Tuesday, June 18, 2019

Dementia and Alzheimers Disease - Shocking Research from UCI - MIND

As of 2019, it has been more than 15 years since any new medications have been developed to treat patients with dementia, including Alzheimer's Disease. According to experts, none of the drugs currently available can stop the development of dementia or slow it down.  None of the drugs can reverse dementia or prevent it.  In other words, as of today, there are no successful medical treatments for dementia, despite the "pseudo-scientific" reports you may have read in the newspaper or products you have seen advertised on TV.  Patients are often given medications to help them stay more alert, sleep better, or deal with depression, but these medications do not restore their memory.

These are just a few of the shocking facts reported by Dr. Joshua Grill from the University of California - Irvine MIND program, where their exclusive focus is on memory impairment and neurological disorders. UCI - MIND is one of thirty research centers around the United States which have been given the task of studying dementia and Alzheimer's Disease by the Centers for Disease Control.

How Big is the Problem of Dementia in the U.S.?

By early 2019, there were an estimated 5.8 million Americans living with Alzheimer's Disease, the most common form of dementia.  Nearly two-thirds of them are women.  This may be partly because Alzheimer's Disease and other forms of dementia are closely linked to aging, and women tend to live longer than men.  However, there are other factors which affect your risk, in addition to aging.  Hispanics are 1.5 times as likely as Caucasians  to develop Alzheimer's Disease.  African-Americans are twice as likely as Caucasians.  However, regardless of your background, no one can feel as though they are safe from dementia.

People of every race and demographic face the risk of developing dementia.  In California, where I live, 11 percent of senior citizens currently have Alzheimer's Disease and one out of eight people over the age of 55 will eventually develop it.  People who live to be 90 have about a 40% chance of being diagnosed with some type of dementia. People who live to be 85 have a 20% chance of having dementia. Even as early as age 80, there is a 10% chance you will be diagnosed with dementia. Unfortunately, the older you are, the greater your risk. 

What are Common Causes of Dementia?

As you see in the graphic from UCI - MIND at the top of this article, dementia is an umbrella term which covers a number of causes of memory loss and cognitive impairment.  In a few cases, such as when the dementia is accidentally caused by certain prescription medications, the brain function can sometimes be restored when the medications are adjusted.

In most cases of dementia, the underlying pathology is progressive and irreversible.  The most common cause of dementia is Alzheimer's Disease, and the word Alzheimer's is sometimes used almost interchangeably with the term dementia.  However, other common causes of dementia are just as debilitating.  They include Frontotemporal Lobar Degeneration (the most common cause of dementia in those under the age of 60), Parkinson's Disease related dementia, dementia with Lewy Bodies, vascular dementia (common in people with heart disease) and Creutzfeld Jacob Disease.

It is possible to have more than one type of dementia develop simultaneously.  For example, someone with Alzheimer's Disease or Parkinson's Disease could also develop vascular dementia because of their history of heart disease.  In addition, the patient's medications, a stroke, or a former brain injury could make the symptoms even worse.

Dementia is Financially Devastating for Families

In 2019, Alzheimer's Disease cost the U.S. $290 billion.  By 2050, it is estimated that Alzheimer's will cost the U.S. $1.1 trillion.  This does not include the value of the estimated $18.5 billion in unpaid care given by the family members of these patients.

Many families eventually have to either institutionalize the loved one or pay someone to come into their home and care for them.  This is because patients often reach the point where they need 24 hour a day care, and have to be protected from risky behaviors such as trying to cook, or wandering off.  The lifetime cost of dementia care can amount to an estimated $350,174 per individual living with dementia (in 2018 dollars).

One way to deal with the high cost of future memory care for you and your spouse is to purchase long-term care insurance, preferably while both of you are in your 50s or 60s and decades away from needing the care.  Although Medicare does not cover the cost of any type of long-term care, in some cases the cost may be covered by Medicaid.  It would be smart to explore the financial requirements necessary to qualify for Medicaid in your state.  Another option is to save enough money, if possible, to cover the cost of putting a loved one in a memory care facility. Even some types of life insurance could help defray the cost.  Having a plan can make the situation a little easier when the time comes.

