September 23, 2016

Journal of Dementia Care vol 24 no 5 Sept/Oct 2016




Full text articles  and books and DVDs are available to members of Alzheimer’s Australia NSW by emailing NSW.Library@alzheimers.org.au 

Reaching out effectively to Gypsies and travellers – pg 12 - 14

A previous article in the July/August edition of Journal of Dementia care explored factors of Traveller lifestyles that increase the risk of dementia. The current article builds on this topic by discussing what can be done to support and assist people in the Traveller communities. Primarily the article focusses on building trust between health care professionals and those in the community. This will enable Travellers to have a greater understanding of dementia, its risk actors and to feel more confident in accessing services.

 

PARO the seal shows promise – pg 15

PAROs are cute seal robots that have become a popular tool in animal assisted therapy when a living animal is not available. PAROs respond to light, touch, movement sound and temperature enabling them to respond to being held or spoken to like a real animal.

The robots are more commonly used in Japan however, Age UK Lewisham & Southwark’s Stones End Day Centre has become the first day care facility in the UK to own a PARO. The article reports that the responses of the day centre members was extremely positive with many experiencing a calming effect from interacting with the robot.

 

Living well with progressive non-fluent aphasia – pg 16-18

In this article Jane Twigg, supported by Jenny La Fontaine, discusses the nature of progressive, non-fluent aphasia (PFNA), how it affects her life and strategies she uses to live well. The article also provides advice for professionals for communicating effectively with someone with PFNA.

 

‘Golf days Out’ – an innovation in care and respite – pg 18-19

‘Golf days Out’ was created by Anthony Blackburn to provide people with dementia and their carers an opportunity to play golf – a highly beneficial activity for people with dementia as it combines physical exercise, cognitive stimulation and socialising. Participants with dementia are assigned a “golfing buddy” from one of the interested local golfers. The buddy pairs then play the nine-hole course to p or practice on the driving range or putting green. The ‘program is currently being evaluated however early signs suggested the participants are pleased with ‘Golf Days Out’ and some of this feedback is shared in the article.

 

Getting to know the voluntary sector – pg 20-21

Tara Smith and Jill Manthrope report on an audit they conducted regarding hospital nurses’ knowledge of local dementia voluntary groups. The Nurses interviewed were aware of some local groups but did not always know the function of these groups and didn’t often work in partnership with these organisations. The authors recommend that hospitals make an effort to connect with local dementia voluntary groups.

 

Talking mats: a model of communication training – pg 22-25

This article describes Talking Mats, a visual method of communicating with people with dementia. Talking Mats uses pictures as symbols to help people with dementia express their likes/dislikes, what they may need help with or their views on certain topics. Results from the evaluation suggest that Talking Mats is a useful communication tool which helps engage people with dementia.

 

Living in Care: an exercise to promote empathy – pg 27-28

Ian James and colleagues interviewed care staff at residential aged care homes to help staff empathise with the perspectives of people with dementia. The care staff were asked to reflect on what they would find difficult as a resident in an aged care home and how they would respond to this difficult aspect of residency. The staff showed a broad range of response, many concerns being highly individualised. The authors reflect that such conversations with staff could promote greater empathy towards challenging behaviours and result in residents being treated with greater dignity and respect.

 

A self-management group for people with dementia – pg 29-32

This article describes the results of a study that provided people in the early stages of dementia with self-management skills. The course covered information about dementia, enjoying activities, staying well, managing memories, maintaining relationships, planning ahead, coping skills and local resources. Feedback from participants in the program was positive with the vast majority saying ti was helpful and enjoyable. Further comments from people with dementia and carers are contained in the article.
Common sense to evidence-based practice - pg 32-33

Researchers draw on their own experience to explain why care  work can lay the foundations for an academic career
top tips include :
  • don't be afraid to ask questions
  • be realistic about time that you can commit
  • do your own service evaluations within your workplace
  • join a stakeholder or experts
  • help researchers disseminate the recommendations  of their  research
  • engage via social media
  • make sure research matches your  interests and the interests of the people you work with
  • attend relevant research days
Book reviews

 
 

Nothing About Us, Without Us!: 20 Years of Dementia Advocacy
Advocating for dementia for 20 years, Christine Bryden has been instrumental in ensuring that people with dementia are included in discussions about the condition and how to manage and think about it. This collection of her hard-hitting and inspiring insider presentations demands 'nothing about us, without us!' and promotes self-advocacy and self-reflection. Provocative and insightful, the pieces included in the book address issues that demand attention, and will change the way dementia is perceived, and the lives of people with dementia and their families.
'Christine's journey as a dementia advocate is truly remarkable.

