Archive for November, 2011

Depression comes in many forms. Mild depression may range from the colloquial use of “I’m having a bad day” to depressive symptoms that are not severe or pervasive enough to meet current diagnostic standards for Major Depressive Disorder (which is more severe and has to persist for at least two weeks). Dysthymia is an enduring but comparatively mild form of depression. Sadly, recent surveys indicate that as many as 40% of community dwelling elders (by most standards those over 55) have some form of depression. This puts those afflicted at greater risk of mortality and suicide as well as poorer quality of life than those who are not depressed. Does having a diagnosis of dementia increase the prevalence of depression in the elderly? The answer depends on the cause of dementia. The prevalence of depression in dementia due to Alzheimer’s […]

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What To Place or Not to Place When Monday, November 28, 2011 TBD – All Ages Where Arden Courts (map) 15950 McGregor Boulevard Fort Myers, FL 33908 Other InfoCall 454-1277 to register « Back to the calendar

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What Coping with Guilt When Tuesday, November 29, 2011 TBD – All Ages Where Arden Courts (map) Naples, FL Other InfoCall 417-8511 to register « Back to the calendar

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Alzheimer’s disease unfolds over the course of decades. In the early stages (as discussed in part one), the afflicted person displays increasing loss of short-term memory and becomes increasingly disengaged from activities. Higher level, complex skills such as doing a checkbook and using a computer become more of a challenge. Older, overlearned skills work well whereas learning new skills or habits become increasingly difficult. Rehabilitation is self-generated if started early. If memory loss becomes severe enough to meet the criteria for dementia, rehabilitation must be accomplished by others (e.g., family, home care, or facilities) as independence is lost. The goal of treatment and rehabilitation is not to restore memory but rather to increasingly mold the environment to take advantage of learned habits and skills and keep the person with memory loss engaged and active. Competence no longer matters. What matters […]

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Alzheimer’s disease unfolds over the course of decades. It is slow and progressive. Alzheimer’s is a chronic disease that may or may not produce symptoms and the symptoms vary from one person to the next. The good news is that, as with any chronic disease, we can manage and treat all seven stages of Alzheimer’s disease if we focus on memory and engagement in the world. This article focuses on memory rehabilitation before you become demented. The next part will focus on rehabilitation if memory loss becomes severe enough and you meet the criteria for dementia. Normal. The normal stage of memory loss is where we all hope to stay. You are independent. You have senior moments. You are engaged with life and have good initiative. You manage your own short term memory with strategic memory supports. Forgetfulness. Forgetfulness is […]

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Alzheimer’s disease is often misunderstood. These misunderstandings create a false sense of fear and futility. We are bombarded by new studies that are often contradictory. We are inundated with “alternative” treatments that are supported by anecdotal testimony and clever marketing. We live in a time of reductionist medicine that promises cures and preventative lifestyles but can’t deliver on all of its promises. We can treat chronic diseases: diabetes, certain cancers, heart disease, and chronic pain. Alzheimer’s is a chronic disease that is also easier to manage and treat if caught early. The key is to identify small changes early and, as with any chronic disease, focus on life style and proactive planning. 1. Alzheimer’s unfolds over the course of decades. There is a great deal of time to plan treatment strategies that work. Plan to have a good life even […]

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My last two articles focused on medical treatments for Alzheimer’s disease. Cholinesterase inhibitors donepezil (Aricept), Rivastigmine (Exelon), galantamine (Razadyne), produce statistically significant but small effects. Namenda (memantine) appears to only work in moderate to severe dementia. Attempts to find effective drugs that modify the disease process have so far failed. As long as there are no powerful treatments for Alzheimer’s disease, we need to consider strategies for delaying the onset. Physical exercise and diet are the best strategies for delaying onset. The so called Mediterranean diet may be an effective way to slow down the progression of Alzheimer’s disease based on epidemiological evidence. Although there are many variants, the main components of a Mediterranean diet are high consumption of fruits, vegetables, nuts, legumes, cereals, and fish. Olive oil is the central source of monounsaturated fat (canola oil is the main […]

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