What is it Like to Live with Someone who has Dementia?

It can be frustrating and exhausting to live with someone who is developing dementia.  Behavior changes are often noticeable even before the memory loss. They may have difficulty doing things which used to be easy for them, such as cooking, driving or handling money. They may experience mood swings, ranging from apathy to depression or anxiety.  They may virtually stop talking, or they could become hostile and argumentative, even violent in extreme cases.  They could become childlike and excessively dependent on you.  They may cry easily.  At times, they may behave inappropriately.  You may eventually be required to take care of their basic hygiene and do virtually everything for them. They may ask you the same questions over and over again.

No one is going to have all of the above-mentioned behavior changes, but regardless of what differences you observe, it will be obvious that what was once a loving relationship could eventually turned into a nurse-patient relationship.

The confusing aspect of these behavior changes is that they often build slowly and most people will not recognize them as early symptoms of dementia.  Your spouse may be able to perform routine tasks and engage in conversations with you for years after the behavior changes start, but they could have more difficulty getting along with the neighbors or relatives.  They might become a prime example of a "grumpy old man or woman."  They may become a bit more reclusive.  Their memory may seem fairly normal, other than annoying you by forgetting what you told them yesterday.  You may feel as though they have changed and are not as much fun as they once were, but it could be years before you recognize that these were the early stages of their developing dementia.

Real Life Examples of Dementia

A friend of mine, whose husband has dementia caused by Parkinson's Disease, initially took her husband to adult day care one day a week, so she could grocery shop and run other errands.  She is now taking him to adult day care three days a week.  The amount of care he requires continues to increase, and someday the community resources my friend relies on may not be enough.  Eventually, he may need around-the-clock care, if he reaches the point when she cannot care for him by herself during the hours when he is not in day care.  Around-the-clock care or a memory facility will put a severe financial strain on her.  His dementia developed fairly rapidly, over just a couple of years after his retirement.

My own mother died of Alzheimer's Disease, which was probably complicated by vascular dementia. My father cared for her for a decade after her initial diagnosis, since her dementia developed slowly.  He enrolled her in several trial drug studies, but they did not seem to help.  In the three years prior to her death, my mother was cared for in my sister's home, where she had the full attention of my father, my sister and my brother-in-law.  Even then, she managed to slip away a few times and it was only because of watchful neighbors that she was found before she wandered too far.  Once, when my sister and brother-in-law were at the store, my father went into the bathroom and could not find my mother when he came out.  She had slipped out of the house barefoot and wearing only a light nightgown in the middle of winter.  A neighbor who lived several houses away found my mother knocking at her door and the neighbor called my sister.  If my mother had been outside much longer, the results could have been fatal.

My mother also fell down the stairs a couple of times and had to be hospitalized for broken bones, even though my sister had a chair lift installed in her home.  However, my mother was not able to use it by herself and she would sometimes try to walk up and down the stairs when no one was watching.  These falls may have also had a subtle effect on her dementia progression.

You are Not Helpless - You can Reduce Your Risk of Dementia

This may seem like a lot of negative information, but there is also some some encouraging news.

First, a small amount of memory loss, diagnosed as mild cognitive decline, may never progress beyond that point.  Just because you forget what you had for breakfast this morning does not mean you are on your way to total dementia. Do not panic every time you misplace your keys.

In addition, researchers around the world are continuing to work on a wide variety of medications which they hope will slow down some of the various causes of dementia. Obviously, different approaches will be needed for the wide variety of health issues involved, but scientists are relentless in their research.

Meanwhile, even though there are currently no medications which can stop or cure dementia, there are a few personal actions you can take to lower your risk of getting it in the first place.  Below are two lists of the things you should be doing if you want to reduce your risk of dementia.  These lists are based on actual research by scientists at UCI - MIND and other memory research facilities.  Currently, these actions are more effective than any medication on the market!

Cut Your Risk Factors for Developing Dementia

Stop smoking - If you smoke, stop!