 This collection of talks and presentations demonstrate the incredible progress that has been made as a result of her determination to make the world a more inclusive place for people living with dementia.' - Marc Wortmann, Executive Director, Alzheimer's Disease International
'Christine Bryden chronicles her two-decade journey living with a diagnosis of dementia, exploding myths and stereotypes along the way. Even in the face of cognitive struggles, Christine embodies personal growth, sharing her insights about the lived experience of dementia.' - G. Allen Power, MD, author of Dementia Beyond Drugs and Dementia Beyond Disease

'This should be compulsory reading for all professionals, people living with dementia and families affected by dementia. There is no us and them. There is only us.' - Professor Dawn Brooker, Director of the Association for Dementia Studies, University of Worcester, UK and author of Person-Centred Dementia Care



 

September 18, 2016

a new Teepa Snow DVD - a must see for any community

 
Spirituality in Dementia Care
with Teepa Snow and Rev. Linn Possell
  1. Have you struggled to meet the spiritual needs of a family member living with dementia?
  2. Do you run a faith-based organization and would like to know how to best help a person living with dementia and their families stay connected to their community of faith?
  3. Learn with dementia expert Teepa Snow and Reverend Linn Possell about basic spiritual needs throughout life, what may or may not change when someone is living with dementia and how to best meet those needs.
Watch this program and learn
◾How to meet the spiritual needs that remain when a person is in the midst of brain change
◾How to connect with the spirit of someone living with dementia to create a “soul to soul” relationship
◾How to help family members better manage feelings of guilt, sadness and grief
◾How to offer the highest quality of life by focusing on what the person living with dementia is still able to do.
 
 

September 17, 2016

for healthcare professionals - Barbara, the whole story and more...



Barbara's Story : her whole journey

Training guide for staff - DVD and Resources CD + training briefing cards
Abstract
Barbara’s Story  is a DVD about the experience of a person with dementia in hospital. Produced by older people’s specialist at Guy’s and St Thomas’ hospital in London, it forms part of a package of awareness raising and training that is aimed at the trust’s 12,500 staff. By following the journey of an older person with dementia through hospital, it paints a meaningful picture for all staff, even, according to Mala, moving some people to tears as they watch.
Barbara faces many challenges during her stay, including staff failing to recognise when she needs help. However, the interventions of a compassionate nurse ensure that what could be a portrayal of a catalogue of wrongs – of which nurses have heard plenty lately – is in fact a positive illustration of the power of nurses to get care right.
Secretary of state for health Jeremy Hunt has highlighted the film as gold standard practice in raising awareness of dementia among staff and it is hoped that it may be used nationally to support knowledge of dementia.
By following the journey of an older person with dementia through hospital, the film paints a


An evaluation of Barbara€™s story : final report

The initial Barbara’s Story film shows the experience of an older woman (Barbara) through her eyes, as she attends a hospital appointment and is admitted for investigations. The film was shown regularly from September 2012 to April 2013 and attendance was mandatory for all Trust staff: a total of 11,054 clinical and non-clinical staff attended. Barbara’s Story was also embedded into the corporate induction programme for new Trust staff. At each session, Barbara’s Story was shown, along with some group discussion and distribution of Alzheimer’s Society resources, Trust safeguarding and dementia and delirium information, and the Trust values and behaviours framework.
Safeguarding team members facilitated a discussion after the film and highlighted key learning points the, DVDs, additional resources and facilitator guides is freely available for both Trust staff and externally and has been distributed widely: nationally and internationally.

