THE SEASONS OF ONES LIFE Dementia and Alzheimers

1
THE SEASONS OF ONES LIFEDementia and
Alzheimers

• Prepared and Presented by
• Dr. Theresa Bradley, Psy.D.
• BRAVA CORPORATION
• www.bravacorp.com
• Ideas for the world from a world of ideas
• 4500 Connecticut Avenue NW 309 Washington, DC
  20008
• infor_at_bravacorp.com 202-537-2969

2
BRAVA CORPORATIONMENTAL HEALTH SERVICES

• If you have a parent or a loved one who has
  severe memory loss, dementia or Alzheimers this
  presentation will help you to implement
  prevention measures, understand the symptoms, how
  to obtain proper diagnosis and begin an effective
  treatment plan. You will learn how to protect
  yourself from this debilitating disease.

3
FACTS

• Today, 5 Million people (est.) suffer from
  Alzheimers or dementia.
• It is estimated that 60 Million people will be
  over age 65 by 2010 with 20 suffering from
  dementia or Alzheimers
• Thus, 13,000,000 million people a total of the
  number of people in the state of Florida today
  will suffer dementia or Alzheimers and its
  related disorders.

4
THE BRAIN A LOOK INSIDE

• PREVENT
• DETECT
• DIAGNOSE
• TREAT
• AND EVEN HALT ALZHEIMERS AND DEMENTIA

5
CAUSES OF DEGENERATION OF THE MIND

• 1. Formation of chemicals called free radicals
• that kill brain cells, lack of antioxidants.
• 2. Too much neurotransmitter-GLUTAMATE
• damages brain cells (begins at age 30).
• 3. Accumulation of substance called
• Beta Amyloid disrupts brain pathways.
• 4. Too much beta amyloid triggers strong
  inflammatory response further damage.
• 5. A protein called TAU, forms the backbone
• of nerve cells, becomes twisted and destroys
  cell function and damages brain cells.

6
COMBINED WITH OTHER FACTORS

• Stress
• Hypertension
• Alcohol
• Tobacco
• Poor diet
• Lack of exercise
• Drug Abuse (marijuana, cocaine, etc.)
• Brain trauma or injury

7
THE HEALTHY BRAIN

• The brain is the most complex and powerful organ
  in the universe.
• The brain is the command and control center of
  your life.
• The brain makes you who you are.
• The brain senses and integrates your inner world
  and the world around you.
• The brain produces your thoughts, feelings,
  memories, forethoughts and actions.
• The brain is the organ of learning, loving and
  working.

8
THE HEALTHY BRAIN SPECT IMAGING
9
UNHEALTHY BRAIN Alzheimers
10
UNHEALTHY BRAIN - Stroke
11
UNHEALTHY BRAIN Nicotine Alcohol
12
UNHEALTHY BRAIN - Heroin Marijuana
13
UNHEALTHY BRAIN Cocaine Meth
14
DISEASES Impairs Brain Function

• The brain uses over 100 BILLION NEURONS to
  perceive, analyze incoming information decides
  what, if anything, to do about the information
  and then instructs the body to do it.

15
BRAIN DISEASE

• A diseased brain reduces the number of neurons,
  reduces the synapses, impairs generation of
  action potentials, disrupts cell body machinery,
  damages axons to slow the speed they travel
  through the whole network.
• Alzheimers disease leads to nerve cell death and
  tissue loss throughout the brain. Over time, the
  brain shrinks dramatically, affecting nearly all
  its functions.

16
HEALTHY BRAIN ADVANCED
ALZHEIMERS
17

• In the Alzheimer brain
• The cortex shrivels up, damaging areas involved
  in thinking, planning and remembering.
• Shrinkage is especially severe in the
  hippocampus, an area of the cortex that plays a
  key role in formation of new memories.
• Ventricles (fluid-filled spaces within the brain)
  grow larger.

