Source: People’s Pharmacy

Is there really a connection between drinking juices out of aluminum cans and developing Alzheimer’s disease?

It is unlikely that drinking fruit or vegetable juice from aluminum cans would increase the risk of Alzheimer’s. Aluminum cans are coated with a plastic lining to prevent corrosion and protect juice from acquiring a metallic flavor.

These liners are not completely innocuous, we fear. Many of them contain bisphenol A (BPA), a compound that mimics estrogen. A December analysis in Consumer Reports notes that some juice and canned foods contain measurable amounts of BPA.

A dementia or Alzheimer’s diagnosis can be tough on families and caregivers. Two experts recently partnered to literally re-write the manual for families and caregivers in central Virginia and help them offer a dementia patient the best possible quality of life.

Dr. Barbara Braddock, assistant professor in the Curry School of Education at the University of Virginia, specializes in communication and cognitive disorders. Ellen Phipps, with the Alzheimer’s Association is a therapeutic recreation specialist, which uses leisure activities to improve health. They came together to write the connections manual.

Phipps said, “One of the main points is families need to re-learn how to interact with the person with dementia.”

It starts with figuring out what that person enjoyed doing before their dementia set in.

Phipps stated, “You have to discover what is important to one particular person then you have to understand what functional level they are at.”

Dr. Braddock said, “That’s an easy way to connect with someone especially using their old memory and their procedural memory, their how-to memory, in moving through the activity.”

By using the connections booklet, care givers like Beth Czaplinski of Rosewood Village Assisted Living, can find a way to reach patients in a simple way.

Czaplinski stated, “It keeps them active and they are not sitting in front of the TV just watching their lives go by on the screen.”

If you can choose an engaging activity that taps into the patient’s personality, the results are impressive.

Dr. Braddock said, “There is some research that engaging in meaningful activity will actually decrease apathy, disinterest and even behaviors like anger and aggression.”

The two authors say the book is unique because it lets caregivers tailor a fun activity to the dementia patient, instead of a one-size-fits-all approach.

Contact the Western and Central Virginia chapter of the Alzheimer’s Association to get a copy of the connections book.

The West Virginia chapter of the Alzheimer’s Association is looking toward 2010 with a renewed sense of hope in its battle against the debilitating disease often referred to as “the long goodbye.”

Memory Walks and other fundraisers have been taking place all around the state throughout October and November, which is National Alzheimer’s Awareness Month.

However, the holiday season often proves to be one of the busiest times for the association.

As families gather for celebrations, more calls come into the association’s 24-hour help line from residents concerned about loved ones’ odd behavior or mood swings that may be associated with Alzheimer’s. Extended visits with loved ones can call attention to these changes that often go unnoticed throughout the year.

“That’s when people may start noticing maybe it’s not a good idea for Mom or Dad to be staying at home by themselves, cooking for themselves or dispensing medication,” said Laurel Kirksey, development director for the West Virginia Alzheimer’s Association.

Across the country, someone is diagnosed with Alzheimer’s every 70 seconds but the rate is even more rapid in West Virginia due to the state’s aging population.

The Alzheimer’s Association estimates 48,000 mountain state residents are currently living with Alzheimer’s, but Kirksey admits the disease is likely underreported. She says physicians are sometimes hesitant to make the diagnosis, which can only truly be confirmed after death when a brain autopsy is performed.

Symptoms of Alzheimer’s and dementia can often be confused with other diseases and disorders like depression. But experts say it’s important not to ignore signals and to seek medical advice as soon as possible.

“Early detection is so important,” Kirksey said. “We see so many families that brush it off and wait until their loved one no longer has the capacity to make their own decisions. It’s a really treacherous process.”

For South Charleston resident Susan Young, the reality of Alzheimer’s hit three years ago when her husband John was diagnosed with the disease at just 55 years old.

Young says small shifts in her husband’s behavior raised the first red flags.

John started having trouble keeping track of his duties at work, often became confused doing daily chores at home, became emotionally detached and would sometimes sit and stare into space for short periods of time.

The Youngs went to medical centers in West Virginia, North Carolina and Ohio before ultimately accepting the diagnosis of early-onset Alzheimer’s.