Freedom to learn
This is the text that championed a revolutionary approach to education that changed the way we teach. Now, in the Third Edition, it's challenging the status quo with twenty years of evidence that defies current thinking. Five exciting new chapters focus on issues of importance now and in the future--learning from those who love learning; researching person- centered issues in education; developing the administrator's role as a facilitator; building discipline and classroom management with the learner; and person-centered views of transforming education. Freedom to Learn, Third Edition is written in the first person, with two goals in mind--to aid the development of the minds of students, and to encourage the kinds of adventurous enterprises being carried out daily by dedicated, caring teachers in creative classrooms and supportive education.













Jolts! : Activities to Wake Up and Engage Your Participants
 
In Jolts! master trainer Thiagarajan introduces a brand-new set of powerful training activities specially designed to get participants to sit-up, listen, and learn. These interactive experiential games and activities give participants a powerful wake-up call, startling them into re-examining their assumptions and habitual practices, and encouraging self-reflection, problem solving, and fresh perspectives. The activities in Jolts! are interactive and emotionally charged--carefully chosen for their ability to make participants think, and think differently. Written for trainers at all levels and HR professionals"
 
Understanding brain aging and dementia : a life course approach
The life course method compares an individual's long-life and late-life behaviors to gauge one's mental decay. Arguing the life course approach is the best and simplest model for tracking mental development, Lawrence J. Whalley unlocks the mysteries of brain functionality, illuminating the processes that affect the brain during aging, the causes behind these changes, and effective coping strategies. Whalley identifies the genetic factors that determine the pace of aging and the behaviors, starting in childhood, that influence how we age. Through vignettes, charts, and tables, he composes an accessible book for patients, family members, and caretakers struggling to make sense of a complex experience.

These resources are available for loan to members of AANSW - if you would like to reserve them please email the Library on nsw.library@alzheimers.org.au
 
 








Dementia, culture and ethnicity : issues for all
 
This book explores the relationship between dementia, culture and ethnicity, looking at the latest evidence and research to determine the impact of diversity on dementia care services. By examining the key issues and providing suggestions for change, this book shows how dementia professionals can provide culturally appropriate care for all.
With contributions from experienced dementia practitioners and care researchers, this book examines the impact of culture and ethnicity on the experience of dementia and on the provision of support and services, both in general terms and in relation to specific minority ethnic communities.
 
 









Mindfulness-based elder care : a CAM model for frail elders and their caregivers
by Lucia McBee
Drawing on years of experience as a geriatric social worker and mindfulness-based stress reduction practitioner, the author has taken Jon Kabat-Zinn's Mindfulness-Based Stress Reduction program and adapted it to the particular needs of elders, their families, and professional caregivers. Mindfulness practices focus on abilities, rather than disabilities, in order to provide paths to the inner strengths and resources that we all possess. McBee's Mindfulness-Based Elder Care conveys the benefits of mindfulness through meditation, gentle yoga, massage, aromatherapy, humor, and other creative therapies to this special population. She provides clear, concise instructions for her program, as well as a wealth of anecdotal and experiential exercises, to help readers at all levels of experience. Hers is the first book to fully explore the value of mindfulness models for frail elders and their caregivers. This innovative book is suitable for use with a variety of populations such as nursing home residents with physical and cognitive challenges, community-dwelling elders, direct-care staff, and non-professional caregivers.













Dementia beyond disease : enhancing well-being
 
Focusing on seven essential domains of well-being, G. Allen Power,  challenges readers to evaluate their attitudes, expectations, and approaches and to embrace new ways of thinking that will lead to better solutions to problems encountered in all types of care settings. Learn how to overturn the prevailing disease-based care practices by emphasizing well-being and the many ways it can be enhanced in people with dementia. See how current care practices chronically erode individual well-being and then discover more dignified and strengths-based alternatives that build it up.


