Archive for the 'Elderly' Category

Treatment for sleep apnea may improve mental function in Alzheimers

NightAlzheimer’s patients who also have obstructive sleep apnea may experience improved mental function from treatment with continuous positive airway pressure (CPAP), according to a recent study from University of California San Diego.

Previous studies have suggested that more severe dementia is associated with more severe obstructive sleep apnea. And in fact, Alzheimer’s patients have a high incidence of obstructive sleep apnea. Previous studies have found that approximately 70% to 80% of Alzheimer’s patients experience at least five episodes of apnea or hypopnea per hour and 40% to 50% have 20 or more episodes per hour.

Sleep apnea occurs when a person’s breathing repeatedly stops and starts for short periods of time during sleep. This abnormal breathing pattern only occurs during sleep, therefore, the person with the disorder may be the last to know he or she has a problem.

Obstructive sleep apnea (OSA), is usually associated with loud snoring (though not everyone who snores has this disorder). Risk factors for obstructive sleep apnea include being male, overweight, and over the age of forty. This condition occurs two to three times more often in older adults and is twice as common in men as in women.  However, sleep apnea can affect anyone at any age, even children.

If you think you might have sleep apnea, ask your health care provider for help.

Read more about Obstructive Sleep Apnea from Bay Area Medical Information

via Ancoli-Israel S, et al “Cognitive effects of treating obstructive sleep apnea in Alzheimer’s disease: a randomized controlled study” J Am Geriatr Soc. 2008; 56: 2076-2081.

via MedPage Today, December 4, 2008

Simple screening for mental decline in five minutes

The Mini-Cog is a simple written screening toolScreening for mild cognitive impairment can be accomplished in less than five minutes with a three-word memory test and a clock-drawing task, according to Emory researchers. This new test, called the Mini-Cog, is reasonably accurate and allows quick screening by health care professionals. It appears to be a valuable aid for early identification of patients who might be at risk for later development of a serious dementia, such as Alzheimer’s Disease. 

The Mini-Cog, combined with a simple functional activities questionnaire, accurately diagnosed 83% of patients with mild cognitive impairment, in this recent Emory study.  Current screening for mild cognitive impairment is often logistically difficult because it typically requires 40 to 60 minutes of formal neuropsychological testing and it only achieves 80% accuracy or higher. 

Dementia is defined by the American Psychiatric Association as an acquired syndrome of decline in memory and at least one other cognitive domain such as language, visuo-spatial, or executive function sufficient to interfere with social or occupational functioning in an alert person.  It’s very important to keep in mind that the word dementia describes a general syndrome and many different diseases can cause dementia. Alzheimer’s disease and cerebrovascular ischemia (vascular dementia) are the 2 most common causes. Some potentially reversible conditions, such as hypothyroidism or vitamin B-12 deficiency, are also some of the many different causes of dementia.

The Mini-Cog test results should only be used in conjunction with other testing  in forming a diagnosis by a health care professionals, and should not be used in isolation of diagnostic tests for Alzheimer’s disease.

If a family member starts showing signs of memory loss or other symptoms of mental decline, never assume that nothing can be done.  See your health care provider for evaluation and help.

“Memory Loss Screening Tool for Caregivers/Family” from Bay Area Medical Information

The Mini-Cog” from Bay Area Medical Information

Symptoms Linked to Ovarian Cancer

A new study has found that ovarian cancer is associated with a specific set of symptoms that should trigger further evaluation by a physician, or ideally a gynecologist. As a result of this study, a statement has been released to the public urging that a woman be evaluated if she has the following nonspecific symptoms almost daily for more than a few weeks:

  • Bloating
  • Pelvic or abdominal pain
  • Difficulty eating or feeling full quickly
  • Urinary symptoms (urgency or frequency).

Broccoli may slow progression of COPD

A recent study has indicated that  an anti-oxidant found in broccoli, sulforaphane, may help slow the progression of COPD.  The work is preliminary and conducted solely on mouse cells, but this research may hold the key to determining why some people develop emphysema while others don’t. 

While eating broccoli may be good for your lungs, if you’re a smoker, the best thing to do for them is put down the cigarette.

via MedPageToday

Brain atrophy associated with low intake of Vitamin B12

Brain moleculesVitamin B12 is good for the brain. In a recent study out of Oxford, England, low levels of vitamin B12 were associated with increased rates of brain atrophy in older people.(1,2)   (The image shows the neurons in the brain signalling each other. The mists of color show the flow of important molecules like glucose and oxygen. Image courtesy of NIGMS/artist Kim Hager at the Univ of California, and neurobiologist Neal Prakash, UCLA.)

