In an article at Health.com , Dr. David Geldmacher, M.D., professor of neurology at the University of Alabama at Birmingham, states that “having high glucose is a stressor to the nervous system and the blood vessels. The emerging information on Alzheimer’s disease and glucose shows us that we do need to remain vigilant on blood sugar levels as we grow older.”

Diabetes is broken down into two categories, Type 1 which is insulin dependent and Type 2 which is non-insulin dependent. People with Type 1 give themselves daily injections to manage their illness, while people with Type 2 make their own insulin, but their cells do not respond to it properly.

Type 2 diabetes is the more common of the two, affecting 85-90 percent of reported cases. These people can keep their blood sugar levels under control with managed weight, exercise and oral medications.

One thought among researchers is that having diabetes may block the body’s effectiveness in breaking down an amyloid or protein, therefore clumping and creating the plaque associated with Alzheimer’s disease. Joseph R. Burdo, Ph.D., assistant professor at Bridgewater State College in Bridgewater, Mass., reports that everyone’s blood contains a small amount of the protein, but for diabetics, “there may be a synergistic toxicity between the amyloid and high level of blood glucose that is leading to the problems with proper blood vessel formation.”

Science has come to understand how insulin works throughout the body, but with the brain it is not clear. Nor is it clear as to how the insulin gets into the brain. According to Brown Medical School neuroscientist, Suzanne M. de la Monte, brain cells create their own insulin. Neurologist, Jeffrey M. Burns, director of the Alzheimer and Memory Center at the University Of Kansas Medical Center, believes that a portion of the insulin comes from the pancreas.

Wherever this insulin comes from, there is agreement that it is crucial for the “growth and survival of the neurons” that create the brain’s synapses; important for memory and learning. Lower brain insulin levels decreases one’s abilities in these areas.

After many studies and research, Ms. de le Monte stands on the premise that Alzheimer’s and diabetes come from the same disease – and refers to Alzheimer’s as Type 3 diabetes. Until further research is done, she supports exercising as a way to rev up blood flow to the brain and build insulin responsiveness throughout the body as a whole. “It won’t prevent Alzheimer’s…You’re making the brain work harder and delivering more nutrients to the brain.”

“Maryland drivers can now add three emergency contacts to their driver’s license so police will know who to call if an accident occurs. The emergency contact information is stored electronically on an individual’s driver’s license and will be available only to authorized law enforcement personnel. You can go to MVA’s website at www.mva.maryland.gov <http://www.mva.maryland.gov/>  and add your three emergency contacts in just a few minutes. Go to the website, click “On-line Transactions, then click “More” and then click “Emergency Contacts” to add your emergency contacts.”

This information is only available to police and medical personnel

This new information benefits everyone, young and old alike. The MVA is to be commended for its intelligent use of available technology.  The process is similar in many respects to Silver and Amber Alert laws, except in this case the data is collected in advance of the actual need.

The Silver Alert program is patterned after the Amber Alert legislation for tracking missing children, but is focused on seniors with Alzheimer’s disease and other forms of dementia. Upon notification of a missing older adult, the state police are notified, given a description of the person, vehicle, license number, and area where the person was last known to be. This information, along with a contact number is then posted on highway signs throughout the area. To date, 38 states have passed legislation specifically titled Silver Alert, other legislation substantially the same as silver alert, or broader legislation that encompasses this age group. In most of the remaining states, legislation is in process. A similar bill is pending at the federal level.

Elders want to travel – to vacation, visit family and friends, fulfill a dream, go again to a place in memory. This may seem impossible or difficult at best. He’s blind. She has dementia. He has Alzheimer’s. She can’t go down the street without getting lost, how is she going to make it to the wedding 2,000 miles away?

Given, elder travel is different from the backpacking days of our youth, but it doesn’t have to be gone. Accompanied senior travel makes the world safer, larger, brighter, and a lot more fun for the individual.

A woman we’ll call Michelle contacted our office. Her husband Al had Alzheimer’s Disease and she needed someone with him so he would be safe while she was away at work. His car keys had been taken away, but Al was not one to sit around; he liked to go out and about. And he had one passionate desire: to see Pearl Harbor.

Born in 1925, Al’s father woke him the morning of December 7, 1941. Pearl Harbor had been bombed! “Boy,” he said, “you best go down to the post office and sign up to go fight.” Only 16, Al had to wait a couple of years before serving four years in the army. He later graduated from the University of Maryland, married and raised a family. He was involved in the Boy Scouts, sharing his pride in the “Great U.S. of A.” And someday, he said, he’d see Pearl Harbor.