“It was a shock because it’s definitely not what we had planned for our retirement years one day,” said Young.

For now, John is taking medication that helps slow the progression of his disease and is still cognizant enough to function at home by himself while Susan is at work. But as his symptoms worsen, Susan worries about how to properly care for her husband.

“It’s hard to ask friends for help. We’ve always been so independent and it’s always been so easy for John to do things,” Young said.

Young says she’s considered hiring someone to come into her home to help with John’s needs but isn’t yet sure where to turn when that time comes.

The Alzheimer’s Association reports that 70 percent of Alzheimer’s patients are actually cared for at home. Typically, a relative takes on that responsibility.

“There are really strong feelings that no one else can take care of my Mom or Dad like I can,” Kirksey said.

“But it turns into a 24-hour, seven-day a week job and it’s really difficult, especially on caregivers.”

In fact, research done by the association finds that 60 percent of caregivers will pass away before their loved one suffering from Alzheimer’s due to a stress-related illness.

But Kirksey says options are limited in West Virginia for people who want to hire professional help to come to their homes.

Last year, Dr. Mark Newbrough, head of geriatric physicians for West Virginia University, testified before a state senate committee that the mountain state will soon face a significant shortage of qualified geriatric health care workers.

Kirksey says the association has also started noticing a pattern in calls coming into the state help line.

“More and more people were asking for names of individuals who could come into their home and care for their loved one for maybe eight hours or just a few hours a day while they were at work or just to give them a respite,” said Kirksey.

Currently, there is no database of professionals trained in dementia care and no certification process available.  Because dementia and/or Alzheimer’s are difficult to care for, that specific arena of the health care field sees a high turnover rate.

But the Alzheimer’s Association and Charleston’s Garnet Career Center are partnering in an effort to deal with these deficiencies.

Beginning in January, Garnet will offer a brand new dementia care training course with curriculum developed by the Alzheimer’s Association.

Programs dedicated to dementia care are rare across the country and didn’t exist in West Virginia at all until now.

“We’re hugely excited about it.  We can’t stop telling people this could potentially be a breakthrough in dementia care and are so proud to be leading this effort,” said Kirksey.

The program will begin in January at Garnet and will consist of a total of 48 hours of training broken down into classes two days a week for eight weeks.

The cost of the course is $280 and enrollment is ongoing now.

Kirksey says the program will be led by instructors provided by the Alzheimer’s Association and will target three groups of individuals.

The first group consists of people who are looking at the possibility of starting their own small business in private in-home care.  As part of the class, participants will learn about taxes, professional protocol, and other aspects of starting a private business.

Secondly, the program will allow people already in a health care field to improve their skills relating to dementia care in a long-term setting.

Finally, people wanting to care for loved ones suffering from dementia can take the course to learn techniques to take back to their own homes.

“The more you learn about Alzheimer’s disease and the way it affects the brain, the better you can care for patients,” said Kirksey.

Leaders at Garnet and the Alzheimer’s Association hope to start with a small group of ten to 20 students for the initial class and build up the program from there.

Meanwhile, Susan Young advises anyone struggling with a recent diagnosis of Alzheimer’s to find their own support system before making any difficult decisions about care and treatment.

“We are blessed with the support and love of family and friends,” she said.

Young also encourages people to take advantage of support groups offered by the Alzheimer’s Association and to get involved in initiatives like Memory Walks.

“It’s very important to have that outlet outside of the home.”

Anyone who suspects a loved one may be exhibiting symptoms of Alzheimer’s disease is urged to call the statewide 24-hour hotline at 1-800-491-2717 or to simply stop by a local office.

Resources such as information on the ten most common signs of the disease are available online at www.alz.org.

In Massachusetts, approximately 70% of those with Alzheimer’s disease are cared for at home, so the Alzheimer’s Association is preparing for a surge in calls to its 24/7 Helpline during the holiday season. For most families, holidays are filled with opportunities for togetherness and sharing, but for a family dealing with Alzheimer’s, holidays can also be stressful and filled with special challenges, according to the experts at the Alzheimer’s Association.