Vitamin B12 is found in meat, fish, fortified cereals, and milk, but up to 30 percent of adults >50 have difficulty absorbing the naturally occurring form of vitamin B12 from food sources. Synthetic vitamin B12 in a supplement or in fortified foods is better absorbed and is recommended by the Nat’l Academies of Science. The Recommended Dietary Allowances (RDAs) of Vitamin B12 for adults is 2.4 µg/ day. Adults age 50 and over should obtain their daily requirement of Vitamin B12, and all B Vitamins, in fortified breakfast cereals or from multivitamin-mineral supplements.(3) 

Fortunately you don’t have to worry about toxic levels of Vitamin B12 as it is a water-soluble vitamin and has a very low potential for toxicity. There have been no adverse effects reported due to excess vitamin B12 intake from food or supplements in healthy individuals.(4)

  1. via Low B12 Linked to Brain Atrophy, MedPage Today, Sept 8, 2008
  2. via Vogiatzoglou A, et al “Vitamin B12 status and rate of brain volume loss in community-dwelling elderly” Neurology 2008; 71: 826-832. 
  3. via  Institute of Medicine, National Academies of Science The Institute of Medicine serves as adviser to the nation to improve health. 
  4.  Vitamin B12: Vitamin Supplement Fact Sheet from the Office of Dietary Supplements, National Institute of Health

Eye irritation, a common problem with a simple solution

Irritated eyesHave your eyes gradually become irritated and somewhat reddened? Have you noticed slight difficulty with reading? If you have, it’s important to check with your health care provider or eye doctor right away instead of merely dismissing these symptoms as being due to annoying allergies or the unavoidable pitfalls of aging.

This can be a cause for a number of serious conditions, but it can also be caused by one very common disorder, which is relatively simple to treat. It is called Dry Eye Syndrome and affects approximately 10-30% of the population, especially those older than 40.

The symptoms, at first, are only barely noticeable, but over time one or more of the following eye symptoms start developing:

  • irritation
  • itching
  • burning
  • redness of the whites of the eyes or the margin of the eyelids
  • mucous build up or dry crusty mucous on the eyelid margin
  • sometimes excessive watering instead of dryness 
  • light sensitivity
  • blurred vision, and difficulty reading

The symptoms are made worse by smoky or dry environments, indoor heating, and excessive reading or computer use. Running a ceiling fan all night in the bedroom is very drying to the eyes and enough to cause a flare up of symptoms.  It’s hard to believe that this could make a difference since you’re sleeping with your eyes closed, but apparently the wind from the fan reaches the surface of your eye and drys it out, even when the eyelid is closed. 

If you think you might have Dry Eye Syndrome, see your health care provider or eye doctor and ask about:

  • Artificial tears (Artificial tears are sold over-the-counter and are to be used several times a day.  Recommended artificial tears include: Systane, Optive, Refresh, Gen-Teal, Visine Pure Tears, Soothe, Thera-Tears)
  • Punctal Plugs to be inserted by an ophthalmologist. Your tears drain through tiny openings (puncta) in your eyelids.  Your ophthalmologist can treat dry eyes by painlessly plugging these tiny openings with microscopic silicone plugs (punctual plugs). These plugs close the tiny opening (punctum) that you have in the inner corner of your upper and lower eyelid so your own tears remain in your eyes longer.  This procedure does not last permanently and has to be repeated after a period of time. The clinical efficacy of silicone punctal plug therapy
  • Restasis (A prescription eyedrop that successfully treats the underlying cause of dry eye in most patients.  Ask your doctor if it is right for you.)
  • Fish oil capsules 500 mg twice daily or Flaxseed oil capsules 1000 mg twice daily with meals. Caution: Taking fish oil supplements should be done in consultation with your physician. High intakes could cause excessive bleeding in some people. Of particular concern are people expecting to undergo surgery, or those with bleeding disorders such as hemophilia, and those taking blood thinners, such as Coumadin (warfarin) heparin, Lovenox, anti-platelet drugs, such as Plavix (clopidogrel); and nonsteroidal anti-inflammatory drugs, such as ibuprofen (Motrin, Advil) or naproxen (Naprosyn, Aleve), or even aspirin. Also, small reductions in blood pressure can occur.

via “Dry Eye Syndrome” Medline Plus


Regular exercise linked with improved memory

Older adults enjoying exerciseRegular exercise was associated with improved memory in older adults with mild mental decline, in this recent study from Australia.  The exercise program consisted of fifty-minute, moderate-intensity exercise, three times weekly for six months.  Walking was the most frequent activity, although some chose light strength training or other aerobic exercise. In this randomized controlled trial, 311 volunteers were aged 50 to 89 years old, and participants reported memory problems but did not meet the criteria for dementia.

