Tuesday, 30 September 2014

THE ILLNESS THAT ROBS YOUR MEMORIES

(Source:  The Sunday Star, 28 September 2014, contributed by Geriatricians, Dr Rizah Mazzuin Razali & Dr Alan Pok Wen Kin of Hospital Kuala Lumpur in conjunction with Alzheimer’s Disease Foundation Malaysia’s Royal Charity Concert “Konsert Amal DiRaja - Forget Me Not”  to be held on 5 December 2014 at the Plenary Hall, KLCC, in celebration of the 69th Birthday of his Royal Highness The Sultan of Selangor, DYMM Sultan Sharafuddin Idris Shah Al-Haj, to raise funds for the building of a Dementia Training and Care Centre in Section One, Petaling Jaya. 

The 72-piece Orchestra to be led by Malaysian Conductor, Eugene Pook will feature the renowned Shanghai Symphony Orchestra, with special guest stars, multiple award winning singer-songwriter Najwa Mahiaddin and prize-winning violinist, Huang Bin. For event enquiries, please call ADFM at 03-7956 2008/7958 3008 or email office.adfm@gmail.com. For ticketing enquiries, call TicketCharge at 03-9222 8811 or visit www.ticketcharge.com.my)

  
Alzheimer’s disease is a progressive degenerative disease of the brain which causes gradual depletion of brain cells and resultant loss of mental capability.

The personality and behavioural changes of loved ones who suffer Alzheimer’s disease are often incomprehensible to family members, oftentimes leading to conflicts and dilemmas.

Aloysius Alzheimer, a German neuro-pathologist, first described this illness in 1907 in Auguste Deter, a 51-year-old lady who had been experiencing memory, language, as well as psychological problems like hallucination and disorientation.

After she passed away, the postmortem of her brain showed presence of abnormal protein deposits that have now become synonymous with Alzheimer’s disease.

These abnormal proteins result in loss of connection between nerve cells, or neurons, in the brain, and eventually, lead to the death of these cells.

Anatomically, the hippocampus is one of many areas in the brain that play a big role in encoding new memories, and it is one of the first regions of the brain to suffer damage in Alzheimer’s.

Generally, there are three types of Alzheimer’s disease: young-onset that occurs at age 60 years or younger, which is fortunately rare; late-onset, which is the most common type occurring at age 60 and above; and familial Alzheimer’s disease, entirely inherited and occurs at a much younger age, often in the 40s.

The worldwide prevalence of dementia is estimated to be around 30 million people, with 4.6 million affected annually.

The forecasted rate of increase is estimated to be more than 300% in India, China, South Asia and the Western Pacific, including Malaysia, where the prevalence of the elderly with Alzheimer’s disease is likely to exponentially increase with the increasing ageing of the population, resulting in substantial financial and social impact on our society.

Alzheimer’s disease is a progressive degenerative disease of the brain, which causes gradual depletion of brain cells and resultant loss of mental capability.

The most prominent feature of this disease is short-term memory loss.

Events from long ago are remembered well, but those that have occurred recently are recalled with difficulty.

Those with Alzheimer’s may constantly repeat themselves, and forget things that transpired just moments ago.

They may also frequently misplace belongings such as their glasses, keys and money.

Other symptoms include problems with language, which may present as difficulty in finding the right word for everyday objects; being unable to recognize familiar faces or items; losing the ability to use familiar tools and objects; and having trouble performing complex tasks such as driving and banking.

These features may begin very subtly at first, but become more obvious as the disease progresses.

As people with Alzheimer’s deteriorate, they will find it more and more challenging to manage their day-to-day lives.

They will first lose skills that have been acquired over their lifetime, such as managing finances, cooking meals or using a phone.

At more advanced stages, relatively simple activities such as bathing, dressing and toileting, will be impaired.

The rate of progression of Alzheimer’s disease varies from person to person.

However, there is a persistent and inexorable decline from minimal deficit to complete dependence, at which time the person will lose the ability to walk, speak and control their bladder and bowels.

Death occurs at the end, usually from infections such as pneumonia.

The time a person with Alzheimer’s has from symptom onset to death, is between five and 15 years (average eight to 10 years).

