STANDING ON ONE LEG FOR 20 SECONDS CAN PREDICT CHANCE OF DEMENTIA

In the standing on one leg with eyes closed test, men and women able to hold the position for less than two seconds were three times more likely to die than those who could hold it for ten seconds or more

Balancing on one leg may indicate if a person is at risk of dementia or stroke, a study has found.

Scientists found that an inability to stand on one leg for more than 20 seconds was associated with micro-bleeds and "silent" strokes.

Although the brain injuries were too small to cause symptoms, scientists warned they could indicate growing problems.

Silent strokes, or lacunar infarction's, are known to increase the risk of both full-blown strokes and dementia.

Lead researcher Dr Yasuharu Tabara, from Kyoto University in Japan, said: "Our study found that the ability to balance on one leg is an important test for brain health.

"Individuals showing poor balance on one leg should receive increased attention, as this may indicate an increased risk for brain disease and cognitive decline."

The scientists looked at 841 women and 546 men with an average age of 67 who were asked to stand with their eyes open and one leg raised up for a maximum of 60 seconds.

Participants performed the test twice and the better of the two times was used in the study analysis.

They also had magnetic resonance imaging (MRI) scans to assess their levels of cerebral small vessel disease, which can interfere with blood flow in the brain.

The research, published in the journal Stroke, showed that 34.5 of those with more than two lacunar infarction lesions had trouble balancing.

The same was true for 16 per cent of participants with one lacunar infarction lesion and 30 per cent of men and women with more than two sites of micro-bleeding.

"One-leg standing time is a simple measure of postural instability and might be a consequence of the presence of brain abnormalities," said Dr Tabara.

Earlier in the year researchers at the Medical Research Council found that standing on one leg may predict which 53-year-olds at risk of early death.

Men aged 53 years old who could balance on one leg for more than ten seconds and stand up and sit down in a chair more than 37 times in a minute were found to be least at risk of dying early by the researchers.

  

Women of the same age who could stand up and sit down more than 35 times in a minute and stand on one leg for more than ten seconds were also at the lowest risk compared to those who performed less well.

(Source:  The Telegraph, by Sarah Knapton, Science Editor, 18 December  2014)

Colombia Village's 'Curse' Could Hold Alzheimer's Cure

When John Jairo, a meticulous night watchman, lost his job for leaving all of his employer's doors open, his family knew they were hit by the "Yarumal curse."

Yarumal, a Colombian village perched in the Andes Mountains, has a high incidence of a genetic mutation that predisposes its population to Alzheimer's - a bleak heritage that scientists now hope could help lead to a treatment to prevent the disease.

Jairo is just 49 but his brain has already been gnawed away by Alzheimer's, a disease caused by toxic proteins that destroy brain cells, leading to memory loss and death.

Emaciated, he gazes vacantly at his daughter Jennifer, who at 18 years old already fears his fate.

"I'm constantly afraid it will happen to me. Whenever I lose something, I tell myself it's because I've already got it," she said.

Her father, "who used to be so happy," has been reduced to a restless, sometimes aggressive ghost of himself, who tries to escape the house day and night, she said.

Last year, a neighbor with the same condition slipped out without anyone noticing. His family found him frozen to death in the hills nearby.

Inherited from the village's European ancestors, the "paisa" genetic mutation -- named for the residents of the Colombian province of Antioquia - causes a devastating form of early-onset Alzheimer's.

A single parent can hand down the mutation, located on the 14th chromosome.

Those who have it have a 50 percent chance of developing Alzheimer's, sometimes by age 40.

In some families, parents and children have progressed through the illness together, from memory loss to dementia.

But a talented neurologist named Francisco Lopera, who grew up in Yarumal, hopes there is a blessing in the village's curse.

'Brain Bank'

Neurobanco is Colombia's only brain bank and a mainstay for global research on brain diseases, with a donation of 234 brains stored at -80 degrees Celcius, many of which belonged to Alzheimer patients (AFP Photo/Raul Arboleda)

Thirty years ago, Lopera, the Head of the Neuroscience Program at the University of Antioquia, set himself an ambitious mission: to find a treatment to prevent Alzheimer's, the most common form of dementia in the world.

