Study Showed:

In the study, Catherine M. Roe, Ph.D., and Colleagues at Washington University studied nearly 200 seniors (mean age 67) over a five-year period. Thirty-seven had a diagnosis of Alzheimer’s disease, while 161 had no signs of dementia.

The Researchers injected the study participants with a radioactive substance called Pittsburgh compound B, and then scanned their brains using an advanced imaging technique called positron emission tomography, or PET. The imaging agent, developed by Scientists at the University of Pittsburgh Medical Center, indicates brain areas damaged by Alzheimer’s by attaching to deposits of beta-amyloid, the toxic protein that builds up and forms plaques in the brains of those with the disease.

In the study, certain individuals’ brains absorbed the most Pittsburgh compound B, an indication that their brains were riddled with the greatest numbers of beta-amyloid plaques. But the more years of education that they had, the less likely they were to perform poorly on memory and thinking tests. In other words, their education seemed to protect them against the memory loss and other sympt oms of Alzheimer’s disease.

“The results support the hypothesis that cognitive reserve influences the association between Alzheimer’s disease pathological burden and cognition,” the Authors wrote.

It is thought that symptoms of Alzheimer’s would eventually emerge as beta-amyloid plaques continue to accumulate, even in the most highly educated people. But for many seniors, living into their 70s and 80s sharp as a tack, education and mental stimulation is thought to strengthen cognitive reserve and possibly protect against Alzheimer’s. And many people will die of other causes before the effects of Alzheimer’s become evident.

Further testing of individuals living into old age will allow Researchers to continue to test this theory. In the meantime, stay in school, turn off the TV, and do crossword puzzles or word games to help stimulate and maintain the brain.

(Source: Alzinfo.org, The Alzheimer's Information Site, 13 April 2009)
a href='http://www.alzinfo.org/newsarticle/anmviewer.asp?a=345'>Brain Scans Support Cognitive Reserve Theory for Preventing Alzheimer’s

READING, CRAFTS HELP KEEP THE BRAIN YOUNG

More good news on the neurobics front: Reading books, playing games or engaging in computer activities or crafts like pottery or quilting helps keep the brain young into old age, according to a new report. And while reading was good for the brain, watching too much TV seemed to be bad for it.

The findings, to be presented at the American Academy of Neurology’s 61st Annual Meeting in Seattle in late April, add to a growing body of evidence that mental challenges, or “neurobics,” like crossword puzzles and word games help keep memory and thinking sharp.

The research, from the Mayo Clinic in Rochester, Minn., involved a random sampling of 1,321 men and women in their 70s and 80s. Among the participants, 197 had mild cognitive impairment, a form of memory loss that sometimes precedes Alzheimer’s disease. The remainder had no memory problems.

Both groups filled out questionnaires about their everyday activities during the previous year. They also answered questions about what they engaged in during middle age, when they were in their 50s and 60s.

The researchers found that during the later years, those who regularly engaged in mentally-stimulating tasks like reading, crafts and computer activities were 30 to 50 percent less likely to suffer from serious memory loss compared to people who did not do those activities. People who watched television for less than seven hours a day as seniors were 50 percent less likely to develop memory loss than people who watched TV for more than seven hours a day.

People who participated in social activities and read magazines during middle age were about 40 percent less likely to develop memory loss than their less social peers or those who read less frequently.

“This study is exciting because it demonstrates that aging does not need to be a passive process,” said study author Yonas Geda, M.D., M.Sc., a Neuropsychiatrist at the Mayo Clinic. “By simply engaging in cognitive exercise, you can protect against future memory loss.”

The Researchers warned that these kinds of studies, which depend on participants’ recall of long past events, can be unreliable. But a growing body of evidence points to the benefits of mental stimulation in helping to ward off memory loss. Such activities may help to preserve and strengthen connections between brain cells in areas of the brain critical for memory.

(Source: Alzinfo.org Newsletter, 13 April 2009)
a href='http://www.alzinfo.org/newsarticle/anmviewer.asp?a=346'>Reading, Crafts Help Keep the Brain Young

10 TIPS FOR KEEPING THE BRAIN SHARP INTO 2009

One piece of excellent news in the past year was that brain health seems to be improving among older Americans. A large national survey from the University of Michigan found that over a 10-year-period ending in 2002, memory loss and thinking problems were down significantly among seniors aged 70 and up, from 12.2 percent to 8.7 percent. That’s a change that translates into hundreds of thousands of men and women, though Alzheimer’s is still a top concern for millions worldwide.

Researchers aren’t sure why the decrease in cognitive impairment is occurring, but they suspect that a better educated and more affluent older generation that is less likely to smoke and more likely to eat better and get regular exercise may be helping to keep the brain young. Here’s a roundup of ALZinfo.org's Wellness and Prevention stories from the past year that may help set the tone for a brain-healthy new year.

1. Stay Mentally Challenged
Seniors who engage in reading books or newspapers, doing crossword puzzles and word or card games, or who attend adult education classes may be more likely to ward off Alzheimer's as they age. Researchers at Columbia University in New York found that participation in intellectual and social activities among seniors was associated with fewer cases of Alzheimer's disease.

2. Practice Good Waist Management
Having a thick middle in the middle years increases the risk of developing Alzheimer's disease, a study of more than 6,500 adults from Northern California found. Belly fat, in particular, may be bad for the brain. Having a large abdomen increased the risk of dementia regardless of whether someone was normal weight, overweight or obese.

3. Work It
Another study, from Duke University, found that having a job that challenges the intellect may help to keep the mind sharp into old age. And the more complex the job, the better memory and thinking skills held up after retirement. The jobs that proved most beneficial included careers like law, medicine and journalism. But any tasks that required complex organization, decision-making and multi-tasking boosted brain function late into life.