A person with Alzheimer’s may also present with behavioural changes and psychiatric manifestations.

The person’s mood may be affected, with the person experiencing depression, anxiety or apathy, or he may develop psychosis, with hallucinations and delusional thoughts.

Some people become disinhibited or aggressive, and others may exhibit purposeless repetitive behaviour, such as constantly fidgeting or wandering aimlessly at night.

Generally, disturbing conduct becomes more common in moderately severe disease.

The enormous physical, psychological and financial impact on the caregivers, however, are not often understood by friends and relatives.

Caregivers may not know how to get help or are sometimes embarrassed by these bizarre behaviours of their loved ones.

Too often, they try to handle such difficult situations on their own, and this usually results in more frustration and guilt.

Often, caregivers have to quit their jobs to give fulltime care to this highly demanding person with Alzheimer’s, and as a result, suffer significant loss of income.

The situation may disrupt their future plans and create much conflict within them.

Alzheimer’s disease is not curable, but there are ways to help caregivers cope and manage a person with this illness.

Caregivers need to have a sound understanding of this disease to enhance optimal care, and with pharmacological and non-pharmacological methods, the outcome of care is more likely to be successful.

There are a few drugs that can be used to improve cognition, function and behaviour, but these drugs do not change the course of the illness and may not be effective for everyone.

Non-pharmacological treatment should be considered in all patients with Alzheimer’s, and it has to be tailored to the individual to achieve a balance, as excessive stimulation or over-activity may be counterproductive.

Examples of non-pharmacological therapy include making changes to the environment by moderating noise and other levels of stimulation, using signage, easier access to toilets, well-lit surroundings, improving time orientation by using a prominent calendar/clock, and recreational activities that may enhance quality of life such as exercise, gardening, music, art, pet therapy etc.

Avoiding confrontations and using distraction techniques are useful in preventing anger outbursts that usually end with more agitation and irritabilities.

Using simple words rather than multi-layered sentences help the patient understand instructions, and thus, help them perform their tasks more efficiently.

Knowing the diagnosis earlier means supporting people earlier, and timely and useful information, advice or assistance from either a healthcare professional or support group such as Alzheimer’s Disease Foundation Malaysia (ADFM) can help both the person and caregiver cope better as the disease advances.

Prompt diagnosis allows for future planning.

Early strategizing gives time to work through complex legal, financial and personal matters such as making a will, sorting out property issues and making changes to living arrangements.

Being diagnosed early also enables people with Alzheimer’s to be actively involved in discussions about their future while they still retain their mental capacity, particularly regarding treatment choices and end-of-life care.

This eliminates guesswork and potentially avoids future conflict among caregivers.

Therefore, a timely diagnosis allows a person with Alzheimer’s disease and the caregiver to have the best quality of life possible.

The goal is for the person to live a good life and stay independent for as long as possible despite having Alzheimer’s disease, as life does not stop with the diagnosis.



Wednesday, 24 September 2014

WORLD ALZHEIMER REPORT 2014

In conjunction with World Alzheimer’s Day (21 September), Alzheimer's Disease International [ADI] launched the World Alzheimer Report 2014, focused upon sets of potential modifiable risk factors in four key domains:
·      Developmental
·      Psychological and Psychosocial
·      Lifestyle  
·      Cardiovascular Risk Factors.

The World Alzheimer Report 2014 examines the latest existing evidence associated with dementia risk factors, ranging from smoking to socializing, and provides an analysis of interventions that have been trialed to create change around the world.  The report provides an invaluable resource and the basis upon which to campaign for change, and opens the door for more research in the area.

The Report highlights that:

·   dementia risk for populations can be modified through reduction in tobacco use and better control and detection for hypertension and diabetes, as well as cardiovascular risk factors.  A good mantra is “What is good for your heart is good for your brain”.

·   brain health promotion messages should be integrated in public health promotion campaigns such as anti-tobacco or non-communicable disease (NCD) awareness campaigns, with the message that it’s never too late to make these changes.

·   dementia needs to be included on World Health Organization (WHO) and National NCD Planning.

