Prevention is the best medicine

What sort of changes can I make in my diet and exercise regimen to prevent Alzheimer’s?
Acting Now

Dear Acting Now,
This is a relatively new approach to fighting Alzheimer’s, and applies to just about all disease and aging processes – not just Alzheimer’s disease. Eating healthy and exercising is becoming more and more relevant in the prevention of all disease processes. Of course we know that Alzheimer’s disease is a regressive, degenerative brain disorder – not just a “little memory problem” that can easily be reversed. However a healthful diet and regular exercise is the first step in trying to prevent or slow the progress of Alzheimer’s.

The most commonly touted diet for Alzheimer’s disease prevention is a typical Mediterranean diet – one that is high in fruits and vegetables, whole grains, healthy fats such as nuts and olive oil, and lean proteins and leaves out refined sugar and carbohydrates. I am far from being a diet, exercise or nutrition advisor, so talk to a nutritionist or your doctor for more specific answers to your dietary questions. If you’re searching on your own, the Mayo Clinic  and WebMD have some good information to get you started. As with all diet and or exercise programs, discuss major dietary and exercise changes with your doctor.

I have had the opportunity to attend the Dementia Congress for five of the last seven years, and in 2007 they presented a strong emphasis on the value of diet and exercise (this might be good resource to investigate, as the Dementia Congress has made much of their dietary information available on CD). In general, 30 minutes of exercise 3-7 times per week is recommended to help boost brainpower. There are also programs such as Maintain your Brain (by the Alzheimer’s Association), and a fair number of books published on the subject of Alzheimer’s prevention that include tips for ways to change behaviors to improve the brain’s ability to create new neural pathways.

This is clearly not my area of expertise, but it is an area of focus so many people – from scientists to laypeople – that information is readily available. I do believe that it makes everyone feel less fearful and helpless to know that we can take some preventative measures in determining our own potential health outcomes. Fortunately, there are a growing number of studies that indicate there is great potential for senior health when a person follows such regimens.

How to make a difference

What is the best way to donate to Alzheimer’s research?  What organizations have the best reputation for their use of donated funds?

Making A Difference
 

Dear Making A Difference,
I don’t think there is a standard answer for this, because with all donations, one needs to do some personal homework that starts by answering some questions about your personal agenda.  Think about what you want to happen with the money you donate:

  • Do you want to affect only scientific research?
  • Do you want to donate to caregiver impact, research on care alternatives, or research on related disorders such as vascular dementia? 
  • Do you want to donate time as well as money?  This can help extend funds for your favorite charities.
  • Do you want your donation to be applied regionally or nationally?

 

With these questions answered, I would recommend going online and starting with the Alzheimer’s Association and Alzheimer’s Foundation.  Visit your local Area Agency on Aging, because some of the grants they facilitate need matching funding to provide support for an Alzheimer’s patient and caregiver, or to help with an opportunity to participate in medical or research studies.

 

There are many other research organizations that just look at specific aspects of Alzheimer’s disease and its many related disorders.  Get specific with your website searches; instead of “Alzheimer’s,” search for donation opportunities related to stroke and vascular organizations, Lewy Body Dementia, and others.  There are a lot of choices to research. Check with your state or local medical school, or any memory center to see what they need to enhance research programs or make them possible.  Find out what the philosophy, funding, and purpose of an organization is, and determine how it fits into your vision and where you feel you can make the most difference in accordance with your goals.  There are endless possibilities, as well as a great need for money.  Any organization that claims to do research should be able to provide you with the details on how the donated funds are used for its research.  Once you have gathered this information the best place for your funds should be apparent.

When one leaves the other behind

My father died recently. He was very ill, but had no dementia. He had been taking care of my mother who was diagnosed with dementia several years ago. They had been living in their home of many years. Mom’s at home alone now, and it seems like she is doing okay. Sometimes she doesn’t even seem to know that my father is gone. Do we need to move her from her home?
Mom’s Girl

Dear Mom’s Girl,
Your mother clearly needs a return visit to the doctor who diagnosed her with dementia. He can evaluate her and, at your request, order a complete work-up for her current mental status. At the very least, an occupational therapy evaluation will determine her capability to care for herself safely, or determine if she requires 24-hour supervision based on her knowledge of emergency response strategies.

Think of this situation in comparison to a first-grade child. At this age, children usually know their name, their address, meal times, sleep schedule, and how to dial 911 if there is an emergency. When answering the phone, they generally know not to reveal private information, not to buy or accept things from strangers, and safe methods for answering the door (including not letting strangers into the house). However, even with all those capabilities, children this age are not allowed to be left home alone. Your mom should have all those capabilities, and then some.

With the help of your physician and some other health care professionals, your mother’s capabilities can be impartially evaluated to determine if she has at least the capabilities of a seven-year-old. If she can’t be alone, there are many options to help her stay in the home: a family member might be able to move in and she can attend a day center while they are at work, 24-hour care is available in the home, and there are organizations that can arrange for caretakers to share homes with the person who needs assistance. Information about these resources is often available through the doctor’s office, your geriatric care manager, or on the internet.

Early onset Alzheimer’s

My husband has early-onset dementia. He is now 53. Do you know of any resources for someone like him? Most of the information that I can get is for people over 65 with more advanced dementia. Neither one of us is ready to deal with that. I work full time, and he cannot tolerate being at home by himself all day. Right now I take him to his brother’s, but all they do is sit around all day there! Please help!
Kathleen

Dear Kathleen,
Unfortunately, there are few resources for persons with early-onset dementia. You are definitely on the right track in being concerned that he has nothing to do! Does your husband seem content with the situation at his brother’s house? I am glad you both realize that he shouldn’t be home all day.

If I were you I would look for a senior day center. Even though the people there are mostly older, the staff is usually well-trained in dementia care, and knows appropriate ways to interact with him to maintain his dignity. Very often, early onset and early diagnosis (less advanced) patients enroll in these centers as volunteers, and can actually assist with much of the programming. The center may need a lot of help moving things around, pushing wheelchairs, etc., and he can truly be of assistance – which will make him feel needed.

I know a young man (in his 50’s) who did just that. The staff put him in charge of an exercise program, and with a minimal amount of support he actually ran the exercise program for the other patients in the center. The center used a video of the exercises as he stood in front and lead the group. Everyone was much more engaged and able to participate when they had a live person showing them how. As time went on, and his disease progressed, going to the center was a comfortable and developed routine – and he just segued into the program.

Resources for early-onset patients are starting to be more common in some places, and even if there’s nothing in your area, you might be able to pique some interest based on your husband’s need by talking to some local nursing facilities.