Category Archives: Alzheimer’s and Dementia

Namenda (Memantine): Medication for Alzheimer’s disease?

Is Namenda (Memantine) a good medication for Alzheimer’s disease?

Namenda (Memantine) is one of the newer medications approved by the FDA for the treatment of Alzheimer’s disease. This Alzheimer’s disease medication is manufactured by Forest Laboratories and is marketed in the United States under the name of Namenda for patients who are suffering from moderate to more severe forms of Alzheimer’s disease or dementia. It began being marketed in January, 2004 in the United States although it previously was sold for some time in Canada and Germany. Many families of Alzheimer’s or dementia patients have been purchasing the medication from Canada for some time over the Internet. Some of the current estimates are that possibly 4 million patients currently have Alzheimer’s disease, with about 1 million suffering from severe symptoms of dementia. Namenda (Memantine) medication is the first drug offered for use with patients in the moderate to severe stages of Alzheimer’s disease.

Does Namenda (Memantine) medication help?

Namenda has been found to help with the thinking and memory skills of patients who have moderate to severe impairment in their cognition. Cognition is their ability to think through their problems. Namenda does not help everyone but has been found to help some people to slow the pace of deterioration, which allows some individuals to maintain some of their cognitive skills and functioning capabilities for a longer period of time. This obviously helps both the Alzheimer’s patient and the caregivers in many ways.

Is Namenda (Memantine) different from any other Alzheimer’s medications?

There are some similarities between Namenda and some of the other Alzheimer’s and memory drugs on the market. However, there are actually more differences than similarities. One of the main similarities is that very much like other Alzheimer’s medications (Aricept, Exelon, Reminyl and Cognex) it does not really improve the functioning or memory skills of the individual. It merely retards the deterioration, which then allows the individual to function at a higher level and maintain their independence for a longer period of time. Additionally, the most prominent feature of Namenda is that unlike the other Alzheimer’s medications it is known to be more effective in the moderate to severe stages of the disease. Some of the other medications seem to be more oriented toward the mild to moderate stages and are rarely prescribed for individuals who have more pronounced symptoms. These other medications delay the breakdown of the brain chemical acetylcholine, which is a neurotransmitter and extremely important to the communication between nerve cells in the brain. Namenda blocks excess amounts of the neurotransmitter glutamate, which is believed to damage and/or kill nerve cells in the brain. Physicians now prescribe combinations of the memory medications to get better results and to ease the transition from the mild to moderate or severe stages of the disease.

Is there much hope for Namenda?

One of the newer developments is that doctors now use Namenda with Aricept and other memory medications as an adjunctive treatment and also to assist as Alzheimer’s disease continues to progress. However, this medication is not considered to be a miraculous cure for Alzheimer’s disease. It should not be given a false sense of hope that it is going to turn back the hands of time and restore previous memory and functioning. Even for patients with the most severe symptoms of Alzheimer’s disease, this is considered merely a means to delay the deterioration in memory. Also however, it may be an additional step toward more effective treatments and possibly, eventually a cure for Alzheimer’s disease.

Namenda Side Effects:

Vomiting, sleepiness, pain, high blood pressure, headache, hallucinations, dizziness, coughing, constipation, confusion

Namenda Special Warnings and Side Effects:

This medication is not recommended for people with severe kidney impairment. Also, there are disease conditions which cause or alter the alkaline balance in the urine, which could result in a buildup of this medication in your body. You should always tell your doctor about any kidney problems such as renal acidosis, urinary tract infections or major dietary changes.

Namenda Side Effects and Drug and Food Interactions:

In addition to the Namenda side effects mentioned above, this medication should not be taken with some other medications as the effects of either or both may be increased, decreased or altered in some other way. As always it is important check with your doctor before you take Namenda with any of the following medications:

Amantadine (Symmetrel)
Cimetidine (Tagamet, Tagamet HB)
Cough suppressants that contain dextromethorphan (usually denoted as “DM”)
Glaucoma drug such as Diamox and Neptazane
Hydrochlorothiazide (HydroDIURIL)
Ketamine (Ketalar)
Nicotine (Nicoderm patch, Nicorette gum)
Quinidine (Quinidex)
Ranitidine (Zantac)
Sodium bicarbonate (baking soda, Alka-Seltzer)
Triamterene (Dyrenium DM)

Namenda Dosages:

Recommended Namenda Dosages for Adults:

The recommended Namenda dosage for adults is 10 mg taken twice a day. At the initiation of treatment with this medication, it is recommended to take it at the dose or 5 mg once a day for seven days, and then gradually increasing it by 5 mg every seven days, up to a maximum dosage of 20 mg.

As you increase Namenda and you notice any side effects, your doctor may want to wait a week or so before increasing you dosage. Your physician may also be very careful with people who have impaired kidney functioning and may stay at a lower dosage.

How should your Namenda dosage be taken?

Namenda should be taken exactly as prescribed by your doctor. As mentioned above, the usual Namenda dosage is increased gradually over one week intervals, usually at the level of 5 mg per week. Most doctors will wait a week before increasing the dosage. Taking dosages in it excess of the recommended amount will have no additional benefit for the patient. This medication can be taken with or without food.

