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Archive for Facts about Dementia
What is Korsakoff Syndrome?
Korsakoff Syndrome is a chronic memory disorder caused by severe deficiency of thiamine (vitamin B-1). Thiamine helps brain cells produce energy from sugar. When levels fall too low, brain cells cannot generate enough energy to function properly.
Korsakoff syndrome is most commonly caused by alcohol misuse, but can also be associated with AIDS, cancers that have spread throughout the body, chronic infections, poor nutrition and certain other conditions.
Korsakoff syndrome is often — but not always — preceded by an episode of Wernicke encephalopathy, which is an acute brain reaction to severe lack of thiamine. Wernicke encephalopathy is a medical emergency that causes life-threatening brain disruption, profound confusion, staggering and stumbling, lack of coordination, and abnormal involuntary eye movements.
Because the chronic memory loss of Korsakoff syndrome often follows an episode of Wernicke encephalopathy, the chronic disorder is sometimes know as Wernicke-Korsakoff syndrome. But Korsakoff syndrome can also develop in individuals who have not had a clear-cut prior episode of Wernicke encephalopathy.
Korsakoff syndrome and its associated thiamine deficiency is not the only mechanism through which heavy drinking may contribute to chronic thinking changes and cognitive decline. Alcohol misuse may also lead to brain damage through the direct toxic effects of alcohol on brain cells; the biological stress of repeated intoxication and withdrawal; alcohol-related cerebrovascular disease; and head injuries from falls sustained when inebriated.
Causes and Risk Factors
Scientists don’t yet know exactly how Korsakoff syndrome damages the brain. Research has shown that severe thiamine deficiency disrupts several biochemicals that play key roles in carrying signals among brain cells and in storing and retrieving memories. These disruptions destroy brain cells and cause widespread microscopic bleeding and scar tissue.
Most cases of Korsakoff syndrome result from alcohol misuse. Scientists don’t yet know why heavy drinking causes severe thiamine deficiency in some alcoholics, while other may be affected primarily by alcohol’s effects on the liver, stomach, heart, intestines, or other body systems.
Treatment
Some experts recommend that heavy drinkers and others at risk of thiamine deficiency take oral supplements of thiamine and other vitamins under their doctor’s supervision.
Many experts also recommend that anyone with a history of heavy alcohol use who experience symptoms associated with Wernicke encephalopathy, including acute confusion, prolonged nausea and vomiting, unusual fatigue or weakness, or low body temperature or blood pressure, be given injectable thiamine until the clinical picture grows clearer.
Once acute symptoms improve, individuals should be carefully evaluated to determine if their medical history, alcohol use and pattern of memory problems may be consistent with Korsakoff syndrome. For those who develop Korsakoff syndrome, extended treatment with oral thiamine, other vitamins and magnesium may increase chances of symptom improvement.
Abstaining from alcohol is a cornerstone of effective long-term treatment. Those with Korsakoff syndrome have a reduce tolerance for alcohol and may be at high risk for further alcohol-related health problems.
What is Lewy Body Dementia?
Lewy Body dementia is a type of dementia that leads to progressive decline in thinking, reasoning, and independent function because of abnormal microscopic deposits that gradually destroy certain brain cells. The deposits are called “Lewy bodies” after the neurologist who discovered them.
Lewy bodies are also found in several other brain disorders, including Alzheimer’s disease and Parkinson’s disease dementia. Many people with Parkinson’s eventually develop problems with thinking and reasoning, and many people with Lewy Body dementia experience movement symptoms, such as hunched posture, rigid muscles, a shuffling walk and trouble initiating movement. This overlap in symptoms and other evidence suggest that dementia with Lewy bodies, Parkinson’s disease, and Parkinson’s disease dementia may be linked.
Prevalence
Most experts estimate that Lewy Body dementia is the third most common cause of dementia after Alzheimer’s disease and vascular dementia, accounting for 10 to 25% of cases.