18
HOW MEMORY LOSS STARTS

• Dementia is defined as a progressive condition
  with two or more impairments in mental skills
  that interfere with a persons ability to
  function in his usual manner social, family,
  personal or professional life.

19
EARLIEST ALZHEIMERS STAGES

• In the earliest stages, before symptoms can be
  detected with current tests, plaques and tangles
  begin to form in brain areas involved in
• Learning and memory
• Thinking and planning

20
Early Stage Symptoms

• Early or mild stage
• memory loss, especially of recent events
• difficulty in recalling names conversations
• misplacing objects 
• becoming lost in familiar neighborhoods
• repeating stories and conversations
• difficulty in learning new information
• personality changes
• decreased motivation and drive
• easily upset or anxious 

21
DIAGNOSING ALZHEIMERS - ADRD

• 95 of persons with ADRD are diagnosed four years
  after the first symptoms appear. By that time
  they are mildly demented and completely dependent
  upon others for their care.
• Detecting ADRD this late is equivalent to
  diagnosing a diabetic when she is blind, has
  kidney failure, and can no longer feel her limbs.
  
• Starting treatment at the end stage of the
  disease is usually ineffective.

22
MILD TO MODERATE ALZHEIMERS

• In mild to moderate stages, brain regions
  important in memory and thinking and planning
  develop more plaques and tangles than were
  present in early stages. As a result, individuals
  develop problems with memory or thinking serious
  enough to interfere with work or social life.
  They may also get confused and have trouble
  handling money, expressing themselves and
  organizing their thoughts. Many people with
  Alzheimers are first diagnosed in these stages.
• Plaques and tangles also spread to areas involved
  in
• Speaking and understanding speech
• Your sense of where your body is in relation to
  objects around you.

23
Moderate Alzheimers

• Middle or moderate stage
• worsening memory loss, especially of current
  events
• depression, withdrawal, agitation, confusion,
  disorientation, paranoia
• increasing reliance on family for decision making
  and managing personal life

24
SEVERE ALZHEIMERS DISEASE

• In advanced Alzheimers disease, most of the
  cortex is seriously damaged. The brain shrinks
  dramatically due to widespread cell death.
  Individuals lose their ability to communicate, to
  recognize family and loved ones and to care for
  themselves.

25
Severe Alzheimers

• Later or severe stage
• unaware of time and place
• inability to identify family members
• increasing insecurity, suspiciousness, agitation,
  paranoia
• disturbed sleep, decreasing coordination
• requires constant care

26
JUST A SENIOR MOMENT?

• Research suggests that people who are aware of
  their memory lapses probably do not have a
  serious problem.
• While it is normal to forget the name of an
  acquaintance or the location of the car keys,
  people who forget the name of a close friend or
  what the car keys are for should consult with
  their doctors.

27
BRAIN DISEASES

• The most common brain diseases
• 1. Alzheimers
• 2. Lewy Body Disease
• 3. Parkinsons Disease
• 4. Frontal-Temporal Lobe Disease

28
KNOW YOUR RISKS

• Each audience member is provided a written
  test with interpretive scoring
• THE SHANKLE-AMEN DEMENTIA DECTECTION
  QUESTIONNAIRE

29
REDUCE YOUR RISK

• Know and reduce the risk factors that are under
  your control.
• Have a regular memory screening to detect
  problems early.
• Obtain an accurate, early diagnosis and then
  treatment.

30
YOUR RISK FACTORS NOT UNDER YOUR CONTROL

• Age the biggest risk factor
• Gender after age 75 ADRD
• greater risk for women
• Ethnic unknown
• Genetic 2 ApoE4 genes
• increases beta amyloid
• deposits and plaque formation.
• A family history that includes
• ADRD or Parkinsons Disease are
• more likely to develop ADRD or
• dementia.

31
Consulting With Your Doctor

• Anyone who is worried about a memory problem
  should
• see a doctor
• BEFORE TAKING ANY VITAMINS OR SUPPLEMENTS.