Missed doses….

If you miss your latest dose of Namenda you should take it as soon as possible. However, if it is almost time for the next dose you should skip the missed dosage and return to your usual dosing schedule. Never take two doses of Namenda at the same time.

How do you store Namenda?

This medication should be stored at room temperature.

Over dosage of Namenda:

If Namenda is taken in excess of the recommended dosage you may have serious consequences. If you believe you may have taken an over dosage of this medication, you should call your doctor or seek immediate emergency medical attention.

Symptoms of Namenda overdosage:

Stupor, sleepiness, restlessness, psychosis, loss of consciousness, hallucinations
Taking this medication as directed is absolutely essential to the effective use of this medication for Alzheimer’s disease.

Adapted from the PDR Family Guide to Prescription Drugs 9th Edition by Paul Susic Ph.D. Licensed Psychologist

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Aricept (Donepezil): Medicine for Alzheimer’s Disease?

Aricept: Brand Name

Donepezil: Generic Name

Aricept (Donepezil): Medicine:Overview

Aricept is a medicine used to treat Alzheimer’s disease and other forms of dementia in the earlier stages of the disease process. It is not a cure but may offer some improvements in an individual’s memory, language skills, attention, and ability to perform normal activities of daily living. Aricept is a medicine that is usually prescribed in the earlier stages for what is usually referred to as mild or moderate dementia. The generic form of Aricept, donepezil has been approved by the FDA. In order to receive the best price on Aricept at your local pharmacy ask for the generic form, donepezil.

Aricept (donepezil) medicine information your doctor needs to know:

In order to prescribe this medicine for Alzheimer’s disease, your doctor needs to know if you have any of the following conditions:

• if you’re breast-feeding, pregnant or trying to get pregnant
• if you have any allergies to this medicine or any other medicines, foods, dyes or preservatives
• if you have any stomach ulcers and bleeding or stomach or intestinal disease
• if you have severe headaches
• seizures or convulsions
• Parkinson’s disease
• low blood pressure
• liver problems or disease
• heart disease or problems associated with heart rhythm
• any head injury
• difficulties passing urine

How is this medicine usually taken?

Aricept (donepezil) is in a tablet form and is taken by mouth. These tablets should be taken with a glass of water or may be taken with food. Always follow the dosing routine prescribed by your doctor. This medicine is frequently taken before bedtime and should never be taken more often or less than the recommended frequency. It should continue to be taken even if symptoms get better. You should never quit taking this medicine unless your physician tells you to. You should contact the pediatrician to find out if this medication can or should be used for children.

Aricept (donepezil) dosage;

Aricept (donepezil) dosage for mild to moderate Alzheimer’s disease:
For adults, the usual starting dosage is 5 mg once a day. Your doctor may then increase your dosage as necessary or appropriate.

Aricept (donepezil) dosage for severe Alzheimer’s disease:

The usual dosage for severe Alzheimer’s disease for adults is 10 mg once a day. Sometimes a dosage of 10 mg a day is also used for maintenance for individuals with severe Alzheimer’s disease. Your dosage will be adjusted by your doctor according to your own individual needs.

If you miss a dose of your medicine, you should take it as soon as possible. If it is almost time for your next dose you should only take the upcoming dose. You should never take extra dosages or double up on your medicine.

Side effects of Aricept (donepezil):

Side effects may occur with the use of this medicine. If you notice any Aricept side effects you need to report them to your doctor immediately. Some of the main side effects can include:

• weight loss
• vomiting
• unusual bruising or bleeding or red or purple spots on the skin
• uncontrollable movements
• sweating
• stomach pain
• heart palpitations or slow heartbeat
• hives or a skin rash
• agitation, increased confusion or nervousness
• fainting, falls or dizziness
• severe diarrhea
• changes in vision or balance

Some of the following Aricept side effects usually don’t require medical treatment but should be reported to your doctor if they continue or seem to be problematic:

• muscle cramping
• pain in the joints
• nausea
• limited or loss of appetite
• heartburn or indigestion
• headache
• drowsiness
• mild diarrhea

Is there anything else that may interact negatively with donepezil?

You should tell your doctor about all medications you are taking including nonprescription medicines, herbal products and nutritional supplements. Also, you should tell your doctor if you are a frequent user of drinks that contain caffeine or alcohol, if you smoke or use any illegal drugs. These can have an effect on how your medicine works. You should also consult with your healthcare practitioner prior to discontinuing or reducing any of your medications. Some of the following medications may interact negatively with Aricept:

• some antidepressants such as fluoxetine, fluvoxamine, paroxetine, sertraline
• some antibiotics such as erythromycin and clarithromycin
• some diabetes drugs
• atropine
• benztropine
• bosentan
• carbamazepine
• dexamethasone
• dicyclomine
• digoxin
• galantamine
• glycopyrrolate
• hyoscyamine
• Ipratropium
• Itraconazole or ketoconazole
• medications for motion sickness
• medicines for treating HIV infection or AIDS
• muscle relaxers for surgery
• modafinil
• nonsteroidal anti-inflammatory drugs such as ibuprofen
• oxybutynin
• phenytoin
• phenobarbital
• propantheline
• quinidine
• rifampin, rifabutin, rifapentine
• rivastigmine
• St. John’s wort
• tacrine
• trihexyphenidyl

Where should I store Aricept?