“Caregivers may feel overwhelmed maintaining holiday traditions while caring for their loved one, and they also hesitate to invite family and friends over to share the holiday for fear they will be uncomfortable with behavior changes in the family member,” said Alzheimer’s Association’s Lindsay Brennan. Brennan manages the 24/7 Helpline for Massachusetts and New Hampshire.

In addition to providing 24/7 Helpline assistance, including holidays, the Alzheimer’s Association offers the following suggestions to families with a loved one with the disease:

• Call a face-to-face meeting or arrange for a long-distance telephone conference call with family and friends to discuss holiday celebrations. Make sure that everyone understands your care giving situation and have realistic expectations about what you can and cannot do.
• Give yourself permission to do only what you can reasonably manage. If you’ve always invited 15-20 people to your home, consider inviting five for a simple meal. Consider having a potluck dinner or asking others to host the holiday at their home.
• Share ways to interact positively, including telling family to always say their name and how they are related when speaking with a person with middle and later-stage dementia. Consider having a smaller room available where the person with dementia can talk with one or two family members at a time. Encourage family to reminisce and not ask questions about the near past.

“We recommend that caregivers let family members who are looking forward to a visit know that they may notice some changes like forgetfulness or confused behavior,” said Brennan. “They can tell family and friends that a warm smile and gentle touch on the shoulder is always appreciated even when other things are changing.”

For those with questions and concerns about Alzheimer’s, call 800-272-3900. The 24/7 Helpline is free and confidential. Information and an online Helpline are available at www.alz.org/MANH.

The Alzheimer’s Association provides education and support for those dealing with Alzheimer’s. Offices are located in Watertown, Raynham, Springfield and Worcester, MA and Bedford and Lebanon, NH.

SOURCE Alzheimer’s Association MA/NH Chapter

It’s well known that many great entertainers — Johnny Depp, George Clooney and Lionel Hampton, for example — have Kentucky roots. Not so well known, we suspect, is that the University of Kentucky is today a hotbed of cutting-edge research on Alzheimer’s disease, for which there currently is no cure.

About 5.3 million people in the United States suffer from the brain-destroying disease, and the numbers are expected to skyrocket as millions of baby boomers age into the most vulnerable group. Most people die within four to six years after diagnosis.

Dr. Ronald C. Peterson, a Mayo Clinic researcher and head of the Alzheimer’s Association’s medical and scientific advisory committee, puts the urgency of the work that’s being done at UK into perspective: “We have to do something about this situation soon or, as the baby boomers age, Alzheimer’s disease alone will bankrupt the health care system.” Alzheimer’s disease currently impacts the system to the tune of $148 billion a year.

Meanwhile, Dr. William Markesbery, a neurologist and neuropathologist, who directs UK’s Sanders-Brown Center on Aging, is regarded as a leader in Alzheimer’s research. His work, for example, disproved a once-popular theory about Alzheimer’s cause, and he’s amassed a large collection of donated brains for research that “is incredibly important,” said Tammy Johnston, of Lexington, whose parents both volunteered to donate their brains. It’s another example of one generation contributing to the next.

Dr. Markesbery, 77, anticipates that we’re five or maybe 10 years away from specialists being able to routinely detect changes in the brain that generate symptoms of the disease. Researchers’ goals are eventually to prevent such symptoms from ever developing.

Whenever the time comes, it’ll be a happy day. UK’s work on Alzheimer’s is just more proof that “Bucks for Brains,” which has been so instrumental in luring top scientists and medical researchers to Kentucky, continues, a decade later, to pay big dividends.

Apples and apple products research suggests role for America’s favorite fruit in brain health.

Did you know that apples and apple products may help prevent or delay the onset of Alzheimer’s disease? Research from the University of Massachusetts at Lowell as well as Cornell suggests that eating and drinking apples and apple juice, in conjunction with a balanced diet, can help protect the brain from the effects of oxidative stress that may play a role in the development of Alzheimer’s disease.

Alzheimer’s Disease Awareness Month
November is Alzheimer’s awareness month, and there are more than 5 million Americans living with it according to the Alzheimer’s Association. Worldwide, it is estimated that about 16 million people have Alzheimer’s disease. In addition to each person with the disease, there is often at least one other person who directly cares for him or her and a host of healthcare and support workers in the background.