When our Companion, Gary, met Al, they hit it off immediately. When Gary wasn’t available, his wife and fellow employee Bonnie filled in. (There has to be consistency of care givers or the Alzheimer’s victim gets confused.) Al knew one of them would be there if Michelle couldn’t be.

Al knew he’d never get to Pearl Harbor. Michelle knew differently. She knew she couldn’t handle Al alone, and that she needed a little ‘down-time’ herself. She and Al asked Gary and Bonnie if they would accompany them on a trip to Hawaii.  Four months later the four of them left for the two-week cruise. Unexpectedly, Al noticed a gravelly-voice singer on the beach, with a box in front that read, “If inquisitive to hear, put some $ in the box.” Al put money in and sat mesmerized as the singer sang.

Al passed away three years later. But for three years, he had pictures to look at and talk about – from a place in history, a place he always wanted to go to but feared he wouldn’t be able to – with family and friends.

What Gary and Bonnie did with Al and Michelle was a continuation of what they were already doing with their clients, accompanying them wherever they wanted to go. And why not? This trip was just a little longer.

Ella Wheeler Wilcox had it figured out when her poem, “Solitude”, was published in 1883. Here is the first stanza:

Laugh, and the world laughs with you:
Weep, and you weep alone;
For the sad old earth
Must borrow its mirth,
It has trouble enough of its own.

Especially as we age, it’s easy to get caught up in life’s daily stresses. Physical ailments, retirement worries, illness of a friend or elderly neighbor down the street –  the list goes on. Yet research has shown that people who laugh live longer. According to Sven Svebak of the medical school at Norwegian University of Science and Technology, adults who have a sense of humor outlive those who don’t find life funny, and the survival edge is particularly large for people with cancer.

He released his study of about 54,000 Norwegians, tracked for seven years, at the 2007 American Psychosomatic Society meeting in Budapest, Hungary. The greater a role humor played in their lives, the greater their chances of surviving the seven years. Adults who scored in the top quarter for humor appreciation were 35 percent more likely to be alive than those in the bottom quarter, he says.

In a subgroup of 2,015 who had a cancer diagnosis at the start, a great sense of humor cut someone’s chances of death by about 70 percent compared with adults with a poor sense of humor.

Like your muscles, your brain needs regular workouts to stay healthy and fit as you age. Because just as we lose some muscle as we get older, so can our brains atrophy The brain’s “cognitive reserve”— its ability to withstand neurological damage due to aging and other factors without showing visible signs of slowing or memory loss — diminishes through the years. That can make it more difficult to perform mental tasks. But, just as weight workouts add lean muscle to your body and help you retain more muscle in your later years, researchers now believe that following a brain-healthy lifestyle and performing regular, targeted brain exercises can also increase your brain’s cognitive reserve.

So, as Gerry Hopman says, “Keep learning: computer, languages, skills, crafts, whatever. Never let the brain be idle. An idle mind is the devil’s workshop, and the devil’s name is Alzheimer’s.”

And why shouldn’t we laugh? The way they’re playing with our social security we’re going to have to live longer just to get our money back!

The recent Alzheimer’s Association International Conference in Paris has brought forth numerous articles and presentations, ranging from clinical trials and their follow-up to predictive models such as the study by Deborah Barnes, PhD, MPH, Lowering Risk Factors Might Prevent Millions of Cases of Alzheimer’s Disease presented here and published in The Lancet Neurology.

She and her colleagues used mathematical modeling to calculate “population attributable risks” (PARs) for potentially modifiable Alzheimer’s risk factors to project the potential impact of risk factor reduction on Alzheimer’s prevalence.

Just what are these PARs? In the author’s words, “what mattered most was how common the risk factors were in the population, For example, in the U.S., about one third of the population is sedentary, so a large number of Alzheimer’s cases are potentially attributable to physical inactivity.”

“The authors identified the following factors that increase the risk for Alzheimer’s: diabetes, high blood pressure, obesity, smoking, sedentary behavior, depression and low educational level. These conditions are modifiable.”

Their study found that, worldwide, these risk factors could account for the following proportion of Alzheimer’s Disease cases:

Together, the seven potentially modifiable risk factors contributed to roughly 50 percent of Alzheimer’s cases worldwide (51 percent, 17.2 million) and in the U.S. (54 percent, 2.9 million).

“We selected these risk factors because they have what we found to be the most consistent evidence for being associated with a risk of Alzheimer’s,” said Dr. Barnes.