Aricept may be stored at room temperature between 15° and 30°C (59° and 86°F). You should always keep it out of the reach of children. Always throw away any unused medications after the date of expiration.

Some final words about Aricept (donezepil) medicine for Alzheimer’s disease:

Aricept is a medicine that has been found to assist in delaying the gradual deterioration associated with dementia and Alzheimer’s disease. However, there is no cure for Alzheimer’s disease and only an experienced clinician can help to determine whether you or your loved one has Alzheimer’s or some other type of dementia that may be assisted with Aricept (donezepil).

Some information adapted by Paul Susic Ph.D. Licensed Psychologist from the AARP Guide to Pills by Maryanne Hochadel PharmD BCPS, (editor-in-chief)

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Alzheimer’s Disease Medications: What You Really Need to Know

Alzheimer’s Disease Medications Overview:

Alzheimer’s disease medications have been prescribed over the last couple of decades and have had some benefit for individuals suffering from this devastating disease. However, it is essential to recognize that medications for Alzheimer’s disease and other forms of dementia are not a cure and have some limitations in preventing the continuing deterioration of the brain. The American Academy of Neurology concluded that these drugs which are primarily cholinesterase inhibitors “should be considered in patients with mild to moderate Alzheimer’s disease although studies suggest a small average degree of benefit.” Clinicians who prescribe these drugs frequently will give them for about a two months trial and may discontinue their use if no improvement is seen.

Alzheimer’s Disease Overview:

In order to determine the necessity for Alzheimer’s disease medications, first you must have a good understanding of the disease and its various forms. Alzheimer’s disease is a progressive deterioration of the brain that significantly impairs memory, thinking, problem-solving and eventually activities of daily living. It is most commonly found among the elderly, and currently is believed to account for 50% to 60% of all cases of dementia. It is estimated that by the year 2050 a possible estimated 11.3 million to 16 million Americans may suffer from Alzheimer’s disease.

It is not currently understood what causes Alzheimer’s disease, although several factors have been identified which may impact upon its development including family history and genetics and advanced age. Some estimates state that approximately 10% of individuals over the age of 65 may have the disease and nearly half of individuals over the age of 85 may be affected by the disease as well.

It is believed that Alzheimer’s disease causes a loss of brain cells resulting in memory loss, language difficulties, problems performing familiar tasks, disorientation to time and place, problems in abstract thinking, changes in mood or behavior, and even changes in personality. The disease process is varied and progressive and may occur over several years or many.

Alzheimer’s Disease Medications and Diagnosis:

In order to determine whether Alzheimer’s disease medications are necessary or appropriate, a definitive diagnosis is required. The most well defined diagnosis can only be conducted by examining the brain tissue upon autopsy. Obviously, prior to an autopsy, in order to have the most probable diagnosis, a complete medical examination needs to be completed evaluating a complete medical history, physical assessment, neurologic and mental evaluation, radiological findings and laboratory tests by a doctor familiar with the disease and the testing process associated with Alzheimer’s disease. There is no one test that can be conducted at this time to determine whether Alzheimer’s disease exists. Research and clinical experience has found that the disease progression for Alzheimer’s can vary from 3 to 20 years after the onset and possibly another 8 to 10 years after it has been diagnosed. This extensive diagnostic process will be conducted prior to prescribing any Alzheimer’s disease medications.

Alzheimer’s Disease Medications and Treatment:

Currently there are no medical treatments or medications known to cure or even stop the progression of Alzheimer’s disease although several have been found to delay the progression. Currently the most widely used Alzheimer’s disease medications are:
donepezil (Aricept),
rivastigmine (Exelon),
galantamine (Razadyn, Reminyl),
memantine (Namenda)
and tacrine (Cognex).

These medications are believed to primarily increase a neurotransmitter (brain messenger) called acetylcholine in the brain, which is believed to be affected by the Alzheimer’s disease process.

Alzheimer’s Disease Medications and the Progression of the Disease:

The Alzheimer’s disease medications currently on the market cannot cure or even stop the progression of the disease process. However, they are believed to limit the severity of the symptoms of confusion and memory loss for a period of time and to delay its progression.

Two types of medications have been approved by the US Food and Drug Administration (FDA) to treat the symptoms of Alzheimer’s disease. The first is the cholinesterase inhibitors which includes Aricept, Exelon and Razadyn and memantine (Namenda). These are used to treat some of the basic symptoms of memory loss, confusion, disorientation, problem solving and reasoning. More recently there is a medication that combines one of the cholinesterase inhibitors (donepezil) with memantine called Namzaric.

