Wednesday, May 28, 2008

183 Alzheimer's screening questionaire

Worried that you or a loved one has dementia? here are a few questions to ask, from a WSJ article:
1. Problems with judgment (such as trouble making decisions, bad financial moves)

2. Less interest in hobbies or activities

3. Repeating the same things over and over (questions, stories or statements)

4. Trouble learning how to use a tool, appliance or gadget

5. Forgets correct month or year

6. Trouble handling complicated financial affairs (such as income taxes, balancing checkbook)

7. Trouble remembering appointments

8. Daily problems with thinking and/or memory

If you answer yes to two or more questions, seek help from a qualified doctor.

My father had 3 & 4 for a long time, and he also had major speech problems, which isn't on the list, and that's when my mom took him to the doctor. Not after we heard about his raspberry bushes for the 150th time, or his complaints that he couldn't use the computer.
But of course who thinks of dementia until it's too late? We need this information to go out to EVERYONE.
(screenprint, PMID: 16116116)
(You may have noticed that I have started including the PubMed references for the original studies, when I can find them. I use this tool at work now to verify references, and it's also great for finding medical articles.)

182 Antipsychotic drugs kill AD patients

My dad was on an anti-psychotic drug. The doctors at Yale put him on it when he first started getting violent. The drug is mentioned in this article, which says dementia patients on such drugs are more likely to die.
Elderly people with dementia who are given antipsychotics, even for a very short period of time, are more likely to end up in the hospital or even die....However, the problems underlying the need for such medications, behavioral problems such as aggression and agitation, are very real, and the alternatives to antipsychotics are limited...
Yeah--treat the aggression and maybe kill the patient, or allow the patient to harm or even kill someone else? That's a conundrum. And yes, I'm being sarcastic.
According to information gleaned from medical records, community-dwelling adults who had recently received a prescription for a newer antipsychotic medication were 3.2 times more likely than individuals who had received no antipsychotic therapy to be hospitalized or to die during 30 days of follow-up.
Of course, my dad was on them for at least 6 months before he died, and he wasn't given them only when he went into the nursing home. Honestly I don't believe they contributed to his death.
(Screenprint; PMID: 18504337)

181 obesity ups AD risk by 80%, and some personal stuff

Obviously this is something that concerns me greatly, as I am morbidly obese and had 2 relatives with Alzheimer's:
Obesity may boost dementia risk by up to 80%

Researchers at the Johns Hopkins Bloomberg School of Public Health have found that being obese can increase the risk of Alzheimer's disease by as much as 80 per cent.
Their analysis of published obesity and dementia prospective follow-up studies over the past two decades shows a consistent relationship between the two diseases. ...Based on a pooled analysis of their findings from 7 of the studies, baseline obesity compared to normal weight increased the risk of Alzheimer's disease by 80 percent on average.
The team further concluded that being underweight also increases the risk of dementia and its subtypes. ...from "Obesity and central obesity as risk factors for incident dementia and its subtypes: a systematic review and meta-analysis" was written by M. A. Beydoun, H. A. Beydoun and Y. Wang. (PMID: 18331422) (article screenprint)

80%!? 80%!! Just shoot me right now. My father was overweight until he was diagnosed, but he wasn't obese by any standards--he had a big beer belly kind of gut. He had thin arms and legs.
Supposedly just having a 1st degree relative with AD gives you a 50% chance. Increase that by 80% and I might as well invest in long term care insurance right now. Totally depressing.
I'm having a bad week, of sorts. Tuesday at 6:45 a.m. someone hit my parked car and took off, leaving it pushed 6 feet forward with almost $2,000 worth of damage. My husband saw the truck, but didn't get the plate. Yesterday we drove around in the area and guess what? Found a truck--two blocks away--of the right size, shape, color, and brand, and it had a big old hunk o' damage in the front. The police will be knocking on his door, as they've already inspected the truck and seen that the damage matches my car. Jerk.
My grandmother is being a brat. My mom invited one of my friends over to her house for Memorial Day hot dogs and hamburgers. My grandmother barely greeted her and sat all through the meal with the "puss" face on, not talking to anyone. She was angry because my mom went to the Peabody Museum to see the Mexican art exhibit there, and had lunch with me and my friend, leaving her alone. She is really back on the "you can't leave me alone" kick. My mom dealt with being a caretaker for 3 years with my dad. My grandmother doesn't need a caretaker. She doesn't want to LIVE alone, fine, but that doesn't mean my mom can never leave the house. My mom can't get a job. Hell, she can't even take a walk without my grandmother bitching. It's totally not working out, and of course my grandma's apartment and her furniture and car are all gone so there is no going back My grandmother wanted this arrangement and all she does is complain.
Monday was the 6-month anniversary of my dad's death. I did not realize it until Tuesday. I'm glad. Is that awful, to be glad I forgot to be sad on that day? I've been sad so much for him. I want to think of him in the Elsewhere Bar, hoisting up a glass, maybe with some veterans. I hate that I have to drive by the nursing home where he died every day on the way to work, but I guess that's one way to numb myself, right?
(I've got some spare time tonight, so I'm blogging like mad! Enjoy.)