32
REDUCING RISK FACTORS Prevention Steps

• There is objective medical data (see www.alz.org
  and www.nih.gov) to show that
• Certain anti-oxidants, including Vitamin E,
• Ginkgo Biloba and Alpha Lipoic Acid may have
• disease delaying effects.
• Agents that prevent over stimulation by the
• neurotransmitter glutamate (prescription)
• Exelon, Reminyl, and Aricept (prescription)
• agents that enhance the neuro transmitter
• acetylcholine, a key brain substance

33
REDUCING RISK FACTORS Prevention Steps

• Low dose ibuprofen 200 400 mg/every other day
  block the production of beta amyloid reduces
  chance of AD 50.
• Low does aspirin (175 mg or less/alternate every
  other day with ibuprofen) reduces the chance of
  developing AD by 33 to 50.
• Structured activity programs delays disease
  progression institutionalization.
• Regular exercise probably delays disease
  progression.

34
VITAMINS SUPPLEMENTSfrom Preventing
Alzheimers by Dr. William Shankle, MD and
Dr. Daniel Amen, MD

• Vitamin E Mixed tocopherols Alpha/Gamma 400 I.U.
  2 xs/day no symptoms
• 1,000 I.U.
  2xs/day if symptoms
• Ginkgo Biloba 60 120 mg 2xs/ day
• Coenzyme Q10 (CoQ10) 100-400 no symptoms
• 1,200 mg/day if
  symptoms
• Omega-3 Fish Oils 650 mg/day

35
VITAMINS SUPPLEMENTS

• Alpha Lipoic Acid 1,000 2,000 mg/day
• Acetyl-L-Carnitine (ALC) 300 mg/day
• Phosphatidylserine 100 300 mg/day
• Aspirin low dose less than 175 mg/take on odd
  numbered days of the month alternate with
  ibuprofen
• Ibuprofen 200 400 mg/even d day of month

36
COST PER DAY RISKS YOU CAN CONTROL

• Non-prescription over the
• counter from your
• local pharmacy
• 20 - 25 per day in lieu of
• 300,000 for Dementia
• Alzheimers treatment and care

37
Stay Physically Active

• INCREASE YOUR ACTIVITY LEVEL
• PARK YOUR CAR FURTHER AND WALK
• TAKE THE STAIRS, NOT THE ELEVATOR
• RIDE A STATIONARY BIKE WHILE WATCHING TV
• REGULAR AND VIGOROUS PHYSICAL ACTIVITY INCREASES
  BLOOD FLOW TO THE BRAIN HELPS YOU THINK CLEARER
  AND FEEL BETTER

JUST GET MOVING!
38
Develop Healthy Eating Habits

• EAT FRUITS AND VEGETABLES THAT CONTAIN
• ANTI OXIDANTS
• COLORFUL
• FRUITS VEGETABLES SUCH AS
• ORANGES
• BERRIES
• SPINACH
• CARROTS
• BROCCOLI
• SWEET POTATOES
• TOMATOES

39
WORRIED ABOUT MEMORY LOSS?

• Exercise your mind
• Learn to play a
• musical instrument
• Playing Scrabble or
• doing crossword puzzles
• Interacting with others
• Switching careers
• Starting a new career
• Starting a new hobby,
• such as crafts, painting,
• biking or bird-watching
• Learning a foreign language
• Staying informed about
• what's going on in the world
• Reading

40
NURTURE YOUR RELATIONSHIPS

• Healing the Heart is a course in learning to
  identify and fulfill the
• needs of your body, mind, heart and soul.
• This course is experiential and interactive,
  encouraging you to
• expand your sense of self so you can increase
  your capacity for love
• and compassion.
• The Bradley Center for Well Being will teach you
  tools and
• daily techniques to move beyond your emotional
  pain and make
• peace with the aspects of your life with which
  you struggle.