Medications for the Early to Moderate Stages of Alzheimer’s Disease:

The medications that are currently used to treat the early to moderate stages of Alzheimer’s disease all fall within the classification of cholinesterase inhibitors. These medications are used to treat the symptoms of memory loss, language difficulties and the basic thinking and reasoning skills.

The cholinesterase inhibitors are believed to prevent the breakdown of acetylcholine, which is a neurotransmitter in the brain. This chemical messenger is very important in the process of learning and memory and is involved in the communication process between nerve cells. It is believed to be necessary to keep the acetylcholine levels high in the brain if possible. By keeping the levels of these chemical messengers high it seems to delay or slow down the progression of the disease process. The effectiveness however varies from individual to individual. These medications are usually well-tolerated although side effects have been noted to include nausea, vomiting, increased frequency of bowel movements and loss of appetite.

Alzheimer’s Disease Medications for the Moderate to Severe Stages:

The only medications prescribed for the moderate to severe stages of Alzheimer’s disease are memantine (Namenda) and a combination of memantine and donepezil referred to as Namzaric. Memantine is usually prescribed to improve memory, reasoning, language skills, attention and the ability to perform simple tasks. Memantine can be used alone or with donepezil (Aricept). There has been some research that indicates that taking a cholinesterase inhibitor such as Aricept along with memantine may be helpful. Namzaric combines the two into one medication.

Memantine is believed to regulate glutamate in the brain which is a chemical involved in information processing, as well as storage and retrieval of information. It has been found to improve the mental and daily functioning for some people. No medication however is harmless and side effect free, with some of the basic side effects including confusion, dizziness, headache and constipation.

Alzheimer’s Disease Medications and the Future:

Medications used to treat Alzheimer’s disease are relatively new and have been developed primarily over the last couple of decades. Currently, there is no cure for Alzheimer’s disease and medications are used to moderate and possibly delay the progress of the disease. Research is constantly being developed using people with mild cognitive impairment compared to healthy volunteers used as control subjects. However, we are only on the cutting edge of developing effective Alzheimer’s disease medications.

Some information adapted by Paul Susic Ph.D. Licensed Psychologist from Worst Pill Best Pills: A Consumer’s Guide to Avoiding Drug-Induced Death or Illness and additional information from

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Alzheimer’s Disease: Causes, Symptoms and Diagnosis

Alzheimer’s Disease Introduction:

The most common form of dementia is Alzheimer’s disease. Although it is very uncommon before the age of 60, the incidence of Alzheimer’s disease becomes more common as an individual ages. Although it seems to effect only about 1% to 3% of people between the age of 60 to 64, the incidence of developing this dementia increases to approximately 30% for those over the age of 85. In the United States, as many is 4 million people may currently have the disease.

In Alzheimer’s disease, the brain deteriorates in a specific way resulting in the loss of nerve cells in the brain. Specific abnormalities develop in the brain cells referred to as tangles (neurofibrillary tangles) and plaques (senile or amyloid plaques) which then form between the nerve cells. It is also believed that there is disruption resulting in a reduction in the neurotransmitter (brain messenger between the cells) acetylcholine.
Some individuals may also have atherosclerosis, which then may lead to strokes. The strokes made then result in a vascular dementia, sometimes resulting in a mixed dementia. Mixed dementia is when an individual has both vascular dementia and Alzheimer’s disease or another form of dementia.

Cause of Alzheimer’s Disease:

At the present time, the cause of Alzheimer’s disease is unknown. The current belief in the medical community is that the development of Alzheimer’s disease may be as a result of some combination of genetics and the environment, although the environmental factors contributing to its development are not currently known. Although it is not known the relative contributions between genes and the environment, it is known to run in families and may possibly be more inheritable among individuals who develop it at an early age.

Alzheimer’s Disease Symptoms and Progression:

Alzheimer’s disease symptoms are very similar to the symptoms of other forms of dementia including a loss of memory, language problems, disorientation, behavioral problems and difficulties in activities of daily living. A person with Alzheimer’s disease is not required to have all of these symptoms however.
A couple of the more prominent changes in memory observed in people with Alzheimer’s disease is that changes are subtle and progressive. Some of the early changes may be almost unnoticeable at first but will progressively become worse over time, and will eventually get to the point of being totally disruptive in an individual’s activities of daily living.

The first change noticed in people with Alzheimer’s disease is a change in recent or short-term memory. Also, personality changes may be noticed as well. Some have been known to develop emotional changes such as depression, anxiety or an unusual level of fearfulness. There may be a higher level of fluctuation emotions noticed as well. Also, in the earlier stages, individuals may also notice minor changes in language abilities such as difficulty finding the correct words, misusing words or using general rather than specific language. Also, they quickly develop problems in judgment and the ability to think abstractly.

Unfortunately, some individuals may begin to develop behavioral problems. These problems result in their becoming irritable, agitated and sometimes physically aggressive. Also, they may begin to pace or even wander. Many Alzheimer’s patients develop insomnia, having trouble either initiating or maintaining sleep and sometimes may confuse night and daytime.

