Link Between Passive Smoking And Dementia

An international study by scientists in China, the UK and USA has found a link between passive smoking and syndromes of dementia.

The study of nearly 6,000 people in five provinces in China reveals that people exposed to passive smoking have a significantly increased risk of severe dementia syndromes.

Passive smoking, also known as 'second-hand' smoke or environmental tobacco smoke (ETS), is known to cause serious cardiovascular and respiratory diseases, including coronary heart disease and lung cancer. However, until now it has been uncertain whether ETS increases the risk of dementia, mainly due to lack of research. Previous studies have shown an association between ETS and cognitive impairment, but this is the first to find a significant link with dementia syndromes.

The study, published in Occupational and Environmental Medicine, is a collaboration between scientists at King's College London and Anhui Medical University, China, along with colleagues in the UK and USA.

According to the World Health Organization (WHO), nearly 80 percent of the more than one billion smokers worldwide live in low- and middle-income countries, where the burden of tobacco-related illness and death is heaviest; but only 11 percent of the world's population are protected by comprehensive smoke-free laws.

China is the largest consumer of tobacco in the world, with 350 million smokers. Since 2006, the Chinese government has actively promoted the introduction of smoke-free environments in hospitals, schools, on public transport and in other public places, but implementation has not been widespread.

Recent data show that the prevalence of passive smoking is still high, with over 50 percent of people exposed to environmental tobacco smoke on a daily basis. China also has the highest number of dementia sufferers in the world, with increasing rates of new cases as the population ages.

Dr Ruoling Chen, senior lecturer in public health from King's College London, and colleagues interviewed 5,921 people aged over 60 in the rural and urban communities of Anhui, Guangdong, Heilongjiang, Shanghai and Shanxi to characterise their levels of ETS exposure, smoking habits and assess levels of dementia syndromes.

They found that 10 percent of the group had severe dementia syndromes. This was significantly related to exposure level and duration of passive smoking. The associations with severe syndromes were found in people who had never smoked and in former and current smokers.

The data from the Anhui cohort, which were collected at baseline in 2001-03 for dementia syndromes and in the follow up in 2007-08 for ETS exposure and dementia, further excluded the possibility that dementia syndromes caused people to be more exposed to environmental tobacco smoke.

Dr Ruoling Chen, also a visiting professor at Anhui Medical University said: 'Passive smoking should be considered an important risk factor for severe dementia syndromes, as this study in China shows. Avoiding exposure to ETS may reduce the risk of severe dementia syndromes.

'China, along with many other countries, now has a significantly ageing population, so dementia has a significant impact not only on the patients but on their families and carers. It's a huge burden on society.'

The findings from this study, together with a second recent study by Chen and colleagues published in Alzheimer's & Dementia on the links between passive smoking and Alzheimer's disease, strengthen the case for public health measures to protect people from exposure to environmental tobacco smoke.

'At present, we know that about 90 percent of the world's population live in countries without smoke-free public areas. More campaigns against tobacco exposure in the general population will help decrease the risk of severe dementia syndromes and reduce the dementia epidemic worldwide.'

He added: 'The increased risk of severe dementia syndromes in those exposed to passive smoking is similar to increased risk of coronary heart disease - suggesting that urgent preventive measures should be taken, not just in China but many other countries.'


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n.p. (2013, January 11). "Link Between Passive Smoking And Dementia." Medical News Today.
 

What is an Assisted Living Facility?

Assisted Living Facilities (ALF's) are housing facilities for the elderly with any sort of disability that would prevent them from being able to live independently. ALF's provide supervision or assistance with activities of daily living or better known as ADL's. These tasks can be simple as brushing ones teeth to more complicated tasks like eating, bathing or using the restroom. ALF's also supervise the residents to help ensure their health, safety and over-all well being. They also have a trained staff licensed to regulate and hand out medications.

There are 4 major benefits to staying in an Assisted Living Facility.

1. Safety. Assisted living centers are set up to provide a safe, comfortable environment for elders. Many, though not all, have secure entrances. Nearly all are monitored enough so that elders aren't vulnerable to attack or burglary as they may be if they stay alone in their home. Just the fact that there are other people around makes communal living safer than being alone in a house. Also, most assisted living centers have alerting systems so if residents have emergencies in their own apartments or rooms, they can summon help.

 

2. Meals. Appetites can diminish as we age, plus many people don't enjoy eating alone. Elders home alone often warm up something in the microwave or on the stove rather than preparing a nourishing meal. They then may eat in front of the TV for company. In assisted living, meals are provided and they often offer many choices of food. But the biggest plus may be that people have company for their meals.