"Most treatments have failed because they're administered too late. Our strategy is to intervene before the disease destroys the brain," said Lopera.

For several months, he has been testing an experimental drug on a group of 300 healthy patients aged 30 to 60 years old who have the paisa mutation.

The results are expected around 2020.

The trials are part of a $100 million project financed by the National Institutes of Health and Banner Research Institute in the United States, as well as Swiss pharmaceutical group Roche.

The active molecule in Lopera's drug targets the beta-amyloid proteins that attack the brain.

The stakes are high worldwide: more than 36 million people suffer from Alzheimer's and, without a cure, the number could rise to 66 million in 2030 and 115 million in 2050, according to the World Health Organization.

That's nearly one new case every four seconds - three times the rate of HIV infections.

"We don't know what causes Alzheimer's, but for one percent of the cases worldwide, it's genetic in origin. And that opens a very important window toward finding a preventive treatment," said Lopera, who estimates 5,000 people are at risk in and around Yarumal.

At his university, a small room filled with refrigerators and formaldehyde jars holds a "brain bank" created with organ donations from local residents -- an invaluable research source.

"It was very hard for them to accept, in addition to their suffering, donating their loved ones' brains," said Lucia Madrigal, a nurse in the neuroscience department who organizes cognitive stimulation workshops for patients.

"But without that social link, the scientific project could never have seen the light of day," she said.

Herself a fit 60 something with no plans to retire, she has lived Yarumal's nightmare along with residents.

"Some say they'd rather kill themselves. Then they get sick and they forget," she said.

Marta, an energetic 72 year-old grandmother from Yarumal, who has settled in the regional capital Medellin, said she is praying for Lopera's treatment to work.

Two of her daughters, aged 43 and 47, are suffering memory loss and "becoming small children again," she said.

Another daughter, 53-year-old Alitee, is "just a body" who drinks from a baby bottle.

"I've trusted my children to God. It's his decision," she said.

  

(Source:  AFP - By Philippe Zygel, December 18, 2014 12:01 PM)

REPORT SHOWS UNDER NUTRITION AS A MAJOR PROBLEM AMONG PEOPLE WITH DEMENTIA

A new report, released on 11 February 2014, highlights that under nutrition is a major problem among people with dementia, and stresses the importance of recognizing nutrition as a potential key factor in the well being of people with dementia.

Research reviewed in the report finds that 20-45% of those with dementia in the community experience clinically significant weight loss over one year.

Alzheimer’s Disease International (ADI) and Compass Group commissioned a team of researchers, led by Professor Martin Prince from the King’s College London Global Observatory for Ageing and Dementia Care, to produce the report ‘Nutrition and dementia: a review of available research’.

The report reviews existing research on dietary factors across the life course that might increase or decrease the risk of developing dementia in later life. While obesity in mid-life may be a risk factor for developing dementia in late life, weight loss tends to become a more significant issue in the decade leading up to the clinical onset of the disease and accelerates thereafter.

The report also details actions that could improve the nutrition of people with dementia through diet and external factors such as modifying the meal time environment, and supporting and training carers. Given the evidence for effective interventions, there is much untapped potential to improve the food intake and nutritional status of people with dementia.

Professor Prince, from King’s College London, says: “For older people, under nutrition is arguably a greater health concern than obesity, and it is particularly common among people with dementia. This is a neglected area of research with important implications for quality of life, health and functioning. While weight loss in dementia is very common and can be an intrinsic part of the disease, it could be avoided and we should be doing more to tackle the problem.”

Marc Wortmann, Executive Director, ADI, says: “I am very pleased that ADI and Compass Group commissioned this report. We believe that a focus on diet, nutrition and well being is a positive approach to supporting people with dementia and carers of this devastating disease. The report also shows we need more research into the potential role of nutrition in reducing the risk of developing dementia.”