As the disease process continues, some individuals may even develop psychosis. Psychotic symptoms associated with Alzheimer’s disease are usually hallucinations, paranoia and/or delusions.

The progression of Alzheimer’s symptoms and ultimately the disease process is very unpredictable with people usually living approximately 8 to 10 years after the earliest signs of the disease. In the initial phases of the disease process, individuals experience things pretty much in the way they always have, enjoying the same activities and entertainment. However, as in all dementias, eventually memory problems become so pronounced that they can no longer participate in activities they have always enjoyed and will eventually become totally dependent on others. Once Alzheimer patients get to the stage of not been able to walk anymore, most individuals will only live an average of about six months. There is a lot of variation however with some individuals becoming bedbound and continue to live for several years.

Alzheimer’s disease diagnosis:

One of the first distinguishing characteristics in diagnosing an individual with Alzheimer’s is whether the individual develops a dementia that seems to have a progressive pattern. The Alzheimer’s disease diagnosis is initially based upon the pattern of symptoms, usually asking the individual and family members or other caregivers about memory problems and other symptoms of deterioration in activities of daily living. The diagnosis will later include a physical examination and other tests such as mental status exam, urine and blood tests, possibly computed tomography (CT) or magnetic resonance imaging (MRI). Some of these tests are used to exclude other possible diseases and conditions which could either cause or exacerbate underlying memory problems. After completing these tests, doctors are usually fairly accurate in their diagnosis of Alzheimer’s disease.

Confirmation of the diagnosis of Alzheimer’s disease can only be done upon death when a sample of the brain tissue is then examined under a microscope. At that time, the previously mentioned neurofibrillary tangles and senile plaques may then be seen throughout the brain. Newer tests such as positron emission tomography (PET) and analysis of spinal fluid are also believed to have possible utility in assisting with confirmation of Alzheimer’s disease. At the present time however, these tests are not believed to be very accurate and are not used very often.

Treatment of Alzheimer’s disease:

Similar to the treatment of other dementias, cholinesterase inhibitors seem to sometimes stabilize or mildly improve memory and mental functioning, but they cannot stop the progression of Alzheimer’s disease. Although inconclusive as to its effectiveness, ginkgo biloba has sometimes been used as an herbal treatment for Alzheimer’s disease.

New drugs continue to be researched constantly which may prevent or slow down the progression of Alzheimer’s disease. One recent example is the use of nonsteroidal anti-inflammatory drugs (NSAID’s) which are commonly used in the treatment of arthritis. Vitamin E is believed to possibly prevent or slow the progression of the disease process, although research is currently inconclusive related to the use of this vitamin. Obviously, risk and benefits of these and all treatments should be discussed with the patient’s physician.

Finally, individuals diagnosed with Alzheimer’s disease also have a high incidence of atherosclerosis or conditions which make it worse. This is of concern in that those individuals will then be at high risk for stroke, which is obviously a serious concern which needs to be eliminated to the best degree possible.

Some information adapted by Paul Susic Ph.D. Licensed Psychologist from the Merck Manual of Aging

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Dementia Types and Causes: Tell me About It.

Dementia Types and Causes: An Introduction

Dementia is a term that refers comprehensively to a variety of symptoms and diagnoses related to a multitude of different causes. Ultimately, dementia is a disorder that results in an individual developing difficulties in thinking, remembering, understanding, communicating and ultimately in controlling behaviors.

Dementia : An overview

The most prominent dementia type is Alzheimer’s disease. However, different forms of dementia affect different mental abilities and are manifested in very different ways. In addition to the way the symptoms are presented, they also progress in very different ways. Dementia by its very nature progresses. At the present time, it cannot be cured. Eventually people with dementia require complete care.

Although dementia can begin at any age, for the most part, it is a disease of the elderly. About 6% to 8% of people over the age of 65 have dementia. As people get older the rate of dementia continues to climb to a higher level with approximately 35% of people over the age of 85 having dementia. Even though it is a fact that the rate of dementia increases as people become more elderly, it is not inevitable as many people never develop dementia although they may get to the age of 100 and older.

Unfortunately, as people get older and begin to forget or misplace things they began to fear that they are developing dementia and in particular Alzheimer’s disease. Much of this forgetting is normal and not dementia, although some of these people may develop dementia at a later point in time.

Dementia Types and Causes:

The most common and most notorious dementia type is Alzheimer’s disease. Additionally, there are many other types of dementia such as vascular (multi-infarct) dementia which is a result of strokes and Lewy body dementia. Some people may have a mixed dementia which may include more than one dementia cause. Some of the less common dementias are as a result of Parkinson’s disease or a tumor or may be the result of normal-pressure hydrocephalus.
In Alzheimer’s disease as in some other dementias, the neurotransmitter acetylcholine in the brain may be low. These neurotransmitters are chemical messengers that help the nerve cells (neurons) to communicate with each other. In addition to helping with many different bodily functions, acetylcholine assists in learning, memory and concentration. Sometimes there are other changes that take place in the brain, although it is not clear whether they are the result or the cause of these specific types of dementia.