The report reveals that control of diabetes and high blood pressure as well as measures to encourage smoking cessation and to reduce cardiovascular risk, have the potential to reduce the risk of dementia even in late-life. The report found that diabetes can increase the risk of dementia by 50%. Obesity and lack of physical activity are important risk factors for diabetes and hypertension, and should, therefore, also be targeted.

While cardiovascular health is improving in many high income countries, many low and middle income countries show a recent pattern of increasing exposure to cardiovascular risk factors, with rising rates of diabetes, heart disease and stroke.

Smoking cessation is strongly linked in the report with a reduction in dementia risk. For example, studies of dementia incidence among people aged 65 years and over show that ex-smokers have a similar risk to those who have never smoked, while those who continue to smoke are at much higher risk.

Coinciding with the launch of the report, survey data released by Bupa has shown over two thirds (69%) of people around the world are concerned about getting dementia in later life, but many are unclear about the causes and the actions they can take to potentially reduce their risk.  

If we can all enter old age with better developed, healthier brains we are likely to live longer, happier and more independent lives with a much reduced chance of  developing dementia.


Download the Full Report here.

Take a look here at the info-graphics about risk reduction. 

Click on Video highlights the presentations and discussion at the launch of the World Alzheimer Report 2014 in London.


Friday, 29 August 2014

ADFM MEMORY WALK, SUNDAY, 21 SEPTEMBER - WORLD ALZHEIMER'S DAY



  MEMORY WALK 

COMMEMORATE 
WORLD ALZHEIMER'S DAY 

21 SEPTEMBER  2014
Lebuhraya Bukit Jalil, Bukit Jalil, 57000 Kuala Lumpur (Entrance: Gate 3)



"Every 4 seconds, someone in the world develops dementia. There are now 44 million people worldwide living with the disease, 62% of which live in low and middle-income countries. By 2050, this number will triple to 135 million. As a result, dementia will be the most serious health crisis of the 21st century.” - ADI.

ADFM, together with ADI and its Federation of 84 Alzheimer Associations Worldwide, will be commemorating World Alzheimer’s Day with the Theme “DEMENTIA: CAN WE REDUCE THE RISK?”, focusing ON WAYS to reduce the risk of developing dementia by adopting brain healthy personal lifestyles. 

In Malaysia, ADFM and its Local State Support Groups will be hosting a MEMORY WALK in Penang, Johor and Ipoh on Sunday, 21 September 2014 (contact your respective local state support groups).

JOIN US, WALK as a whole family to raise public awareness of dementia, combat stigma and give your support to persons living with dementia and their caregivers.

MEMORY WALK PROGRAM (FT/SELANGOR):

7.00am   Warming up exercises
7.30am   Sing-along session by AD clients
7.45am   Memory Walk - flag-off by Patron, Puan Sri Wendy Ong 

Note:  Fun walk - 2km for PWDs and 5km participants. No worries if you can't complete the 5km.  Your presence and support is more important !!
  

Registration Fee:  RM20 per participant.  (AD Clients FREE)
(Participant will get T-shirt, cap, goody bag, drink and food.)

Your generous sponsorship/donations towards the organizing of the Memory Walk are most welcome (Tax Exempt Receipt for Donations). 

To Register, click on -> Registration Form

ENQUIRY: Jenny / Michael at 03 – 7931 5850 / 016 608 2513, Email: jenny@adfm.org.my

SUPPORTED BY:

     


Friday, 18 July 2014

LIFESTYLE CHANGES ARE KEY TO EASING ALZHEIMER'S RISK

While medications have consistently failed to prevent Alzheimer's or significantly slow its progression, commonsense health activities can make a profound difference, a growing body of research shows.

"Health doesn't always come in the form of a pill," said Alan Lerner, Director of the Brain Health and Memory Center at University Hospitals Case Medical Center in Cleveland, and a Neurologist at Case Western Reserve University.

The combination of eating well, exercising, keeping mentally and socially engaged, and managing obesity, high blood pressure and diabetes can reduce someone's risk of memory decline, according to a new study from Finland. The study, presented Sunday at the Alzheimer's Association International Conference in Denmark, is the first to examine the impact of all four factors together; other studies have looked at pieces of healthy lifestyles, but not the combination.