The Report recommends that:

·      The adoption of nutritional standards of care for people with dementia should be considered throughout the health and social care sectors. These could include regular monitoring of weight, as well as assessments of diet and feeding behaviors, and the need for feeding assistance.

·      Family and professional carers should be trained and supported to understand and meet the challenges involved in maintaining adequate nutrition for people with dementia.

·      Evidence-based advice should be provided to inform consumer choices regarding the balance of risks and benefits associated with the use of nutritional supplements claimed to protect cognition in late life, before or after the onset of dementia.

·      More research should be conducted into the effective components of a diet that might prevent dementia and the progression of mild cognitive impairment.

(Source:  ADI, News Release, 11 February 2014)

SHADOWING IN ALZHEIMER'S : WHAT IS SHADOWING AND HOW CAN YOU COPE WITH IT?

What Is Shadowing?

Shadowing is when people with Alzheimer's disease or another type of dementia constantly follow their caregivers around. They may mimic him, walk wherever he goes, and become very anxious if the caregiver tries to spend any time away from them.

Why Do People with Dementia Shadow Their Caregivers?

Often, shadowing appears to be driven by the person's anxiety and uncertainty. They may feel like their caregiver is the one safe and known aspect of life, almost like a life preserver. The minute the caregiver walks into a different room, goes outside or shuts a door to use the bathroom, the person with Alzheimer's may become afraid, unsure and upset.

Why Is Shadowing Thought of as a Challenging Behavior?

While shadowing isn't one of the more typical challenging behaviors such as aggressiveness or paranoia, it can present a significant challenge. Caregivers dealing with shadowing often report a feeling of claustrophobia, where they're constantly with their loved one and never allowed to do anything alone. Even taking a shower without interruption can be a challenge for a caregiver.

How Can Caregivers Cope with Shadowing?

One way to reduce the frustration of being constantly followed around is to remind yourself that your family member is afraid and anxious. How you interpret their behavior (as a result of fear instead of as purposely trying to irritate you) can make all the difference.

For example, one gentleman I knew felt like his wife was trying to control his every action and interaction because she was continuously following him around and wouldn't even let him work in the garage alone. While this behavior was extremely frustrating, his perception of her acting this way in order to control him made things worse.

Recognizing shadowing as a reaction to anxiety and confusion can help provide extra energy to respond to it.

Additionally, it is imperative that you as a caregiver find a way to escape periodically. Even the most dedicated, loving and patient caregiver needs a break. To protect your emotional well-being, allow yourself some private time to take a shower or take some deep breaths. You can set a timer and remind your loved one that you'll be back when the timer sounds.

Maybe a neighbor will take a walk with your loved one, or a respite caregiver can spend a couple of hours with your loved one while you go to a support group. Is there another family member or friend who can regularly visit? You may also want to check on adult day care centers that have programs for people with dementia. Whatever it is, taking some kind of time off can refill your emotional energy and allow you to continue to care for your loved one well.

How Can Shadowing Be Reduced?

1.   Meaningful Activities

One way to reduce shadowing is to involve your loved one in engaging and meaningful activities. These don't have to be structured activities with a group of people in a facility setting. Rather, they can be right in your own home, and can be part of a reassuring daily routine. The key is for the activities to be meaningful for that person so that they capture her attention, thus reducing her obsession with you. For example, your loved one could fold clothes or towels daily, or work on a jigsaw puzzle.

For more information about meaningful activities, here's an article that lists several ideas: Ideas for Meaningful Activities for People with Dementia

2.   Snacks

The Alzheimer's Association in New York recommends "cereal therapy" or "gum therapy"- where you give the person some food to snack on or gum to chew to occupy them. Of course, make certain the snack you choose is not one that would be likely to cause choking.

3.   Music

You can also give the person headphones with a recording of their favorite musical selections to listen to, or even make a recording of yourself speaking to your loved one to reassure them. Music benefits many people with Alzheimer's, and the familiarity can be calming and relaxing.

You are invited to visit the online Forum to share ideas with other caregivers for coping with some of the challenging behaviors of dementia.