It is not known what exactly causes Alzheimer’s disease and at present there is no known cure. But there is hope and help for those people with Alzheimer’s. Research into the disease is offering answers to many questions from how to prevent it, to how to delay the disease’s onset. To learn more about Alzheimer’s disease and how you can help, visit the Alzheimer’s Association at www.alz.org.

Apple and Apple Products Research
Apples and apple products may play a role in the prevention and delaying the onset of Alzheimer’s disease. Researchers have discovered that regular consumption of apple juice can not only help keep your mind functioning at its best, but may also be able to delay the key aspects of Alzheimer’s disease from developing, playing an important role in therapy and treatment of the disease.

To date, much of the research has been done with animals but human studies are on the horizon. One of the most recent studies published demonstrated that mice receiving the equivalent of two glasses of apple juice per day for one month produced less of a protein that is commonly found in the brains of individuals suffering from Alzheimer’s disease.¹

In addition, research from the University of Massachusetts at Lowell suggests that consuming apple juice may protect against cell damage that contributes to age-related memory loss, even in test animals that were not prone to developing Alzheimer’s disease and other dementias. The study, published in the Journal of Alzheimer’s Disease , indicated that these brain health findings are encouraging for all individuals who are interested in staying mentally sharp as they age.²

Other Reasons to have an “Apple a Day”
Apples and apple products are delicious, nutritious and easy to include in your daily routine. They provide essential vitamins, minerals and fiber that may help to protect you from developing other chronic diseases. The 2005 Dietary Guidelines for Americans recommends that we eat more fruits and veggies than any other food group — for adults, that’s 3½ to 6½ cups (7 to 13 servings) daily for better health. One small apple, 1-cup of 100% apple juice or cider, or 1-cup of applesauce all count as 1 cup of fruit towards your goal for the day. Looking for new ways to incorporate America’s favorite fruit into your diet? Visit the U.S. Apple Association website to find recipes and more ideas.

¹Chan, A and Shea, T. Dietary Supplementation with Apple Juice Decreases Endogenous Amyloid-B2 Levels in Murine Brain. Journal of Alzheimer’s Disease, 2009; .16 1).
²Tchantchou F, Chan A, Kifle L, Ortiz D, Shea TB. Apple juice concentrate prevents oxidative damage and impaired maze performance in aged mice. Journal of Alzheimer’s Disease. 2005; 8 (3): 283-287.

It was to become the last holiday our family would all be together.

My brother was able to get a rare holiday off and would be home for Thanksgiving. My father had dementia and rarely spoke, and although he still knew my younger sister, he no longer recognized me or my older sister. He had also recently stopped recognizing my mother.

A good day had become defined not by how difficult or exhausting it was, but by whether her sweetheart of 57 years knew her.

My mother had prepared his favorites. She felt no one else could make the turkey, dressing, homemade dinner rolls and pumpkin pie just the way he liked. My two sisters and I helped in the small ways she would let us. The good china and table cloths were brought out. The table was set with flowers and arranged so that he would be surrounded by his children.

When our father recognized my brother, it seemed that the day would be all that our mother had hoped. My brother escorted dad to the table and tried to seat him, but he just stood there, unable or unwilling to sit down. We all took turns coaxing, cajoling, pleading and trying to cue him by pressing the seat against his knees — nothing worked. By this time, our mother was in tears and we decided to let him stand until he was ready.

It was then that he spoke — he thanked God for having his whole family there with him that day. Then he sat down.

It has become our most blessed Thanksgiving ever.

Holidays can be very stressful for caregivers. Caring for your loved one and trying to keep up holiday traditions can take its toll on the caregiver and the family. Your loved one may also feel a sense of loss during the holidays.

Here are some tips to help your celebrations be joyful and blessed:

Adjust your expectations:

• No one should expect you to maintain every holiday tradition

• Give yourself permission to do only what you can manage

• Choose traditions that are most important to you

• Host a small family dinner instead of a big holiday party

• Serve a take-out holiday meal or have a potluck dinner where others bring a dish

Involve your loved one — there are many activities you may be able to do together:

• Wrap gifts

• Bake favorite holiday recipes — maybe the person can stir batter or decorate cookies.

