Tuesday, 18 June 2013


Ashley Campbell vividly remembers the day when she first began to notice the changes in her father, country music legend, Glen Campbell.
She was in high school and had invited her friends over to watch a movie - Lord of the Rings. Her father poked his head in, mid-film, to say hello and inquire about what they were watching. Ashley told him and he left.
He came back several minutes later, asking the same question and receiving the same answer.  The scenario then repeated itself for a third time.
As she recalls the episode, Ashley, now 26, admits initially attributing her father's behavior to his characteristic unconventionality. "My dad's always been a little eccentric," she says, her voice tinged with deep affection. "I didn't think much of it, at the time."
Eccentricity has long been considered the purview of the highly-creative. And Glen, an actor, former television show host, and six-time Grammy winner, certainly fits the bill.
Unfortunately, it wasn't the crooner's creativity that was driving this new behavior.
Though the Campbell's didn't know it at the time, Glen was beginning to show signs of dementia - Alzheimer's disease, to be exact - a degenerative brain condition hallmarked by memory loss, confusion and hallucinations.
The show must go on
Glen received an official Alzheimer's diagnosis in early 2011. He and his family chose to go public about his condition later on that year.
Ashley says she was too young to have been involved in the family's decision to announce her father's diagnosis (and thus, brave the staggering stigma that surrounds Alzheimer's disease). But she states that the choice wasn't a difficult one for her parents to make, given that Glen was continuing to record and planned on touring at least one more time. "He was still performing and we didn't want people to attribute any of his behavior to drugs," Ashley says.
Glen showed few public signs of slowing down as he embarked on his farewell tour and released a new album, entitled: "Ghost on the Canvas."
Ashley, a budding musician in her own right, got to accompany Glen on his final tour - which ended in December 2011.
During the tour, Ashley, her brother, Shannon, and their band, "Victoria Ghost," opened for Glen. Once the "Rhinestone Cowboy" took to the stage, Ashley could be seen standing just to the side of her father, her fingers deftly picking on a banjo, or flying across the keys of a keyboard as part of his backup band.
She says that the experience was invaluable, both personally and professionally.
"I can't even put it into words how priceless it was for me to be able to perform with my dad. It was a ridiculously valuable experience for me as a performer. But, more importantly, it was so great to watch my dad doing what he loves. Being able to witness the legacy he created and to see all of the fans who love and support him - being caught in that crossfire of encouragement was amazing," she says.
Her presence also served as an anchor for Glen, whenever he flubbed a note, or lost track of what songs he'd already played. During these rare instances, Ashley was ready to step in and diffuse the tension, gently guiding her father back on track, whenever he lost his way.
She also acted as a stand-in spokesperson for her father whenever he would step into the public eye. It is a role that Ashley seems uniquely suited for, which makes it even more amazing when she admits that she fell into it naturally. "It wasn't really a conscious decision. It's just my way of being supportive of him and productive at the same time," she says.
Ashley's mother, Kim, is Glen's other rock.
Kim acts as Glen's primary caregiver and Ashley moved back in with her parents several years ago to help out. Together, the two of them form a formidable team, each filling in whenever they're needed. "She leans on me, I lean on her, we lean on each other," says Ashley. "No one can do this alone."
A different kind of legacy
The Campbell's decision to tell the world about Glen's struggle with Alzheimer's, combined with their unwavering support has enabled Glen to be transformed into a generational icon of a much different kind than he's used to being.
Glen's candor, combined with his dogged determination to continue to pursue a lifelong passion of performing, seems to have converted him from pop culture icon, into a symbol of the baby boomer generation's ongoing fight against the stark realities of a disease that has no cure and no truly effective form of treatment.
It's this last truth - the lack of a functional cure for Alzheimer's - that the Campbell's are banding together to help change.
Like many newly-anointed caregivers, Ashley and her family initially had no idea of the scope of the Alzheimer's epidemic, nor the size of the community of people caring for loved ones with the disease.
"After the announcement, there was this amazing outpouring of support from the fans and their families," she says. "Meeting so many people who were affected by the disease was a huge incentive for us to become advocates."
Glen, Kim and Ashley all recently traveled to Washington D.C., where Ashley gave a moving testimony about her father's struggles with Alzheimer's to the Senate Special Committee on Aging. During her oration, she stressed the need to funnel funds into finding a remedy for the disease.
With her parents sitting nearby, Ashley spoke frankly of Alzheimer's effect on her father's memories.
"Now, when I play banjo with my dad, it's getting harder for him to follow along and it's going to get harder for him to recall my name," she says, her voice breaking a bit as she admits the blunt truth about what the future might hold, "It's hard to come to the realization that someday my dad might look at me and I will be absolutely nothing to him."
In those moments, it seems as though Ashley herself serves as a stand-in for every person who has ever had to witness a loved one slowly succumb to the effects of Alzheimer's.
When asked if shouldering such a heavy burden of responsibility is difficult, given her young age, Ashley politely demurs. "You kind of learn to take each day as it comes. It's a lot easier to do something like this when it's for someone you love. It's not hard - it's an honor."
Coping by coming together
As hard as the journey ahead is likely to be, Ashley and the rest of her family aim to make the most out of the time they have left with their beloved patriarch.
"Obviously it would be better if he didn't have it," she says of her father's condition. "But, it helps to try and put a positive spin on something you can't change. I've gotten to spend so much time with him since we started touring together. I've learned not to take any moment for granted. To me, he's not just an amazing musician - he's an incredible dad. Thankfully, I've gotten to spend time with both."
Indeed, Ashley was there when Glen received his Lifetime Achievement Award at the 2012 Grammy's. She's performed with him in front of thousands, played duets with him in the privacy of their home, and she's pledged to be there for him, until the end.
When asked what she would say to the countless men and women caring for family members with Alzheimer's, Ashley Campbell recites the most important (and most often overlooked) tenant of the caregiver credo: "Don't ever think that you should, or could, do this alone. You have to find a support system because there are times when you can't do anything but lean on one another. No one should have to go through this alone."