Assumption of Causality

The investigators calculated PARs for each risk factor individually and all seven combined, both in the United States and worldwide. They then calculated the number of AD cases that could potentially be prevented by 10 percent and 25 percent reductions in risk factor prevalence. An important caveat of the study, said Dr. Barnes, is that PARs assume causality.

At 19 percent, the risk factor that contributed most to AD worldwide was low educational level, which was defined as no education beyond grade school. Investigators were surprised that low educational level topped the worldwide list but attributed it to the fact that lack of education is so common. She noted that 40 percent of people worldwide have no education beyond a very basic level.

In their article, the researchers explain that “education and mental stimulation throughout life are believed to lower risk of AD and dementia by helping to build cognitive reserve, enabling individuals to continue functioning at a normal level despite experiencing neurodegenerative changes.”

In an accompanying editorial, also published online in Lancet Neurology, Laura Fratiglioni, MD, PhD, Karolinska Instituet-Stockholm University, and Chengxua Qiu, PhD, from Stockholm Gerontology Research, cautioned that none of the risk factors in the study has yet been proven to have a causal relationship to AD. http://www.medscape.com/viewarticle/746680

But this doesn’t explain it all. For a risk factor to be linked to Alzheimer’s, Alzheimer’s sufferers would have to exhibit a greater incidence of this particular condition for one to say that obesity, for example, creates a higher relative risk of getting Alzheimer’s disease.

As the authors correctly state, “what’s needed now are large interventional trials to determine whether reducing these risk factors will in fact reduce incident AD and follow the mathematical model.”

Arts for the Aging was founded in 1988 by Ms. Lolo Sarnoff, a sculptor then 72 years old, in response to a request from the National Institutes of Health. The NIH had asked her to conduct workshops for seniors with Alzheimer’s disease. Ms. Sarnoff agreed and soon observed that art in every form was beneficial to the mood of most seniors. Reports by nurses showed less agitation and aggressive behavior in patients, and these moods continued even after the patients left her workshops.

Now in its 23^rd year, Arts for the Aging it is recognized by the National Endowment for the Arts as a pioneering arts program for older adults, and a model for excellence in life-long learning and creative aging. Infusing the latest field research and evaluation into its work, AFTA remains true to the founder’s innovative vision, giving seniors – especially those with dementia, including Alzheimer’s disease – a sense of healing, self-worth and independence.

Arts for the Aging offers older adults specially designed, best-practice programs to promote health improvement and life enhancement through the arts.  Free outreach workshops are provided to small groups of older adults who are vulnerable and who are living with impairments such as dementia. Workshops take place at underserved adult care centers in communities where local residents strive to age in place. Visual, performing, literary, multidisciplinary and intergenerational arts programs are led by trained, professional teaching artists. The one-hour sessions are self-contained; they hold the interest of those with brain degeneration by exposing them to new artists and new media each week. Groups are immersed in painting, poetry, live instrumental music and more. In 2010, AFTA served over 500 older adults through these programs.

The National Endowment for the Arts’ recent Creativity and Aging Study (http://www.nea.gov/resources/accessibility/CnA-Rep4-30-06.pdf) demonstrated that regular participation in professionally-led programs can minimize age-related physical and cognitive impairments, and contribute to better physical, intellectual and emotional health.  In 2010, Arts for the Aging’s offerings focused on achieving positive outcomes for Alzheimer’s and dementia sufferers. Throughout those workshops, 85% of attendees actively participated – impressive considering that three quarters suffered from memory-related ailments, a third were wheelchair bound and others suffered from various debilitating afflictions. One indicator of the severity of participants’ collective memory is that just 40% recall previous Arts for the Aging visits.

Yet post-workshop, an average of 90% show appreciation to the teaching artists, thereby demonstrating seniors’ connection to the artists, their engagement and their  positive attitudes. This bonding is essential to the emotional health of adults who age in place since they may not interact with other people on a regular basis.  Other 2010 outcomes:

• 72% interacted with others, a sign of the social bonds our workshops form.
• 52% shared memories or stories, a practice we encourage continually, given the prevalence of memory-related afflictions in our workshops.
• 75% left the workshops smiling.

Learn more about Arts for the Aging at www.AFTAarts.org.

Mr. B. had moderate to advanced Alzheimer’s Disease during the eight years we worked with him and often had hallucinations of things that most of us can’t see. He would frequently mistake his wife for his mother or daughter, or argue with his reflection in a car window, sometimes thinking his wife was inside and locking him out. When I was driving him around he would look in the back seat and ask if that was my baby, or if I knew whose it was. I would simply respond, “No I don’t know.” His wife had Macular Degeneration and was exhausted from taking care of him, doing more of the chores, managing all the finances, trying to live in her spouses bi-polar fairyland so as not to upset and agitate him. She needed a break.

