LANGUAGE 'PREDICTS DEMENTIA RISK'

People with superior language skills early in life may be less likely to develop Alzheimer's disease decades later, research suggests.

A Team from Johns Hopkins University studied the brains of 38 Catholic nuns after death.

They found those with good language skills early in life were less likely to have memory problems - even if their brains showed signs of dementia damage.

The study appears online in the Journal Neurology.

Dementia is linked to the formation of protein plaques and nerve cell tangles in the brain.

But scientists remain puzzled about why these signs of damage produce dementia symptoms in some people, but not others.

The Researchers focused on nuns who were part of an ongoing clinical study.

They divided the women into those with memory problems and signs of dementia damage in the brain, and those whose memory was unaffected regardless of whether or not they showed signs of dementia damage.

And they also analysed essays that 14 of the women wrote as they entered the convent in their late teens or early 20s, assessing them for complexity of language and grammar.

The study showed that language scores were 20% higher in women without memory problems than those with signs of a malfunctioning memory.

The grammar score did not show any difference between the two groups.

Lead Researcher Dr Juan Troncoso said: "Despite the small number of participants in this portion of the study, the finding is a fascinating one."

"Our results show that an intellectual ability test in the early 20s may predict the likelihood of remaining cognitively normal five or six decades later, even in the presence of a large amount of Alzheimer's disease pathology."

Brain Cell Growth

The study also found that brain cells were largest in women who retained a normal memory despite showing signs of disease in their brains.

The Researchers said this suggested that a growth in brain cells might be part of the body's early response to the onset of dementia, and this might help to prevent memory impairment.

Dr Troncoso said: "Perhaps mental abilities at age 20 are indicative of a brain that will be better able to cope with diseases later in life."

Dr Susanne Sorensen, Head of Research at the Alzheimer's Society, said: "It is interesting that the nuns in the study with better language skills in their youth avoided memory problems in later life."

"However, the research is in a very small, select group and it would be difficult to say at this stage if language skills could really predict dementia."

Rebecca Wood, Chief Executive of the Alzheimer's Research Trust, said: "One possible implication of this study is that an intellectual ability test in the early 20s may predict the likelihood of remaining cognitively normal five or six decades later.

"However, prominent exceptions exist, including Authors like Terry Pratchett and Iris Murdoch, who developed dementia despite their linguistic brilliance."

(Source: BBC News, July 8, 2009)

Saturday, 25 July 2009 : Alzheimer's Caregivers Sharing Session & Talk on "A Holistic Approach to Management of Dementia"

Dear Members/Public,

ADFM KL-PJ AD Caregivers Support Group Committee is having a Caregivers Sharing Session and Talk on “A Holistic Approach to Management of Dementia” on 25 July 2009.

The Agenda:

Day/Date: Saturday, 25 July 2009
Time: 2:00pm
Venue: Rumah Alzheimer’s, PJ Day Care Centre, No. 6, Lorong 11/8E, Section 11, 46200 Petaling Jaya

Program:

2:00 pm - Registration of Attendance.
2:30 pm - Talk on “A Holistic Approach to Management of Dementia” by Dr Daniel Zainal Abdul Rahman.
3:15 pm - Caregivers Sharing Session – Dr Daniel Zainal Abdul Rahman, Jasmin & Christin from ADFM PJ & Taman Seputeh Day Care Centre will facilitate the sharing , and Q&A Session.
4:00 pm - Light refreshment.

Kindly confirm your attendance to:

ADFM Secretariat, Kath Leong /Janet Low at Tel: 603 – 7956 2008 / 7958 3008 OR Email to: adfmsec@streamyx.com

OR you can register online with the ADFM National Alzheimer's Caregivers Online Network (NACON) at: adfmcaregivers@gmail.com

(1) CARE-GIVERS SHARING SESSION

Alzheimer’s Caregivers are encouraged to participate in the Sharing Session. This is the occasion for the Care-givers to come forward to get acquainted with each other, seek support and assistance, and share their experiences.

Dr Daniel Zainal, Jasmin & Christine will be around to attend to you.

(2) SYNOPSIS – A HOLISTIC APPROACH TO MANAGEMENT OF DEMENTIA

Dr Daniel Zainal Abdul Rahman in his presentation will cover the causes of Dementia, Symptoms and Signs Management.

