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New Alzheimer’s Scan For Early Diagnoses

August 17, 2011 Leave a comment

Alzheimer’s is the most common form of dementia, a brain disorder that primarily affects the elderly. It is named after a German doctor, Alois Alzheimer, who in 1996 noticed anomalies in the brain tissue of a woman who had died of a strange mental illness. There were abnormal clumps called amyloid plaques and tangled bundles of fibers, both of which are the most common signs of Alzheimer’s. Other brain changes can occur as well. Nerve cells die in areas of the brain vital to memory and other mental abilities, and the connections between nerve cells are disrupted, impairing thinking and memory. The disease is slow moving and in its earliest stages, may merely appear to be mild forgetfulness and be confused with age-related memory change. There may be problems remembering recent events or activities, or the names of familiar people or objects. As the disease progresses, the forgetfulness becomes more severe, interfering with daily activities, such as brushing one’s teeth. There are problems speaking, understanding, reading or writing, and eventually the brain damage becomes so severe as to require total care.

In January, the FDA’s Drug Advisory Committee voted unanimously to recommend approval of a new imaging agent to detect early Alzheimer’s disease. The agent, florbetapir, is produced by Eli Lilly and Company under the name Amyvid. Amyvid would be injected into the patient and used in conjunction with PET (positron emission tomography) scans to illuminate and detect the beta amyloid plaques in the brain that cause Alzheimer’s disease. PET scans performed with Amyvid would allow physicians to provide prognostic information to patients and their families even at a time of limited therapeutic approaches to treat Alzheimer’s disease. In addition, the availability of imaging agents that can reliably detect amyloid plaques will be an absolute prerequisite to select patients that may benefit from future specific anti-amyloid based Alzheimer therapies. Experts agree the test could become a critical part of detecting Alzheimer’s before symptoms take hold, but a clinical reality is far from imminent.  Although years away, researchers envision the amyloid PET scan could join the ranks of other routine mid-life surveillance tests such as colonoscopy and mammography for early detection. Before FDA approval, manufacturer Eli Lilly and Company must demonstrate that standards for interpreting brain scans can be made consistent enough to routinely guarantee an accurate diagnosis.

Because there is currently no cure for Alzheimer’s, Dr. Sam Gandy, the Mount Sinai Chair in Alzheimer’s Disease Research in NYC acknowledges the test may not be considered worth the cost even if the FDA approves the recommendation. He added that, “”Medicare may decide that the added value does not merit reimbursement without a meaningful intervention.” Since 2007, molecular imaging has been utilized in improving diagnoses of Alzheimer’s and other dementias with PET scans using other imaging agents such as FDG. FDG stands for fluorodeoxyglucose, a short-lived radioactive form of sugar injected into people during PET scans to show activity levels in different parts of the brain. In Alzheimer’s, low activity is mostly in the back part of the brain; while frontal lobe dementia occurs in the front. In 2008, researchers in France developed an automated system for measuring brain tissue loss using magnetic resonance imaging (MRI) technology to help doctors diagnose Alzheimer’s disease and mild cognitive impairment. In Alzheimer’s disease, the buildup of certain proteins in the brain leads to brain cell and brain tissue death; the hardest-hit part of the brain is the hippocampus, which affects memory.The automated MRI system helps in diagnosing Alzheimer’s by speeding up the process of visually measuring shrinkage in the hippocampus consistent with the disease.

800Seniors.com is a leading referral system in the Elderly Healthcare industry. We are located on 5400 Atlantis Court, Moorpark, California 93021. 800Seniors.com provides the perfect match between seniors searching for health care provisions such as Home Care Philadelphia, Home Health, Skilled Nursing, Hospice Care, Medical Supplies, as well as a variety of Assisted Living Facilities and Care Homes nationwide. Take the confusion and hassle out of the search. For more information call 1-800-768-8221, visit http://800seniors.com or fax us your details at (805)517-1623.

About The Author: Gloria Ha’o Schneider is an expert in senior citizen and baby boomer issues. Her topics revolve around Senior Living and Healthcare to provide the latest information to this demographic as well as their families and loved ones.