Symptoms
Hallmark Lewy Body symptoms include:
- Changes in thinking and reasoning
- Confusion and alertness that varies significantly from one time of day to another or from one day to the next
- Parkinson’s symptoms, such as a hunched posture, balance problems, and rigid muscles
- Visual hallucinations
- Delusions
- Trouble interpreting visual information
- Sleep disorders, such as acting out dreams
- Memory loss that may be less prominent than in Alzheimer’s
Diagnosis
There is no single test — or any combination of tests — that can conclusively diagnose Lewy Body dementia during life. A clinical diagnosis of Lewy Body dementia represents a physician’s best professional judgment about the reason for the person’s symptoms.
Treatment
There are no treatments that can slow or stop the brain cell damage caused by Lewy Body dementia. Current strategies focus on helping symptoms. If your treatment plan includes medications, it’s important to work closely with your physician to identify the drugs that work best for you and the most effective doses.
References, Resources, and Support
http://www.alz.org/dementia/dementia-with-lewy-bodies-symptoms.asp
Know the 10 Signs of Alzheimer’s Disease
It may be hard to know the difference between age-related changes and the first signs of Alzheimer’s disease. Some people may recognize changes in themselves before anyone else notices. Other times, friends and family will be the first to observe changes in memory, behavior, or abilities.
To help identify problems early, the Alzheimer’s Association has created a list of warning signs for Alzheimer’s and other dementias. Individuals may experience one or more of these in different degrees.
1. Memory loss that disrupts daily life
One of the most common signs of Alzheimer’s, especially in the early stages, is forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over and increasingly needing to rely on memory aids (e.g. reminder notes or electronic devices) or family members for things they used to handle on their own.
2. Challenges in planning or solving problems
Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficult concentrating and take much longer to do things than they did before.
3. Difficulty completing familiar tasks at home, at work or at leisure
People with Alzheimer’s often find it hard to complete daily tasks. Sometimes people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game.
4. Confusion with time or place
People with Alzheimer’s can lose track of dates, seasons, and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.
5. Trouble understanding visual images and spatial relationships
For some people, having vision problems is a sign of Alzheimer’s. They may have difficulty reading, judging distance and determining color or contrast, which may cause problems with driving.
6. New problems with words in speaking or writing
People with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g. calling a “watch” a “hand-clock”).
7. Misplacing things and losing the ability to retrace steps
A person with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time.
8. Decreased or poor judgment
People with Alzheimer’s may experience changes in judgment or decision making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean.
9. Withdrawal from work or social activities
A person with Alzheimer’s may start to remove themselves from hobbies, social activities, work projects, or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced.
10. Changes in mood or personality
The mood and personalities of people with Alzheimer’s can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone.
Connection between Alzheimer’s Disease and Down Syndrome
What is Down Syndrome?
Down syndrome is a condition in which a person is born with extra genetic material from chromosome 21, one of the 23 human chromosomes. In ways that scientists don’t yet understand, the extra copies of genes present in Down syndrome cause developmental problems and health issues. Down syndrome nearly always affects learning, language, and memory, but its impact varies widely from person to person. People with Down syndrome are valued members of their families and communities, and they contribute to society in a multitude of ways.
Prevalence and Prognosis
One in every 691 babies in the U.S. is born with Down syndrome, making Down syndrome the most common genetic condition. Approximately, 400,000 Americans have Down syndrome.
Due to advances in medical technology, individuals with Down syndrome are living longer than ever before (as many as 80% of adults with Down syndrome reach age 60, and many live even longer).
Down Syndrome and Alzheimer’s Disease (AD)
Studies suggest that more than 75% of those with Down syndrome aged 65 and older have Alzheimer’s disease, nearly 6 times the percentage of people in this age group who do not have Down syndrome. Because people with Down syndrome live, on average, 55 to 60 years, they are more likely to develop younger-onset Alzheimer’s (occurring before age 65) than late-onset Alzheimer’s (occurring at age 65 or older). Scientists think that the increased risk of dementia — like other health issues associated with Down syndrome — results from the extra genes present.