SPEAKER’S PROFILE

Dr Daniel Zainal Abdul Rahman, a Consultant Psychiatrist, with 25 years experience as a Clinician and Head of Department in various government hospitals. Dr Zainal is currently in the private sector running clinics sessions mainly at Pantai Medical Centre (Bukit Pantai), Hospital Tawakkal, Tropicana Medical Centre (Kota Damansara), Hospital Pusrawi, and a clinic specializing in drug–substitution therapy. His clinical experience covers the whole spectrum of psychological/psychiatric disorders.

Dr Daniel Zainal is a qualified clinical hypnotherapist from the London College of Clinical Hypnosis (LCCH), and an affiliate member of the British Society of Clinical Hypnosis (BSCH ) and have attended various workshops on areas related to clinical hypnotherapy run by LCCH.

From: ADFM KL-PJ Alzheimer's Caregivers Support Group Committee

STATINS MIGHT STAVE OFF ALZHEIMER'S

Treatment with a cholesterol-lowering drug might protect against Alzheimer's disease, new research suggests.

Scientists have long known that nerve cells in people with Alzheimer's die prematurely because they are strongly overstimulated, a process called excitotoxicity.

Theorizing that the cholesterol drug lovastatin might ward off cell death, researchers at the University of Groningen, The Netherlands, conducted animal experiments in which they administered lovastatin (Altoprev, Mevacor) to overstimulated nerve cells. Lovastatin is a first-generation member of a class of drugs, statins, that has revolutionized the treatment of high cholesterol.

Lovastatin did indeed prevent cell death and, just as important, blocked the loss of memory that accompanies excitotoxicity, according to the lead scientist on the project, Amalia Dolga. Earlier, Dolga had shown that statins seem to stimulate the protective capacity of tumor necrosis factor, a key player in the brain's immune response. In addition, some researchers have speculated that high cholesterol might be a risk factor for Alzheimer's, suggesting that lowering cholesterol could be beneficial.

The findings are in the June Issue of the Journal of Alzheimer's Disease.

The degenerative disease attacks brain cells and ruins memory and thinking.

No cure has been found, but treatments have been shown to improve a person's quality of life.

(Source: HealthDay, June 30, 2009)

IN OLD AGE, FRIENDS CAN KEEP YOU YOUNG. REALLY !!!

Going to the ballpark, visiting friends and playing bingo are simple diversions for many of us. But for the elderly, these social pastimes may play a critical role in preserving their physical and mental health.

In fact, a new study suggests that the less time older people spend engaged in social activity, the faster their motor function tends to decline. "Everybody in their 60s, 70s and 80s is walking more slowly than they did when they were 25," says Dr. Aron Buchman, a Neurologist at the Rush University Medical Center in Chicago and lead author of the study, which was published in the June 22 issue of the Archives of Internal Medicine. "Our study shows the connection between social activity and motor function - and opens up a whole new universe of how we might intervene."

An increasing body of evidence has suggested that participating in mentally stimulating activity, socializing frequently and exercising may help protect against age-related decline - at least cognitive decline. As early as 1995, Neuroscientist Carl Cotman, who studies aging and dementia at the University of California at Irvine, published a paper in Nature showing that physical exercise produces a protein that helps keep neurons from dying and spurs the formation of new neural connections in the brain. More recently, Cotman demonstrated in studies of elderly dogs and mice that enriching their social environment is associated with improvement in brain function.

Researchers are also finding that social activity may be linked to the same protective effect in people. A recent study of 2,500 adults ages 70 to 79, published in the journal Neurology, found that those who were able to stay mentally sharp were also those who exercised once a week or more, had at least a ninth-grade literacy level and were socially active.

But what has social activity got to do with motor skills? In Buchman's study, which looked at 906 seniors, average age 80, in northeastern Illinois over a five-year period, increased social activity was associated with adeptness in a range of physical tasks, including walking in a straight line, standing one-legged and on tiptoes, turning full circle without falling and placing pegs on a board. On a social-activity scale of 1 to 5 - with 1 indicating participation in various social activities once a year, and 5 showing activity every day or nearly every day - a one-point difference in social activity corresponded to a five-year difference in motor function. With each one-point drop on the social-activity scale, study participants' rate of physical decline increased 33%. In participants whose score fell one point over the course of a single year, that translated to a 40% increased risk of death and a 65% higher risk of a disability.