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Clinical Progress For Alzheimer’s Detection

August 17, 2011 Leave a comment

Doctors can usually determine if a patient has dementia, and around 90 percent of the time they can accurately identify whether the dementia is due to Alzheimer’s disease. This diagnoses however, usually takes place after the disease has profoundly affected the brain and is causing severe symptoms. At this point in time, Alzheimer’s can only be diagnosed with complete accuracy after death, when microscopic examination of the brain reveals the characteristic plaques and tangles of the disease. In early April, The National Institute on Aging and the Alzheimer’s Association issued a new set of guidelines that categorize Alzheimer’s disease into three stages:
A phase when dementia has already developed and mental dysfunction is apparent.
A middle phase in which mild problems emerge but daily functions can still be performed.
The most recently discovered phase, in which no symptoms are evident but changes are taking place in the brain and are manifested by alterations of certain biomarkers (measurable substances in the blood or spinal fluid correlated with the disease) or in imaging studies such as MRI or PET scans.

This clarification is especially important since there are currently no drugs available that can effectively halt or significantly delay the onset of symptoms, although a few of the approved drugs can slow progression of the disease for a few months in a minority of patients. Currently, cerebral spinal fluid analyses and brain scans test for abnormal levels of the proteins beta-amyloid and tau, or shrinkage of certain brain areas, respectively. These tests, however, are still under investigation and are not yet reliably predictive for definite diagnosis of Alzheimer’s, except in advanced cases. The use of biomarkers in Alzheimer’s dementia and mild cognitive impairment due to Alzheimer’s was also proposed as a research agenda only, and is not intended for application in clinical settings at this time.

William Thies, Ph.D., Alzheimer’s Association Chief Medical and Scientific Officer said, “It is our hope that incorporating scientific knowledge gained and technological advances made over the past quarter century will improve current diagnosis, bring the field closer to earlier detection and treatment and, ultimately, lead to effective disease-modifying therapies.” He added that the “Development and publication of these articles is a major landmark in the field. That said, publication of these articles is not yet the end of the process of developing new diagnostic criteria for Alzheimer’s, but is another major step in the process.” The ultimate goal is to identify reliable biomarkers that will accurately predict the eventual development of Alzheimer’s. “The sooner we can get such indicators, the more likely we’ll be able to interfere with the disease’s progress, especially when we develop effective new pharmaceutical treatments,” says ACSH’s Dr. Gilbert Ross. “Building such a database of research will hopefully break the chain of events that, at this point, irrevocably lead to Alzheimer’s. Hopefully, we’ll be able to break this chain within ten years or less, when the pathogenesis is more clearly delineated and focused drug interventions will be accelerated.”

800Seniors is a distinguished nationwide Senior Healthcare referral service. They are based in Southern California, located on 5400 Atlantis Court, Moorpark, California 93021. 800Seniors offers seniors citizens a range of different health care options. Based upon their needs they can opt for Home Care, Home Health, Skilled Nursing, Hospice Care, Medical Supplies, as well as a variety of Care Homes Phoenix and Assisted Living nationwide. 800Seniors makes life easier by taking away the confusion and hassle. For more information about 800Seniors call 1-800-768-8221, visit http://800seniors.com or fax us your details at (805)517-1623.

About The Author: Gloria Ha’o Schneider is an expert in senior citizen and baby boomer issues. Her topics revolve around Senior Living and Healthcare to provide the latest information to this demographic as well as their families and loved ones.

Walking & Nighttime Restlessness In Those With Dementia

August 11, 2011 Leave a comment

As countless studies have shown, nighttime routine, especially in the hectic society we live in, is key to having clarity the next day. Even without the research, most people know what it is like trying to function normally the day after a bad night’s sleep. Impaired sleep is especially common in older persons and is associated with poor daytime function, greater risk of mood disorders, poorer quality of life, impaired immune function and greater rates of falls, injuries, physician visits and healthcare costs. Sleep problems are particularly prevalent in persons with Alzheimer’s disease and related dementias. Many independent and assisted living homes are part of a larger complex called a Continuing Care Retirement Community. CCRCs are communities that offer several levels of health care on one campus. Some states refer to them as “residential living.” Independent Living is for residents who do not require personal assistance. Assisted Living is for those who require some assistance with the activities of daily life such as eating, bathing, walking and medication.