 

Many centers offer kitchenettes, so people have the option of preparing some meals in their apartments if they choose, which some do, especially breakfast. However, the pull of communal dining is pretty strong once they get used to company. When people have company for a meal, they generally eat better, so these communal meals can help keep a senior healthy. Also, many assisted living centers keep an eye on how well the elders eat to see if supplements seem to be necessary.

 

3. Transportation. Most assisted living centers provide group transportation for shopping and to community events. Also, they can generally arrange transportation for seniors who need to get to clinic appointments. Each center is different, but the ability to go where they want is important to elders, and many seniors can no longer drive, or choose not to drive in heavy traffic. Assisted living centers can be a big help getting people where they want to go.

 

4. Socialization. Socialization is perhaps the most important reason why many people who insist that they will hate assisted living end up thriving. Many elders have slowly gotten so they don't want to go out of their home because it's too difficult to get where they want to go. Significant lifelong friends have health problems or have died.

When not actively used, social skills can decline, causing anxiety when elders do go out among people. Depression can set in, furthering their reluctance to be socially active. Elders without social exposure can become virtual hermits, except for those who have family visits. While family visits are fun, seniors needs peers, as well. In assisted living, even those who swore they'd hate it often find, once they adjust, that they again enjoy the company of peers. They play cards, listen to music, exercise, have snacks, go to community events and have people come in to entertain them.

 

 

 

A good facility provides choices. They don't force involvement, but they encourage residents to try different activities. The facility staff should find out what activities the senior has enjoyed in the past and try to find something similar that they can do at the center. The vital ingredient, however, is that the elders are around peers. The chance to form new friendships grows with each day they live in a good center. Socialization has been shown to keep many people active and healthier than they would be if they remained alone at home.

While assisted living isn't the answer to every elder's living problems, it does help many have a healthier, happier life. This, in turn, often increases life expectancy. However, quality of life may be the key factor in the growing success of good assisted living facilities, as it should be with every service we provide for our elders.

 

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Structural Damage To The Brain From High Blood Pressure Demonstrated Among People As Young As 40

Uncontrolled high blood pressure damages the brain's structure and function as early as young middle-age, and even the brains of middle-aged people who clinically would not be considered to have hypertension have evidence of silent structural brain damage, a study led by researchers at UC Davis has found.

The investigation found accelerated brain aging among hypertensive and prehypertensive individuals in their 40s, including damage to the structural integrity of the brain's white matter and the volume of its gray matter, suggesting that vascular brain injury "develops insidiously over the lifetime with discernible effects."

The study is the first to demonstrate that there is structural damage to the brains of adults in young middle age as a result of high blood pressure, the authors said. Structural damage to the brain's white matter caused by high blood pressure previously has been associated with cognitive decline in older individuals.

Published online in the medical journal The Lancet Neurology, the study will appear in print in the December 2012 issue. It emphasizes the need for lifelong attention to vascular risk factors for brain aging, said study senior author Charles DeCarli, professor of neurology and director of the UC Davis Alzheimer's Disease Center.

"The message here is really clear: People can influence their late-life brain health by knowing and treating their blood pressure at a young age, when you wouldn't necessarily be thinking about it," DeCarli said. "The people in our study were cognitively normal, so a lack of symptoms doesn't mean anything."

Normal blood pressure is considered a systolic blood pressure -- the top number -- below 120 and a diastolic pressure -- the bottom number -- below 80. Prehypertensive blood pressure range is a top number between 120 and 139 and a bottom number between 80 and 89. Blood pressures above 140 over 90 are considered high.

Elevated blood pressure affects approximately 50 million Americans and is associated with a 62 percent risk of cerebrovascular disease, such as ischemic stroke, and a 49 percent risk of cardiovascular disease. It is the single-greatest risk factor for mortality in the United States.

Earlier studies have identified associations between elevated blood pressure and a heightened risk of brain injury and atrophy leading to reduced cognitive performance and a greater likelihood of dementia, making hypertension an important, modifiable risk factor for late-life cognitive decline. There is evidence, the study says, that lowering blood pressure among people in middle age and in the young elderly can help prevent late-life cognitive decline and dementia.

Titled "Effects of Systolic Blood Pressure on White Matter Integrity in Young Adults: From the Framingham Heart Study," the research sought to decipher the age of onset, extent and nature of the effects of elevated systolic blood pressure on cognitive decline among participants in the Framingham study, a longitudinal evaluation begun more than 60 years ago of the cardiovascular health of the residents of Framingham, Mass., that is now in its third generation of participants.