If certain disorders are not adequately treated dementia may increase. Some of these underlying disease processes are chronic obstructive pulmonary disease (COPD), diabetes and heart failure. When these diseases are adequately treated, many individuals have improvement in their dementia symptoms.

Medication and Dementia:

There are many medications that can temporarily cause or worsen symptoms of dementia. Some of the worst contributors to either causing or increasing symptoms of dementia are medications used to assist with sleeping such as over-the-counter sleep aids or sedatives, cold remedies and medication used to treat depression and anxiety. Some of these remedies can be purchased over-the-counter without a prescription. Also, drinking even moderate amounts of alcohol can increase the symptoms of dementia in a vulnerable individual.

Delirium is also known to cause symptoms that may be believed to be dementia. Delirium is a temporary disorder usually attributable to some underlying cause such as medication use, disease and even lifestyle changes such as hospitalization. Delirium is not considered to be a dementia type although it may be a causative factor.

Some information adapted by Paul Susic Ph.D. Licensed Psychologist (Health and Geriatric Psychologist) from The Merck Manual Health & Aging

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Dementia and Alzheimer’s Caregivers Make the Holidays Wonderful

Holidays may be hard:

The holidays are expected to be a bright and cheerful time, filled with family and friends. For those caring for another it can be a time filled with stress, disappointment, frustration and sadness. For individuals who have been experiencing MCI, Dementia or Alzheimer’s, they may feel even greater distress and a deeper sense of loss. This is caused by the changes he or she has experienced. Caregivers far too often are overwhelmed. Family may want too much from the senior and the caregiver as well. For the Caregiver, they can end up feeling pulled in many directions at the same time. They may want to participate in the holiday hub bub, and spend long periods of time with the other family members or have them to the house. This can be overwhelming physically, emotionally, and financially. Caregivers may be concerned about how family will react to the changes that have happened to the loved one as a result of the advancing of the disease.

Get honest about your family. If they have not been involved all year long, then they do not understand the changes that have occurred. As the primary caregiver, it is up to you to ensure they understand the circumstances surrounding your loved one, and respect that you know what is best for them.

Some simple rules of thumb:

Do not expect that any of your family members understand the changes that have taken place. They may not understand how the loved one will react with the entire family and extended family gathered together. You need to be the one to make sure everyone else understands that Dad or Mom may not be able to participate as they did in the past, and neither can you.

Extremely long drives to the sister that lives 90 miles away may not be feasible. These drives can be physically exhausting, and the strange house may cause unnecessary anxiety and acting out.

Large gatherings with lots of noise, and small children, are difficult. They may not be able to hear well with so many people talking and a lot of noise. This may very well cause your loved one much anxiety and fear. Your family may not have truly understood that Mom or Dad, may not remember their names, or confuse or forget grandchildren. They may take it personally, and have feelings of hurt and dismay.

About the Author:

Coach Chez is a recovery coach, helping individuals make lasting change in behavior and emotions. Senior Motivate 4 Success helps Seniors and Families find ways to deal with change as we age. Check us out at  Senior Motivate 4 Success and be sure to see our special program for the holidays at Holiday Program

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Untangling the Alzheimer’s Brain 

Alzheimer’s is a debilitating disease where circuits in the brain literally get ‘tangled up’ and cause cognitive problems. Research into the causes and possible treatments for Alzheimer’s is intensive and beginning to provide rays of hope for families hit with this disorder.

The Triple Threat

One tool that researchers have used extensively is a mouse model, which is genetically destined to get Alzheimer’s disease due to three separate genes. There are several paths to Alzheimer’s, but having a gene that increases your risk for getting the disease does not guarantee you will get it. It still depends on many lifestyle factors, including your physical activity, nutrition and level of physical health. However, the Alzheimer’s mouse model, called the 3xTg-AD mouse, has the deck stacked against it with multiple genes increasing its risk and almost guaranteeing disease.

A couple of recent studies used these mice to look at the role of some specific dietary factors in helping or hurting the mice’s chances. The first study looked at low omega-3 to omega-6 ratios in the context of a low or high fat diet. The second study used vitamin B3 (nicotinamide) to try and counter some of the cognitive problems the mice develop as Alzheimer’s progresses.

Fish for Brains

Julien et al. from Lavel University in Quebec published a study in the Neurobiology of Aging, in which they reported a double whammy of low omega-3s and high fat that seems to make the genetically susceptible mice fair worse. Unfortunately, the diet they discovered as further increasing Alzheimer’s risk is not that different from what most westerners are eating.

Many folks in North America eat too much saturated fat and not enough good omega-3 fat from fish. When researchers gave this kind of diet to the Alzheimer’s mice, the brains of the mice had several increased markers of Alzheimer’s pathology. In teasing out the dietary problems, researchers found that either a high fat diet or a diet low in omega-3s, caused problems. When they combined the two, feeding low omega-3s in the context of a high fat diet, those problems compounded.

