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Dementia - Symptoms

Symptoms of dementia vary depending on the cause and the area of the brain that is affected. Memory loss is usually the earliest and most noticeable symptom. Other key symptoms of dementia include:

Having difficulty recalling recent events. Not recognizing familiar people and places. Having trouble finding the right words to express thoughts or name objects. Having difficulty performing calculations. Having problems planning and carrying out tasks, such as balancing a checkbook, following a recipe, or writing a letter. Having trouble exercising judgment, such as knowing what to do in an emergency. Having difficulty controlling moods or behaviors. Depression is common, and agitation or aggression may occur. Not keeping up personal care such as grooming or bathing.

Some types of dementia cause key symptoms:


People who have dementia with Lewy bodies often have highly detailed visual hallucinations. They may fall frequently. The first symptoms of frontotemporal dementia may be personality changes or unusual behavior. People with this condition may not express any caring for others, or they may say rude things, expose themselves, or make sexually explicit comments.

Symptoms of dementia that come on suddenly suggest vascular dementia or possibly deliriumshort-term confusion caused by a new or worsening illness.

Coping With Alzheimer's: Special Instructions for Caregivers


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Early Warning Signs: When to Call the Doctor About Alzheimer's


Are you worried about an older loved ones memory or behavior? Has your mom been getting lost while running errands? Has your dad started to ask the same questions, over and over? Signs of the early stages of Alzheimers disease arent always clear-cut -- after all, it can be hard to distinguish them from age-related memory changes.

To help guide you, here are the Alzheimers warning signs to watch for, along with advice about seeing a doctor and getting a diagnosis.
Alzheimer Disease Warning Signs

Many people confuse Alzheimers disease with dementia. Whats the difference? Alzheimers is a disease; dementia is a group of symptoms that include loss of memory, thinking, and reasoning skills. However, dementia isnt always caused by Alzheimers disease; it can be result from other conditions as well. Although some memory changes may be age-related, memory problems that interfere with daily life are not. According to experts, common early signs of Alzheimers disease or other dementias include:

Memory loss. Although older memories might seem unaffected, people with dementia might forget recent experiences or important dates or events that interferes with daily life. Anyone can forget some details from a recent event or conversation or recall them later. People with dementia might forget the entire thing. Repetition. People with dementia may repeat stories, sometimes word for word. They may keep asking the same questions, no matter how many times theyre answered. Language problems. We all struggle to remember a word occasionally. People with dementia can have profound problems remembering even basic words. Their way of speaking may become contorted and hard to follow. Personality changes. People with dementia may have sudden mood swings. They might become emotional - upset or angry - for no particular reason. They might become withdrawn or stop doing things they usually enjoy. They could become uncharacteristically suspicious of family members -- or trusting of telemarketers. Disorientation and confusion. People with dementia may get lost in places they know very well, like their own neighborhoods. They may have trouble completing basic and familiar tasks, like cooking dinner or shaving. Lack of hygiene. Sometimes this is the most obvious sign of Alzheimers disease. People who have dressed smartly every day of their lives might start wearing stained clothing or stop bathing. Odd behavior. We all misplace our keys from time to time. People with Alzheimers disease and other dementias are prone to placing objects in odd and wholly inappropriate places. They might put a toothbrush in the fridge or milk in the cabinet under the sink.

If your loved one is exhibiting any of these Alzheimers warning signs, dont panic. Having these symptoms doesnt mean that your loved one necessarily has Alzheimers disease. But you need to schedule an appointment with the doctor for an evaluation
Seeing the Doctor With Alzheimers Disease Concerns

For a first appointment, you can start with your loved ones primary care provider. Or you might go right to a specialist, like a psychiatrist or a neurologist. Over time, you may have a number of experts involved in your loved ones care.

Unfortunately, theres no definitive test for Alzheimers disease. So doctors can use a number of different techniques to come up with a diagnosis. In addition to a typical physical exam and blood and urine tests, these could include:

Mental status tests. The doctor may ask a series of questions that assess a persons mental function. They test a persons short-term memory, ability to follow instructions, and problemsolving skills. Specific tests include the mini-mental state exam (MMSE) and the mini-cog. Neurological exams. In checking for signs of Alzheimers, doctor will also check your loved ones neurological function, including speech, balance, coordination, and reflexes. Imaging tests. CT scans, MRIs, and PET scans can help rule out other causes for the symptoms like tumors or strokes.