The research included 579 Framingham participants who were, on average, 39 years old when recruited for participation in the study, which launched in 2009. Their blood pressure was measured as the average of two physician-recorded blood pressures. The study subjects were organized into groups with normal blood pressure, those who were prehypertensive and those with high blood pressure. Whether they were receiving treatment for high blood pressure and whether they smoked also was noted.

The meticulously conducted study used magnetic resonance imaging (MRI) to determine the participants' brain health using a variety of measurements of white matter injury and gray matter volume. The MRI exams included diffusion tensor imaging, a particular kind of image that reveals microscopic details of tissue architecture within the white matter of the brain. The white matter includes the axons, the biological "wires" of the brain that carry information from one part of the brain to the other. Measurements from diffusion tensor imaging, such as fractional anisotropy, take on larger values if the axons are more intact. White-matter hyperintensities -- white-matter areas that appear intensely white on another kind of MRI scan -- suggest more severe damage than fractional anistropy does, and gray matter density also were examined. The imaging studies then were combined to create a global measurement of brain health that compared normal and hypertensive subjects.

The results were that, in hypertensive individuals, fractional anisotropy in the frontal lobes was reduced by an average of 6.5 percent. The hypertensives also had 9 percent less gray matter, on average, in their brains' frontal and temporal lobes. Hypertensive individuals' brains were significantly less healthy than those of subjects with normal blood pressure. For example, a typical 33-year-old hypertensive's brain health was similar to that of the typical 40-year-old normotensive subject. So, for those 33-year-olds, high blood pressure had prematurely aged the brain by seven or so years.

The authors did not postulate a mechanism for the damage. However, they noted that high blood pressure causes arteries to stiffen, thus making the blood flowing to the brain pulse more strongly. This stresses the blood vessels of the brain, likely making it more difficult for them to nourish brain tissue such as axons.

"This work suggests that recently described white matter microstructural damage associated with high blood pressure in the elderly may be detectable earlier in the life span, further reinforcing the view that vascular brain injury may develop insidiously over several decades," said Pauline Maillard, the study's lead author and a postdoctoral fellow in the UC Davis Department of Neurology. "These results emphasize the need for early and optimum control of blood pressure, which is neither routinely achieved nor subject to testing in randomised controlled clinical trials."


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Source: http://www.medicalnewstoday.com/

Could Alcohol Be Bad for Your Brain?

VANCOUVER, July 18, 2012 – Light to moderate alcohol consumption has generally been considered to have some health benefits, including possibly reducing risk of cognitive decline. However, two studies reported today at the Alzheimer’s Association International Conference^® 2012 (AAIC^® 2012) in Vancouver suggest that moderate alcohol use in late-life, heavier use earlier in life, and “binge” drinking in late-life increase risk of cognitive decline.

“The many dangers of misuse of alcohol, and some of its possible benefits, have been widely reported, and there needs to be further clarification by the scientific community,” said William Thies, PhD, Alzheimer’s Association^® chief medical and scientific officer. “Certainly no one should start drinking in order to reduce Alzheimer’s risk, as these two new reports attest.”
“We need to know more about what factors actually raise and lower risk for cognitive decline and Alzheimer’s disease. To do that, we need longer term studies in larger and more diverse populations, and we need more research funding to make that happen. We have learned incredible amounts about heart disease and stroke risk from long-term research like the Framingham Study – we have solidly proven lifestyle risk factors that people can act on every day. Alzheimer’s now needs its version of that research,” Thies added.

“In 2050, care for people with Alzheimer’s will cost the U.S. more than $1 trillion, creating an enormous strain on the healthcare system, families, and federal and state budgets. Recognizing this growing crisis, the first-ever U.S. National Plan to Address Alzheimer’s was unveiled in May. Now this plan must be swiftly and effectively implemented. We need Congress to support this implementation with an additional $100 million for Alzheimer’s research, education, outreach and community support,” Thies said.

20-year alcohol consumption patterns and cognitive impairment in older women

Whether moderate alcohol consumption has an impact on cognitive impairment in late-life is unsettled with some studies suggesting a protective effect. To date, few studies have examined patterns of alcohol consumption over time in relation to cognitive status, especially in very late-life.
Tina Hoang, MSPH, of NCIRE/The Veterans Health Research Institute, San Francisco and the University of California, San Francisco, and colleagues followed more than 1,300 women aged 65 and older for 20 years. They measured frequency of current and past alcohol use at the beginning, midpoint (years 6 and 8) and late phases (years 10 and 16) of the study. The researchers assessed participants at the end of the study for mild cognitive impairment and dementia. At baseline, 40.6% were nondrinkers, 50.4% were light drinkers (0 to 7 drinks/week), and 9.0% were moderate drinkers (7 to 14 drinks/week). Heavy drinkers (14 drinks/week) were excluded.
The scientists found that:

• Women who reported drinking more in the past than at the beginning of the study were at 30% increased risk of developing cognitive impairment.
• Moderate drinkers at baseline or at midpoint had similar risk of cognitive impairment to non-drinkers; however, moderate drinkers in the late phase of the study were roughly 60% more likely to develop cognitive impairment.
• Women who changed from nondrinking to drinking over the course of the study had a 200% increased risk of cognitive impairment.