 











Dementia beyond drugs - changing the culture of care
Embracing humanistic, enlightened practices that address all the common challenges in dementia care, this book describes culture change within residential care settings while reducing the administration of psychotropic drugs.
  • a critical look at medication use
  • experiencing the institutional model
  • deeper look at institutionalization
  • introducing the experiential model
  • deinstitutionalizing care environments
 
  • Bingo and bird funerals : meaning and activity in daily life
  • Death of the nursing home?
  • basic interpersonal approaches
  • language and communication
  • general advice for anxiety and agitation
  • ""I want to go home"" :
  • "They're poisoning the food"" : nondrug approaches to paranoia, hallucinations and delusions
 
 

September 16, 2016

Our most popular and useful books for carers

 These resources are available for loan to members of AANSW - if you would like to reserve them please email the Library on nsw.library@alzheimers.org.au



Creating moments of joy : for the person with Alzheimer's or dementia
When a person has short-term memory loss, his life is made up of moments. We are not able to create a perfectly wonderful day with those who have dementia, but it is absolutely attainable to create perfectly wonderful moments—moments that put smiles on their faces, a twinkle in their eyes, or trigger memories. Five minutes later, they won’t remember what you did or said, but the feeling you left them with will linger.



Loving someone who has dementia : how to find hope while coping with stress and grief

Research-based advice for people who care for someone with dementia. It's not about the usual techniques, but about how to manage on-going stress and grief. Dr  Boss helps caregivers find hope in "ambiguous loss" having a loved one both here and not here, physically present but psychologically absent. Outlines seven guidelines to stay resilient while caring for someone who has dementia. Discusses the meaning of relationships with individuals who are cognitively impaired and no longer as they used to be. Offers approaches to understand and cope with the emotional strain of care-giving. Boss's book builds on research and clinical experience, yet the material is presented as a conversation. She shows you a way to embrace rather than resist the ambiguity in your relationship with someone who has dementia.



When a family member has dementia : steps to becoming a resilient caregiver

Caring for a person with dementia is a difficult and often- overwhelming task. In addition to the inevitable decline in memory and physical function, most persons with dementia develop one or more troublesome behaviour problems, such as depression, fearfulness, sleep disturbances, paranoia, or physical aggression at some point in their disease. Behavioural challenges in dementia are highly idiosyncratic. No two patients are alike, and interventions that work well with one person are often ineffective with another. Caregivers often become stuck: either unable to figure out how best to help their loved one, or unable to consistently implement positive practices they know would improve their situation. This book offers caregivers a set of practical and flexible tools to enable them become more resilient in the face of difficulty and change. McCurry teaches caregivers how to take advantage of their own creativity and inner resources to develop strategies that will work in their unique situations. She presents her set of five core principles and then brings them to life through vignettes. Anyone who lives, works, or comes in contact with a person who has dementia will benefit from this volume.














The selfish pig's guide to caring

Be ing a carer is long, lonely and hard, yet there is limited support and formal training. As a result, carers suffer frequent damage to physical and mental health. Oddly, though carers by definition are anything but selfish pigs, they are liable to feelings of guilt, probably brought on by fatigue and isolation. So Hugh Marriott has written this book for them - and also for the rest of us who don’t know what being a carer is all about. His aim is bring into the open everything he wishes he'd been told when he first became a carer. And he does. The book airs such topics as sex, thoughts of murder, and dealing with the responses of friends and officials who fail to understand.


Talking to Alzheimer's : simple ways to connect when you visit with a family member or friendAlzheimer's can have a devastating impact on a patient's close relationships and all too often, family members and friends feel so uncomfortable that they end up dreading visits, or simply give up trying to stay in contact with the patient. This book offers a wealth of practical things you can do to stay connected with the Alzheimer's patient in your life. It offers straightforward suggestions and invaluable do's and don'ts, with advice on everything from dealing effectively with the inevitable repetition that occurs in conversations with an Alzheimer's patient to helpful strategies for saying no to unrealistic demands. It also includes thoughtful tips to remind you to take care of your own feelings and suggestions for helping children become comfortable with visiting.


Mom's OK, she just forgets : the Alzheimer's journey from denial to acceptance
These and similar expressions of denial are often heard in families struggling with the difficult challenges of Alzheimer’s or dementia in a loved one. Denial may seem to be an acceptable coping mechanism when faced with a disease that has no cure. But in fact the failure to accept reality can work against the welfare of the person suffering from a disease that causes dementia, making a bad situation worse for the whole family. Young suggest various behaviours, tools, and techniques for moving beyond denial. Real people who have faced the many problems brought about by Alzheimer’s speak out, with hope, from these pages. They share their journeys from denial to loving action and an improved attitude that helps them deal with their personal plights.