Memory Care, sometimes referred to as “special care” provides assistance to those who are have cognitive impairment and suffer from Alzheimer’s disease and other types of dementia. Skilled Nursing and Rehabilitation, both short and long term, are provided at an on-campus Health Care Center. Many patients living in the Memory Care wings need special nighttime monitoring to assure their safety because of restlessness and the tendency to wander, a condition that accompanies the disease. Scientists theorize that sleep disturbances in people with dementia may be caused in part by a reduction of external cues that synchronize our internal “clock” to the 24-hour light and dark cycle, called the Circadian Rhythm.  Within the Circadian cycle, a person usually sleeps approximately 8 hours and is awake 16. During the wakeful hours, mental and physical functions are most active and tissue cell growth increases. During sleep, activities nearly disappear and there is a decrease in metabolic rate, respiration, heart rate, body temperature, and blood pressure. The activity of the digestive system decreases during the resting period, but that of the urinary system increases.

insomnia by *dreamon72 on deviantART

Patients with Alzheimer’s and dementia whose biological clocks are not functioning normally are significantly affected with restlessness, insomnia and the resulting nighttime wandering. A variety of factors can trigger wandering in Alzheimer’s patients, but it is more likely to happen if a patient or resident:
Is restless, pacing, or making repetitive motions.
Is having trouble finding familiar places like the bathroom or kitchen.
Is trying to investigate where familiar people are.
Seems to be performing a hobby or chore, but gets nothing done.
Becomes lost or confused in a new environment.
Attempts to go to work or fulfill some other former obligation.
Wants to “go home” even if they are already are.

Healthcare workers and staff in memory care units utilize methods of dissuading or preventing an Alzheimer’s or dementia patient from wandering such as:
Encouraging daytime movement, exercise, and recreational activities such as music therapy or movie watching, especially if the person is pacing or seems restless. Lower levels of daily physical activity have been proven to be associated with sleep disturbances. Making sure basic needs, like hunger, thirst or bathroom necessities are met, as the person may wander to meet these needs. Securing exit doors in a way that makes them difficult to open, or camouflaging doorknobs or doors with cloth or curtains. Placing large signs on exits that say “Stop” or “Do Not Enter.” Taking precautions, knowing the triggers, and planning can all help protect and retrieve a patient with dementia who may be restless and try to wander off.

800Seniors.com is a leading referral system in the Elderly Healthcare industry. We are located on 5400 Atlantis Court, Moorpark, California 93021. 800Seniors.com provides the perfect match between seniors searching for health care provisions such as Home Care, Home Health, Skilled Nursing, Hospice Care, Medical Supplies, as well as a variety of Assisted Living Los Angeles and Care Homes nationwide. Take the confusion and hassle out of the search. For more information call 1-800-768-8221, visit http://800seniors.com or fax us your details at (805)517-1623.

About The Author: Gloria Ha’o Schneider is an expert in senior citizen and baby boomer issues. Her topics revolve around Senior Living and Healthcare to provide the latest information to this demographic as well as their families and loved ones.

Tube Feeding Depends On The Attitude Of The Facility

July 6, 2011 Leave a comment

By the year 2030, the number of people in the United States over 65 will soar to 71.5 million. The healthcare industry is keeping pace by providing communities with the housing and care resources needed to accommodate the nation’s aging population. Independent, assisted living and memory care facilities are oftentimes located on the same property and are known as Continuing Care Retirement Communities.  At a CCRC, residents can move within the tiers as their conditions may change over the years. Many assisted living facilities are also stand alone homes that frequently have wings for providing memory care to those residents with loss of cognitive skills such as those with Alzheimer’s disease or other forms of dementia.

Tube feeding is a procedure used in acute care hospitals for patients recovering from certain surgeries, those with neurological problems, some going through intense chemotherapy or for any reason, are unable to receive proper nutrition by swallowing. Feeding tubes, or the medical term, Percutaneous Endoscopic Gastrostomy, (PEG), are frequently utilized to provide nutrition for the elderly. Many of these elderly patients reside in assisted living facilities and skilled nursing facilities. Though the procedure is fairly routine medically, there are many complex issues surrounding PEG use, particularly for patients near the end of life, where the decision to use or not to use a PEG is frequently made without the participation of the patient.

The ethical picture is further clouded by several studies that question the medical benefit of PEGs in elderly demented patients, a group that receives a high percentage of the PEG procedures currently done. Other studies have found a surprisingly high death rate for those patients within one month of a PEG insertion. Tube feeding has been shown to have no demonstrable benefit in assisted living or skilled nursing patients with advanced cognitive impairment, yet its use within this population reveals a striking and unexplained variation within the United States.