"The routine things, the things that are simple, have turned out to be protective," said Yonas Geda, a Professor of Neurology and psychiatry at the Mayo Clinic in Scottsdale, Ariz., who was not involved in the Finnish study. "It keeps going back to the old advice from grandma."

In that study, 1,260 Finnish volunteers, ages 60-77, were divided into two groups – one that was encouraged to follow the four healthy lifestyle factors and the other that was given standard care.

At the end of the two-year study period, the group that paid extra attention to healthy eating, exercising, engagement and management of heart-health risk factors performed significantly better on tests of memory and other cognitive abilities than the control group. Researchers will follow both groups an additional seven years to see if the improvement continues.

Geda presented his own research at the conference, showing that exercise in midlife appears to be protective against dementia decades later. People who simply took an after-dinner stroll three times a week in their 50s and 60s were less likely to suffer memory problems in their 80s, according to the study.

He and his colleagues have also shown in past research that mental and social activities, such as reading books, going to Bible study, playing the piano and knitting can reduce the risk of memory loss, as can eating in moderation.

"This is really good news to society," said Geda, who has added an occasional after-dinner stroll to his own schedule. "Physical activity and mental activities are accessible to all people."

Another study, which Lerner led and presented at the conference, was the first to explore whether it is worthwhile to put dementia patients through the discomfort and expense of cataract surgery.

A group of 28 patients who had the surgery declined much more slowly than 14 people with similar vision problems who did not, the study found. The improvement was at least as large as the benefits seen with medication, he said.

"You don't stop being a person just because you have a dementia," Lerner said. "We find that really taking care of the whole person is very important, especially when it comes to sensory deprivation — if you don't perceive it, it's very difficult to remember it."


(Source:  USA Today, 14 July 2014)

Monday, 14 July 2014

ONE IN THREE ALZHEIMER'S CASES PREVENTABLE, SAYS RESEARCH

One in three cases of Alzheimer's disease worldwide is preventable, according to research from the University of Cambridge.

The main risk factors for the disease are a lack of exercise, smoking, depression and poor education, it says.


Previous research from 2011 put the estimate at one in two cases, but this new study takes into account overlapping risk factors.

Alzheimer's Research UK said age was still the biggest risk factor.


Writing in The Lancet Neurology, the Cambridge team analysed population-based data to work out the main seven risk factors for Alzheimer's disease.

These are:
·         Diabetes
·         Mid-life hypertension
·         Mid-life obesity
·         Physical inactivity
·         Depression
·         Smoking
·         Low educational attainment

They worked out that a third of Alzheimer's cases could be linked to lifestyle factors that could be modified, such as lack of exercise and smoking.

The researchers then looked at how reducing these factors could affect  the number of future Alzheimer's cases.  


They found that by reducing each risk factor by 10%, nearly nine million cases of the disease could be prevented by 2050.                                                     

In the UK, a 10% reduction in risk factors would reduce cases by 8.8%, or 200,000, by 2050, they calculated.

Current estimates suggest that more than 106 million people worldwide will be living with Alzheimer's by 2050 - more than three times the number affected in 2010.

Healthier old age

Professor Carol Brayne, from the Institute of Public Health at the University of Cambridge, said: "Although there is no single way to treat dementia, we may be able to take steps to reduce our risk of developing dementia at older ages.”

"We know what many of these factors are, and that they are often linked.”

"Simply tackling physical inactivity, for example, will reduce levels of obesity, hypertension and diabetes, and prevent some people from developing dementia.”

"As well as being healthier in old age in general, it's a win-win situation."

Dr Simon Ridley, Head of Research at charity Alzheimer's Research UK, said there was still much to discover about the disease.

"While age is the biggest risk factor for most cases of Alzheimer's, there are a number of lifestyle and general health factors that could increase or decrease a person's chances of developing the disease.”

"However, we still do not fully understand the mechanisms behind how these factors are related to the onset of Alzheimer's."

Investment

Dr Ridley said there were more than 820,000 people in the UK living with dementia, and an ageing population would lead to spiraling numbers being affected.

"As there is still no certain way to prevent Alzheimer's, research must continue to build the strongest evidence around health and environmental factors to help individuals reduce their risk."