We began taking him out to every possible free venue in Washington, DC in an effort to provide both physical and mental stimulation. One day per week was for swimming. When the weather was nice we’d walk along the National Mall with him, popping in and out of the Smithsonian Museums. Book stores, cafes, parts of the C & O Canal, and monuments helped round out the mix. It was working. His wife got respite during the day and he would fequently come home tired and sleep through the night.

Mt. T also had Alzheimer’sDisease and had survived WWII after being separated from his wife in the Netherlands. Often, he would slip back to war time, and into his native tongue, telling stories as if they’d happened yesterday. The main challenge with Mr. T. was getting him to bathe and helping control his sometimes violent outbursts. We were able to find a young caregiver with a Dutch last name and who spoke a bit of German. He was able to understand enough of Mr. T’s Dutch to carry on a conversation, responding in English of course. Mr. T refused to take showers all week long. He’d usually tell us that he’d already taken one that day or yesterday or the day before. Our senior caregiver would simply respond, ” Oh, okay”, and change the subject. After five or ten minutes he would try again to make the shower happen, and he was almost always successful.

Some tips we have for dealing with difficult dementia cases follow:

1. Don’t argue or debate facts and reality.

2. Distract them with a new task if they start to become agitated. For example, If Mr. B was arguing with his reflection we’d say, “I don’t know why the door is locked. Let’s go to that cafe, get a drink, and think about what to do”. Often, by the time we got our drinks he would have forgotten about the situation already.

3. Ask them for their help with tasks. Get them working in the garden, sweeping the floor, or loading the dishwasher.

4. Get them out of the house. We all get cabin fever and dementia can greatly exacerbate this. Physical and mental stimulation are important for those suffering from Alzheimer’s.

5. Get them talking! Alzheimer’s patients often have a great recollection of the past. Ask them questions about when they were in college, the war (take your pick), where they got married, or Washington, DC in the 1960s.

6. Recognize some days will be bad. Some will be even worse. Don’t take it personally.

We strongly believe that all people need to have access to community. Those who suffer from memory impairment should not be locked up in Alzheimer’s wards in nursing homes and assisted living.  They need to be out with other people, living a real life, even if they are living a fantasy world in their own minds.

Care for You’s CEO and Executive Director were pleased to attend the August 30^th ceremony at the U.S. Immigration and Naturalization Service to witness Kamaldeen Abubaker take the oath to become a U.S. citizen. A companion with the Company for the past three years, Mr. Abubaker came to the United States from Nigeria in 2001. He is married with three small children.

Mr. Abubaker’s first assignment with Care for You was to staff a retired Air Force (former Army Air Corps) General who suffers from Alzheimer’s disease. Upon being contacted by the bank that manages the General’s trust, the Care for You executive director scheduled an assessment with the family.

The family initially requested an individual to act in the capacity of an “aide de camp,” as this was a term that resonated with the General. The General’s children, a son and two daughters, stated that the General and his wife wanted to remain in their own home as they grew older, and not move into assisted living or a nursing home.

Mr. Abubaker’s initial assignment was for five hours per day to perform a list of duties including:

• Daily shopping with the General for household needs
• Regular lunches at a local restaurant
• Assistance in sorting papers and files in his office to determine what to save, discard, or set aside for his son to review
• Assistance with using the computer for email
• Taking direction from the General and keeping him busy as he was easily bored in retirement
• Working on “projects” per direction from the family.

Mr. Abubaker quickly gained the General’s and family’s trust, and strong relationships were formed.

Much has happened over the past three years. The General’s wife has died. After two brief stays in assisted living facilities, the family realized the General was extremely unhappy and determined to have him spend his remaining years in his own space. Care for You was requested to increase staffing to 24/7; Mr. Abubaker is lead companion on the team. And we are pleased to have Mr. Abubaker on our team.

Can’t find your car keys? Forget what’s on your grocery list? Can’t remember the name of the personal trainer you liked at the gym? You’re not alone. Everyone forgets things occasionally. Still, memory loss is nothing to take lightly. You can do simple things every day to improve your memory — starting today!

No. 1: Stay mentally active

Just as physical activity helps keep your body in shape, mentally stimulating activities help keep your brain in shape — and memory loss at bay. Do crossword puzzles. Read a section of the newspaper that you normally skip. Take alternate routes when driving. Learn to play a musical instrument. Volunteer at a local school or community organization.

