Tag: University of Virginia

That ‘D’ word

And I don’t mean dog!

Still continuing with another dog-free day because this is a supremely important topic: Dementia.

I’m well into my 75th year and have poor recall. I do everything to fight the loss of memory. We are vegan, or technically pescatarian, we both go to the nearby Club Northwest twice a week and I ride my bike every other day.

In the current issue of The Economist magazine there is a special report on Dementia:

As humanity ages the numbers of people with dementia will surge

The world is ill-prepared for the frightening human, economic and social implications

Recently we took delivery of a REDjuvenator because it holds out hope, and is claimed, to offset the more disastrous aspects of ageing.

It’s early days but there are indications that it is doing some good.

So it was with great interest that I read the other day the following article and even more grateful that it comes with permission to republish.

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Does forgetting a name or word mean that I have dementia?

Your medical team should determine whether you have dementia or just normal memory loss due to aging.
Fred Froese via Getty Images

Laurie Archbald-Pannone, University of Virginia

The number of cases of dementia in the U.S. is rising as baby boomers age, raising questions for boomers themselves and also for their families, caregivers and society. Dementia, which is not technically a disease but a term for impaired ability to think, remember or make decisions, is one of the most feared impairments of old age.

Incidence increases dramatically as people move into their 90s. About 5% of those age 71 to 79 have dementia, and about 37% of those about 90 years old live with it.

Older people may worry about their own loss of function as well as the cost and toll of caregiving for someone with dementia. A 2018 study estimated that the lifetime cost of care for a person with Alzheimer’s, the most common form of dementia, to be US$329,360. That figure, too, will no doubt rise, putting even more burdens on family, Medicare and Medicaid.

There’s also been a good deal of talk and reporting about dementia in recent months because of the U.S. presidential election. Some voters have asked whether one or both candidates might have dementia. But, is this even a fair question to ask? When these types of questions are posed – adding further stigma to people with dementia – it can unfairly further isolate them and those caring for them. We need to understand dementia and the impact it has on more than 5 million people in the U.S. who now live with dementia and their caregivers. That number is expected to triple by 2060.

First, it is important to know that dementia cannot be diagnosed from afar or by someone who is not a doctor. A person needs a detailed doctor’s exam for a diagnosis. Sometimes, brain imaging is required. And, forgetting an occasional word – or even where you put your keys – does not mean a person has dementia. There are different types of memory loss and they can have different causes, such as other medical conditions, falls or even medication, including herbals, supplements and anything over-the-counter.

Older people wonder and worry about so-called senior moments and the memory loss they perceive in themselves and others. I see patients like this every week in my geriatric clinic, where they tell me their stories. They forget a word, get lost in a story, lose keys or can’t remember a name. Details vary, but the underlying concern is the same: Is this dementia?

A doctor looks at images of a brain scan.
Your doctor may want to do a brain scan to determine if there are any issues.
Andrew Brookes via Getty Images

Normal memory loss

As we age, we experience many physical and cognitive changes. Older people often have a decrease in recall memory. This is normal. Ever have trouble fetching a fact from the deep back part of your “mind’s Rolodex”? Suppose you spot someone at the grocery store you haven’t seen in years. Maybe you recognize the face, but don’t remember their name until later that night. This is normal, part of the expected changes with aging.

What’s more of a potential problem is forgetting the name of someone you see every day; forgetting how to get to a place you visit frequently; or having problems with your activities of daily living, like eating, dressing and hygiene.

When you have troubles with memory – but they don’t interfere with your daily activities – this is called mild cognitive impairment. Your primary care doctor can diagnose it. But sometimes it gets worse, so your doctor should follow you closely if you have mild cognitive impairment.

You want to note the timing of any impairment. Was there a gradual decline? Or did it happen all of a sudden? This too you should discuss with your doctor, who might recommend the MoCA, or Montreal Cognitive Assessment test, which screens for memory problems and helps determine if more evaluation is needed.