These data are consistent with previous observational studies in humans that show people who eat less omega-3s have increased rates of Alzheimer’s disease. Unfortunately, studies have not shown success of using omega-3 supplementation to treat Alzheimer’s once it takes hold. However, there has been some success in treating early mild dementia. These studies, along with the new data from mice suggest that we should get plenty of omega-3s into our diet earlier to help drive down the risk of Alzheimer’s later.

Vitamin B3 gets an A

Still, there may be good news on the Horizon for those who are already heading down the Alzheimer’s road. Green et. al. from UC-Irvine published a study in the Journal of Neuroscience that demonstrated some remarkable effects of vitamin B3 at protecting the genetically prone mice from getting Alzheimer’s.

Now, before you rush out and start dosing up, realize this is a preliminary study that used whopping amounts of vitamin B3. Researchers fed mice at about 100 times the RDA and at about 10 times doses previously shown to cause some toxicity in humans. Still, the study is promising because it helps reveal some ways in which we might approach preventing Alzheimer’s disease in high-risk populations.

Researchers dosed up the 3xTg-AD mice with large amounts of nicotinamide, an active form of vitamin B3, in their drinking water. These mice performed as well as normal mice on many memory and other cognitive tests. Conversely, the Alzheimer’s prone mice that didn’t get the vitamin B3 showed the expected cognitive decline associated with Alzheimer’s.

Food Matters

The cool thing about both of these studies is that they open the door for more research using nutritional approaches to treat and prevent Alzheimer’s disease. It’s clear that genetics plays a role in some, but not all cases of dementia. But it’s also clear that we don’t have to accept our genetic predispositions in many cases. It is not fate. They way we choose to live our lives, including what we choose to eat, will play a large role in our cognitive future.

Journal of Neuroscience (2008), 28(45): 11500-11510.
Neurobiology of Aging (2008), In Press. 

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About the Author:
Dr. Simon Evans holds a PhD in molecular biology with 15 years research and teaching experience in neuroscience and a current faculty position in the Psychiatry Department at the University of Michigan. He is a member of the Society for Neuroscience, the American Society for Nutrition and the Michigan Metabolomics and Obesity Center; with expertise in neurochemistry and nutrition. He is the author of dozens of scientific publications on stress, depression and brain function as well as the acclaimed book, BrainFit for Life, published in the Spring of 2008.

Dr. Evans also holds a national coaching license from the United States Soccer Federation and over two decades coaching experience, which enables him to help people find and use their full potential. Dr. Evans has merged his interests in brain function, health, and performance coaching into public seminars and workshops designed to educate audiences about brain health and motivate them to take action to achieve it.
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People With Alzheimer’s Disease – Helpful Tips For Encouraging Them to Remain Active  

Alzheimer’s disease is a devastating condition that affects approximately 1-2% of the general population. It is one of several conditions that are called dementias, accounting for about 50% of reported cases of dementias.
While the symptoms and outcomes of Alzheimer’s disease are very serious, the assumption that people with the disease can no longer function is incorrect and unfair. People in the advanced stages of Alzheimer’s are certainly very limited, but many other people can still be active with a little help from family or friends.

Your ability to help a loved one or friend with Alzheimer’s disease be as active as possible rests with the approach you take with her. By following these steps, you can greatly enhance your chances of success.

1. Keep it simple – break tasks such as cooking or performing personal hygiene down into specific milestones that can be followed in order. For example, telling someone with Alzheimer’s to cook an omelet will be overwhelming to her and will probably not succeed while instructing the person to perform each specific task that goes into making the omelet will be easier to follow and less stressful.

2. Be calm and reassuring – people with Alzheimer’s disease can be very sensitive to the feelings of others and will react negatively to irritation or impatience.

3. Familiarity and repetition – do not give up if the person does not succeed with the task or activity the first time. Repeating the task over time will often improve her ability to complete it successfully.

4. Do not argue or attempt to convince – if the person is not receptive to a task, do not push her too hard to do it. At this point, it is best to redirect her to something more familiar and safer and then try again with the original task at a later time.

5. Plan the activities – spontaneity is not a good approach to take with someone with Alzheimer’s disease. Plan activities carefully and minimize interruptions and surprises.

6. Use visuals to stimulate and reinforce activities – people with Alzheimer’s react positively to visual prompts. Posting signs around the home that provide instructions such as “brush teeth” or “wash face” can be very helpful. Also, a collage or scrap book of pictures can help to stimulate memories and turn into an enjoyable activity.

There are a variety of activities that people with Alzheimer’s disease can enjoy. Much of it depends on the individual’s interests and level of functioning, and on the approach that is taken to encourage her to participate. Remember, process is more important than the outcome when encouraging people with Alzheimer’s to participate in activities. A kind, gentle, and supportive approach is usually far more successful than placing high expectations and providing negative feedback.

About the Author:
Steve Watson has provided assistance to seniors and their families for over 8 years. He owns a home health agency in Tallahassee, Florida called Comfort Keepers that provides home health and companion care for seniors who want to remain in their own homes and be as independent as possible.