(Source:  about.com, Alzheimer’s/Dementia)

IDEAS FOR MEANINGFUL ACTIVITIES FOR PEOPLE WITH DEMENTIA

While there’s nothing wrong with bingo as an activity, there are many reasons to think creatively when it comes to activities for those with Alzheimer’s disease and other kinds of dementia.

One of the keys is that the activity should be meaningful for the person. Often, meaning is tied to past occupation or hobbies, so what’s meaningful for one person might not be so for another.

Whether you’re caring for a loved one in your own home or for a patient at a facility, consider the person’s interests, occupation and passions. If you work in a facility and don’t know the person’s history, ask their family members or observe their reaction to different activities. Then, choose a few activities they've responded well to and note the areas of interest. Here are a few types of people and corresponding activities to consider.

1.  The Homemaker

For those individuals who primarily took care of a home, you might offer a cloth to dust dressers or handrails, or to wash the table. They might enjoy folding a basket of washcloths and towels, or the task of setting the table. The object here is not to have the individual do large amounts of work, but rather to give the person something familiar and meaningful to do.

Just a note here. If you’re using this idea in a facility, you may want to ask the physician for an order that allows therapeutic work and receive permission from the family as well.

2.  The Fix It Individual

Was your loved one the fixer, the handyman, or the go-to guy? Maybe he’d like to sort through and match up nuts and bolts, or tighten screws into pieces of wood. Perhaps he’d like to connect smaller PVC pipes together. There are also activity boards with lots of “to do” things attached that you can purchase.

3.  The Mechanic

If his passion is cars, maybe he’d enjoy looking at pictures of old cars or tinkering with smaller engine parts. Some towns hold car events where older cars are displayed or driven down a road; if yours does, consider bringing him to that event. He also may be able to help you wash the car.

4.  The Pencil Pusher

For the person who sat at a desk and worked with papers, pens and pencils, she might love having a pile of papers to file, an adding machine or calculator to use, forms to complete or documents to read. Some people might like carrying a notebook and pen around to write down information.

5.  The Musician

If music is her thing, offer her opportunities to use this gift. People in the early to mid-stages of Alzheimer’s may be able to sing in a choir or play the piano. I know one woman with dementia whose leads a sing-along almost daily because of her musical gifts. She’ll even take requests for which songs to play, and despite her poor memory, plays songs almost faultlessly.

If he enjoys listening to music rather than performing it, make recordings of his favorite songs and play them for him.

6.  The Parent / Caregiver

Have you ever noticed how people with dementia often brighten up and take note when babies and children are around?   A child can often get a response when adults fail. Interactions with children and babies have been a normal part of many people’s lives. Sometimes when a person is living in a facility with other people of similar age or living at home and not getting out often, they no longer interact regularly with kids. Create opportunities for interaction with kids, whether that’s arranging for a visiting time, going on a walk together or bringing by your new baby to a facility near you.

Some older adults, particularly women, may also enjoy holding and caring for a baby doll. Often, the person connects with that baby doll and enjoys the sense of a familiar role in caregiving for the doll.

7.  The Animal Lover

If your family member loves pets, consider having him walk the dog with you or brush the dog’s hair. If he’s not able to do these things, he might enjoy having a bird or two in a cage or a fish aquarium to watch.

In the middle to late stages of Alzheimer’s, some people are comforted by holding a stuffed kitten or puppy. I’ve often observed them stroking the fur and holding it close.

8.  The Gardener

Is she an accomplished gardener? Provide her with a place to plant seeds, water them and watch them grow. She might also enjoy flower arranging or harvesting and preparing vegetables.

9.  The Puzzler

Although people with dementia typically have impaired memories, some of them are still quite capable of doing crossword puzzles, word searches and jumbles. Others might enjoy simple jigsaw puzzles as well. Have some different puzzle opportunities sitting out for your loved one to do.

10.  The Engineer

If he collected trains growing up, or is simply fascinated by them, consider setting up an electric train so he can help arrange the tracks or simply watch the activity. You can also gather a book collection or movies about trains.