Also, the Centers for Disease Control and Prevention lists problems in these areas as possible signs of dementia:

  • Memory
  • Attention
  • Communication
  • Reasoning, judgment and problem solving
  • Visual perception beyond typical age-related changes in vision

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More severe issues

When memory loss interferes with daily activities, see your doctor about what to do and how to make sure you’re safe at home.

There are numerous types of severe memory loss. Dementia tends to be a slow-moving progression that occurs over months or years. Delirium is more sudden and can occur over hours or days, usually when you have an acute illness. Depression can also cause memory changes, particularly as we get older.

A computer illustration of amyloid plaques, characteristic features of Alzheimers disease.
A computer illustration of amyloid plaques among neurons. Amyloid plaques are characteristic features of Alzheimer’s disease.
Juan Gaertner/Science Photo Library via Getty Images

Dementia and other brain issues

Alzheimer’s dementia is the most common type of dementia, followed by vascular dementia. They have similar symptoms: confusion, getting lost, forgetting close friends or family, or an inability to do calculations like balance the checkbook. Certain medical conditions – thyroid disorders, syphilis – can lead to dementia symptoms, and less common types of dementia can have different kinds of symptoms. Alzheimer’s has a distinct set of symptoms often associated with certain changes in the brain.

Focusing on safety and appropriate supervision, particularly in the home, is critical for all people with dementia. Your doctor or a social worker can help you find support.

It’s also important to be aware of two other things that can lead to decreased mental functioning – delirium and depression.

Delirium, a rapid change in cognition or mental functioning, can occur in people with an acute medical illness, like pneumonia or even COVID-19 infection. Delirium can occur in patients in the hospital or at home. Risk for delirium increases with age or previous brain injuries; symptoms include decreased attention span and memory issues.

Depression can happen at any time, but it’s more common with aging. How can you tell if you’re depressed? Here’s one simple definition: when your mood remains low and you’ve lost interest or joy in activities you once loved.

Sometimes people have recurring episodes of depression; sometimes, it’s prolonged grieving that becomes depression. Symptoms include anxiety, hopelessness, low energy and problems with memory. If you notice signs of depression in yourself or a loved one, see your doctor. If you have any thoughts of harming yourself, call 911 to get help instantly.

Any of these conditions can be frightening. But even more frightening is unrecognized or unacknowledged dementia. You must, openly and honestly, discuss changes you notice in your memory or thinking with your doctor. It’s the first step toward figuring out what is happening and making sure your health is the best it can be.

And, as with any disease or disease group, dementia is not a “character flaw,” and the term should not be used to criticize a person. Dementia is a serious medical diagnosis – ask those who have it, the loved ones who care for them or any of us who treat them. Having dementia is challenging. Learn what you can do to support those with dementia in your own community.The Conversation

Laurie Archbald-Pannone, Associate Professor Medicine, Geriatrics, University of Virginia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Please, if you are of the age where this is more than an academic interest then read the article carefully and especially that piece of advice towards the end:

But even more frightening is unrecognized or unacknowledged dementia. You must, openly and honestly, discuss changes you notice in your memory or thinking with your doctor. It’s the first step toward figuring out what is happening and making sure your health is the best it can be.

As is said growing old is not for cissies.

None of us can put off the fateful day when we will die and in our case we do not believe in any form of afterlife, in other words we are confirmed atheists, so all we can do is to live out our remaining years as healthily as possible and loving each other and our precious animals.

But having said that I know that all of us want to live out our lives with healthy, active brains and it’s clear that we can’t leave it to chance.

In closing, I recently purchased the book Outsmart Your Brain written by Dr. Ginger Schechter (and others). It was just $9.99 and contains much advice regarding the best foods and exercise for a healthy brain. I recommend it!

The knowing of dogs.

A fascinating study on human empathy strikes a chord with man and dog, perhaps.

Let me start with a true account from the evening of Monday, 19th August.

That evening, at 7pm, I had an appointment with my doctor in Grants Pass.  Jean stayed at home looking after our guests and preparing the evening meal.

The journey from the doctor’s clinic back to home, a distance of 20 miles, takes a little over half-an-hour.  The last 3 miles are along Hugo Road; about 6 minutes including opening and closing the gate across our driveway.