"The idea that cognitive and physical function are connected is something that has just come out in the last few years. It is one of the new horizons in health care and prevention," says neurologist and aging expert Dr. Joe Verghese of the Albert Einstein College of Medicine in New York City, who published an article in the New England Journal of Medicine in 2002 showing that changes in walking patterns could be an early sign of dementia.

While further research needs to be done to establish the exact impact of social activity and exercise on specific age-related declines - it's likely that a reduction in social activity may simply be a symptom of physical decline, since people may naturally withdraw from social engagement as they lose motor skills - most researchers would agree that it is not unreasonable to encourage seniors to get out there more. Only 10% of people over 65 get the recommended amount of exercise (at least 2.5 to 5 hours a week), and given that seniors already tend to be more socially isolated than younger adults, it's difficult to motivate them to become more active. "If you are alone, you are less likely to follow recommendations," notes Verghese. It might help, though, if you visit with Grandma more often and let her know that a regular pastime may just help her stay fitter and sharper longer.

(Source: Time.com - June 2, 2009)

STAY UPBEAT, ACTIVE TO KEEP THE MIND YOUNG

To stave off the mental decline associated with old age, engage in intellectually challenging activities, maintain a positive outlook and keep up your social life.

Those are the findings of what researchers say is the largest-ever review of studies on aging and the brain.

The review, which spanned three decades and covered more than 400 studies, found that remaining physically, mentally and socially active has a substantial impact on whether older adults experience declines in memory and cognition, which includes the ability to learn and solve problems.

"How people spend their lives does really have an impact on how they age cognitively," said study co-author Robert S. Wilson, a Professor of Neurological and Behavioral Sciences at Rush University Medical Center in Chicago. "The observational studies suggest people who are more intellectually active, socially integrated, physically active and who are relatively free from negative emotions like depression and anxiety all seem to be associated with aging better cognitively."

As the population ages, being able to keep mental decline at bay for even a little longer could have significant public health implications.

"There is going to be a huge burden of old people who are cognitively impaired," Wilson said. "If we can develop strategies that delay the onset of the disease by six months or a year or two, we can substantially reduce the human suffering and the cost of caring for them."

The study, which will appear in Psychological Science in the Public Interest, was released June 24 in Washington, D.C.

It identified several aspects of a person's lifestyle that can have a major impact on mental function: exercise, staying socially integrated, participating in mentally stimulating activities and maintaining an optimistic, agreeable, goal-oriented attitude.

Though exercise had a powerful impact on mental function, the type of exercise made a difference.

In studies that asked older people how physically active they were, those who reported doing the most exercise had somewhat better mental functioning than those who were more sedentary, but the effect wasn't dramatic.

However, people who took part in studies that put them on a regular aerobic exercise program saw substantial gains in mental functioning.

Among older adults, even those who do relatively more exercise than their peers probably aren't doing all that much, Wilson said.

"Left to their own devices, most older people in this country don't exercise all that much at all," Wilson said. "Any exercise is good, but actually doing a regular program of aerobic exercise is better."

Walking, the most commonly cited exercise, can be part of an aerobic exercise program, but the pace must be fast enough to raise the heart rate.

Recent research has looked at whether specific products or programs, such as video games, improve cognitive functioning in older people. Although there is nothing on the market that is scientifically proven to increase memory and thinking skills, Wilson said, he thinks such products could be available soon.

But you don't have to go out and buy something to engage in intellectually stimulating activities, said Dr. Gary Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York City.

Doing a crossword puzzle, playing chess or learning a language can fit the bill. Research shows that taking part in activities that are novel, challenging and in which you are personally invested can have a lasting impact on mental functioning.

"The reality is, as we age, cognitive processes slow down," Kennedy said. "It may take you longer, and you may have to practice longer to master something new, but hopefully you have health and the time to actually do that."

Though cognitive decline was once seen as an inescapable part of aging, public perception is beginning to change, and recent studies back that up.

"Most people's brains are under assault in old age, and the lifestyle stuff doesn't appear to stop that pathology," Wilson said. "But lifestyle does appear to help your brain tolerate that pathology. It helps you get more out of what you have left and to adapt to the changes in your brain, and it appears to make a big difference."

In an accompanying editorial, Jonathan W. King and Richard Suzman, from the U.S. National Institute of Aging, said that the study's findings overall paint a "fairly optimistic" picture.