A funny thing happened on the way to the nursing home: a different handbook for carers of dementia patients

This short, funny book- is a series of snapshots rather than a handbook as such. It describes, with a mixture of humour and pathos, some of the experiences of caring for a spouse with dementia, and in so doing imparts practical and useful advice. It is one person's view of how to manage an increasingly common problem, and explains why a sense of humour, and indeed a sense of the ridiculous, are very necessary attributes for surviving the caring process.
 The author's methods of managing his wife's difficult behaviour are excellent examples of lateral quick thinking. Dealing with an imagined visit from a duchess at 2 am, or the urgent need to plant a tree in the middle of the dining room floor, requires a good imagination and fast footwork - it contains some useful ideas for dealing with some of the more difficult behaviours associated with the dementing process.











 
Relate, motivate, appreciate: a Montessori approach : promoting positive interaction with people with dementia
Relate, Motivate, Appreciate model: Relate The person you know has lived a rich and full life. They may have been a parent, spouse, brother, sister, professional, housewife, friend and/or lover. The first and most important step is to be able to relate to and focus on what were their past experiences. Motivate Most of us are motivated by things we enjoy. When considering activities that the person might enjoy, we need to reflect on their past life experience. What activities did they do in the past? For example, did they enjoy: • cooking? – if so, consider pouring or mixing activities • accounting? – counting, writing , gardening? – growing vegetables or flowers • music? – listening, dancing, playing an instrument. Appreciate You may experience feelings of loss and grief for the relationship you once had with the person living with dementia. With these in mind it is important that we try to give the person some confidence and roles back and, in that sense, return some meaning to their lives. The aim should be to enable the person living with dementia to regain control of aspects of their life, through meaningful activities that have a purpose..

September 13, 2016

new issue of - American Journal of Alzheimer's Disease & Other Dementias



Table of Contents

August 2016; 31 (5)

Top of FormArticles are available for loan to members of AANSW - if you would like to request them please email the Library on nsw.library@alzheimers.org.au

Review

A Systematic Review of Metacognitive Differences Between Alzheimer’s Disease and Frontotemporal Dementia

AM J ALZHEIMERS DIS OTHER DEMEN August 2016 31: 381-388,

Clinicians often have difficulty distinguishing between various forms of dementia to achieve a correct diagnosis. Little research has been done to examine whether awareness of one’s cognitive deficits, or metacognitive monitoring, might differ between dementia diagnoses, thereby providing an additional means of differentiating between dementia subtypes. We review articles examining metacognitive comparisons between two of the most common dementia subtypes: Alzheimer’s disease and frontotemporal dementia. Greater monitoring deficits were apparent in frontotemporal dementia than in Alzheimer’s disease, and participants with frontotemporal dementia were less likely to utilize task experience to update and improve the accuracy of subsequent monitoring judgments. Results provide evidence for the utility of metacognitive measures as a means of distinguishing between Alzheimer’s disease and frontotemporal dementia.

Current Topics in Research

 

Association of Dementia and Peptic Ulcer Disease: A Nationwide Population-Based Study

AM J ALZHEIMERS DIS OTHER DEMEN August 2016 31: 389-394,

Objective: We determine the association between dementia and the subsequent peptic ulcer disease (PUD).

Methods: We identified patients with diagnosed dementia in the Taiwan National Health Insurance Research Database. A comparison cohort without dementia was frequency-matched by age, sex, and comorbidities, and the occurrence of PUD was evaluated in both cohorts.

Results: The dementia and control cohort consisted of 6014 patients with dementia and 17 830 frequency-matched patients without dementia, respectively. The incidence of PUD (hazard ratio, 1.27; 95% confidence interval, 1.18-1.37; P < .001) was higher among patients with dementia. Cox models showed that being female, diabetes mellitus, chronic kidney disease, coronary artery disease, and chronic obstructive pulmonary disease were independent risk factors for PUD in patients with dementia.