Half complete memory by *Jangmai on deviantART

The Journal of the American Medical Association has published a report on a study of patients with advanced cognitive impairment and found that 70% of feeding tube insertions were done in the acute care hospital prior to the patient being moved to an assisted living facility. The study suggests that higher insertion rates are associated with the following acute hospital factors:

For profit ownership vs. government owned
Larger size vs. smaller size (more than 310 beds vs. less than 101 beds)
A more aggressive approach to end of life care, meaning greater use of the intensive care unit in the last 6 months of life as opposed to a memory care facility or hospice.

A field study was also done in two South Carolina assisted living facilities. Field studies are based on the idea that humans are best understood to the fullest possible context if it includes the place where they live, the improvements they’ve made to that place, how they are making a living and providing food, housing, energy and water for themselves or others, what language(s) they speak and so on. The study revealed a startling variation in the culture of the organizations and its influence on attitudes toward tube feeding. Key features in assisted living facilities with low use of feeding tubes:

A more home like environment in which food, mealtimes, and family are central.
Administrative support in solving feeding problems.
Emphasis on the value of, and sufficient staff for hand feeding.
Family inclusion in decision making.

In contrast, the high use feeding tube facility had an impersonal, institutional atmosphere with strictly scheduled and poorly staffed mealtimes.  Staff attitudes favored tube feeding, and though the decision making process was not clear, it emphatically did NOT include family. If you are considering a Continuing Care Retirement Community or a standalone assisted living facility that most often includes a memory care wing for the cognitively impaired, it is essential to ask about their policy on tube feeding. Using an experienced, qualified referral service to assist you in the process, can help you determine the attitudes and policies of the organization where you or your loved one will reside.

800Seniors.com is a leading referral system in the Elderly Healthcare industry. We are located on 5400 Atlantis Court, Moorpark, California 93021. 800Seniors.com provides the perfect match between seniors searching for health care provisions such as Home Care, Home Health, Skilled Nursing, Hospice Care, Medical Supplies, as well as a variety of Assisted Living Philadelphia and Care Homes nationwide. Take the confusion and hassle out of the search. For more information call 1-800-768-8221, visit http://800seniors.com or fax us your details at (805)517-1623.

About The Author: Gloria Ha’o Schneider is an expert in senior citizen and baby boomer issues. Her topics revolve around Senior Living and Healthcare to provide the latest information to this demographic as well as their families and loved ones.

Memory Loss: What’s Normal And What Isn’t

June 17, 2011 Leave a comment

Most of us have moments or glitches when we have trouble remembering something that just happened, like where we placed our keys when we got home, or the name of someone you met 10 minutes earlier. In younger people, there could be a host of reasons why these things happen. There are many psychological and physical disorders that affect memory that have nothing to do with aging. Stress, depression, being preoccupied or just downright tired can cause brief memory glitches. Other causes can include low blood sugar, taking medications such as antidepressants and antihistamines or having an over or underactive thyroid.

According to Dr. De Santi in a recent Ladies Home Journal article, “aging does play a role in memory loss much in the same way you may not run as fast in your 40s as you did in your 20s.” “And while you lose neutrons as you age, your brain makes new ones. There’s a big difference between normal slowing down and serious cognitive impairment,” Dr. De Santi says. How can you tell if your memory problems are serious? A memory problem is serious when it affects your daily living. If you sometimes forget names, you’re probably okay.

Thoughts by *marimochida on deviantART

Problems that aren’t part of normal aging :

Forgetting things much more often than you used to
Forgetting how to do things you’ve done many times before
Trouble learning new things
Repeating phrases or stories in the same conversation
Trouble making choices or handling money
Not being able to keep track of what happens each day
Trouble doing things that requires steps (such as following a recipe)

Another difference between normal memory problems and dementia is that normal memory loss doesn’t get much worse over time. Dementia gets much worse over several months to several years. It may be hard to figure out on your own if you have a serious problem. Talk to your family doctor about any concerns you have. If your memory problems are caused by a certain medicine you’re taking, your doctor can prescribe another medicine that doesn’t have the side effect. If another condition is causing your memory loss (such as depression), your doctor can help you treat that condition. If a loved one has progressed into a state of serious, cognitive impairment and is having difficulty with everyday tasks, you may want to consider an assisted living environment.

800Seniors.com is a leading referral system in the Elderly Healthcare industry. We are located on 5400 Atlantis Court, Moorpark, California 93021. 800Seniors.com provides the perfect match between seniors searching for health care provisions such as Home Care, Home Health, Skilled Nursing, Hospice Care, Medical Supplies, as well as a variety of Assisted Living San Diego and Care Homes nationwide. Take the confusion and hassle out of the search. For more information call 1-800-768-8221, visit http://800seniors.com or fax us your details at (805)517-1623.