"It could well be possible to design interventions that, when combined with appropriate lifestyle changes, could possibly at least slow the rate of cognitive decline," they wrote.

(Source: HealthDay, June 24, 2009)

CIMB CARES CAMPAIGN: DONATE TO ADFM VIA CIMB CLICKS - http://www.cimbclicks.com.my/cimbcares.htm

Dear Members and the Public ,

DONATE TO ADFM
VIA CIMB CLICKS - http://www.cimbclicks.com.my/cimbcares.htm

CIMB has created an ONLINE PAYMENT PORTAL for the General Public to make cash donations to the NGO’s of their choice. This Online Payment can be made as a one time donation or through standing instruction.

Alzheimer's Disease Foundation Malaysia (ADFM) is one of the participating recipients in the CIMB Cares Campaign.

We seek the support of ALL MEMBERS and the general Public to donate generously to ADFM via the Online Payment Portal – click on the link below :

http://www.cimbclicks.com.my/cimbcares.htm

Your generosity will help towards our various programs and activities to promote greater awareness of Alzheimer’s disease in Malaysia.

Whatever amount you can contribute will be greatly appreciated, so please don't wait.

Thank you,
ADFM – Alzheimer’s Disease Foundation Malaysia

STUDY FINDS 4 THINGS THAT KEEP OLD MINDS SHARP

Some people seem to be able to keep their wits well into old age. But what's their secret?

New research reveals a host of factors that may contribute to a sharper mind late in life, including exercise, education, non-smoking behavior and social activity.

While other research has shown that genetics play a role in whether people get dementia, the study adds to a growing body of research that is uncovering ways you can up the odds of keeping your brain healthy and your memory sharp now and later.

The study tested the cognitive ability of 2,500 people aged 70 to 79 over eight years. More than half of the subjects showed normal age-related decline in mind function and 16 percent had a considerable decline during the course of the study. But 30 percent of participants did not show a change in their cognitive skills, and some even improved on the tests.

The researchers then looked to see what could account for this difference:

EXERCISE: They found that people who exercised moderately to vigorously at least once a week were 30 percent more likely to maintain a sharp mind than those who did not work-out as often.

EDUCATION: People with at least a high school education were almost three times more likely to keep up their cognitive ability than those without this education. And those who had a ninth grade literacy level were nearly five times more likely to maintain the ability (a specific word recognition test was administered during the study to assess the subject's literacy level.)

NOT SMOKING: There was also a connection between smoking and brain function in old age. Non-smokers were almost twice as likely to stay quick-minded as those who smoked.

SOCIALIZING: Finally, some social activity may also be good for the mind. The results showed that subjects who volunteered, worked or lived with someone else were 24 percent more likely to keep up their cognitive function.

Some of these factors such as exercise and smoking are behaviors that people can change. Discovering factors associated with cognitive maintenance may be very useful in prevention strategies that guard against or slow the onset of dementia.

The results were published in the June Issue of Neurology. The research was funded by the National Institutes of Health.

The study supports past research that has pointed to exercise as a way to protect your brain and prevent the development of cognitive disorders. Exercise stresses your body, and causes it to release certain growth factors that can strength neurons and keep them healthy.

(Source: Life Science, June 8, 2009)

MODERN BRAIN SCANNING TECHNOLOGY OFFERS SIMPLE LOOK AT EVERYTHING FROM HEAD TRAUMA TO TUMORS

The Charles M. and Marilyn Newman Professor and Chairman of Radiology at Mount Sinai, Drayer has been a radiologist specializing in the brain and spine for 30 years.

WHO’S AT RISK:

Thanks to advances in MRI and CT technology, doctors can get highly detailed images of the brain, a procedure used for patients with a wide variety of conditions. “Any patients with neurological or psychiatric symptoms might require an image of their brain, including patients [suffering from] stroke, brain tumor, multiple sclerosis, brain infections, Alzheimer’s, Parkinson’s and head injury,” says Drayer.

As for groups at risk, “The same group at risk of heart attack is at risk of stroke, which some people call a ‘brain attack,’ ” says Drayer. “The warning signs of stroke are called TIA [transient ischemic attack], and people with high blood pressure, diabetes and a history of smoking are at higher risk.” Alzheimer’s and Parkinson’s diseases are associated with advancing age, while brain-tumor and head-trauma patients can be any age, including children, teenagers and otherwise healthy young adults.