Moderate your alcohol consumption - Women should not consume more than one five-ounce drink of alcohol in a day; men should not drink more than two five-ounce drinks in a day.  You can lower your dementia risk even more if you only consume alcohol occasionally, not every day.

Avoid being overweight - Control your weight, particularly in middle age.  Maintaining a healthy weight is good for the brain.

Reduce your risk of cardiovascular disease and stroke - Control your blood pressure and cholesterol. Anything which is good for the heart is also good for the brain.

Avoid head trauma - People with a history of concussions may be especially vulnerable to memory loss. In addition, losing your balance and falling late in life can also cause dementia.  Make sure your home is safe and use a walker or cane if your doctor recommends one. Many senior citizens benefit by taking a balance class.

Improve your sleep quality - Take the time to get a good, solid seven to eight hours of regular sleep every night.  Your brain needs plenty of deep sleep in order to regenerate.  It is believed that some of the toxins which build up in the brain during the day are cleaned out during sleep.

More Actions Which Lower Your Dementia Risk

Eat a Healthy Diet - The Mediterranean diet, with its emphasis on fruits, vegetables, whole grains, and small amounts of fish and poultry is a good diet for the brain.  If you want to try an eating plan which is especially designed to benefit the brain the most, you may be interested in "The MIND Diet Plan and Cookbook."  Eating properly is one of the best steps you can take to protect your brain.

Daily exercise - Physical exercise causes fresh blood to flood through the brain, giving it the oxygen it needs to function well.  A brisk daily walk can help keep the blood moving.  Several walks a day will be even more effective. Avoid being sedentary. 

Take care of your overall health - Our brain is unlikely to do well as we age if we do not take care of the rest of our body.  See your doctor at least annually for a full physical. Follow their personalized instructions.  If you are taking several medications, make sure you are taking the correct dosage.  Go to the dentist, as well.  There is a definite connection between poor dental hygiene and both heart problems and memory problems.  Manage diabetes and any other chronic illnesses you may have.  Uncontrolled blood sugar can cause a variety of health problems.

Be a lifelong learner - Never, ever stop learning new things.  Take a class; learn a new language; take up a hobby; go back to school; read a book; become more proficient on the computer; play chess or bridge; work puzzles.  Continue to challenge your brain right up to the end of your life.

Manage your stress - Whether it means a walk in the woods, yoga, meditation, prayer, or simply spending time alone working on a hobby you love, anything you do to handle your stress will keep your brain relaxed, too.  When you are stressed, the blood vessels in your brain (and the rest of your body) constrict, and less blood and oxygen get where they are needed.  Relaxation helps our blood to flow better, and helps clear toxins from the brain.

Socialize - Although a little time alone is good for you, as with so many things, it can become unhealthy when taken to extremes.  It is very important to also spend time socializing with other people.  When you have a simple conversation, it keeps your brain in shape because you are constantly responding to what the other person is saying.  If you "zone out," you are not fully participating in the conversation.  You have to become engaged and interested in the conversation if you want to get the most out of it.  Practice having interesting conversations with people you enjoy.  Listen to what they say and respond appropriately.  This is great for your brain.  In addition, socializing with friends can help lower our stress levels.  Get out there and enjoy other people!

You Can Participate in a Dementia Study

If you are interested in joining a dementia study, there is a good chance that one is being conducted near you.  I have signed up to participate in the studies going on at UCI - Irvine, and will continue to report here on this blog about what I learn.  Several of my friends are participating, too.

To see which cities have a research center near you, check the attached map.

You can learn more about the trials going on at the various research centers throughout the nation and get more information, as well as their contact information, by checking out this website:

https://www.nia.nih.gov/health/alzheimers-disease-research-centers

You may also want to sign up for the newsletters from one or more of the research centers.  This is a great way to stay current on cutting edge dementia research. 

To learn more about dementia, other common health problems as we age, Medicare, Social Security, financial planning, where to retire and more, use the tabs or pull down menu at the top of the page to find links to hundreds of additional helpful articles.

You are reading from the blog:  http://www.baby-boomer-retirement.com

Photo credit: Photos of UCI-MIND slides taken by author

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