Make sure to do your part. The doctor will need some basic information from you, so go in prepared with details about:

The Alzheimers symptoms youve noticed and when they began. Other health conditions your loved one has. The daily medications she uses, including supplements and alternative treatments. Your loved ones diet and alcohol use. Any important changes in your loved ones life -- like retirement, a recent move, or the death of a spouse.

Because Alzheimers warning signs may be confused with changes that can come with old age, its diagnosis may not be clear-cut. If youre not satisfied with the doctor's assessment, get a second opinion. Alzheimers disease can go on a long time, and during those years youll need to work closely with a doctor. Its key that you find a caring, sympathetic healthcare professional you trust.
Dont Ignore Alzheimers Warning Signs

Of course, you might not want to see a doctor yet. You might want to wait and see if things get worse. Many people put off consulting an expert for years - long after theyve noticed obvious symptoms of Alzheimers disease. Why?

People worry that their loved ones will be offended or angry if they mention their memory problems. Considering that Alzheimers disease has no cure, people might assume that theres no point in rushing off to get the bad news. Deep down, people dont want to admit to themselves that something might be wrong.

These are all very understandable, very human reasons to put off seeing an expert. But if you suspect your loved one might have Alzheimers, you need to see a doctor soon. Heres why.

Your loved one may not have Alzheimers disease. Dont assume the worst. Even if your love one has dementia, it might not be Alzheimers. Other conditions can cause dementia or similar symptoms. They include vitamin deficiencies,thyroid problems, depression, drug interactions,

and alcohol abuse. Many of these conditions are treatable. Putting off a trip to the doctor could leave your loved one suffering pointlessly. The sooner Alzheimer's disease is diagnosed, the sooner you can get treatment. Alzheimers disease isnt curable, but it is treatable. Drugs can help slow down the progression of Alzheimers symptoms for a limited time. Your loved one may also be eligible for clinical trials, in which new, cutting-edge Alzheimers treatments are available. The sooner Alzheimers disease is diagnosed, the sooner you can plan for it. Accepting that a loved one has Alzheimers is terribly difficult. But the sooner you do, the better off you are. The earlier you catch it, the more time youll have to learn about the condition and prepare for whats ahead.

For your loved ones sake -- and for your own -- dont ignore the possible warnings signs of Alzheimers disease. Dont wait until theres a crisis before you see a doctor. If you have any concerns about your loved ones memory or behavior, schedule an evaluation now.

Dementia - What Increases Your Risk


Aging is the main risk factor for all types of dementia. Some diseases that cause dementia (such as early-onset Alzheimer's disease and some frontotemporal dementias) may run in families. You have a greater chance of developing vascular dementia if you:
Recommended Related to Alzheimer's
How to Help Your Aging Parents Without Going Broke By Kate AshfordFrom making their daily life easier to affording in-home care, here's the (money) wise guide you need When Sue Dietz noticed her mother's dementia worsening, she began spending every day at her parents' house near Pittsburgh making sure her mom was eating properly and taking medications. But the schedule became too much when Dietz's daughter in North Carolina had a baby. "It wasn't fair to my daughter that I couldn't be with her when she needed me, too," says Dietz, 56... Read the How to Help Your Aging Parents Without Going Broke article > >

Are male. Have high blood pressure (hypertension). Have had a heart attack. Have atherosclerosis, a buildup of fat and calcium in the arteries, which can lead to coronary artery disease. Have diabetes. Have high cholesterol. Have had a stroke or transient ischemic attack (TIA).

Other factors that may increase your risk of dementia include:

Having ongoing low blood pressure if you are older than 75. Researchers think this risk may be the result of the brain not getting enough blood. More studies are needed to determine the best blood pressure for older adults, one that lowers their risk for heart disease but provides enough blood flow to keep the brain healthy.2

Having a high level of homocysteine. Homocysteine is an amino acid normally found in small amounts in the blood. High levels of homocysteine are thought to cause plaque to build up in the blood vessels. Over time, this can lead to serious problems such as stroke, heart attack, and pulmonary embolism. It may also lead to mental declines. Homocysteine levels are generally stable until age 40 but then begin to increase naturally, especially after age 70.3 Using hormone therapy after the age of 65. Hormone replacement therapy (HRT)-a combination of estrogen and progesterone-was once believed to provide protection from dementia or cognitive impairment. However, the Women's Health Initiative found that HRT actually increased the risk for Alzheimer's disease and other dementias in women age 65 and older who took it for more than 4 years.4 Estrogen alone (estrogen replacement therapy) had similar effects.5 Whether either of these therapies might help reduce the risk of later dementia when used around the age of menopause is not known.6