• Set the table and avoid centerpieces with candles and artificial fruits and berries that could be mistaken for edible snacks

• Read cards you receive together and recall stories about the sender

• Look through photo albums or scrapbooks and reminisce about people in the pictures and past events

• Watch a favorite holiday movie

• Sing favorite songs

• Read special passages from the bible

You can celebrate even when your loved one is in a care facility:

• Decorate your loved ones room together

• Join in any facility-planned holiday activities

• Bring favorite holiday foods to share

• Sing holiday songs and ask if other residents can join in

• Read a favorite holiday story or poem out loud

There is no cure or long-term treatment for Alzheimer’s disease, a neurodegenerative condition that destroys brain cells and inevitably leads to memory loss and death.

The few drugs available on the market today only treat symptoms, not the underlying, disabling cause of the disease.

But after years of research, Dr. Cherian Verghese, a certified physician investigator and medical director of Keystone Clinical Studies in Norristown, believes drugs that attack Alzheimer’s in its early stages are enticingly within reach.

“At Keystone we conduct studies on medicines that affect the brain; basically neurology and psychology,” Verghese said, sipping a mid-afternoon cup of coffee at Starbucks.

“For 20 or 30 years we have done research without any new understanding of what is going on, and now we’re looking at it from at least three or four different approaches.”

Alzheimer’s will surely be one of the “defining diseases” for the coming decade, “globally, nationally, and even locally,” Verghese said. “The prevalence is rising. Currently, 5.2 million Americans have Alzheimer’s, and it is expected to quadruple by the year 2040. About 5 percent of the population over 65 has it, and this percentage roughly doubles with every five years of age, such that by age 85, nearly 50 percent could develop Alzheimer’s.”

With its roughly 16 percent elderly population, Montgomery County is above the national average of around 11 percent, he noted.

“And even Pennsylvania has a higher percentage of elderly people than the rest of the country. There are a  few reasons for that, with many of our families staying in the same neighborhood here; they don’t go far. There are very stable communities here and we have a lot of retirement communities.  “All of this is impressionistic, however; not fact.”

His pride in the Keystone State partly inspired the name of his company, Verghese added.

“We wanted to fly the Pennsylvania flag in the national spotlight, but we also see ourselves as the connection between the pre-clinical world — the drug-development world — and the clinical world of patients.”

As they are supervised by the Food and Drug Administration, all approved drugs must undergo clinical trials for safety and effectiveness, Verghese explained.

“Every drug we have now, including Prozac, went through the same testing at one time,” he said.

While Keystone also conducts clinical trials on drugs to treat depression, bipolar disorder and other conditions, its focus is on developing drugs to treat the “ticking time bomb” that is Alzheimer’s.

“Many baby boomers will have Alzheimer’s. The Medicare cost alone of Alzheimer’s was $91 billion in 2005, and it is expected to go to $160 billion in 2010. This does not count the cost of other insurance plans, Medicaid  and indirect costs. Experts fear that just this one illness can result in the bankruptcy of our health care system.

“Worldwide, it is felt to be among the most disabling and burdensome illnesses. In 2005 we spent $10 billion and that will go up to $116 billion by 2010 … a 65 percent jump.”

Because the disease is incurable, currently available drugs are simply used to modify it somewhat, Verghese said.

“They don’t change the course of the illness. For example, the statins we take for heart disease are disease modifers. Once statins come on board, the incidence and problems of heart disease have gone down dramatically.

We have no such thing with Alzheimer’s. The medications that are available for regular clinical treatment have a very modest effect. They have a small, short-lived effect of improving memory in some persons with AD. However, they have no effect on other aspects like personality change and problems with communication. The downward progression of the illness continues uninterrupted.”

But his research tells him there is a light shining at the end of the tunnel, Verghese noted.

“A lot of the historical factors are now coming together. The exact cause of Alzheimer’s is not known. But it has been known for over 100 years now that the main change in the brain is the accumulation of a sticky protein called amyloid. There are many other changes, like the presence of neurofibrillary tangles inside cells, inflammatory changes, and progressive cell death.