41
PROTECT YOUR BRAIN

• Head trauma can increase your risk of dementia
  and Alzheimers Disease.
• People who participate in swimming, golf, tennis,
  table tennis and walking, which have reduce risks
  of head trauma, have a lower rate of memory loss.

42
STOP SMOKING

• Smokers have twice the risk of dementia and
  Alzheimers as do people who have never smoked.
• STOP NOW ITS NEVER TOO LATE
• If you quit smoking now, you can reduce the risk
  of your memory loss

43
DEMENTIA ALCOHOL RELATED

• Alcohol affects the brain by
• Blocking the entry of calcium into the cells to
  inhibit neurotransmitter release and reduce the
  cells electrical activity.
• Blocking the transport of oxygen into the cells
  energy-production centers.
• Reducing the effectiveness of many different
  types of neurotransmitters, especially those
  involved in learning and remembering.

44
DRINK ALCOHOL IN MODERATION, IF AT ALL

• People who drink heavily for years can experience
  permanent brain damage, and theyre at a higher
  risk of developing memory problems and dementia.
• For anyone 65 or older, that means one drink
  daily at most

45
MANAGE YOUR STRESS
46
RELAX STRESS BUSTERS

• A soothing musical landscape for when you need
  to relax, Relax 2 features an hour of down-tempo,
  dreamy, indulgent music that makes a fantastic
  companion for any sort of activity in which
  calmness is a necessity.

47
30 MINUTES PER DAY MEDITATION

• By reducing fatigue, meditation enables you
  to connect with your higher self where energy,
  creativity and inner awareness are your natural
  state of being..

48
Practice Deep Diaphragmatic Breathing
49
DiagnoseHow would you know unless you look?
50
Talk to your doctor GENETIC RISK FACTORS

• Discuss your concerns if you have a family
  history of memory loss, dementia or Alzheimers.
• He or she can come up with state of the art
  strategies for preventing memory loss as you age.
• Genetic testing can be performed.
• See your doctor regularly
• Make sure your thyroid gland is functioning
  normally.

51
DETECT Learn how to detect problems early

• Test yourself
• or ask your doctor to test you once per year.
• Instead of watching TV
• visit these internet sites frequently
• www.alz.org (National Alzheimers Assoc.)
• www.nih.gov (National Institutes of Health)
• www.nia.nih.gov (National Institutes on
  Aging)

52
Make a valuable contribution to knowledge that
will help people in the future

• The Alzheimer's Disease Neuro-imaging Initiative
  (ADNI) (See www.alz.org) is a major research
  study, sponsored by the National Institutes of
  Health, to determine whether brain imaging can
  help predict onset and monitor progression of
  Alzheimers disease.
• Researchers are looking for volunteers to
  participate in the study who are between
• 55 and 90 years of age.

53
PROACTIVE PREVENTION

• Prevention trials recruiting at multiple U.S.
  sites
• Phase III trial of vitamin E to prevent cognitive
  decline in individuals with Down syndrome.Trial
  details at ClinicalTrials.gov Fact sheet
  Vitamin E
• ACCORD-MIND study Phase III trial testing
  whether statins, blood pressure medication and
  blood sugar-lowering drugs can reduce the rate of
  cognitive decline and brain changes associated
  with diabetes.Trial details at
  ClinicalTrials.gov Fact sheet Statins
• Prevention of Alzheimer's Disease by Vitamin E
  and Selenium (PREADVISE).Trial details at
  ClinicalTrials.gov.Fact Sheet Vitamin E.

54
YOUR TREATMENT OPTIONS
BRADLEY CENTER FOR WELL BEING
55
ACKNOWLEDGEMENTS

• Mayo Clinic Alzheimers
• National Institutes of Health
• National Institutes on Aging
• Alzheimers Association
• Daniel Amen, M.D. and William Shankle, MD
  Preventing Alzheimers