He added: "This new study also highlights that many cases are not due to modifiable risk factors which underlines the need to drive investment into new treatment research."

Of the seven risk factors, the largest proportion of cases of Alzheimer's in the US, UK and the rest of Europe can be attributed to physical inactivity.

The study says about a third of the adult population in these countries are physically inactive.

Physical inactivity is also linked to increased risks of other health problems, such as cancers and cardiovascular diseases.


(Source:  BBC News Health, 14 July 2014)

MEMORY LOSS: IT’S NOT INEVITABLE

The brain contains about 100 billion neurons. A common misconception is that tens of thousands of neurons die each day. In reality, few neurons die over a person's lifetime, but they do shrink. This shrinkage may partially explain why mental functioning slows in middle and older age. (Serious memory problems do occur when major disorders such as a stroke or Alzheimer's destroy whole clusters of neurons.)

In addition to the shrinkage of neurons, starting in middle age the brain begins producing smaller quantities of many neurotransmitters -- chemical messengers that relay information between nerve cells. Brain blood flow is also reduced 15 to 20 percent between ages 30 and 70, although the shrinkage of neurons may account for the reduced flow because less tissue requires less blood.

Cultural attitudes and preconceptions about aging and memory loss can also influence the occurrence of memory lapses as people age. In one study, researchers compared the memory skills of two groups known to harbor few stereotypes concerning old age -- the people of China and deaf Americans -- with those of a third group known to have numerous preconceptions about aging, hearing Americans. Among these preconceptions is the notion that aging causes an inevitable decline in memory skills.

The study results suggest that there is a strong link between culture and memory: The first two groups were less forgetful than the third group, and older Chinese participants performed as well as the younger people in each of these groups. The implication is that if people expect their memory to get worse, they may be less diligent in trying to remember.

Other research indicates that the mental processes required to remember newly acquired information are the same as those needed to retrieve memories from long ago -- something most older people do quite well. This finding implies that older people retain the capacity to recall recent events, but the new information is not being recognized as important or is being discarded instead of stored.

Some researchers interpret this to mean that occasional memory lapses may result from a failure to pay close attention to the information rather than an inability to remember. Thus, it appears that forging new memories depends in large part on staying interested, active and alert.



(Source:  John Hopkins Health Alert, 14 July 2014)

Saturday, 12 July 2014

ADI NEWS RELEASE - SMOKING INCREASES RISK OF DEMENTIA

The World Health Organization (WHO) and Alzheimer’s Disease International (ADI) in its latest report highlighted the serious risk that tobacco use creates for dementia. 

The Key Message is:

▪     Smoking is a risk factor for dementia, and quitting could reduce the dementia  burden.

▪     Second-hand smoke exposure may also increase the risk of dementia.

▪     14% of Alzheimer’s disease cases worldwide are potentially attributed to   smoking.

▪     As no treatments are currently available to cure or alter the progressive course of dementia, it is essential to identify modifiable risk factors for reducing the occurrence of the disease, delaying its onset or reducing its burden.

▪     Governments should actively implement and enforce the measures of the WHO Framework Convention on Tobacco Control, especially smoke-free environment laws and systematic access to tobacco cessation services.

Geneva, 09 July 2014:

Smokers have a 45% higher risk of developing dementia than non-smokers, according to information published today by the World Health Organization (WHO) in collaboration with Alzheimer’s Disease International (ADI).

Evidence reviewed by WHO reveals a strong link between smoking and the risk of dementia, and the more a person smokes, the higher the risk. It is estimated that 14% of Alzheimer’s disease cases worldwide are potentially attributable to smoking.

WHO warns that exposure to second-hand smoke (passive smoking) may also increase the risk of dementia.

"Since there is currently no cure for dementia, public health interventions need to focus on prevention by changing modifiable risk factors like smoking,” says Dr Shekhar Saxena, Director of the Department for Mental Health and Substance Abuse at WHO. “This research shows that a decrease in smoking now is likely to result in a substantial decrease in the burden of dementia in the years to come."

Tobacco use is already recognized as the one risk factor common to four main groups of non-communicable diseases (NCDs): cancers, cardiovascular disease, chronic lung disease and diabetes.