SIGNS AND SYMPTOMS:

Doctors have identified a cluster of symptoms that most often bring people in for brain imaging. “Key signs are weakness or numbness, often on one side of the body, loss of speech, vision or hearing, dementia or loss of memory, confusion, involuntary movements and headaches,” says Drayer. “Anyone who is acutely becoming weak or losing their speech should immediately come to an ER in a stroke center that is equipped to prevent the more severe consequences.”

Many neurological conditions will affect one side of the body more than the other. “That’s because a condition affecting one side of the brain usually causes symptoms on the other side of the body,” says Drayer. “For instance, if the tumor is on the right side of the brain, they might have symptoms in the left arm or leg.”

The standard test for people who have suffered head trauma is a CT scan. “That’s now routine,” says Drayer. “If you’ve had severe head trauma, we scan to see if there’s blood on the brain.” Alzheimer’s and Parkinson’s patients most often present with symptoms such as memory loss and tremors or other involuntary movement.

Some patients pick up on their own symptoms, and sometimes doctors or family members note them. “Some patients have chronic problems, others subacute problems, others acute problems — for example, after an auto accident or a stroke,” says Drayer. “At some point they need an image, an MRI or CT scan, to help determine their course of treatment.”

TRADITIONAL TREATMENT:

Modern brain imaging is light-years ahead of the technology in use as recently as 1970. “Traditionally, imaging of the brain was very invasive and difficult,” says Drayer. “For example, for the brain you would do a pneumoencephalogram, where doctors did a spinal tap and inserted air into spinal fluid.

“It was kind of barbaric,” says Drayer, “but it was the best thing we had in 1970.” The patient often had to be hospitalized for a week to recuperate from this diagnostic procedure.

New technology is fast, noninvasive and usually painless. “Now we do an MRI or CT scan to image the brain or spine,” says Drayer. “It takes five minutes for a CT scan or 45 for an MRI. What used to take a week in the hospital and wasn’t as accurate, now takes only 45 minutes and is accurate to millimeter resolution.” The images are now digital, and instead of running X-ray films around the hospital, doctors can read them immediately at work stations and share them with referring physicians or the patient.

In the past, imaging was only diagnostic. “We used it to find out: ‘Do you have a disease or don’t you have a disease?’ ” says Drayer. “Now we use imaging for prevention and therapy as well. Interventional neuroradiologists are treating disease rather than just diagnosing it. ... Imaging is giving information at the molecular level to see biochemical and physiological events in the brain,” says Drayer. “This helps us understand the underpinning of the disease.”

“CT scans are extremely quick and simple,” says Drayer. “There is radiation involved, so we try to keep the dose as low as possible.” These scans are good for very sick and unresponsive patients and are especially good for determining if there is acute blood on the brain, which is why they are standard in cases of head trauma. CT is also used during the acute stroke phase.

The highly sensitive MRI is the scan familiar from television; the patient lies down and enters a tubular chamber. “The MRI can be a little claustrophobic, but 95% of patients handle it well,” says Drayer. “It provides much more elegant and complete information.” Doctors choose MRI scans — which usually last about 45 minutes — for what Drayer calls “healthy sick people,” such as those with a neurological or psychiatric problem who are otherwise healthy — for example, a young woman with transient weakness or loss of vision being checked for multiple sclerosis.

PET scans are becoming more important in brain imaging. “This is molecular imaging — it defines the biochemistry of the disease,” says Drayer, who explains the scans are commonly used for following the progress of brain tumors and Alzheimer’s disease.

These tests are also extremely accurate: “We can see things in the brain that are a millimeter in size.”

RESEARCH BREAKTHROUGHS:

Now that the technology for CT, MRI and PET scans is so advanced, doctors think the next big breakthroughs will be in understanding how the brain works. “Eventually, we’ll be able to look at the brain not just when it has a disease — like stroke, Alzheimer’s — but when it is normal and we understand how it works,” says Drayer. “Already we use functional MRI to show for example, that if you’re a professional musician, your brain works differently from a nonmusician; if you’re a professional golfer, your brain works differently when you hit a golf ball than a less experienced golfer.”