Symptoms of AD in Down Syndrome
In individuals with Down syndrome, changes in overall function, personality and behavior may be more common early signs of Alzheimer’s than memory loss and forgetfulness. Early symptoms include:
- Reduced interest in being sociable, conversing or expressing thoughts
- Decreased enthusiasm for usual activities
- Decline in ability to pay attention
- Sadness, fearfulness or anxiety
- Irritability, uncooperativeness or aggression
- Restlessness or sleep disturbances
- Seizures that begin in adulthood
- Changes in coordination and walking
- Increased noisiness or excitability
References, Resources, and Support
To learn more about this important topic or to access resources and support, please visit the websites listed below:
Click to access Aging%20and%20Down%20Syndrome.pdf
http://www.nlm.nih.gov/medlineplus/downsyndrome.html
http://www.alz.org/dementia/down-syndrome-alzheimers-symptoms.asp
2013-2014 Alzheimer’s Disease Progress Report: Insights and Challenges
Watch this video to learn more about what researchers are doing on a global level to help win the fight against Alzheimer’s disease. Check out the full 2013-2014 Alzheimer’s Disease Progress Report here.
NEW-2014 Facts and Figures
The Alzheimer’s Association 2014 Alzheimer’s Disease Facts and Figures report reveals that there are more than five million Americans living with Alzheimer’s disease, including 170,000 here in Michigan.
Additionally, there are 15.5 million Americans caring for someone with Alzheimer’s or another dementia. 505,000 of them are Michigan residents.
The Alzheimer’s Association Facts and Figures reveals that a woman’s estimated lifetime risk of developing Alzheimer’s at age 65 is 1 in 6, compared with nearly 1 in 11 for a man.
In addition to the human toll, Alzheimer’s Association Facts and Figures confirms that Alzheimer’s is the most expensive condition in the nation. Nearly one in every five dollars spent by Medicare is on people with Alzheimer’s or another dementia.
We have seen diseases like breast cancer, heart disease and HIV/AIDS make tremendous progress in prevention, early detection and treatment after the federal government made a significant investment. Comparable investments in Alzheimer’s are now needed to realize the same successes and save millions of lives.
If we could eliminate Alzheimer’s tomorrow, we could save half a million lives every year.
Want to learn more about this report? Check out the links below.
2014 Facts and Figures Full Report
2014 Facts and Figures Fact Sheet
2014 Facts and Figures Michigan Fact Sheet
2014 Facts and Figures Infographic
2014 Facts and Figures Chalk Infographic
Want to become an advocate for Alzheimer’s public policy? Click here.
Amyloid PET Imaging and Other Diagnostic Tools used for Alzheimer’s Disease
Ever thought about how physicians arrive at a diagnosis of Alzheimer’s disease or other dementias?
Finding Alzheimer’s disease (AD) is often a game of ruling out other causes — are the memory problems due to AD or is it something else? Is it caused by depression, vitamin deficiency, stress, sleep disturbances, infection, etc., etc.? Or are the memory problems in fact being caused by Alzheimer’s disease? Unfortunately there is no pass/fail test that will tell us immediately whether or not the person has a diagnosis. Because of the uncertainty with diagnosis, even experienced physicians can make mistakes and mis-diagnosis is not unheard of.
Comprehensive Diagnosis
- Subjective complaints
- Cognitive Testing
- Medical History
- Medical Tests (i.e. blood work and brain imaging)
Rule out
- Disturbed sleep
- Emotional disorders
- Metabolic disorders
- Eye and ear impairments
- Nutritional deficiency
- Tumors
- Infections
- Alcohol, drugs, or medication interactions
It used to be that brain autopsy was the only way to receive a definitive diagnosis of Alzheimer’s disease, but with improved testing this is no longer the case. Experienced clinicians have a 95% accuracy rate in diagnosis. Furthermore, physicians can now administer tests that measure specific biomarkers in the brain that help them to determine a diagnosis.