“Tobacco is one of the biggest public health threats the world has ever faced, killing nearly six million people a year,” says Dr Douglas Bettcher, Director of the Department for Prevention of Non-communicable Diseases at WHO. “WHO urges governments to actively implement and enforce the measures of the WHO Framework Convention on Tobacco Control, especially smoke-free environment laws and access to tobacco cessation services”.

Laurent Huber, Director of the Framework Convention Alliance (FCA) for Tobacco Control, comments: “It is no surprise to see these findings confirm that tobacco smoking is a major risk factor for dementia. This adds yet another item to the long list of the devastating consequences of tobacco and gives even more reason for personal and public health action to help people to quit smoking.”  

“The research also shows that quitting smoking later in life might be beneficial so encouraging and supporting current tobacco users to quit should be a priority,” says Serge Gauthier, chair of the ADI’s Medical Scientific Advisory Panel.

Dementia affects more than 44 million people worldwide, with almost two thirds of them living in low- and middle-income countries. 

“Every year, there are 7.7 million new cases of dementia. In 2010, the global cost was calculated at US$ 604 billion, which represents 1% of global GDP (gross domestic product),” says Marc Wortmann, ADI Executive Director. “No government can ignore the opportunity to link this new information into its planning and health system activities to reduce smoking and control NCDs.”

ADI believes that this information brief can form the basis for countries to add messages about brain health and dementia risk into public health anti-smoking programs and interventions. 

For further information:

Click on -> Tobacco Use and Dementia   
Visit : http://www.who.int/tobacco/publications/en/ 

Wednesday, 9 July 2014

ALZHEIMER'S DISEASE COULD BE PREVENTED AFTER NEW BLOOD TEST BREAKTHROUGH

Scientists at Oxford University and Kings College London develop blood test which can predict the onset of Alzheimer's so that drugs could target the disease before symptoms appear

A blood test has been developed to predict if someone will develop Alzheimer’s within a year, raising hopes that the disease could become preventable.

After a decade of research, scientists at Oxford University and King’s College London are confident they have found 10 proteins which show the disease is imminent.

Clinical trials will start on people who have not yet developed Alzheimer’s to find out which drugs halt its onset.

The blood test, which could be available in as little as two years, was described as a “major step forward” by Jeremy Hunt, the Health Secretary, and by charities which said it could revolutionize research into a cure.

“Although we are making drugs they are all failing. But if we could treat people earlier it may be that the drugs are effective,” said Simon Lovestone, Professor of Translational Neuroscience at Oxford. “Alzheimer’s begins to affect the brain many years before patients are diagnosed with the disease. If we could treat the disease in that phase we would in effect have a preventative strategy.”

Clinical trials into so-called “wonder drugs” such as BACE inhibitors and anti-amyloid agents, have shown little improvement for sufferers. Scientists believe that by the time Alzheimer’s is diagnosed, an irreversible “cascade” of symptoms has already occurred.

About 600,000 people in Britain suffer from Alzheimer’s and hundreds of thousands have mild cognitive impairment. Last month, David Cameron pledged to fast-track dementia research.

The new test, which examines 10 proteins in the blood, can predict with 87 per cent accuracy whether someone suffering memory problems will develop Alzheimer’s within a year.

The researchers used data from three international studies. Blood samples were taken from 1,148 people, 476 of whom had Alzheimer’s, 220 with memory problems, and a control group of 452 without any signs of dementia. The scientists found that 16 proteins were associated with brain shrinkage and memory loss and 10 of those could predict whether someone would develop Alzheimer’s.

Mr Hunt said: “This is welcome research on an issue we’re made a national priority. Developing tests and bio markers will be important steps forward in the global fight against dementia as we search for a cure.”

Previous studies have shown that PET brain scans and plasma in lumbar fluid could be used to predict that onset of dementia from mild cognitive impairment. But PET imaging is highly expensive and lumbar punctures are invasive and carry risks.

The first tests are likely to be available in between two and five years. However, the study is likely to throw up ethical dilemmas about whether patients should receive potentially devastating news about their future. Prof Lovestone said it was unlikely that GPs would use the test until a treatment was available.