The next steps for brain imaging will be for doctors to determine individuals who are more prone to developing chronic diseases like Alzheimer’s and Parkinson’s; they can then lay the groundwork for preventing or delaying the onset of these debilitating disorders.

QUESTIONS FOR YOUR DOCTOR:

A good question to start with is, “Could I benefit from a CT or MRI scan?” Your internist, neurologist or neurosurgeon will determine whether you are a good candidate.

Another good question is, “What are the risks?” For MRI, there is no risk except the discomfort of lying in the MRI machine. “In cases of severe claustrophobia, some people need to be sedated to help them through the exam,” says Drayer. For CT scans, the risk is the radiation intrinsic to the exam, but most centers are very diligent about using the lowest possible dose.

(Source: CNN DailyNews, June 3, 2009)

MUSIC THERAPY TREATS DISEASES AND CONDITIONS FROM PARKINSON'S DISEASE TO DEMENTIA

Belting out tunes in the shower may not only be music to your ears, but may also treat a variety of disorders such as Parkinson’s disease, aphasia and dementia.

Singing has both physical and neurological benefits, according to a CNN article in which Dr. Wendy Magee, International Fellow in Music Therapy at the Institute of Neuropalliative Rehabilitation in London, described music as a “mega-vitamin for the brain” that can improve a host of conditions.

“When neural pathways are damaged for one particular function such as language, musical neural pathways are actually much more complex and much more widespread within the brain,” she told CNN. “Music seems to find re-routed paths and that is why it is such a useful tool in terms of helping people with different kinds of brain damage because it can help to find new pathways in terms of brain functioning.”

Music is effective in treating not just certain medical disorders but also autism and Attention Deficit Hyperactivity Disorder (ADHD), says Dr. Robert Melillo, Co-Founder of the Brain Balance Achievement Centers and the author of “Disconnected Kids” (Penguin, 2009).

“Music works to stimulate the balance center of the brain and different chemicals in the brain, such as dopamine, which we know is deficient in Parkinson’s disease,” Melillo explains. “Music can help stimulate the production of dopamine.”

Music is a powerful tool that is used in treatments of kids with ADHD as well, he says. “Different areas of the brain need to be coordinated from a timing standpoint for the brain to work completely as a whole,” he says. “Music, because it has a rhythm to it, can actually cause the brain to change the speed in different areas so that the timing becomes better.”

Researchers in Finland, according to the CNN piece, showed that listening to music for several hours daily can help stroke victims with their rehabilitation while another study described how stroke patients taught to play the piano or drums made faster progress in their recovery than patients who were treated only with traditional therapy.

Music is used to assist stroke patients by having them sing, rather than say the words as they work to regain speech, explains Ellayne S. Ganzfried, Executive Director of the National Aphasia Association.

The treatment, called melodic intonation therapy (MIT), is used in patients recovering from a stroke or brain injury, she says.

“Music is in the right side of the brain and language is in the left,” Ganzfried explains. “It’s thought that if we stimulate the right side of the brain then the left side of the brain will make the connection as well.”

Music may help those with Alzheimer’s and dementia, according to the CNN article, because the therapist can use familiar songs to bring out memories in a patient that may have been lost. And music gives joy both to the singer and the listener, says Gary Baker, a member of the Peace of Heart choir. The group has given 1,200 free performances in nursing homes, hospices, homeless shelters and hospitals.

“Our mission is to heal with music, and the reaction of our audiences is often powerful and emotional,” Baker says. “It seems to be part of the psychology of the human brain that music offers healing. And it offers a little bit of pleasure at the same time.”

(Source: CNN Daily News, June 4, 2009)

CAREGIVER: STRESSED OUT? ADVICE TO HELP YOU COPE

Sometimes, the pressure of caring for someone who is elderly or who has a chronic illness can lead to stress and a condition called "Caregiver Burnout." To prevent this, it's essential to know how to manage your stress.

WHAT IS STRESS?

Stress is a reaction to changes that require you to adjust or respond. Our bodies are designed to feel stress and react to it. Not always a bad thing, stress keeps us alert and ready to escape danger.

It's not always possible to avoid change or the situations that can cause stress; as a result, you can begin to feel overwhelmed and unable to cope. When it persists, stress can affect the body's immune system, leading to illness. The key to coping with stress is to identify the causes of stress in your life, then learn healthy ways to deal with them. It's important to remember that stress comes from how you respond to stressful events. Therefore, you have some control over stress and how it affects you.