“In this group of older women, moderate alcohol consumption was not protective,” Hoang said. “We found that heavier use earlier in life, moderate use in late-life, and transitioning to drinking in late-life were associated with an increased risk of developing cognitive impairment. These findings suggest that alcohol use in late-life may not be beneficial for cognitive function in older women.”
“It may be that the brains of oldest old adults are more vulnerable to the effects of alcohol, but it is also possible that factors associated with changing alcohol use related to coping or loss could be involved. Clinicians should carefully assess their older patients for both how much they drink and any changes in patterns of alcohol use,” Hoang added.

Binge drinking increases risk of cognitive decline in older adults

Little is known about the cognitive effects of heavy episodic (or “binge”) drinking in older people. Binge drinking is a pattern of alcohol consumption in which someone who is not otherwise a heavy drinker consumes several drinks on one occasion.

“We know that binge drinking can be harmful,” said Dr. Iain Lang of Peninsula College of Medicine and Dentistry, University of Exeter, UK. “For example, it can increase the risk of harm to the cardiovascular system, including the chance of developing heart disease, and it is related to increased risk of both intentional and unintentional injuries.”

According to Lang, it is not clear whether binge drinking in older adults has a damaging effect on cognitive health and whether it increases the risk a person will develop dementia.

Lang and colleagues conducted a secondary analysis of data from 5,075 participants aged 65 and older in the Health and Retirement Study (HRS), a biennial, longitudinal, nationally representative survey of U.S. adults age 50 and older, to assess the effects of binge drinking in older people on cognition and mood. Baseline data were collected in 2002 and participants were followed for eight years. Consumption of four or more drinks on one occasion was considered binge drinking. Cognitive function and memory were assessed using the Telephone Interview for Cognitive Status.

Binge drinking once a month or more was reported by 8.3% of men and 1.5% of women; binge drinking twice a month or more was reported by 4.3% of men and 0.5% of women.
The researchers found that:

• Participants who reported heavy episodic drinking once per month were 62% more likely to be in the group experiencing the highest decline in cognitive function, and were 27% more likely to be in the group experiencing the highest amount of memory decline.
• Participants reporting heavy episodic drinking twice per month or more were 147% more likely to be in the group experiencing the highest decline in cognitive function, and were 149% more likely to be in the group experiencing the highest amount of decline in memory.

Outcomes were similar in men and women when analyzed separately.
“In our group of community-dwelling older adults, binge drinking is associated with an increased risk of cognitive decline,” Lang said. “Those who reported binge drinking at least twice a month were more than twice as likely to have the greatest decline in both cognitive function and memory. These differences were present even when we took into account other factors known to be related to cognitive decline such as age and level of education.”

“This research has a number of implications. First, older people – and their physicians should be aware that binge drinking may increase their risk of experiencing cognitive decline and encouraged to change their drinking behaviors accordingly. Second, policymakers and public health specialists should know that binge drinking is not just a problem among adolescents and younger adults; we have to start thinking about older people when we are planning interventions to reduce binge drinking,” Lang added.

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Source: By Dr. Edgerly, research expert - http://www.alzheimersblog.org/

Finding In Home Care

In-home care includes a wide range of services provided in the home, rather than in a hospital or care facility. It can allow a person with Alzheimer’s or other dementia to stay in his or her own home. It also can be of great assistance to caregivers.
Not all in-home services are the same. Some in-home services provide non-medical help, such as assistance with daily living. Other in-home services involve medical care given by a licensed health professional, such as a nurse or physical therapist. Common types of in-home services include:

• Companion services: Help with supervision, recreational activities or visiting.
• Personal care services: Help with bathing, dressing, toileting, eating, exercising or other personal care.
• Homemaker services: Help with housekeeping, shopping or meal preparation.

Skilled care: Help with wound care, injections, physical therapy and other medical needs by a licensed health professional. Often times, a home health care agency coordinates these types of skilled care services once they have been ordered by a physician.
Determining who will provide home care is an important decision. For some, using a home health agency is the best choice. And for others, an individual care provider is a better fit.

