Archive for February, 2012

A part of any good memory evaluation needs to address practical skills in addition to a thorough work up for treatable causes of memory loss and a thorough testing of cognitive skills. These questions take many forms and should be asked of both the person being assessed as well as someone who knows him or her well such as a spouse. Why ask an informant? Simply because the person with memory decline may forget that they forget. This is a major problem in early detection as forgetfulness extends to one’s own deficits. The best way to describe the changes that reflect Alzheimer’s disease is “first in last out.” This means that skills such as complex reasoning and problem-solving change much earlier in the course of the disease than personal care and orientation skills. With the current diagnostic push to identify […]

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I have had several questions asked of me this week that are based on recent news about Alzheimer’s disease and cognitive decline. First, in response to my article on nicotine “Is Nicotine a New Treatment for Alzheimer’s Disease” (January 31), I was asked “Should I start smoking again?” The question arose in response to the recent finding that the nicotine patch may be helpful to those with mild cognitive decline or Alzheimer’s disease. The answer is clearly no. A study published in the Archives of General Psychiatry (February 6, 2012) links smoking to cognitive decline – especially in men. Smoking delivers a multitude of chemicals in addition to nicotine as well as carcinogens. The nicotine patch delivers only nicotine. Another client asked “Should I be giving coconut oil to my husband [he has significant dementia]?” She gave me an article […]

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Memory loss can sneak up on families. Those with early and mild decline changes are adept at coping. Furthermore, others don’t notice until changes are more dramatic. You can even fool yourself. For example, you notice a “senior moment” and ask your friends and they often report the same problems. But how do you know a senior moment from beginning memory loss? The overlap between normal changes of aging and mild memory loss is substantial. There is a push for early detection of dementia including the addition of memory screening as part of Medicare’s annual wellness program. The problem is that the recommendations don’t go far enough for two reasons. First, the screenings are too superficial to find truly early changes. Consider a screening consisting of telling someone three random words that they are to recall later. The words are […]

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Mental stimulation enhances the efficiency of our brain. For example, if I am feeling a little sluggish it often helps to go on a short walk or go to a movie or a concert. The brain is built to respond to change and stimulation. This is true for those with normal memory as well as those with memory loss. Indeed, an essential ingredient of any treatment plan for those with progressive memory loss such as Alzheimer’s disease is to keep them engaged. The activity doesn’t matter. It is in the doing that counts. Participants at well run residential and day care programs for the memory impaired are provided with “palliative” memory rehabilitation through engagement therapy. In essence, therapy allows those with memory loss to remain engaged in joyful and stimulating activities such as walking, socializing, thinking (e.g., word games, watching […]

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