Conclusion: Dementia might increase the risk of developing PUD.

 

Use of Angiotensin-Converting Enzyme Inhibitors, Angiotensin Receptor Blockers, and Risk of Dementia in Heart Failure

AM J ALZHEIMERS DIS OTHER DEMEN August 2016 31: 395-404,

Objective: To test the effect of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) on reducing the risk of dementia in patients with heart failure (HF).

Methods: This retrospective, longitudinal study used a cohort of HF patients identified from a local Medicare advantage prescription drug plan. Multivariable time-dependent Cox model and marginal structural model using inverse-probability-oftreatment weighting were used to estimate the risk of developing dementia. Adjusted dementia rate ratios were estimated among current and former ACEI/ARB users, as compared with nonusers.

Results: Using the time-dependent Cox model, the adjusted dementia rate ratios (95% confidence-interval) among current and former users were 0.90(0.70-1.16) and 0.89 (0.71-1.10), respectively. Use of marginal structural model resulted in similar effect estimates for current and former users as compared with the nonusers.

Conclusion: This study found no difference in risk of dementia among the current and former users of ACEI/ARB as compared with the nonusers in an already at-risk HF population.

 

Toxicological Differences Between NMDA Receptor Antagonists and Cholinesterase Inhibitors

AM J ALZHEIMERS DIS OTHER DEMEN August 2016 31: 405-412,

Cholinesterase inhibitors (ChEIs), represented by donepezil, rivastigmine, and galantamine, used to be the only approved class of drugs for the treatment of Alzheimer’s disease. After the approval of memantine by the Food and Drug Administration (FDA), N-methyl-d-aspartic acid (NMDA) receptor antagonists have been recognized by authorities and broadly used in the treatment of Alzheimer’s disease. Along with complementary mechanisms of action, NMDA antagonists and ChEIs differ not only in therapeutic effects but also in adverse reactions, which is an important consideration in clinical drug use. And the number of patients using NMDA antagonists and ChEIs concomitantly has increased, making the matter more complicated. Here we used the FDA Adverse Event Reporting System for statistical analysis , in order to compare the adverse events of memantine and ChEIs. In general, the clinical evidence confirmed the safety advantages of memantine over ChEIs, reiterating the precautions of clinical drug use and the future direction of antidementia drug development.

 

Tong Luo Jiu Nao, a Chinese Medicine Formula, Reduces Inflammatory Stress in a Mouse Model of Alzheimer’s Disease

AM J ALZHEIMERS DIS OTHER DEMEN August 2016 31: 413-421, Abstract

Aim: The aim of this study is to extend the molecular mechanism of Tong Luo Jiu Nao (TLJN) for Alzheimer’s disease (AD), which is a modern Chinese formula that has been used to treat AD.

Methods: The senescence-accelerated mouse prone 8 strain (SAMP8) is one of the most appropriate models to study the mechanism that underlies AD. The levels of plasma amyloid β (Aβ) and the Aβ deposits were measured using enzyme-linked immunosorbent assay and immunohistochemistry. Immunoblotting was used to observe the effect of TLJN on inflammatory mediator expression in an senescence-accelerated mouse model of AD.

Results: Our data showed that the TLJN-treated groups exhibited a reduction in plasma Aβ levels and reduced Aβ expression. Moreover, TLJN effectively attenuated Aβ-induced activation of extracellular signal-regulated kinase and c-Jun N-terminal kinases and blocked changes in inflammatory mediator expression.

Conclusion: These data suggest that TLJN might have protective effects and could potentially act to attenuate inflammatory stress in the pathogenesis of AD.