How to Help Your Aging Parents Without Going Broke


WebMD Feature from "Good Housekeeping" Magazine

By Kate Ashford From making their daily life easier to affording in-home care, here's the (money) wise guide you need

When Sue Dietz noticed her mother's dementia worsening, she began spending every day at her parents' house near Pittsburgh making sure her mom was eating properly and taking medications. But the schedule became too much when Dietz's daughter in North Carolina had a baby. "It wasn't fair to my daughter that I couldn't be with her when she needed me, too," says Dietz, 56. Although she found in-home help that her parents are paying for, she worries that their money may run out and she'll need to dig into her savings to cover the costs. Dietz isn't alone in dealing with the cost of caring for an aging parent or getting nervous about the prospect. Some 41 percent of baby boomers with a living parent are helping to care for them, according to a recent USA Today/ABC News/Gallup Poll, and nearly half of those who aren't worry about being able to do so in the future. The price tag isn't cheap: MetLife says the average price for in-home nonmedical help runs about $20 an hour, an assisted-living residence costs roughly $36,000 a year, and a private room in a nursing home goes for over $77,000 annually. But you can help aging parents get the assistance they need without burning through family finances. Start here with our guide to the best strategies and resources available. A bonus: The Good Housekeeping Research Institute had a panel of seniors test products that can help keep your parents safe; a small purchase now might avoid a major medical expense later.

Have the Conversation

The first move in gauging the help your parents need is having The Talk. You'll want to find out how much they've prepared for the future, legally and financially. For instance, do they have key legal documents such as a durable power of attorney and an up-to-date will? "Use your own experience to get the conversation going," advises Virginia Morris, author of How to Care for Aging Parents. "Say, 'I'm starting to do my own estate planning, and I wonder what you had drawn up.'" Or print out this article to show them and say, "This article says we should talk about where you keep your papers." It's vital to be prepared; otherwise, you may have to find these documents on your own if your parent, say, can no longer cover up worsening dementia. If you've got a good relationship with your parents, tackle the tricky financial questions as well. Find out if they have long-term care insurance, and if not, how they plan on paying for nursing home care or in-home help if necessary. Again, tell your parents you're thinking about doing estate planning and wondered what financial choices they made. "Make it about you, rather than them," says Hugh Delehanty, editor in chief of AARP Publications your parents are less likely to get defensive.

How to Help Your Aging Parents Without Going Broke


(continued) Get the Right Help

Once you have this information in hand, get your parents' perspective on how they think they are doing and their hopes for the future. Nearly 90 percent of adults over 50 say that they want to remain in their homes as long as they can. And many of them can stay put for years with the right support. Here's how to determine the care they need and then match their needs with the most appropriate type of assistance. If your parents are coherent but have trouble getting around, look into local transportation services and community meal programs like Meals on Wheels (whose staffers will check in on your parents periodically). These types of offerings are community-specific, and their prices vary. The local Area Agency on Aging, sometimes called the Department of Elderly Affairs or the Senior Citizens Office, can fill you in on what's available. Find an office near your parents at eldercare.gov. If your parents are mobile but show mild signs of dementia or forgetfulness, you may want to investigate out-of-home adult day services or day health-service programs. Supervised adult day services let the elderly socialize with other seniors, and day health services may have nurses who can give out shots and medications. These services often have their own facilities or may be part of a local community center. In addition to asking the Area Agency on Aging for names of reputable, convenient programs, you can consult the staffs of nearby senior centers, churches, and synagogues.

If your parents are less independent say, if your mom is having a hard time getting in and out of bed or sometimes forgets she turned on the stove or bath she'll need in-home care. "It took three different people and about three months to find a perfect match for my mother," says Helen Nazar Bishop, whose mom has Alzheimer's. "And we are always communicating with the homecare worker." As a first step in finding a reliable caregiver, start at the Website of the Family Caregiver Alliance (caregiver.org), which has put together the first comprehensive, 50-state online directory of caregiver support programs. For a personalized, overall-care plan, hire a geriatric-care manager, usually a nurse or social worker trained in helping the elderly. You'll typically pay $300 to $800, depending on where your parents live, to have this person visit them in their home, assess how they're doing, and recommend cost-efficient things they might need to stay independent. "Geriatric-care managers have their fingers on the pulse of services available locally," says Elinor Ginzler, senior vice president of livable communities for AARP. For an additional fee, the geriatric-care manager can also make all the arrangements. Expect to pay roughly $80 to $200 an hour for this service, depending on how much attention your parents need and where they live; the cost isn't covered by health insurance, Medicare, or Medicaid. You can find Professional Geriatric Care Managers (PGCMs), who are trained, experienced professionals, by visiting caremanager.org.

