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Depression Can Affect More Than Just The Brain
Back in the early 1990’s Duke University research found that brain scans of depressed elderly subjects showed quicker loss of brain volume compared to those that did not suffer with depression. Researchers reported that the accelerated aging went beyond the obvious unhealthy habits such as diet and lack of exercise.
In a recent Wall Street Journal article, writer Shirley S. Wang reported that medical science is finding more and more that psychological disorders are showing up as diseases in the body, not just in the mind. Diseases that would normally be associated with old age are showing up in younger individuals who have dealt with or who are dealing with depression, psychological stress and post – traumatic stress disorder for long periods of time. To name a few, these diseases include dementia, diabetes, heart disease and hypertension. (An earlier article, Mental Health in Later Life: A Guidebook, may be found on the Care for You website.)
At the cellular level, chromosomal changes are speeding up; better known as “accelerated aging”. This is alerting science to look at emotions as a symptom of the psychological issues affecting the body. Mood will be looked at as an indicator of some larger health problem.
According to Dr. Owen Wolkowitz, psychiatry professor at the University of California, San Francisco, we as a society will no longer look at depression as a mental illness. Along with his research colleagues, Dr. Wolkowitz wants to understand the connection of the mental with the physical so as to provide a better diagnosis/treatment of mental illness and help improve the memory of those with cognitive problems.
Recent studies are looking at the protective coverings at the end of chromosomes as indicators of problems. These coverings are called telomeres and as one ages, they become shorter. Clinical studies at UCSF and in Sweden show similar results in that there is a link between depression and the length of this protective covering.
Scientists and researchers want to continue working to find out how serious the psychological episodes must be to shorten the telomeres, as well as the genetics’ vs. life events’ effects on age-related diseases and why some stressed people don’t experienced shortened telomeres.
The enzyme telomerase protects the covering’s length and through research, Dr. Wolkowitz’ team has determined that some people have biological capabilities to produce higher anti-inflammatory proteins and antioxidant levels.
Lifestyle changes can also increase the levels of this enzyme, as proven by research involving patients diagnosed with prostate cancer. Dr. Dean Ornish, creator of the Preventive Medicine Research Institute, along with UCSF’s research group, worked with this group and after three months found that telomerase levels had increased. The increase occurred after lifestyle changes were made – including lowering psychological distress and cholesterol.
Since telomere length can be determined through a blood sample, current research at UCSF is comparing the test results of study participants with those of average people of the same age. Researchers will be tracking these participants to see if, after given this information, they have a greater desire to improve their lifestyles.
Pressure Sores: What are They and Why are They Important?
Pressure sores are a condition where the skin breaks down due to sitting or lying too long in one position. Pressure sores, sometimes called pressure ulcers or bed sores, are a significant risk for people who are bed-ridden and may cause death in extreme cases. This includes many elderly, especially those in nursing homes and rehab facilities where they lie in bed or sit in a wheelchair for extended periods.
For people who are bedridden, common places for pressure sores are the back or sides of the head, rim of the ears, shoulders or shoulder blades, hip, lower back or tailbone, heels, ankles and skin behind the knees. For people who use a wheelchair, common places for pressure sores are on the buttocks, shoulder blades, spine, and backs of arms and legs where they rest against the chair.
Per the Nursing Home Abuse Center and others, there are four different stages of pressure sores. A doctor should be consulted when any of the following symptoms are evident.
Stage I – The beginning stage of a pressure sore has the following characteristics: The skin appears red on people with lighter skin color, and the skin does not briefly lighten when touched. On people with darker skin, there may be no change in the color of the skin. The skin may appear ashen, bluish or purple, and does not briefly lighten when touched. The site may be painful, firm, soft, and warmer or cooler compared with the surrounding skin.
Stage II – The pressure sore is an open wound with damage to the outer layer of skin and part of the underlying layer of skin. The pressure sore may appear as a shallow, pinkish-red, basin-like wound. It may also appear as an intact or ruptured, fluid-filled blister.
Stage III – The sore is a deep wound, the loss of skin usually exposes some amount of fat; the ulcer has a crater-like appearance. The bottom of the wound may have some yellowish dead tissue. The damage may extend beyond the primary wound below layers of healthy skin.
Stage IV – The sore exhibits large-scale loss of tissue, the wound may expose muscle, bone and tendons. The bottom of the wound likely contains slough or dark, crusty dead tissue. The damage often extends beyond the central wound site below layers of healthy skin.
MedlinePlus, a service of the National Library of Medicine in Bethesda, Maryland, references an excellent article that speaks to recognizing, preventing and caring for pressure sores or ulcers. The article offers advice in several important areas:
- Skin Care (for intact or normal skin)
- Moving and changing position
- Nutrition and Hydration
- Relieving pressure on the area near the ulcer.
Communication and close coordination with the medical community are extremely important in dealing with pressure sores: first, to prevent the pressure sores from occurring, second, to recognize them early on, and third, to aggressively manage them when found.
Latest Dementia Statistics from the World Health Organization
WHO reports that within the next 18 years, the number of people, worldwide, suffering from dementia will likely double to 65.7 million and triple by 2050, due to people living longer. The organization has determined that there are around 35.6 million sufferers today, costing over $600 billion a year for care and treatment.
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.
Smell and Dementia
There’s nothing like the smell of fresh laundry or the air after a good cleansing rain. Realtors recommend baking cookies before a potential buyer visits the seller’s home; thereby giving the house a homey feel. The list could go on, as those smells take us back in time or give us comfort. But what does it mean for those that can no longer smell?
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.
Elderly Drivers and Safety
Several recent reports have shown that older drivers are at increased risk of being involved in a traffic accident resulting in a fatality. Seniors 65 and older account for just 8 percent of total miles driven, yet 17 percent of traffic fatalities involved at least one driver over the age of 65.
Robert Siegel of National Public Radio talked with Frank Moretti, director of research at the nonprofit research group TRIP. Mr. Siegel brought up the problem of left turns. Here is Mr. Moretti’s response:
As you come to a left turn, particularly if there’s not an actual left turn lane, you’re now in a fairly stressful environment. You’re trying to keep track of the vehicles coming at you, trying to gauge their speed, you’re conscious that there are vehicles behind. So, you’re under a fair amount of pressure. And those are the types of environments that are going to be the greatest challenge for someone: that maybe their reflexes aren’t what they once were, that maybe there’s some diminishment of cognitive abilities, their vision might not be as quite as good as it once was.
But it turns out that seniors are not the only ones at increased risk making left turns. UPS, the package delivery company, noticed that left turns were causing its drivers to spend more time in traffic. So, in 2005, the company began implementation of a $600 million “route optimization system” to provide faster, more efficient delivery. In the process, the company minimized the number of left turns. Quite simply, the time and gas cost of sitting at a light waiting to make a left turn was much higher than making a few more right turns. And as Greg Karbowski, UPS engineer, stated, “Our most dangerous accidents are the ones that occur in intersections where trucks are turning left.”
In 2007, for example, the Federal Highway Administration reported there were 2.4 million crashes at intersections, representing 40 percent of all crashes, and one-fifth of all fatal crashes.
So, what should the conscientious senior driver do? It turns out there are several options. The most severe of which is to stop driving. Although this may seem extreme, Edmunds notes that every year, 600,000 drivers 70 or older do just that. A less severe approach is to limit driving by avoiding crowded thoroughfares, driving only during daylight hours and avoiding rush hour traffic.
AARP offers various courses in driving improvement, both on-line and in classroom settings throughout the country.
And finally, a Yale University study found that certain physical activities and exercise were effective in improving flexibility, coordination and response times in traffic situations.
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