This study joins the growing body of literature regarding the health benefits of exercise.  Regular exercise not only greatly extends the length of your life, but to a large extent enhances the quality of your life.  Exercise is good for every organ in your body, and there are studies that show the following benefits of exercise:

  1. Promotes weight loss and burns fat
  2. Strengthens muscles
  3. Improves balance and prevent falls in the elderly
  4. Increases endurance
  5. Increases energy
  6. Decreases pain from arthritis
  7. Improves quality of sleep
  8. Improves blood cholesterol & triglyceride levels
  9. Strengthens the heart
  10. Improves hypertension
  11. Improves sex life (erectile dysfunction, and/or sex drive, and/or energy) 
  12. Lowers blood sugar
  13. Improves immune function
  14. Lowers the risk of breast cancer
  15. Wards off viruses & other common illnesses
  16. Helps relieve symptoms of depression; stabilize mood swings
  17. Promotes a sense of well-being
  18. Improves self image and self-esteem.
  19. Diminishes facial wrinkles

Read more about the Basics of Exercise and how to get started from Bay Area Medical Information 

 via MedPage Today, Sept. 2, 2008

Lautenschlager NT, et al “Effect of Physical Activity on Cognitive Function in Older Adults at Risk for Alzheimer Disease: A Randomized Trial” JAMA 2008; 300: 1027-1037.

The leading cause of injury death for those over 65

Falls are the leading cause of injury death and hospitalization for people over 65 in the United States.   One out of every three persons over age 65 falls each year, and two-thirds of those who fall do so again within six months. 

According to the CDC, “The causes of falls can be divided into two categories, personal factors and environmental factors. Personal factors include muscle weakness, balance problems, limited vision, and taking certain medications such as tranquillizers or antidepressants. Environmental factors include home hazards such as clutter, loose rugs or other tripping hazards, poor lighting, especially on stairs, and not having stair railings or grab bars in the bathroom.”

Preventing a fall in the first place is key, and the CDC has developed a comprehensive program of proven strategies that help reduce falls in older adults: “Preventing Falls Among Older Adults”

Dogs raise spirits at the nursing home

Golden retrieverNursing home visits by a dog, brings out positive behavior from dementia patients, in a recent Australian study.  Researchers from the University of Adelaide, conducted therapy sessions, lasting for one week,  consisting of a one-hour group session twice a week with a group of dementia patients. The therapy group consisted of an activities therapist, two visiting dog handlers, and one dog.  Residents could pat and interact with the dog as the handler walked it around the group. 

They found that the group of dementia patients who participated in the group session tended to laugh, smile, and respond more, and these positive effects lasted for the next six weeks. 

Although this was a small study, the researchers felt that the dogs did indeed make a difference. In an article by MedPage Today, the researcher said, ”One of the hardest things for residents is leaving their pet behind.”

via MedPage Today, August 27, 2008 

via Wordley AM, et al “Animal-Assisted Therapy for People with Dementia Living in Residential Aged Care Facilities” DCC 2008; PS-19.

Nuts and corn might be harmless in diverticular disease

PeanutsA new study of nearly 48,000 men found no truth to the commonly held belief that people with diverticular disease should avoid eating nuts, corn, and popcorn.   

It is commonly recommended that patients with diverticular disease avoid eating these foods because they are believed to increase the risk for complications by damaging the intestinal mucosa or by lodging in the diverticula, according to the researchers. However, there is little evidence to support this, the researchers say, and these recommendations should be reconsidered.  

If you have diverticular disease, and have been avoiding these foods, ask your doctor before adding them back into your diet.

via Strate L, et al “Nut, corn, and popcorn consumption and the incidence of diverticular disease” JAMA 2008; 300: 907-914.

via MedPage Today, August 26, 2008