11.  The Sports Fan

Provide the avid sports lover the chance to mini put, do WI bowling, play the beanbag tossing game or watch a Little League baseball game. You can also arrange for several people to get together to watch the big game on television and eat some junk food, or, I mean healthy alternatives. Or, perhaps he’d get a kick out of sorting through and organizing baseball cards.

12.  The Artist

Art provides a creative outlet to make something, so it provides a purpose and a task. Gather some non-toxic clay, watercolor paints, washable markers, colored pens or pencils, and paper. You can use these materials in a directed way (i.e. “Here’s some clay for you. Today let’s try to make a flower vase” or a non-directed way (“There’s art supplies laid out on the table. Feel free to choose any color of paint to get started.” Clay and paint are great for tactile stimulation and they provide a way to occupy and strengthen the hands as well.

13.  The Faithful

Don’t neglect this important area. For many people, as they age, the importance of spiritual nurturing increases. Offer them books of faith in keeping with their tradition, times of prayer or meditation, or singing together.

(Source:  about.com, Alzheimer’s/Dementia)

NON-DRUG INTERVENTIONS FOR DEMENTIA: 6 STEPS TO DECREASING CHALLENGING BEHAVIORS

Perhaps you're interested in trying some non-drug interventions with a patient or a loved one who has dementia. Although some medications can be helpful in treating the challenging behaviors of Alzheimer's or another dementia, approaches that don't involve medicines should always be the first line of defense. But, do you know where to start?

Some Nursing Professors from Johns Hopkins University are here to help. They published a set of guidelines that outline six steps to take when using non-pharmacological approaches to address behavior challenges in dementia. These guidelines include the following:

1.   Screen for Behavioral Symptoms Early

Try to catch the symptoms in the early stages. You might think that a bout of restlessness is just a short phase, but after someone starts wandering out the door is not a good time to start trying interventions for the first time.

2.   Identify Symptoms.

This may seem like an obvious step, but it's an important one. Taking the time to specifically label behaviors is helpful, especially when the person has more than one challenging behavior.

3.   Delineate the Triggers and Risk Factors for the Symptoms

Look at what precedes the behavior and could be causing it. Consider the following triggers:

•     Environmental Causes

•     Psychological/Cognitive Causes

•     Physical Causes

Also, identify the possible outcome of the behavior.

4.   Choose the Proper Interventions

According to the Johns Hopkins School of Nursing, "an individual with dementia might wake repeatedly each night, voicing fear of being alone in the dark, despite continuous calming efforts. An intervention might mean simply using a nightlight in the patient’s room, or adding long family walks in the evening, to help promote better sleep."

5.   Evaluate the Intervention to make sure that it’s working.

Documenting the behavior and the intervention, as well as the effectiveness of the intervention can prevent you from errors in recall. For example, remembering the one time the intervention didn't work because that stands out in your mind but not the five times it was effective can warp your accuracy and cause you to discontinue an approach that actually may be quite helpful. You can also note the time of day that the behaviors occurred to determine if there's a pattern in the timing.

6.   Follow the Patient’s Progress Over Time

The behaviors of people with dementia often change over time, necessitating a re-evaluation of the above steps. As Alzheimer's disease progresses through the different stages, new behaviors can emerge and previous ones may resolve.

Remaining committed over time to the primary use of non-drug approaches requires an intentional switch in perspective. Rather than thinking immediately about which medication might be effective, train yourself to think about these six steps and make changes in the environment or care of the person first.

Finally, it's important to note that there are some symptoms or circumstances that may necessitate the use of medications, such as the continual presence of distressing hallucinations, delusions, or paranoia. The goal in dementia care is the care and comfort of the person, so if non-drug interventions aren't facilitating that, medications may need to be utilized and then carefully monitored.

(Source:  about.com, Alzheimer’s/Dementia)

DIAGNOSING DEMENTIA: ALZHEIMER'S MAY REALLY BE MINI-STROKES

What causes memory problems? Often, it's plaque in the brain, which leads to Alzheimer's. Now, new research shows a more common culprit may be vascular brain injury. Find out about this type of cognitive decline from stroke, mini-stroke and high blood pressure. Learn why diagnosing the right cause effects therapy and treatment.