4. Stay in School
Research continues to show that the more years of formal education someone has, the lower the risk of Alzheimer's disease. Most recently, investigators in Italy showed that men and women who had many years of schooling and who went on to work in demanding jobs were much more likely stay mentally alert into old age. Even though their brains had many of the changes typical of Alzheimer's disease, education seemed to protect them against memory loss and problems with thinking.

5. Maintain an Active Social Life
Men and women who remained socially connected with friends and family as they aged had sharper memories, a study from the Harvard School of Public Health reported. The findings add to a growing body of evidence that active social engagement is key to keeping the brain fit and lowering the risk of Alzheimer's among the elderly.

6. Walk for the Brain
Seniors who regularly took walks and engaged in other forms of moderate exercise had a lower risk of developing vascular dementia, a form of memory loss tied to poor blood flow in the brain. Vascular dementia is the second most common form of dementia, after Alzheimer's disease, and affects a large segment of the senior population. Poor blood flow may also aggravate the memory loss and symptoms of Alzheimer's disease.

7. Keep Cholesterol in Check
Scientists still aren’t sure whether statins, the popular cholesterol-lowering drugs that are prescribed for heart disease, help protect against Alzheimer's disease. But they do know that having high cholesterol, at midlife or in later years, can raise the risk of Alzheimer's and other forms of dementia. And statin drugs are proven fighters against heart attacks and strokes. To help keep cholesterol in check, eat a heart-healthy diet and exercise regularly, and see your doctor to see if you could benefit from a statin medication.

8. Control Blood Pressure
Getting blood pressure under control, an important step for reducing heart disease and stroke, may also help reduce rates of Alzheimer's as well. And it’s never too late. New findings show that for seniors in their 80s and 90s, lowering blood pressure with antihypertensive medications was good for the brain.

9. Pass the Fish
Once again, research showed that eating tuna and other types of oily fish like salmon, mackerel and anchovies may help lower the risk of memory decline and stroke in healthy older adults. Fish that was baked or broiled, but not fried, appeared to benefit the brain.

10. Surf the Web
Finally, searching the Internet may be good for the brain. Researchers at the University of California, Los Angeles, found that surfing the Web triggers key centers in the brain involved in decision-making and complex reasoning and was better for the brain than reading a book. So whether you turn to the Web to
e-mail friends, read up on the latest Alzheimer's disease research, or join the discussion groups at ALZinfo.org, keep coming back for a brain-healthy 2009.

(Source: http://www.alzinfo.org/alzheimers-distribution/article-10tipsforkeepingbrainsharp.asp)

HAVING A PARENT WITH DEMENTIA MAY AFFECT MEMORY IN MIDLIFE

If your mother or father has Alzheimer’s disease, you may be at increased risk of memory problems in middle age, according to a new report. The findings are to be presented at the American Academy of Neurology’s 61st Annual Meeting in Seattle this spring.

Researchers at Boston University analzyed data from the Framingham Heart Study, a long-running study of people living in Massaschusetts. They gathered data on 715 children of the original study, looking at such factors as memory, thinking abilities, and brain volume. They also tested for a gene called APOE-E4, which is known to increase the risk of developing Alzheimer’s late in life. Their average age was 59.

One group of 282 people had one or both parents with Alzheimer’s disease or another form of dementia. The parents of the remaining 433 did not have an Alzheimer’s diagnosis.

Among people who were carriers of the APOE-E4 gene, those who had parents with Alzheimer’s disease or another form of dementia were at two- to three-fold risk of performing poorly on verbal and visual memory tests compared to those who did not have a parent with Alzheimer’s.

“This result in people with parents who have Alzheimer’s disease is equivalent to about 15 years of brain aging,” said study author Stephanie Debette, M.D., Ph.D., of Boston University. “The effect was largely limited to those who have the APOE-E4 gene, which supports the idea that the gene is probably at least partially responsible for the transmission of Alzheimer’s disease risk between generations.”

The authors noted that despite the low scores on some aspects of the memory test, all the individuals were functioning normally and not everyone with the APOE-E4 gene scored poorly. They called for further testing to determine to what extent a family history of dementia, coupled with the presence of the APOE-E4 gene, really affects memory in middle age, and whether such memory problems may result in an increased risk of Alzheimer’s disease late in life.

(Source: http://www.alzinfo.org/newsarticle/templates/newstemplate.asp?articleid=343&zoneid=10)

EXERCISE CALMS AGITATION ASSOCIATED WITH DEMENTIA

In a pilot study, agitation and functioning improved in a group of elderly nursing home residents suffering from severe dementia when they engaged in just 30 minutes of supervised exercise three times a week.

Edris Aman, a second-year medical student at Saint Louis University School of Medicine in Missouri, who conducted the study, told Reuters Health: "Lots of people just assume that people with this kind of (severe) dementia cannot follow exercise instructions, but they can. It just takes more patience on the part of the exercise coordinator - me in this case."

Aman said his study is unique because it involved people suffering from severe dementia who were living in the "special needs" units of two nursing homes. The 50 study participants, whose average age was 79, performed 15 minutes of aerobic exercise and 15 minutes of weight lifting three times a week.

"Before and after" tests revealed that patients were far less agitated after completing the 3-week exercise program. They also showed significant improvement in their functional status - specifically, the distance they could walk in six minutes.

Aman, who presented his research at the annual meeting of the American Geriatrics Society, said there didn't seem to be an improvement in depression with exercise; however, this was a "very low dose of exercise," he said, and "there are a lot of studies that are emerging" that do show a benefit of exercise on depression.

The take-home message is that, exercise benefits all; even those with severe dementia can reap the benefits of exercise if people are patient enough.

Aman's study is currently "in press" at the Journal of the American Medical Directors Association.

(Source: Reuters Health, 30 April 2009)