For the U.S., results from the 2007 Aging, Demographics, and Memory Study (ADAMS), funded by the National Institutes of Health, Bethesda, Maryland, found that about 3.4 million Americans aged 71 years and older — almost 14% — have dementia, and 2.4 million (9.7%) have Alzheimer’s disease. ADAMS was the first population-based study of dementia to include people from all regions of the country.

Dementia is the general term used for the variety of brain afflictions that cause its sufferers not to be able to remember – continually losing their train of thought and experiencing changes in behavior. The most common form of dementia is Alzheimer’s disease which affects up to 70 percent of dementia victims. More than half of this population live in countries of low to medium income.

According to the WHO report, only 20-50 percent of dementia cases are being recognized, even in richer countries, thereby making it evident that better diagnosis is needed. Oleg Chestnov, WHO’s assistant director general of Noncommunicable Diseases and Mental Health, would also like to see health and social care added to better detection, as he feels that many healthcare workers are not properly trained to recognize this disease.

Currently, there are eight countries that have programs in place to approach the issues of dementia on a national level. Those countries are Britain, France, Netherlands, Norway, Denmark, South Korea, Japan and Australia. Germany and Sweden are providing their citizens with lists of recommendations of how citizens can proceed.

WHO’s report also emphasizes that there is an overall lack of understanding and information, creating fear. Therefore, people resist asking for help. The recommendation is that health care professionals need to:

• help reduce that fear,
• give better care to the victims, and
• provide support for those that care for the dementia sufferer.

In summary, Shekhar Saxena, head of the mental health department at WHO, reports that as people live longer: 1 in 8 people over 65 years of age, and 1 in 2.5 people over the age of 85 will be affected by this disease. Dementia is a disease that cannot be cured but, if dealt with properly, its progress can be slowed.

The olfactory system, being one of the oldest sensory systems, is the first to be affected with the onset of dementia or Alzheimer’s. US researchers have created a list of scents used to help make the determination. These smells include cheese, clove, fruit punch, leather, lemon, lilac, lime, menthol, orange, pineapple, smoke and strawberry. If an individual cannot recognize three of the ten given, then they are five times more likely to develop Alzheimer’s.

But what about people who have had a bad sense of smell all of their lives or have lost the ability to smell in their 20s, 30s, 40s or 50s; ages too young to be given an Alzheimer’s diagnosis? Medical science’s term for this inability, called hyposmia, can be associated with zinc deficiencies (if a cold or sinus infection has been ruled out), smoking, elevated blood alcohol levels or misuse of some cold remedy nasal sprays.

Recommendations include eating more zinc rich foods (lentils, oysters, pecans and sunflower seeds), taking a multivitamin with at least 7 mg. of zinc, exercise, decreasing mucus inducing foods (ice cream, milk and cheese) and increasing moisture either with a humidifier or a saline spray.

Other common causes of smell disorders are:

• Sinus and other upper respiratory infections
• Polyps in the nasal cavities
• Frontal head injuries
• Hormonal disturbances
• Dental problems
• Exposure to certain chemicals, such as insecticides and solvents
• Numerous medications, including some common antibiotics and antihistamines.

Then there are the people who are born without a sense of smell. Many are missing their olfactory bulb which is the most crucial part of brain’s olfactory system. These people are diagnosed with ICA or isolate congenital ansomia. According to Ilona Croy of the Smell and Taste Clinic at the University of Dresden Medical School in Germany, people with ICA can still taste but not in the same way that can be distinguished when one is able to smell.

If you have experienced a sudden loss of smell, please visit with your physician to help determine whether it’s a simple cold or an indicator of something more serious. Our modern medical science can help nip it in the “bulb” and hopefully when you “stop to smell the roses” you’ll really be able to smell them.

Having a conversation with a person with Alzheimer’s disease can be quite difficult. Some people with Alzheimer’s disease can speak but not understand and others can understand but are unable to speak. You may need non-verbal cues using prompts, gestures and smiles. Lots of smiles! It is important that one continue to speak with a person with Alzheimer’s even if they cannot speak. A patient, gentle communicator shows care and can be a comfort.

What can be done?

• Approach a person with Alzheimer’s disease from the front, in the direct line of sight and address them by name.
• Talk slowly and use simple words. Once a conversation has been initiated, give the person time to respond.
• Maintain eye contact. Demonstrate a calm demeanor by being gentle and smile. Use body language and non-verbal cues to reinforce what you are saying. They may not understand your words, but they will get a sense based on your facial expressions and body language.
• Refrain from negative statements. Don’t correct mistakes. This causes agitation and confusion.
• Avoid trying to get a person with Alzheimer’s to perform a task, keep your directions simple. Give the directions one step at a time. Sometimes it is helpful to draw a picture or write what you would like them to do. The ability to read is one of the last things to go.
• Finally, use all the patience you can muster. A person with Alzheimer’s may ask the same question many times. Answer the question twice and then offer the person reassurance that everything is alright. Tell them that you are there to help.
• If you find you are becoming frustrated stop the conversation.

These thoughts are based on the article, “Keep on Talking,” Ashleigh B. Egan, in the fall 2006 edition of “Care ADvantage” magazine which is published by the Alzheimer’s Foundation of America.

The Company’s Client Services start with Companions who perform basic chore and errand services such as cooking, cleaning, laundry, errands, and transportation. Services are available from a minimum of four hours per episode to 24/7/365 coverage.

CompanionPlus services include care coordination, heavy cleaning, access remodeling, lawn and garden, secretarial, legal, and Active Alzheimer’s Care ^SM.

Care for You also offers hoarding recovery services. The Company has a strong history of assisting hoarders who have been served with an eviction notice to remain in their home. By working with the resident, legal, and government health and safety authorities, Care for You has assisted many in making their home clean and safe for continued residence.

Please take a moment to visit the site for a more complete picture of our services.

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.