180 guest article: The ApoE Gene Diet

Pam McDonald, author of The Apo E Gene Diet: A Breakthrough in Changing Cholesterol, Weight, Heart and Alzheimer's Using the Body's Own Genes, contacted me to offer a free article on treating and preventing Alzheimer's through a specialized diet.
You can contact Ms McDonald through her website.
Here it is. I hope it will be of interest and benefit.

The ApoE Gene Diet – An Integrative Medicine Approach to Disease Prevention.

Introduction To The Apo E Gene
We all have the Apo E gene (pronounced by saying each letter, A - P - O - E). This gene plays a key role in our body's internal environment and is a determining factor in the development of chronic disease, especially heart disease and Alzheimer’s disease.

Keep in mind – Heart disease and Alzheimer’s disease are two inflammatory diseases. Our goal is to create a "gene-supportive environment" (GSE), based your individual Apo E genotype and reduce inflammation in the body specifically in the arteries, heart and brain.

The Apo E gene occurs as three variations, or alleles, in humans: Apo E 2, Apo E 3, and Apo E 4. Since genes come in matching pairs, we each have two alleles of every gene, one from each parent. If you received an Apo E 2 from one parent and an Apo E 3 from the other parent, your genotype would be E 2/3. The six possible combinations of Apo E gene pairs are E 2/2, E 2/3, E 3/3, E 4/2, E 4/3, and E 4/4.

How Your Apo E Genotype Affects Your Health
As you can see from the table below, the most common genotype, Apo E 3/3, is found in approximately 64 percent of the population. It is considered the “neutral” Apo E genotype. Combinations that include either the Apo E 2 or Apo E 4 are considered “alternative” expressions of the more common Apo E 3 pairing. People with Apo E 2 or 4 alleles will process foods differently from the way in which an Apo E 3’s body will.

The APOE Gene Diet can help prevent Alzheimer's disease and Heart disease.

The specific pair of Apo E genes you inherited from your parents greatly influences your predisposition to certain illnesses, including heart disease, vascular dementia, Alzheimer's disease, Parkinson's disease, and cancer. For example, persons with the Apo E 4/4 genotype could have up to a 90 percent chance of developing a chronic illness such as Alzheimer's disease. Maintaining an optimal diet and lifestyle for your particular Apo E genotype is known as maintaining a "gene-supportive environment" (GSE), and doing so can dramatically reduce your risk of developing these chronic illnesses. That's why the Apo E Gene Diet was created.

The Apo E Gene Diet
The foundation of the Apo E Gene Diet is a nutritional plan that focuses on eating the optimal percentages of "The Big Three" - carbohydrates, fats and proteins - for your specific Apo E genotype. One diet does not fit all because each Apo E genotype processes foods differently. There is a unique optimal combination of carbohydrates, fats, and proteins which creates the ideal diet for each of the six Apo E genotypes. Creating this optimal balance in your diet provides the foundation for your good health.

The Apo E gene has been shown to be the number one factor affecting how your body uses The Big Three macronutrients or food groups, and this influences the possibility and severity of developing certain diseases. It is extremely important to eat the right balance of carbohydrates, fats and proteins for your specific Apo E genotype.