No. 2: Socialize regularly

Social interaction helps ward off depression and stress, both of which can contribute to memory loss. Look for opportunities to get together with loved ones, friends and others — especially if you live alone. When you’re invited to share a meal or attend an event, go!

No. 3: Get organized

You’re more likely to forget things if your home is cluttered and your notes are in disarray. Jot down tasks, appointments and other events in a special notebook or calendar. You might even repeat each entry out loud as you write it down to help cement it in your memory. Keep to-do lists current, and check off items you’ve completed. Set aside a certain place for your wallet, keys and other essentials.

No. 4: Focus

Limit distractions, and don’t try to do too many things at once. If you focus on the information that you’re trying to remember, you’ll be more likely to recall it later. It might also help to connect what you’re trying to remember to a favorite song or another familiar concept.

No. 5: Eat a healthy diet

A heart-healthy diet is as good for your brain as it is for your heart. Focus on fruits, vegetables and whole grains. Choose low-fat protein sources, such as lean meat, skinless poultry and fish. What you drink counts, too. Not enough water or too much alcohol can lead to confusion and memory loss.

No. 6: Include physical activity in your daily routine

Physical activity increases blood flow to your whole body, including your brain — which may help keep your memory sharp. Aim for at least 30 minutes of aerobic activity a day. If you don’t have time for a full workout, squeeze in a few 10-minute walks throughout the day.

No. 7: Manage chronic conditions

Follow your doctor’s treatment recommendations for any chronic conditions, such as thyroid problems, high blood pressure and depression. The better you take care of yourself, the better your memory is likely to be.

When to seek help for memory loss

If you’re worried about memory loss — especially if memory loss affects your ability to complete your usual daily activities — consult your doctor. He or she will likely do a physical exam, as well as check your memory and problem-solving skills. Sometimes other tests are needed as well. Treatment will depend on what’s contributing to the memory loss.

This article (http://www.mayoclinic.com/health/memory-loss/HA00001) was posted on the Mayo Clinic Web site by Mayo Clinic staff. It is reproduced here in its entirety.

Can’t find your car keys? Forget what’s on your grocery list? Can’t remember the name of the personal trainer you liked at the gym? You’re not alone. Everyone forgets things occasionally. Still, memory loss is nothing to take lightly. You can do simple things every day to improve your memory — starting today!

No. 1: Stay mentally active

Just as physical activity helps keep your body in shape, mentally stimulating activities help keep your brain in shape — and memory loss at bay. Do crossword puzzles. Read a section of the newspaper that you normally skip. Take alternate routes when driving. Learn to play a musical instrument. Volunteer at a local school or community organization.

No. 2: Socialize regularly

Social interaction helps ward off depression and stress, both of which can contribute to memory loss. Look for opportunities to get together with loved ones, friends and others — especially if you live alone. When you’re invited to share a meal or attend an event, go!

No. 3: Get organized

You’re more likely to forget things if your home is cluttered and your notes are in disarray. Jot down tasks, appointments and other events in a special notebook or calendar. You might even repeat each entry out loud as you write it down to help cement it in your memory. Keep to-do lists current, and check off items you’ve completed. Set aside a certain place for your wallet, keys and other essentials.

No. 4: Focus

Limit distractions, and don’t try to do too many things at once. If you focus on the information that you’re trying to remember, you’ll be more likely to recall it later. It might also help to connect what you’re trying to remember to a favorite song or another familiar concept.

No. 5: Eat a healthy diet

A heart-healthy diet is as good for your brain as it is for your heart. Focus on fruits, vegetables and whole grains. Choose low-fat protein sources, such as lean meat, skinless poultry and fish. What you drink counts, too. Not enough water or too much alcohol can lead to confusion and memory loss.

No. 6: Include physical activity in your daily routine

Physical activity increases blood flow to your whole body, including your brain — which may help keep your memory sharp. Aim for at least 30 minutes of aerobic activity a day. If you don’t have time for a full workout, squeeze in a few 10-minute walks throughout the day.

No. 7: Manage chronic conditions

Follow your doctor’s treatment recommendations for any chronic conditions, such as thyroid problems, high blood pressure and depression. The better you take care of yourself, the better your memory is likely to be.

When to seek help for memory loss

If you’re worried about memory loss — especially if memory loss affects your ability to complete your usual daily activities — consult your doctor. He or she will likely do a physical exam, as well as check your memory and problem-solving skills. Sometimes other tests are needed as well. Treatment will depend on what’s contributing to the memory loss.

This article (http://www.mayoclinic.com/health/memory-loss/HA00001) was posted on the Mayo Clinic Web site by Mayo Clinic staff. It is reproduced here in its entirety.