(Source: AgingCare.com, 4 June 2013)

Sunday, 16 June 2013


Knowing how the normal brain ages - and how those changes affect your memory - can make the occasional senior moment less worrisome.  Here’s a timetable of normal brain aging by decade, starting in your twenties.

We tend to think of our brain as different from our other organs. But the brain undergoes predictable changes over time, just like the heart. As with heart disease, good genes and a healthy lifestyle can moderate these age-related changes, but it can't entirely stop them.

Contrary to popular belief, brain neurons (nerve cells) do not undergo a massive die-off with age. Evidence now suggests that some neurons are indeed lost, but the brain continues to grow new ones, albeit at a slower pace. What does happen is that nerve cells in the brain begin to shrink. As a result, the connections between neurons (synapses) begin to deteriorate over time, and chemical messengers (neurotransmitters) become less available to carry information.

With advancing years, these age-related changes alter the transmission of nerve impulses through the brain, leading to slower cognitive processing and delays in recalling stored information. But in the absence of a brain-destroying condition like a stroke or Alzheimer's disease, these changes are mostly a nuisance and don't interfere with a person's ability to function successfully. A general time frame for normal brain aging is described below.

Normal brain aging – Your Twenties
People in their 20s are at the top of their mental game in terms of forming long-term memories and being able to engage in complex reasoning. Creativity, too, may be at its highest during these years, although twenty-somethings don't have a lock on creative endeavors. Many writers, artists, and musicians are their most productive during this time. Slight physical changes in the brain, such as neuron shrinkage, start in a person's 20s.

Normal brain aging – Your Forties
Most people will sense some slowing of their mental processing during their 40s, especially in the area of working (short-term) memory. Tasks like remembering phone numbers, doing mental calculations, or playing challenging card games may require more effort than they did in earlier years. The slow loss of brain volume continues and may begin to accelerate.

Normal brain aging – Your Fifties
The 50s are a threshold, the beginning of accelerated loss of brain volume and more noticeable changes in memory and other areas of cognition. Cognitive changes include:
  • Processing speed slows further. It takes more time to recall names and words.
  • Learning something new takes longer. Once learned, however, the information is usually retained.
  • Multi-tasking (doing several things at once) becomes more difficult.
  • Attention to detail wanes. You probably will remember fewer details of a novel, movie, or painting than a younger person would.
  • Placing an event in time and place becomes more difficult. You may remember the event but not exactly when or where it occurred.
  • Visuospatial processing is more difficult. This might translate into more trouble in copying three-dimensional designs or in reassembling an appliance.
Normal brain aging – Your Sixties
Loss of brain volume continues. The hippocampus and amygdala - brain structures that are critical to memory and other cognitive abilities - are particularly vulnerable. These structures may have shrunk by as much as 25% from their size in young adulthood. The cognitive changes that began in the 50s become more noticeable in one's 60s. Cognitive processing speed may slow further, making it more difficult to learn new information or master complex mental tasks. It also becomes harder to concentrate and to "tune out" distractions. The brain is less adept at forming new memories and establishing the associations that enable us to recall stored memories. Tip-of-the-tongue experiences are more common because the brain has to work harder to retrieve names, dates, and words.

Normal brain aging – Your Seventies and beyond
People in their 70s and 80s vary widely in their cognitive abilities. Many not only remain quite sharp throughout these years but also gain in wisdom. For others, the wear-and-tear of high blood pressure, diabetes, heavy alcohol use, and other health problems will have taken a toll on memory and general cognitive ability. People who develop dementia typically begin to show signs of the disorder in their mid-to late-70s.

(Source:  John Hopkins Health Alert, posted in Memory on 29 March 2010)


Doctors have known for some time that the production of too little insulin by the pancreas and the inability of the cells throughout the body to respond to insulin (insulin resistance) are the hallmarks of type 1 and type 2 diabetes, respectively.

While the relationship between insulin and diabetes is well known, a more recent discovery is the role it plays in regulating brain functions such as the ability to learn and make new memories and to store and recall events. Scientists have also discovered that people with Alzheimer's disease have fewer insulin receptors than healthy patients.