Anyway, according to Jean shortly after 8pm Pharaoh sprang up barking and went across to put his nose against one of the windows that looks out over our front drive and garden.  Jeannie looked at the clock on the kitchen wall and made a note of the time: it was 8:10pm.  She also came over to the window that Pharaoh was looking out of and searched for any reason for his outburst of barking: squirrels, deer, any kind of wildlife or other distraction.  There was none.

A little before 8:20pm Jeannie saw the headlights of my car pull up and moments later I came in through the front door.

It appeared that Pharaoh had sensed the point where I had turned into Hugo Road.

One could easily dismiss this, perhaps by thinking that Jean had unconsciously signalled to Pharaoh that I was on my way home.  But Jean had only the vaguest idea of when I might be back.

Or one could be drawn to the research undertaken by Dr. Rupert Sheldrake, as this extract from a post back in May, 2011 explains.

What an amazing book this is.

Amazing!

I have written about Dr Rupert Sheldrake a few times on Learning from Dogs for pretty obvious reasons!  You can do a search on the Blog under ‘sheldrake’ but here are a couple of links.  Serious Learning from Dogs on January 10th, 2011 and Time for a rethink on the 14th April, 2011.

Anyway, I am now well towards the end of Sheldrake’s revised book, Dogs That Know When Their Owners Are Coming Home and it is more than fascinating.  Bit short of time just now so please forgive me if I do no more than show this video which sets out some of the background to the book.  Sheldrake’s website is here, by the way.

Anyway, what’s this all leading up to?

I can’t recall where it was that I read about a report posted on the Forbes website about the new findings of the power of human empathy.

Study: To The Human Brain, Me Is We

A new study from University of Virginia researchers supports a finding that’s been gaining science-fueled momentum in recent years: the human brain is wired to connect with others so strongly that it experiences what they experience as if it’s happening to us.

This would seem the neural basis for empathy—the ability to feel what others feel—but it goes even deeper than that. Results from the latest study suggest that our brains don’t differentiate between what happens to someone emotionally close to us and ourselves, and also that we seem neurally incapable of generating anything close to that level of empathy for strangers.

The research revealed:

“The correlation between self and friend was remarkably similar,” said James Coan, a psychology professor in U.Va.’s College of Arts & Sciences who co-authored the study. “The finding shows the brain’s remarkable capacity to model self to others; that people close to us become a part of ourselves, and that is not just metaphor or poetry, it’s very real. Literally we are under threat when a friend is under threat. But not so when a stranger is under threat.”

The findings back up an assertion made by the progenitor and popularizer of “Interpersonal Neurobiology,” Dr. Daniel Siegel, who has convincingly argued that our minds are partly defined by their intersections with other minds. Said another way, we are wired to “sync” with others, and the more we sync (the more psycho-emotionally we connect), the less our brains acknowledge self-other distinctions.

Later in that Forbes article Professor Coan is reported:

“A threat to ourselves is a threat to our resources,” said Coan. “Threats can take things away from us. But when we develop friendships, people we can trust and rely on who in essence become we, then our resources are expanded, we gain. Your goal becomes my goal. It’s a part of our survivability.”

So if science is discovering that our subconscious minds are connecting “psycho-emotionally” with the minds of others whom we trust, then it doesn’t seem like too great a leap to embrace human minds psycho-emotionally connecting with the animals that we trust, and vice versa.  Because for thousands upon thousands of years, the domesticated dog and man have depended on each other for food, protection, warmth, comfort and love.

Footnote.

References for those who wish to follow up on this article are:

Original Forbes article, written by David DeSalvo.

David DeSalvo’s website.

Daniel J. Siegelclinical professor of psychiatry at the UCLA School of Medicine and Executive Director of the Mindsight Institute.

Daniel Siegel’s book The Developing Mind.

Professor Robin Ian MacDonald Dunbar, British anthropologist, evolutionary psychologist and a specialist in primate behaviour.  His theory known as Dunbar’s Number explained here.

Oxford Journal: Familiarity promotes the blurring of self and other in the neural representation of threat.