 

Hydrogen Proton Magnetic Resonance Spectroscopy in Multidomain Amnestic Mild Cognitive Impairment and Vascular Cognitive Impairment Without Dementia

AM J ALZHEIMERS DIS OTHER DEMEN August 2016 31: 422-429, To investigate the value of hydrogen proton magnet resonance spectroscopy (1H-MRS) in the differential diagnosis of multiple-domain amnestic mild cognitive impairment (M-aMCI) and vascular cognitive impairment with no dementia (VCIND); 1H-MRS was performed in patients with M-aMCI and VCIND. The level was determined for N-acetylaspartate (NAA), glutamate (Glu), inositol (mI), choline (Cho), and creatine (Cr). Compared with the normal control group, the NAA–Cr ratio in all regions studied was significantly lower in the M-aMCI and VCIND groups. The Glu–Cr ratio in the posterior cingulate gyrus of the M-aMCI group was significantly lower than in the VCIND. The mI–Cr ratio in the frontal white matter of the VCIND was significantly higher than in the M-aMCI group. In the white matter adjacent to the lateral ventricles, the Cho–Cr ratio was significantly higher in the VCIND than the M-aMCI. Our results suggested 1H-MRS is an effective method in the differential diagnosis of M-aMCI and VCIND.

 

Retinal Nerve Fiber Layer Thinning in Alzheimer’s Disease: A Case–Control Study in Comparison to Normal Aging, Parkinson’s Disease, and Non-Alzheimer’s Dementia

AM J ALZHEIMERS DIS OTHER DEMEN August 2016 31: 430-436,

Retinal nerve fiber layer (RNFL) thickness, ganglion cell layer (GCL) thickness, and macular volume (MV) utilizing spectral domain optical coherence tomography (SD-OCT) were compared among patients with Alzheimer’s disease (AD) dementia, non-Alzheimer’s disease (non-AD) dementia, amnestic mild cognitive impairment (aMCI), Parkinson’s disease (PD), and age- and sex-matched controls in a cross-sectional cohort study. A total of 116 participants were diagnosed and evaluated (21 AD, 20 aMCI, 20 non-AD, 20 PD, and 34 controls) after comprehensive neurological, neuropsychology, and magnetic resonance imaging (MRI) volumetric evaluations. Retinal nerve fiber layer thickness, GCL thickness, and MV were measured. Analysis of variance models were used to compare groups on MRI volumetric measures, cognitive test results, and SD-OCT measures. Associations between SD-OCT measures and other measures were performed using mixed-effect models. Spectral domain optical coherence tomography analysis of retinal markers, including RNFL thickness, GCL thickness, and MV, did not differ between amnestic MCI, AD dementia, PD, non-AD, dementia, and age- and sex-matched controls in a well-characterized patient cohort.

Vascular Function in Alzheimer’s Disease and Vascular Dementia

AM J ALZHEIMERS DIS OTHER DEMEN August 2016 31: 437-442,

o    We investigated vascular functioning in patients with a clinical and radiological diagnosis of either Alzheimer’s disease (AD) or vascular dementia (VaD) and examined a possible relationship between vascular function and cognitive status. Twenty-seven patients with AD, 23 patients with VaD, and 26 healthy control patients underwent measurements of flow-mediated dilation (FMD), ankle–brachial index (ABI), cardioankle vascular index (CAVI), and intima–media thickness (IMT). The FMD was significantly lower in patients with AD or VaD compared to controls. There were no significant differences in ABI, CAVI, or IMT among the 3 groups. A significant correlation was found between Mini-Mental State Examination (MMSE) scores and FMD. Furthermore, a multiple regression analysis revealed that FMD was significantly predicted by MMSE scores. These results suggest that endothelial involvement plays a role in AD pathogenesis, and FMD may be more sensitive than other surrogate methods (ABI, CAVI, and IMT) for detecting early-stage atherosclerosis and/or cognitive decline.

 

Cognitive Reserve in Healthy Aging and Alzheimer’s Disease: A Meta-Analysis of fMRI Studies

AM J ALZHEIMERS DIS OTHER DEMEN August 2016 31: 443-449,

Cognitive reserve (CR) has been defined as the ability to optimize or maximize performance through differential recruitment of brain networks. In the present study, we aimed at providing evidence for a consistent brain network underpinning CR in healthy and pathological aging. To pursue this aim, we performed a coordinate-based meta-analysis of 17 functional magnetic resonance imaging studies on CR proxies in healthy aging, Alzheimer’s disease (AD), and mild cognitive impairment (MCI). We found that different brain areas were associated with CR proxies in healthy and pathological aging. A wide network of areas, including medial and lateral frontal areas, that is, anterior cingulate cortex and dorsolateral prefrontal cortex, as well as precuneus, was associated with proxies of CR in healthy elderly patients. The CR proxies in patients with AD and amnesic-MCI were associated with activation in the anterior cingulate cortex. These results were discussed hypothesizing the existence of possible compensatory mechanisms in healthy and pathological aging.