How to Help Your Aging Parents Without Going Broke


(continued) How to Save Money

Hiring help doesn't have to mean draining your parents' bank account or yours. Adult day services, which average $64 a day, are far less expensive than in-home daytime help. And inhome, nonmedical daytime assistance (about $18 an hour) will probably be a bit less costly than an in-home health aide (about $20 an hour), if your parents won't need medical supervision. The federal government might shoulder some expenses, too. Medicare usually pays for some shortterm, in-home medical help prescribed by a doctor for people 65 and older. But it won't pay for long-term custodial care. If your parent does qualify for that, check medicare.gov to find local Medicare-certified in-home health-care agencies. Medicaid rules vary by state. The program may cover home care or day services if your 65-plus parent is nursing-home eligible and meets low-income requirements. So you'll likely have to exhaust your parents' resources before turning to this type of help. If your dad needs constant surveillance, Medicaid would likely require him to go to a nursing home or similar facility (check govbenefits.gov for details). Since this is difficult terrain, consider consulting an elder-care attorney to help navigate regulations and discuss asset-management planning, which will be important if your parents' health declines. Find a specialist at the National Academy of Elder Law Attorneys' site: naela.com.

Look into lowering expenses through local senior programs. For example, utility companies may offer a break on energy bills just give them a call and ask. Church or synagogue volunteer programs might provide a companion to keep your mom company periodically. Some areas have transportation services that can save the cost of using taxis or part-time drivers. In the Boston area, disabled or impaired seniors can use The Ride, which provides a door-to-door wheelchairaccess van or sedan for $2. "I had a 90-something client who took it to work every day," says Suzanne Modigliani, a geriatric-care manager in Brookline, MA. With some delicate conversations and aid from the right places, you can help your parents stay in their homes for as long as possible. "It's hard, make no mistake," Ginzler says. "But respect the fact that Mom and Dad want to control their lives as much as they can. Being compassionate will lead you to the right decisions."
Dealing with Alzheimer's or Dementia

Memory loss goes hand in hand with getting older. It's completely normal for an older person to walk into the kitchen and occasionally wonder, "Now, why was I coming in here again?" But if your mother is, say, coming home from the supermarket empty-handed because she couldn't "find anything" on her grocery list, or if she keeps her cleaning supplies in the fridge, pay attention. These may be signs of dementia or Alzheimer's (see 10signs.org for more info). Talk to your parent's doctor to determine if Alzheimer's may be involved.

How to Help Your Aging Parents Without Going Broke


(continued) Dealing with Alzheimer's or Dementia continued...

If the diagnosis is made, visit the Alzheimer's Association for information and access to support groups. A doctor who specializes in dementia care can prescribe medications that can delay the onset of symptoms, among other options. As the disease progresses, check out the MedicAlert + Safe Return program. For $50 up front and a $25 annual fee, your parent will get a bracelet or pendant identifying her as someone with dementia. If she is found wandering, responders can contact her caregiver or family and EMTs will be able to get her medical records. After a diagnosis, your parent may be angry or in denial. Rather than dictating what should be done, involve her in the conversation. "Coming up with options and talking through them helps a parent feel a sense of control over her experience," says Peter Reed, Ph.D., senior director of programs for the Alzheimers Association.
Paperwork Prep

Learn where your parents keep their financial documents and medical information. This can avoid costly mistakes and let you know the extent of their resources. Here are some of the biggies (for a detailed list, check out the financial-planning area at mymoney.gov, and print one out for your folks).

Wills Durable power of attorney (so someone can legally act on their behalf) and medical power of attorney Advance directive, like a living will, which states wishes for end-of-life care Life insurance policies Long-term-care policies Bank and brokerage accounts Social Security cards Medicare and health insurance cards Doctors' names and numbers List of medications Lawyer and accountant contact information

Originally published on December 9, 2008

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Brain Foods That Help You Concentrate


Ginseng, Fish, Berries, or Caffeine?