The breakthrough was welcomed by dementia charities and academics.

Eric Karran, Director of Research at Alzheimer’s Research UK, which helped fund the research, said it brought the prospect of Alzheimer’s becoming a preventable disease “significantly closer”.

Prof Gordon Wilcock, Emeritus Professor of Geratology at Oxford, added that it was “great news”. The study was published in the Journal Alzheimer’s & Dementia.


(Source:  The Telegraph, 8 July 2014)


Monday, 30 June 2014

CALMING ALZHEIMER'S AGITATION WITH CITALOPRAM

A drug intended to treat depression has been found to reduce agitation in people with Alzheimer's disease. The drug, citalopram (Celexa), appears to be a safer alternative to the traditional antipsychotic medicines used for agitation. Doctors typically prescribe antipsychotics after nondrug treatments, such as behavioral therapy, fail to calm patients.

In a randomized clinical trial reported in JAMA (volume 311, p. 683), Johns Hopkins scientists studied 186 people, average ages 78-79, with Alzheimer's who had symptoms of agitation such as emotional distress, irritability, aggressive behavior, verbal or physical outbursts and restlessness.

They gave about half the patients citalopram with gradually increasing doses up to 30 mg. The remaining patients received a placebo. Participants in both groups, and their caregivers, received counseling as well. After nine weeks, 40 percent of the patients in the citalopram group showed marked improvement in agitation symptoms, compared with 26 percent in the placebo group. Caregivers of patients who received citalopram also reported less stress.

The risks - Citalopram, however, does have some risks; the FDA advises people over 60 to avoid doses above 20 mg. Citalopram been associated with abnormal heart rhythms and a mild decrease in cognitive function. Some study participants who took citalopram also reported anorexia, diarrhea, falls and upper-respiratory infections. Yet, lower doses are still thought to be safer than antipsychotic drugs, which have been associated with stroke, heart attack and death.

The study authors say the next step is more research to determine whether the drug is as effective in doses of 20 mg over a longer period. They also recommend that doctors assess patients individually to determine drug doses, based on factors like the patients' severity of agitation, cardiovascular health and cognitive function.





(Source:  John Hopkins Health Alert, 30 June 2014)

Wednesday, 25 June 2014

SAT/5JULY14 Caregivers Monthly Sharing Session and Talk on Dementia Care Titled "Beyond Diagnosis ... What Next??"

TO:  All Caregivers, 

ADFM National Caregivers Support Network will be having it's July Monthly Caregivers Sharing and Talk on Dementia Care Titled "BEYOND DIAGNOSIS ... WHAT NEXT ??" by Mr Willie Kwa from UK.

Day / Date :  Saturday, 5 July 2014
Time :  2.30pm to 5.00pm
Venue :  ADFM PJ Daycare Centre, No. 6, Lorong 11/8E, 46200 Petaling Jaya.

Objective: How being a Caregiver who is prepared, knowledgeable, supported and in good psychological and physical health ultimately provide the best care !!.  It will be a very interactive talk to allow more interaction from the caregivers with the Speaker.  

Facilitator's Profile:

Willie Kwa is a Malaysian from Taiping and ex distant caregiver to his late dementia Mom. 

Willie is a retired Nurse in UK with over 40 years extensive nursing care experience for people with mental health issues, in particular relating to older people, and with special interest in caring people with various forms of dementia.

He is a member and volunteer with the Alzheimer's Society (UK) for over 30 years in areas of raising awareness of dementia and care issues.   

His experience includes managerial operational responsibility for a 70 beds hospital service for older people with mental health difficulties. Commissioned and managed new services consisting of community, day care centers and in-patient care units.  

Presently, Willie is with private sector giving care to old people with various health problems including all aspects of mental health and dementia care.

COMPULSORY REGISTRATION:  

Kindly register early by click on -> Registration Form and return the completed form to jenny@adfm.org.my or fax to: 03 7960 8481. 

Further inquiries, feel free to call Jenny at 016 608 2513 / 03 7931 5850 or email jenny@adfm.org.my.



From:  ADFM National Caregivers Support Network
June 2014