Alzheimer's is connected to sticky plaques made of beta-amyloid that choke brain cells, thereby causing dementia. People may act like they have Alzheimer's when they really have vascular dementia. Vascular dementia is caused by vascular events (related to blood vessels) such as strokes and mini-strokes, so treatment is different. (Mini-strokes occur in the brain when blood vessels clog up or burst. They can accumulate slowly and can go unnoticed for years.)

For example, the damage caused by plaque is typically treated with acetylcholinesterase inhibitors like Aricept®. These drugs target the nervous system. Vascular problems like mini-strokes are treated with blood-targeting medications and therapies.

Alzheimer's disease and vascular dementia are two types of dementia that are common in the elderly. A person's dementia can even be caused by a combination of the two, called "Mixed Dementia."

With today's technology, both vascular brain injury as well as beta-amyloid plaque can be detected in the brain. They both cause memory and thinking problems, called "cognitive impairment". If the cognitive impairment is strong and interferes with a typical person's day, it is called dementia. If it is mild, it is called MCI (Mild Cognitive Impairment).

Until now, doctors generally assumed that when they saw cognitive impairment, it was probably from plaque building up in the brain. Treatment and therapy were given accordingly. New research is showing that vascular brain injury from strokes or the mini-strokes often caused by high blood pressure may deserve the greater part of their attention.

A study at the Alzheimer’s Disease Research Center at UC Davis has found that vascular brain injury from conditions such as high blood pressure and stroke are greater risk factors for cognitive impairment among non-demented older people than is the deposition of the amyloid plaques in the brain that long have been implicated in conditions such as Alzheimer’s disease.

Published online early today in JAMA Neurology (formerly Archives of Neurology), the study found that vascular brain injury had by far the greatest influence across a range of cognitive domains, including higher-level thinking and the forgetfulness of mild cognitive decline.

The researchers also sought to determine whether there was a correlation between vascular brain injury and the deposition of beta amyloid (Αβ) plaques, thought to be an early and important marker of Alzheimer’s disease, said Bruce Reed, associate director of the UC Davis Alzheimer’s Disease Research Center in Martinez, Calif. They also sought to decipher what effect each has on memory and executive functioning.

“We looked at two questions,” said Reed, professor in the Department of Neurology at UC Davis. “The first question was whether those two pathologies correlate to each other, and the simple answer is ‘no.’ Earlier research, conducted in animals, has suggested that having a stroke causes more beta amyloid deposition in the brain. If that were the case, people who had more vascular brain injury should have higher levels of beta amyloid. We found no evidence to support that.”

"The second,” Reed continued, “was whether higher levels of cerebrovascular disease or amyloid plaques have a greater impact on cognitive function in older, non-demented adults. Half of the study participants had abnormal levels of beta amyloid and half vascular brain injury, or infarcts. It was really very clear that the amyloid had very little effect, but the vascular brain injury had distinctly negative effects.”

“The more vascular brain injury the participants had, the worse their memory and the worse their executive function – their ability to organize and problem solve,” Reed said.

The research was conducted in 61 male and female study participants who ranged in age from 65 to 90 years old, with an average age of 78. Thirty of the participants were clinically “normal,” 24 were cognitively impaired and seven were diagnosed with dementia, based on cognitive testing. The participants had been recruited from Northern California between 2007 to 2012.

The study participants underwent magnetic resonance imaging (MRI) ― to measure vascular brain injury ― and positron emission tomography (PET) scans to measure beta amyloid deposition: markers of the two most common pathologies that affect the aging brain. Vascular brain injury appears as brain infarcts and “white matter hyperintensities” in MRI scans, areas of the brain that appear bright white.

The study found that both memory and executive function correlated negatively with brain infarcts, especially infarcts in cortical and sub-cortical gray matter. Although infarcts were common in this group, the infarcts varied greatly in size and location, and many had been clinically silent. The level of amyloid in the brain did not correlate with either changes in memory or executive function, and there was no evidence that amyloid interacted with infarcts to impair thinking.