 

Family History of Alzheimer’s Disease and Cortical Thickness in Patients With Dementia

AM J ALZHEIMERS DIS OTHER DEMEN August 2016 31: 450-456,

A first-degree family history of Alzheimer’s disease reflects genetic risks for the neurodegenerative disorder. Recent imaging data suggest localized effects of genetic risks on brain structure in healthy people. It is unknown whether this association can also be found in patients who already have dementia. Our aim was to investigate whether family history risk modulates regional medial temporal lobe cortical thickness in patients with Alzheimer’s disease. We performed high-resolution magnetic resonance imaging and cortical unfolding data analysis on 54 patients and 53 nondemented individuals. A first-degree family history of Alzheimer’s disease was associated with left hemispheric cortical thinning in the subiculum among patients and controls. The contribution of Alzheimer’s disease family history to regional brain anatomy changes independent of cognitive impairment may reflect genetic risks that modulate onset and clinical course of the disease.

Opinions and Controversies

Relation of Poor Memory to Soluble Tumor Necrosis Factor Receptor Type Two (sTNF-RII)

AM J ALZHEIMERS DIS OTHER DEMEN August 2016 31: 457-458,

The association of soluble tumor necrosis factor receptor type two with poor memory in patients with breast cancer and controls found by Patel et al (2015) may confirm the finding of Holmes et al in 2009 that tumor necrosis factor α is linked to cognitive decline.

 

September 09, 2016

book review - A leader’s manual for seniors’ discussion groups - ‘LIFE’S LITTLE LESSONS’



A leader’s manual for seniors’ discussion groups
by Lauretta Kaldor

Topics included -technology, advertising, electric car, time capsule of the 1950’s,special moments, multicultural Australia best movies, food tastes, reading for pleasure and more!
                                                              REVIEW
‘LIFE’S  LITTLE   LESSONS’
 
                                    A leaders Manual for Senior’s Discussion Groups
                                                                        By
                                                        LAURETTA  KALDOR
 
 
Diversional Therapist Lauretta Kaldor has published a new manual which every Diversional Therapist, Recreational Activities Officer and staff working in Aged Care, and Community and Day centres will find useful and a valuable addition to their resources.
 
Lauretta,  who has been working as a Diversional Therapist for over 30 years has used not only her skills but her extensive experience to put together the manual entitled
“Life’s Little Lessons” – A leaders Manual for Senior’s Discussion Groups.
Whilst it is aimed at group work, each topic is equally suitable for 1-1 sessions with individual clients
 
There are 21 topics for discussion and all allow for varying levels of education.   They are designed to encourage intelligent debate and engagement.
 
In reviewing this publication I found the directions set out in the first pages helpful.   Lauretta has written each topic as a mini lecture, some of which come with a trivia quiz which provide mental stimulation and encourage social inter-action.   This is particularly valuable for clients attending a day centre who may require social stimulation.
 
The topics promote and stimulate memory recall, so important for those who are ageing and whose social opportunities and activities may be reduced due to poor mobility, cognitive impairment an/or sensory loss.
 
Lauretta points out
 “your audience will probably be people from 60-95 (or Older) and have varying cognitive abilities.   People with early memory loss may have some problems joining in but it is essential to make the session inclusive.......”
 
All of the topics in the manual are relevant to most if not all clients and are sure to stimulate memories.
Reminiscence is an effective tool when used in group situations.  Sharing their life experiences and wisdom validate lives of older people and enhances self-esteem
These clients have much to share and deserve the opportunity to be heard 
This manual and the selected topics provide this opportunity and is a valuable resource for anyone leading a group or who is working 1-1 with an individual client.
 
Reviewed by
Janet Godsell   Diversional Therapist       11/8/2016

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