The following steps can be helpful when trying to find the right care:

• Create a list of care needs and your expectations for how they will be met.
• Call home care providers and find out what help they offer and if it meets your needs.
• Meet with a prospective provider in your home for an interview; prepare questions beforehand.
• Check references; some agencies may conduct criminal background checks. Ask if these have been conducted.

Questions to Ask Potential In-Home Providers:

• Are you trained in first aid and CPR?
• Do you have experience working with someone with dementia?
• Are you trained in dementia care?
• Are you with an agency? (If important to you)
• Are you bonded (protects clients from potential losses caused by the employee)?
• Are you able to provide references?
• Are you available at the times needed?
• Are you able to provide back-up, if sick?
• Are you able to manage our specific health and behavioral care needs?

Costs for home care services vary depending on many factors, including what services are being provided, where you live, and whether the expenses qualify for Medicare or private insurance coverage.

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Resource from alzheimersblog.org

How to Respond to "I wanna go home"

“I want to go home.” Many caregivers hear this from their loved one even when their loved one is sitting in the living room of the home they have lived in for many years. It also happens when there’s a change in environment or routine.

It’s upsetting to think your loved one no longer recognizes the environment around them, but this is part of the disease. The person may not believe they are in their home because they truly don’t recognize it. Or that person is likely not speaking literally but searching for the feeling of home – a sense of familiarity, security or comfort. So, what do you do in this situation?

As you so often do, you want to connect to the emotions behind the words instead of reorienting them to their place. In other words, “connect, don’t correct.” Validate their emotions and try to meet the emotional need. A hug or hand holding can soothe. Ask them to tell you about home and they may be able to tell you about the feeling of home.

If it’s not upsetting, you can reminisce about home, possibly using photographs in a photo album. If this upsets the person, distract them with a pleasurable activity – a walk, a favorite snack, or listening to music. You might need to make up an excuse as to why they can’t go home – “the house is being painted; we’ll go later” and distract with an activity.

Reassurance and comfort go a long way; let your loved one know they are safe, taken care of and loved.



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Source: http://www.alzheimersblog.org/

45 Life Lessons, written by a 90 year old

45 Life Lessons, written by a 90 year old

1. Life isn’t fair, but it’s still good.
2. When in doubt, just take the next small step.
3. Life is too short not to enjoy it.
4. Your job won’t take care of you when you are sick. Your friends and family will.
5. Don’t buy stuff you don’t need.
6. You don’t have to win every argument. Stay true to yourself.
7. Cry with someone. It’s more healing than crying alone.
8. It’s OK to get angry with God. He can take it.
9. Save for things that matter.
10. When it comes to chocolate, resistance is futile.
11. Make peace with your past so it won’t screw up the present.
12. It’s OK to let your children see you cry.
13. Don’t compare your life to others. You have no idea what their journey is all about.
14. If a relationship has to be a secret, you shouldn’t be in it.
15. Everything can change in the blink of an eye… But don’t worry; God never blinks.
16. Take a deep breath. It calms the mind.
17. Get rid of anything that isn’t useful. Clutter weighs you down in many ways.
18. Whatever doesn’t kill you really does make you stronger.
19. It’s never too late to be happy. But it’s all up to you and no one else.
20. When it comes to going after what you love in life, don’t take no for an answer.
21. Burn the candles, use the nice sheets, wear the fancy lingerie. Don’t save it for a special occasion. Today is special.
22. Overprepare, then go with the flow.
23. Be eccentric now. Don’t wait for old age to wear purple.
24. The most important sex organ is the brain.
25. No one is in charge of your happiness but you.
26. Frame every so-called disaster with these words, ‘In five years, will this matter?’
27. Always choose Life.
28. Forgive but don’t forget.
29. What other people think of you is none of your business.
30. Time heals almost everything. Give Time time.
31. However good or bad a situation is, it will change.
32. Don’t take yourself so seriously. No one else does.
33. Believe in miracles.
34. God loves you because of who God is, not because of anything you did or didn’t do.
35. Don’t audit life. Show up and make the most of it now.
36. Growing old beats the alternative — dying young.
37. Your children get only one childhood.
38. All that truly matters in the end is that you loved.
39. Get outside every day. Miracles are waiting everywhere.
40. If we all threw our problems in a pile and saw everyone else’s, we’d
grab ours back.
41. Envy is a waste of time. Accept what you already have, not what you think you need.
42. The best is yet to come…
43. No matter how you feel, get up, dress up and show up.
44. Yield.
45. Life isn’t tied with a bow, but it’s still a gift.