The formation of plaques and tangles in the brain are the two hallmarks of Alzheimer’s disease (AD). Plagues are composed of a protein, beta-amyloid, that abnormally clumps together in AD. Many nerve cells, also called neurons, die as the damage of AD spreads. Dead and dying nerve cells contain tangles, which are made up of a protein called tau. The tangles destroy a vital cell transport system in the brain.
Advances in research have produced certain diagnostic tools that measure levels of tau and beta-amyloid. For instance a clinician may analyze a patient’s cerebrospinal fluid (CSF) to look for these important biomarkers. CSF is a clear fluid that bathes and cushions the brain and spinal cord. Adults have about 1 pint of CSF, which physicians can sample through a minimally invasive procedure called a lumbar puncture, or spinal tap. Research suggests that Alzheimer’s disease in its earliest stages may cause changes in CSF.
Beta-amyloid is under significant scientific scrutiny, and amyloid-plaque formations can be found in all patients with AD. Progress in Alzheimer’s disease research and imaging has made it possible to detect beta-amyloid in the human brain using radioactive tracers and positron emission tomography (PET). See the picture of a PET scan below.
Amyloid PET Imaging
Despite these noteworthy advances, bear in mind that spinal taps and PET scans are not a definitive diagnosis! They are simply tools designed to increase the clinical certainty of the physician’s conclusion. Also note, that these tests are often expensive and not covered by most health insurances. Furthermore, amyloid imaging is usually only conducted in limited situations when the patient’s symptoms are atypical (e.g. young age of disease onset, symptoms do not satisfy criteria for AD, etc.).
Learn more about the steps involved in a diagnosis here, or call our 24/7 Harry L. Nelson Helpline to speak to a live representative.
Mentally Fit
Do computerized brain-training programs really work? Will doing Sudoku or crossword puzzles help to ward off cognitive decline?
As we age, our brain (like the rest of our body) loses some of the agility it once had. Normal aging is associated with a slower processing speed and less efficient working memory in the brain. These age-related changes, however, are modest; they are very different than neurological disorders such as Alzheimer’s disease. Furthermore, scientists now know that our brains are able to adapt, change, and re-organize throughout our entire lives — a phenomenon known as “neuroplasticity”. This means our neurons (nerve cells) have the capacity to learn and re-wire, even into old age. An old brain can learn new tricks!
So maybe you’re still asking — will ‘brain training’ help to promote brain health? Buyer beware. The research on such programs is preliminary and should be considered with caution. The games and exercises designed to improve brain performance aim to use neuroplasticity to improve core cognitive abilities; however, it is unclear whether these effects translate to real-life performance or whether these interventions have any appreciable effect on preventing neurological diseases.
In reality, there are many far more compelling interventions that may help to stave off cognitive decline than brain games or mind teasers. For example, brain-derived neurotrophic factor (BDNF) is a key component of neuroplasticity. Physical exercise and low-fat diets have been linked to increased production of BDNF and aid in neuroplasticity (Gomez-Pinilla, 2011). Want the most bang for your buck when it comes to brain health? Consider adopting a lifetsyle that incorporates regular physical exercise and a healthy, balanced diet.
Caution: There is still no proven method for preventing or delaying cognitive decline.
References
Gomez-Pinilla, F. G. (2011). Exercise impacts brain-derived neurotrophic factor plasticity by engaging mechanisms of epigenetic regulation.European Journal Of Neuroscience, 33(3), 383-390.
lumosity.com
Smith, G. M. (2009). A Cognitive Training Program Based on Principles of Brain Plasticity: Results from the Improvement in Memory with Plasticity-based Adaptive Cognitive Training (IMPACT) Study. Journal Of The American Geriatrics Society, 57(4), 594-603.
Zelinski, E. M., Spina, L. M., Yaffe, K., Ruff, R., Kennison, R. F., Mahncke, H. W., & Smith, G. E. (2011). Improvement in memory with plasticity-based adaptive cognitive training: results of the 3-month follow-up. Journal Of The American Geriatrics Society, 59(2), 258-265. doi:10.1111/j.1532-5415.2010.03277.x
alzheimersactivitiesPLUS 