The Apo E Gene Diet is not a diet in the typical sense of the word. With the Apo E Gene Diet, we use the word "diet" to mean a series of specific recommendations for individual nutrition and other environmental factors, such as exercise and stress levels, to name a few. The goal of the Apo E Gene Diet is disease prevention and a healthy life; it is a personalized plan for your Apo E genotype which will guide you in choosing the optimal:

• fat content with the correct types of fats
• carbohydrate content with the correct types of carbohydrates
• protein content with the correct types of proteins
• caloric content for your needs
• amount and kind of exercise appropriate for you
• balance of stress and relaxation in your life
• quality of mental and emotional environment
• type of energy and intentions you allow into your life (the spiritual component)

Most of the existing dietary recommendations are based on the assumption that one diet plan is appropriate for everyone. Because of that assumption, those diets fail to accomplish long-term weight loss or optimal disease prevention. We are not all the same. In reality, diet and exercise recommendations must be individualized, beginning with a person's genetic foundational recipe.

The Apo E Gene Diet focuses on an individual’s genetic recipe, creating dietary and exercise recommendations for each of the six possible Apo E genotypes a person can have. No other program does this. In addition, the Apo E Gene Diet takes into account the whole person (physical, emotional, and spiritual) in creating a gene-supportive environment which promotes a healthy life, free of chronic illnesses.

The Optimal Diet and Lifestyle For Your Apo E Genotype
So how do you create the optimal diet and lifestyle for your particular Apo E genotype? There are three steps.

1. First, consider reading The Apo E Gene Diet: A Breakthrough in Changing Cholesterol, Weight, Heart and Alzheimer's Using the Body's Own Genes by Pamela McDonald.

2. After reading the book, you can make an informed decision as to whether you want to know your Apo E genotype. Finding out which Apo E genotype you have is done through a simple cheek swab test or non-fasting blood test (more information on testing options).

3. Once you know your Apo E genotype, follow the diet and lifestyle plan outlined in the book for your particular Apo E genotype.

Following these three steps will support you on the path to a healthy life, free of chronic disease.

My experience in supporting patients in implementing the changes
required by the Apo E Gene Diet has led me to develop a number of general
recommendations that apply to all, regardless of their particular genotype.

Recommendations for Implementing The Apo E Gene Diet

In order to make changes in a current lifestyle, the following general
recommendations will help you be successful in those changes.

• Use the principles of integrative medicine that:
• take into account the whole person—body, mind, emotions, spirit,
environment, and lifestyle
• emphasize a supportive, caring, therapeutic relationship
• make use of all appropriate therapies, both conventional and
alternative, and
• use culturally appropriate, natural, effective, minimally invasive
interventions whenever possible

Find a practitioner who is:
• trained in integrative medicine, since nutrition and exercise are
two very powerful tools of integrative medicine
• committed to a healthy lifestyle, self-exploration, and self-development

You will then be guided and supported in:
• stimulating your body’s innate healing with foods that match its
genetic instructions
• utilizing all three food categories (fats, proteins, carbohydrates) in
an optimal balance for your genotype (unless a medical condition
prevents this)
• focusing on foods that do not cause inflammation and are easily
assimilated, metabolized, and cleared by your body
• counting all calories (if weight is an issue)
• choosing natural, whole (that is, unprocessed) foods whenever possible
• utilizing routine blood chemistries and physical evaluations to
make adjustments as treatment progresses
• implementing the exercise program that is best for your individual
Apo E genotype

Apo E Gene Testing—Should I Do It?

Apo E gene testing offers the beginning of improved health and a happier life for many people. Once you know your Apo E gene type, a clear personalized dietary, exercise, and general wellness program provides you with the key to preventing heart disease, Alzheimer's disease, and many other chronic illnesses.

However, we recommend that you be tested only if you are willing to follow the personalized diet and lifestyle program that creates the most supportive environment for your Apo E gene type.

The decision to be tested is a very personal one. Some people want to be tested to learn the appropriate diet and lifestyle for their particular Apo E genotype, thereby minimizing their risk of developing chronic disease. Other people prefer not to know their genetic predisposition toward certain chronic diseases—clearly, this test is not for them.

The best way to make a fully informed decision as to whether you should be tested is to read the book, The APO E Gene Diet, by Pamela McDonald. Otherwise, there are several basic questions that you can ask yourself when considering whether you want to be tested:

1. Why do I want to learn my Apo E gene type?
2. Once I get my results, am I willing to follow the recommended diet, exercise, and wellness program best for my gene type?
3. Who is going to support me in undertaking any lifestyle change program?