Steve has his PhD from the University of Georgia in Public Administration and Master’s in Counseling from the University of Delaware. He received his certification as a Care Manager with specialization in geriatric issues this year.

If you are interested in learning more about how to help an elderly parent or other loved one remain active and healthy, check out this web site where you can, among other things, subscribe to an informative newsletter.
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The Best Friend Approach to Alzheimer’s

When I began to understand the reality of caring for my mother, who has an Alzheimer’s dementia, I was, like everyone else, unsure and filled with questions about how to ‘be’ with her. I was very uncomfortable when she endlessly repeated stories, or mixed up the characters in them. And when the memory of my father began to fade, to be replaced by childhood memories, I was shocked, disoriented, and greatly saddened.

I felt guilty about feeling bored, inadequate in the extreme (where was my wise, earthy, intuitive mother to help me figure this out?). But mostly I had questions: Do I gently correct her, bring her back to the here and now, as one of my sister’s opined? Would this strengthen her grip on “reality”, stimulate her mind and delay her decline? My instinct was let it go, to go along with wherever her story was leading her, but perhaps this was a disservice, perhaps she needed me to anchor her in this world?

I can’t say I ever really got answers that satisfied me, so I was left to follow my intuition – which I have only just found confirmed in The Best Friends Approach to Eldercare, by Virginia Bell and David Troxel. These compassionate authors have worked for many years with long term care of people with Alzheimer’s. The idea behind their approach is that what parents – or other elders – need most is simply a best friend, someone who is understanding, positive, and reassuring. Someone who doesn’t judge them, correct them, tell them what to do or how to think or behave.

In discovering this so-called method, I’ve felt very validated. I realize that I became conflicted when I looked at my mother through the lens of a disease. But when I saw her simply as my mom, I took her as I found her, and extended to her the same simple human kindness I would to any friend. I don’t lecture, correct or try to ‘improve’ her, my job is to connect with her, and to meet and support her where she is.

Here are a few of the basic principles behind the Best Friend’s approach.

Go With the Flow – Caring for your parent is about making them happy, safe, and comfortable. If your father says, “I’m eating breakfast now,’ it might be tempting to note that it’s dinnertime in the hopes of making him less confused, but it’s not as helpful as simply saying, “Yum, it smells good.” Just go with the flow and enter their world.

Let Go of Perfectionism
– Choose activities your parent will enjoy and don’t worry whether they’re done correctly. If s/he can’t follow the rules of a card game anymore, try sorting the cards into suits and colors. If s/he likes helping around the house, give him or her a concrete task to do, like folding laundry. It doesn’t matter if it’s done perfectly. What matters is that your parent is having fun and feels useful.

Above All Else, Show Respect – Remember that yours is an adult relationship that consists of adult activities and communication. Even if your parent has Alzheimer’s, there’s no need to play games meant for kids or to speak as if they’re children. Foster their dignity above all else.

About the Author:

Kathleen Daniel, MS, L.Ac. writes about change and transition from the inside out, combining insights and experience from her lifelong yoga practice with her work as an acupuncturist, organizational consultant, educator, and life and leadership coach. An alumnus of Johns Hopkins Women’s Leadership program, she also leads active retreats for reflection and renewal for women. Website:
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Alzheimer’s Treatment: Experimental Therapies and Alternative Treatments 

Alzheimer’s treatment: Experimental therapies 

Although the reason is not clear, enrollment in clinical trials frequently seems to delay the progression of Alzheimer’s disease.  Some experts state that there could be several explanations for this effect. It could be due to the direct effect of the drug being studied or to improved coping skills that caregivers receive from contact with medical personnel during the study.  Whatever the reason for the delay in the progression of the disease, it is believed that Alzheimer’s disease patients receive more benefits for enrolling in clinical trials than most other medical conditions, since there is currently no cure for Alzheimer’s disease.

The focus of research at this point in time is on delaying the onset of the disease.  The following are currently being researched in terms of their usefulness as preventive agents.  The following treatments are believed to hold hope for the future, although they are still regarded as highly experimental at the present time.

Anti-inflammatory drugs: 

Many experts consider the nonsteroidal anti-inflammatory drugs (NSAIDs) to be showing some promise as preventive therapies.  These medications are commonly used to treat rheumatoid arthritis. While medical researchers are not sure how they work, it is hypothesized that NSAIDs may possibly provide protection against inflammation associated with Alzheimer’s disease, or may have some effect on the delivery of blood to the brain.

Ginkgo biloba as an Alzheimer’s treatment: 

Although it is not clear how ginkgo biloba works, it has been found that patients taking this extract have sometimes had a slower decline in cognitive abilities then patients who received a placebo.  The American Academy of Neurology has concluded that although the evidence is relatively weak, some studies have found that some patients with other types of dementia (not Alzheimer’s disease) may benefit.  Ginkgo biloba is not regulated by the FDA and is therefore not considered a food supplement.  Also, it is important to note that when aspirin is taken at the same time as ginkgo biloba there may also be an increased risk in bleeding.