“There is no doubt that beta amyloid is the first part of the cascade of the things going wrong that will cause AD.”

Keystone Clinical Studies is conducting clinical trials on drugs that remove amyloids from the brain, Verghese said.

“Very high technology methods have been used to understand the structure and genesis of amyloid at a molecular level. Highly specific antibodies have been designed to break up the amyloid, and these compounds are in clinical trials currently.

“There has been some restrained excitement in scientific circles regarding a compound called Dimebon, after the publication of an article last year, in a major medical journal, The Lancet. In a one-year long study, Dimebon prevented deterioration and maybe even improved memory and other functions like behavior and global function. In the scientific world, the results of studies need to be confirmed again in other studies before they are accepted as a real fact and not an observation by chance in one study.”

Dimebon is going through large-scale Phase III clinical trials at Keystone, which if positive, could lead to approval from the FDA for regular clinical use of the medication, Verghese said.

Patients are welcome to participate in future trials for potential treatments of both Alzheimer’s and depression.

Verghese explained that the clinical trial process is divided into two parts: the pre-clinical phase of animal research, before the drug is given to people, and the clinical phase.

“The clinical portion is divided into four phases: safety, proof of concept — does it actually improve the condition? — and third is the big study that gets a drug approved. Phase IV is after the drug is approved, with post-marketing studies to find out how it is working. Keystone takes part in phase two, three and four studies.

“We are doing a lot of outreach efforts to get the word out,” Verghese added. “We’ve talked to doctors, visited senior centers … I would like to get the word out to people that there are options and treatments available.”

As Keystone’s primary investigator, Verghese becomes a patient’s primary physician, he said.

“It’s like the family doctor referring a patient to a cardiologist, who looks after the cardiology part but everything else falls under the family doctor. So I would look after the Alzheimer’s part, the depression part, depending on what kind of study is being done. We work very closely with family doctors because it’s important to know what medicines the patient is on.”

With the sound of the cappuccino machine going full throttle in the background, Verghese was asked what he thought of recent studies that suggest coffee drinking might prevent Alzheimer’s.

“There is no discussion in the scientific community to this extent,” he said. “None of the nutritional approaches have been shown to have an effect in rigorous clinical trials with sound methodology and good statistics.   “There is any number of products that are marketed, some with ‘studies’ to back up. However, there are studies and then there are studies. There is a product that is marketed in Europe, which is made by taking pigs’ brains, dissolving them with enzymes, and then administering the resultant mixture intravenously to patients with Alzheimer’s.

“They say it works, and have a few studies to show that it does. Would I give it to any of my patients? No.”

To contact Keystone Clinical Trials, call 610-277-8073.

During this time of year, people begin thinking about gifts for the holidays. For a loved one with Alzheimer’s disease or other form of dementia, family members and friends oftentimes struggle with appropriate gift items.

Brookdale Senior Living, one of the leading providers of senior living residences in the nation, including Alzheimer’s and dementia care, offers these suggestions.

• A listening device with recordings of favorite songs.

• Framed enlargements of family pictures.

• A picture scrapbook of the loved one’s life, work, awards, and more.

• A photo album filled with pictures of past fun family activities.

• A personal reminisce/life enrichment box with contributions from all family members, based on the person’s specific interests.

• Recorded Bible readings, sermons or poetry.

• Lotions, creams, or favorite scent.

• A music box.

• A therapeutic photo memory quilt or fidget quilt, such as the ones at http://www.patchworkmemoryquilts.com

• A favorite dessert or treat.

• A leisurely stroll through a favorite place.

• A visit to a local church.

• A drive to see the holiday lights.

• A new pillow, sheet set or comforter.

• Soft lap blankets.

• Large print books.

• Soft, fuzzy nightwear or slippers.

• Holiday decorations to decorate their door or apartment.

“Regardless of abilities, loved ones with Alzheimer’s or other forms of dementia will appreciate and respond to gifts,” said Juliet Holt, director of dementia care programming for Brookdale. “These gift suggestions highlight and encourage at least one dimension of living an Optimum Life®. We encourage providing opportunities for success during the holiday season.”