If you do decide to be tested and embark on our APO E GENE DIET and HearthHealth Watchers™ program, we offer guidance and a unique collection of tools for a sustainable lifestyle that will bring you a renewed sense of health and wellbeing. A holistic assessment and life-balancing program, the Wellness Inventory, will help you gain personal insight into your state of physical, mental, emotional, and spiritual wellness. Personalized telephone consulting rounds out the program.
Pamela McDonald FA,FNP Integrative Medicine Fellow.

Wednesday, May 14, 2008

179 another murder, a failed AD vaccine, a new treatment

Is there some kind of epidemic of murder and AD? Or is it just coincidence? Elderly Cambridge suspect in stabbing has Alzheimer's disease: An elderly Cambridge man charged with the attempted murder of his wife was not criminally responsible for the crime due to mental disorder....Gordon Bickford, 79, is charged in the Nov. 21 stabbing of his 77-year-old wife....An earlier psychiatric report indicated Bickford had dementia and was not fit to stand trial. A separate report concluded he was "marginally fit'' to stand trial because he had periods of lucidity. (Screenprint)
Periods of lucidity? Yeah, those are great. And such a period would certainly last long enough for this guy to stand trial. After all, people with AD respond so well to stress, strange environments, strange people, and lots of questions. Instead of going to school, these shrinks should live with (not just "observe") someone with AD. They'd learn a LOT more. Or just ask any of us.
Follow up to the local story: The man who stabbed his wife as part of a failed murder-suicide plot was deemed unfit to stand trial. (Surprise, surprise). I also found the original story; an onlooker tackled the old man after he attacked his wife and foiled his plan. (combined screenprint)

In other news, a vaccine similar to the one my dad tested, while it dissolves plaque, doesn't fix damaged neurons or help gain memory. The test was done on elderly dogs: brain autopsies showed that although plaques had been cleared from multiple brain regions damaged neurons remained. (screenprint)
But you can just smoke a joint and even if pot really doesn't help AD, you'll be too busy standing in the junkfood aisle at Food Bag with extreme munchies to care. (screenprint)

Sunday, May 11, 2008

178-b Alzheimer's + murder = much sadness follow up

I found the story my mom was alluding to. An 85 year old man, newly diagnosed with AD who had just signed paperwork to move into assisted living with his wife, instead decided to kill himself and her. He attacked her with a hammer; she died 2 weeks later, but evidently did not follow through on himself. He is being charged with murder despite his disease. (screenprint).

Yesterday I was in BJ's (a warehouse store) and I saw my dad's best friend. He came over to talk to me and ask how we were doing. He said, "I miss Bob," and he had such honest grief on his face that it was just heartbreaking.

Friday, May 09, 2008

178 Alzheimer's + murder = much sadness

My mom told me today that a guy with Alzheimer's, somewhere in CT recently, took a hammer to his wife and killed her. She was shocked and appalled that the man was arrested. Did she honestly think they'd put him in jail? I'm sure he's in a nursing home or some similar facility. Unfortunately, I could not find more details on the story. Instead I found two other stories, heartbreaking in their similarities.
The first one is a few months old, but I didn't see it earlier: Killer of Alzheimer's wife held. The gist: a 77 year old man, whose 82 year old wife was in a nursing home with advanced AD, walked into the nursing home and shot her in the head and chest in front of everyone and then called the police and turned himself in. This is after 8 years of watching her deteriorate. I cry for him, because I don't blame him one bit. (screenprint) My dad only lasted 3 1/2 years. Five more years of that and I might have felt like shooting him, poisoning him, anything to make his (and my) pain stop.
This one is even worse, if that's possible. No charges against elderly man in shooting death. In this story, an old man with AD killed his wife and then went searching for her.
Drew Waldron, 87, ...shot his wife, Theria Waldron, also 87, once in the head with a handgun some time before 5:30 a.m. on March 28. The woman's body was found in the master bedroom of the couple's home ....The day of the shooting, Waldron was seen by staff of a nearby convenience store. They reported to deputies that he appeared confused. Responding deputies said Waldron reported that his wife was missing and when they accompanied him home, the deputies found the woman's body.
After reviewing his medical history, they had him put into a nursing facility and not charged. (screenprint)
What I want to know is, will stories like this ever not make me cry?