Another intriguing finding: Insulin affects the brain's ability to clear away beta-amyloid-42 (Aß42), the toxic protein that builds up into plaques in the brain. These plaques, along with tangles of another protein called tau, located within cells, are telltale signs of Alzheimer's disease.

The suggestive evidence linking insulin to Alzheimer's disease may help explain why people with diabetes have a greater risk of experiencing cognitive decline and future dementia than individuals who don't have diabetes.

A gateway to the brain. Some researchers now believe that just as insulin is an effective treatment for diabetes, it might also be a useful therapy for Alzheimer's disease. The challenge: getting it to the brain without affecting blood glucose levels, as insulin injections would do. One potential answer: a nasal spray that is inhaled, allowing it to reach the brain within a few minutes, with minimal absorption into the bloodstream.

While recent studies suggest that intranasal insulin therapy may be safe and effective, there are important considerations to keep in mind. First, most studies have been small and have focused on short-term use. Consequently, the safety and effectiveness of intranasal insulin use over an extended period are unknown.

Second, intranasal insulin doesn't work for everyone, but it's not clear why. Some evidence suggests that genetics may play a role. For example, a small 2008 study in the Journal of Alzheimer's Disease found that memory improved after insulin treatment in study participants who did not carry the APOE-ε4 gene -- a known risk factor for late-onset Alzheimer's disease. In those with the APOE-ε4 gene, however, memory deteriorated. Findings from this study raise another potentially troubling concern. Intranasal insulin increased blood levels of Aß42 -- the toxin implicated in the development of late-onset Alzheimer's disease. This may indicate that the insulin was working by removing the protein from the brain and having it removed by the bloodstream, but other reasons are possible.

(Source:  John Hopkins Health Alert, posted in Diabetes on 13 March 2013) 

Thursday, 13 June 2013


(Source:  Bob DeMarco, Alzheimer’s Reading Room, 24 March 2013)

Alzheimer's Communication - Touching Foreheads and Kindness

One of the biggest challenges that Alzheimer's Caregivers face is how to communicate effectively with someone living with Alzheimer's disease. This challenge is particularly difficult when a person living with Alzheimer's becomes nasty and mean.

At the beginning, my mother turned meaner than a junkyard dog. She said mean and nasty things to me every day. This was new. My mother had never engaged in these behaviours with me before.

I had a leg up on this one because I studied communication in college and graduate school.

I understood that when my mother said something mean or nasty that it was the Alzheimer's at work. It was not hard to make this cognitive leap. She had never done it before, now she was. What changed? Her brain changed. It was sick.

Even though I understood what was happening, it still hurt when she said those things to me. She did make me feel angry and sad. Everyday - day in and day out.

I knew I had to do something. I finally realized something had to change - the first thing that had to change was me. I was going to need to learn how to label my feelings so I could control what I was feeling. Instead of mad, ready to take action.

I also decided I was going to have to do something to change Dotty. I already knew that trying to reason with someone suffering from Alzheimer's is like trying to jump over the empire in a single bound.

Here is a quick description of one of the things that I did start doing. And yes, over time Dotty stopped saying those mean and nasty things to me.

Everyday, early in the morning, I bend down and say something nice and positive to my mother. While doing this, I put my forehead on her forehead. I try to get her to smile and say "yes". I call this the positive reinforcement part of the process. When I say something nice, and when she responds yes - it anchors her.

I started to do this first thing in the morning several years ago. But not before I discovered that it worked and stopped her from being mean and vicious. I do it now in the same way I do many things - before it is needed. I call this getting out in front. I also call it getting the day started on the right foot. I don't sit around and wait for the crap to hit the fan.

This is what I started doing in an effort to make my mother feel more secure and to stop saying mean things to me. My hope was that if I could make my mother feel more secure, she would stop being a junkyard dog.

When my mother would say something mean and nasty to me like,

"get out, I can take care of myself".

I would smiled at her, put my head against her forehead, and say something positive like,

"I am here, and I am not going anywhere". While my forehead was still attached to hers I added something like,

"We are both here to take care of each other, we need each other".

I was hoping beyond hope that somehow my mother would come to believe we were a team.

It worked.

The instances of my mother's meanness and nastiness have declined dramatically. Today, she is more like the sweet person I always knew.

I believe the combination of touch, positive reinforcement, the calmness in my voice, and the smile did the trick. It really wasn't hard to do. I did need a lot of practice on the emotional side. I had to get control of my emotions. I had to learn to meet meanness with kindness.

On the other hand, the words came easy because I meant and believed every word I said.

Over time I learned how to communicate in a new, different, effective way. This is pleasing to me, and makes me feel happy.

I relearned something I already learned a long time ago. You get more with sugar than you do with vinegar.

I guess you could say, I became a better person along the way.

I could thank Alzheimer's for this. I won't.

Thank you, Dotty.

Don't be afraid to try it. I'm confident it will change your life.