About The Author: Gloria Ha’o Schneider is an expert in senior citizen and baby boomer issues. Her topics revolve around Senior Living and Healthcare to provide the latest information to this demographic as well as their families and loved ones.

Simple Tests Undertaken By Assisted Living Facilities For Determining Cognitive Impairment Among Seniors

August 9, 2010 Leave a comment

Dementia refers to a cluster of symptoms caused by changes in brain function. Memory loss is the earmark of demen­tia but personality and behavior changes are also common. Nearly everyone experiences memory lapses as they age, but Dementia inter­feres with a person’s ability to carry out daily activities. The risks increase with age. According to statistics they increase by 5% after the age of 65 and by 20% after age 80. New technologies in brain imaging represent significant advances in Alzheimer’s research and diagnosis. Other decidedly, low-tech screening tests may offer a quick and inexpensive snapshot of a person’s cognitive health. Whether any of these tests is accurate enough to be widely used for screening remains uncertain, but taking one or several tests may be useful on an individual basis. Many assisted living facilities are specifically designed for the care of Alzheimer and Dementia patients. These Assisted Living Facilities conduct regular tests on their patients to apprehend their cognitive ability and the progress of their conditions.

Diagnosing the many forms of Dementia is a process of differentiating between age associated memory impairment and Dementia due to a medical condition and involves a process of systematic elimination. Doctors often start by looking at conditions that are correct­able. Patients may have physical or psychological conditions, such as a high fever, urinary tract infections, depression, minor head injuries and dehydration that can affect their mental conditions. Many times their mental conditions can be cured by treating their physical issues. Most serious forms of dementia are not reversible. If physical problems of the patient are addressed and mental conditions of the patients continue, then more serious, irreversible dementias such as Alzheimer’s disease are likely.  A few standard tests are undertaken to measure cognitive impairment of the patient.

Thought Process by ~Cazacan on deviantART

Clock Drawing Test

The Clock Drawing Test is the most well known of the screening tests for dementia. Patients are asked to draw a clock with the hands pointing to a specified time—for example, 2:45. The most complete, well-organized, accurate, and spatially correct drawing is rated a “10,” and the least represen­tative is rated a “1.” The more distorted and inaccurate the drawings are, the more likely the person is suffering from a serious form of Dementia.

Time Test

This test measures the ability to tell time. The patient is given 60 seconds to read the time on a clock and are given 2 attempts to get it right.

Making Change/Simple Math Test

In the change test, the person is given three quarters, seven dimes, and seven nickels and asked to make change for a dollar. The change test has a 3 minute limit, with 2 attempts allowed.

Sniff Test

Researchers have known for some time that loss of the sense of smell can be an early warning sign of Alzheimer’s disease. The beta-amyloid plaques that ultimately destroy memory and other cognitive abilities accumulate first in areas of the brain that are responsible for percep­tion of odors. In a paper presented at a recent meeting of the American College of Neuropsy­chopharmacology, people with mild cognitive impairment were given a 10 item sniff test. The odors were lemon, strawberry, pineapple, lilac, clove, menthol, smoke, natural gas, soap, and leather. Those who participated in the study and misidentified more than 2 of the odors were 5 times more likely to suffer from Alzheimer’s disease than those who performed better on the test.

Important Note:  The tests described are for screening purposes as opposed to diagnostic testing. The tests were designed to be administered and interpreted by a healthcare professional. Poor results are an indication of probable cognitive impairment, but more sophisticated testing is necessary to make a diagnosis of any type of dementia. Assisted Living Facilities regularly perform tests to diagnose dementia among their senior patients. Accordingly medical care is provided for their patients to deal with their specific conditions.

800Seniors.com is a leading referral system in the Elderly Healthcare industry. We are located on 5400 Atlantis Court, Moorpark, California 93021. 800Seniors.com provides the perfect match between seniors searching for health care provisions such as Home Care, Home Health, Skilled Nursing, Hospice Care, Medical Supplies, as well as a variety of Assisted Living Phoenix and Care Homes nationwide. Take the confusion and hassle out of the search. For more information call 1-800-768-8221, visit http://800seniors.com or fax us your details at (805)517-1623.

About The Author: Gloria Ha’o Schneider is an expert in senior citizen and baby boomer issues. Her topics revolve around Senior Living and Healthcare to provide the latest information to this demographic as well as their families and loved ones.

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