Reed said the study is important because there’s an enormous amount of interest in detecting Alzheimer’s disease at its earliest point, before an individual exhibits clinical symptoms. It’s possible to conduct a brain scan and detect beta amyloid in the brain, and that is a very new development, he said.

“The use of this diagnostic tool will become reasonably widely available within the next couple of years, so doctors will be able to detect whether an older person has abnormal levels of beta amyloid in the brain. So it’s very important to understand the meaning of a finding of beta amyloid deposition,” Reed said.

“What this study says is that doctors should think about this in a little more complicated way. They should not forget about cerebrovascular disease, which is also very common in this age group and could also cause cognitive problems. Even if a person has amyloid plaques, those plaques may not be the cause of their mild cognitive symptoms.”

(Source:  Alzheimer’s and Dementia Weekly, 11 December 2013)

3 WAYS TO GET AN ALZHEIMER'S PATIENT TO EAT MORE

(Tips from Bob DeMarco, Alzheimer's Reading Room)

As Alzheimer's or dementia progresses getting a patient to eat a nutritious meal, or to eat enough, can become a problem.

There is a long list of potential problems that cause dementia patients to eat less. There are also many ways that can be tried to deal with or eliminate the problem.

The most important factor in this wide spread problem is in fact, the color of the plate.

Last week I spoke at an Alzheimer's Conference in New York. I was asked several times,

"How can I get my mother to eat more food? Or, she just won't eat what can I do?".

When I started answering at the conference, the entire audience of over 200 people seemed shocked and surprised at my number one suggestion below.

This told me that we need to work harder on getting families into support groups and discussing the most common problems we face in the Alzheimer's dementia community.

As Alzheimer's or dementia progresses, getting a patient to eat a nutritious meal, or to eat enough, can become a problem.

This can cause the Alzheimer's caregiver to become frustrated, confused, and even angry. It can also bring on feelings of sadness and hopelessness.

1.   The First Question I Always Ask is - What Color are Your Plates?

In a study conducted at Boston University, Researchers found that patients eating from RED PLATES consumed 25 percent more food than those eating from white plates. Solid red plates, no pattern embedded.

Before you go, let me ask you this simple question?  Are you sure an Alzheimer's patient can see the food on the plate?  Meaning, see it is a way that you and I do, and then eat it.

Many caregivers understand that as dementia progresses vision and spatial problems can affect the ability of Alzheimer's patients to do things. For example, my mother would often stop walking when she reached an area of white tile in our home. It was almost like there was an in visible fence. I often wondered why. Interesting when she was going in the other direction - from white tile to blue carpet she never stopped.

Are you using white plates when you feed your loved one? If so, consider RED PLATES.

Interestingly, one day while I was watching the Dr. OZ television show a Nutritionist he had on the show said -- "don't eat off red plates because you will eat more".

2. Make eye contact while eating.

Sit directly in front of your loved one living with dementia and make eye contact while eating.

Smile and wait for them to smile back at you.

Then start eating without talking (you start eating).  Keep quiet.

Be patient, very very patient, keep making eye contact, and wait for them to follow your lead.

Be patient are the key words here. You might have to do this for a while before it starts working. Remember, you are trying to break a bad pattern and replace with a good pattern.

3. Did I Say Keep Your Mouth Shut?

Trying to convince a person living with Alzheimer's, if they are at the point of not eating, that they must eat is counterproductive to your effort.

Trying to explain why they need to eat is counterproductive.

The proper mind set here is learning to be a guide. A good guide makes eye contact and smiles.

A good guide demonstrates how to eat each and every time (like it is the first time, every time). The good guide does this with a smile on their face.

One thing you will need to consider is if the person living with dementia is unable to eat - they might find it difficult, painful, or impossible to swallow. You should discuss this issue with a qualified specialist. Specialist means a person or doctor that actually deals with this problem - all the time.

Hopefully, by guiding rather than cajoling you might get a patient to eat just enough.

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