WHAT CAUSES STRESS?

Stress can be caused by anything that requires you to adjust to a change in your environment. Your body reacts to these changes with physical, mental, and emotional responses. We all have our own ways of coping with change, so the causes of stress can be different for each person. Becoming a caregiver is a common source of stress for many people.

When you are not sure of the exact cause of your stress, it may be helpful to know the warning signs. Once you can identify these signs, you can learn how your body responds. Then you can take appropriate steps to reduce the stress.

WHAT ARE THE WARNING SIGNS OF STRESS?

Your body sends out physical, emotional, and behavioural warning signs of stress.

Emotional Warning Signs:
• Anger
• Inability to concentrate
• Unproductive worry
• Sadness
• Frequent mood swings

Physical Warning Signs:
• Stooped posture
• Sweaty palms
• Tension headaches
• Neck pain
• Chronic back pain
• Chronic fatigue
• Weight gain or loss
• Problems with sleep

Behavioural Warning Signs:
• Over-reacting
• Acting on impulse
• Using alcohol or drugs
• Withdrawing from relationships
• Changing jobs often

What Can I Do to Reduce Stress in My Life?

Finding ways to reduce stress will help lessen the long-term emotional and physical toll of care-giving. Tips for managing stress include:
• Keep a positive attitude. Believe in yourself.
• Accept that there are events you cannot control.
• Be assertive instead of aggressive. "Assert" your feelings, opinions, or beliefs instead of becoming angry, combative, or passive.
• Learn to relax.
• Exercise regularly. Your body can fight stress better when it is fit.
• Stop smoking.
• Limit yourself to moderate alcohol and caffeine intake.
• Set realistic goals and expectations.
• Get enough rest and sleep. Your body needs time to recover from stressful events.
• Don't rely on alcohol or drugs to reduce stress.
• Learn to use stress management techniques and coping mechanisms, such as deep breathing or guided imagery.

Coping Mechanisms:

Most people don't have a plan for coping with stress. Fortunately, there are a number of techniques that you can use to help deal with stress, such as:

• Two-minute relaxation - Switch your thoughts to yourself and your breathing. Take a few deep breaths, exhaling slowly. Mentally scan your body. Notice areas that feel tense or cramped. Quickly loosen up these areas. Let go of as much tension as you can. Rotate your head in a smooth, circular motion once or twice. (Stop any movements that cause pain.) Roll your shoulders forward and backward several times. Let all of your muscles completely relax. Recall a pleasant thought for a few seconds. Take another deep breath and exhale slowly. You should feel relaxed.
• Mind relaxation - Close your eyes. Breathe normally through your nose. As you exhale, silently say to yourself the word "one," a short word such as "peaceful," or a short phrase such as "I feel quiet." Continue for 10 minutes. If your mind wanders, gently remind yourself to think about your breathing and your chosen word or phrase. Let your breathing become slow and steady.
• Deep breathing relaxation - Imagine a spot just below your navel. Breathe into that spot, and fill your abdomen with air. Let the air fill you from the abdomen up, then let it out, like deflating a balloon. With every long, slow breath out, you should feel more relaxed.
• Guided imagery - Guided imagery is a meditative technique that involves focusing on a particular sensory image to create a specific physical reaction. Guided imagery (also called guided meditation) is a form of mind-body therapy that can bring about deep relaxation and positive focus, the state of mind and body most conducive to healing. Guided imagery also can be used to release tension, anxiety, and stress.
• Biofeedback - Biofeedback helps a person learn stress-reduction skills by providing precise, immediate information about muscle tension, heart rate, and other vital signs as a person attempts to relax. It is used to learn total body relaxation and also to gain control over certain physiological functions that cause tension and physical pain.
• Behavioural changes - Changing certain thought patterns and behaviours can help you better manage difficult situations and stress. Examples include checking your assumptions, sharing your expectations with others, being assertive, exercising and eating healthy, focusing on positive relationships, forgiving, communicating feelings, listening, and rewarding yourself and others.

By recognizing your warning signs and taking steps to reduce the stress in your life, you should be able to cope more easily with the pressures of being a caregiver.

(Source: WebMD - http://www.webmd.com/healthy-aging/caregiving-insights/handle-stress)