Listen to the buzz about foods and dietary supplements and you'll believe they can do everything from sharpen focus and concentration, to enhance memory, attention span, and brain function. But do they really work? There's no denying that as we age chronologically, our body ages right along with us. The good news is that you can increase your chances of maintaining a healthy brain -- if you add "smart" foods and beverages to your diet.

Caffeine Can Make You More Alert

There's no magic bullet to boost IQ or make you smarter -- but certain substances, like caffeine, can energize and help you focus and concentrate. Found in coffee, chocolate, energy drinks, and some medications, caffeine gives you that unmistakable wake-up buzz -- though the effects are short term. And more is often less: Overdo it on caffeine and it can make you jittery and uncomfortable.

Sugar Can Enhance Alertness

Sugar is your brain's preferred fuel source -- not table sugar, but glucose, which your body metabolizes from the sugars and carbohydrates you eat. That's why a glass of something sweet to drink can offer a short-term boost to memory, thinking processes, and mental ability. Consume too much, however, and memory can be impaired -- along with the rest of you. Go easy on the sugar so it can enhance memory, without packing on the pounds.

Eat Breakfast to Fuel Your Brain

Tempted to skip breakfast? Studies have found that eating breakfast may improve short-term memory and attention. Students who eat breakfast tend to perform significantly better than those who dont. Foods at the top of researchers' brain fuel list include high-fiber whole grains, dairy, and fruits. Just don't overeat; researchers also found high-calorie breakfasts appear to hinder concentration.

Fish Really is Brain Food

A protein source associated with a great brain boost is fish -- rich in omega 3 fatty acids, essential for brain function and development. These healthy fats have amazing brain power: higher dietary omega 3 fatty acids are linked to lower dementia and stroke risks; slower mental decline; and may play a vital role in enhancing memory, especially as we get older. For brain and heart health, eat two servings of fish weekly.

Add a Daily Dose of Nuts and Chocolate

Nuts and seeds are good sources of the antioxidant vitamin E, which is associated with less cognitive decline as you age. Dark chocolate also has other powerful antioxidant properties. And it contains natural stimulants like caffeine, which can enhance focus and concentration. Enjoy up to an ounce a day of nuts and dark chocolate to provide all the benefits you need without excess calories, fat, or sugar.

Add Avocados and Whole Grains

Every organ in the body depends on blood flow, especially the heart and brain. Eating a diet high in whole grains and fruits like avocados can reduce the risk of cardiovascular disease and lower bad cholesterol. This reduces your risk of plaque buildup and enhances blood flow, offering a simple, tasty way to fire up brain cells. Whole grains, like popcorn and whole wheat, also contribute dietary fiber and vitamin E. Though avocados have fat, it's the good-for-you, monounsaturated fat that contributes to healthy blood flow.

Vitamins, Minerals, and Supplements?

Store shelves groan with supplements claiming to boost health. Although many of the reports on the brain-boosting power of supplements like vitamins B, C, E, beta-carotene, and magnesium are promising, a supplement is only useful to people whose diets are lacking in that specific nutrient. Researchers are cautiously optimistic about ginseng, ginkgo, and vitamin, mineral, and herb combinations and their impact on the brain. Check with your doctor.

Benefits of a Healthy Diet

It may sound trite but it's true: If your diet lacks essential nutrients, it can decrease your ability to concentrate. Eating too much or too little can also interfere with your ability to focus. A heavy meal may make you feel lethargic, while too few calories can result in distracting hunger pangs. Benefit your brain: Strive for a well-balanced diet full of a wide variety of healthy, wholesome foods.

Get Ready for a Big Day

Want to power up your ability to concentrate? Start with a meal of 100% fruit juice, a whole grain bagel with salmon, and a cup of coffee. In addition to eating a well-balanced meal, experts also advise:

Get a good night's sleep. Stay hydrated. Exercise to help sharpen thinking. Meditate to clear thinking and relax.

Blueberries Are Super Nutritious

Research in animals shows that blueberries help protect the brain from oxidative stress and may reduce the effects of age-related conditions such as Alzheimer's disease or dementia. Studies also show that diets rich in blueberries significantly improved both the learning capacity and motor skills of aging rats, making them mentally equivalent to much younger rats.