Understanding Dementia Stages Reduces Fear
Social & Mental Health: Creating great memories

Understanding Dementia Stages Reduces Fear

Dementia can be such a confusing disease because it progresses gradually, with subtle changes that may not be immediately apparent. I've had patients newly diagnosed with dementia, and without spending time with them, it's hard to notice any signs. Conversely, in later stages, the symptoms are unmistakable, making communication a significant challenge.

The best approach with someone in the early stages is to ask them to share what they can and cannot understand and to let you know when they are confused or need time to think before responding. Many people mistakenly assume that when an older adult doesn’t answer right away, they didn't hear the question. In reality, they may be processing the information and recalling what they need before answering. This assumption can lead to unnecessary interventions like hearing aids or misdiagnoses when it could be early-stage dementia.

I recently read an article titled "The Do's and Don'ts of Dementia," which I found somewhat misleading as it didn’t address the different stages of dementia. Effective communication requires understanding the individual's level and considering any emotional strain. While the overall tips were helpful, they might be inappropriate for those in the early stages but suitable for those in the later stages.

So, let's explore the stages of dementia before diving into the do's and don'ts. According to the Alzheimer’s Association, there are three stages:

Early Stage (Mild)

In the early stage, individuals may experience mild cognitive decline, often unnoticed by friends and family. They may have memory lapses, but daily functioning remains generally intact. Common difficulties include:

  • Memory loss.
  • Difficulty planning and organizing.
  • Finding the right word or name.
  • Confusion with time, place, dates, or events.
  • Difficulty performing tasks in social or work settings.
  • Mood or personality changes.

Note: Many of these issues can also occur when we are tired or overstressed, so they are not exclusive to dementia.

Middle Stage (Moderate)

The middle stage is marked by more noticeable cognitive decline. Memory loss becomes more apparent, and individuals may struggle with tasks such as managing finances, remembering names and faces, and organizing thoughts. Behavioral changes like confusion and frustration may also emerge. In this stage, you might see:

  • Increased memory loss.
  • Forgetfulness of events or personal history.
  • Moodiness or withdrawal.
  • Difficulty recalling personal information like addresses or phone numbers.
  • Confusion about location or time.
  • Problems recognizing objects and their use.
  • Difficulty making decisions.
  • Trouble with clothing choices and personal hygiene.
  • Incontinence.
  • Sleepless nights.
  • Personality and behavioral changes, including suspiciousness, delusions, or repetitive behaviors.

This stage can last for years, and it’s crucial to have regular check-ins to monitor subtle changes. Someone visiting every three months can often notice declines that daily caregivers might miss.

Late Stage (Severe)

In the late stage, individuals experience significant cognitive decline and a profound impact on daily functioning. Characteristics of this stage include:

  • Profound memory loss.
  • Loss of language, though they may still recognize their name or familiar music.
  • Loss of motor skills, requiring full-time assistance with daily activities.
  • Loss of awareness of recent experiences and surroundings.
  • Inability to recognize familiar people.
  • Difficulty swallowing.
  • Changes in sleep patterns.
  • Increased vulnerability to infections, especially pneumonia.

Care in the late stages must be compassionate and comforting. Enlisting the help of a palliative care expert can guide caregivers through their own self-care and ensure the safety and comfort of the person with dementia.

If you or someone you care for has been diagnosed with dementia, it’s crucial to prepare for these changes in advance. As seniors, we should start conversations early to avoid confusion later. My new FREE guide, The Super Ager's Starter Guide, addresses this very thing. Check out the questions on pages 12-13 to clear up any confusing conversations now, setting a foundation for better communication as the disease progresses.

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preventing dementia
Social & Mental Health: Creating great memories

21 Powerful Ways to Protect Your Brain from Dementia

Are You at Risk for Dementia? Here’s How to Fight Back

As we get older, our risk of developing dementia goes up. For people between 65 and 69 years old, about 2 in every 100 have dementia. In the 90s? Then dementia shows up 33 out of 100 people. This can be pretty scary, but there’s hope. Early diagnosis and making some changes can help slow down dementia.

Can You Slow Down Dementia if Caught Early?

Getting diagnosed early and having access to the right services can help people manage their condition better. It allows them to plan for the future and live well despite the challenges.

21 Ways to Lower Your Risk of Dementia

1. Smoking

If you’ve quit smoking, great job! If someone in your family smokes, they should do it outside and wear a jacket they can take off before coming back in. Secondhand smoke is harmful too.

2. Diabetes

Is your diabetes under control? There are new medications and specialists who can help you keep your blood sugar levels normal. Make sure your doctor is on top of this.

3. Physical Inactivity

You don’t need to run a marathon. Just move your body at least three times a week. Walk, stretch, or do some light yoga. The key is to keep moving!

4. Drinking Alcohol

Limit your drinking to no more than two drinks, twice a week. It’s perfectly okay to choose water with lemon instead.

5. Brain Injury

Have any head injuries checked by a doctor. Even bumps from childhood can be significant.

6. Hypertension

High blood pressure can lead to heart problems and strokes. Cut down on salt and keep your blood pressure in check.

7. Obesity

Are you happy with your weight? Dieting is hard with all the tempting food around, but sticking to a meal plan can help. I follow a consistent diet but allow myself a few cheat meals each week and have lost over 30 pounds!

8. Hearing Impairment

If people tell you the TV is too loud or that you’re shouting, get your hearing checked. Costco offers good hearing tests.

9. Aging

We can’t stop aging, but we can aim to age healthily and actively.

10. Air Pollutants

Air out your house at least once a month, especially the basement, to reduce allergens.

11. Depression

If you’re on antidepressants or see a counselor, make sure your medication isn’t linked to dementia.

12. Atherosclerosis

Eat a healthy diet full of protein, low fat, and minimal sugar, mainly from fruits and veggies.

13. Cholesterol

Avoid processed foods and shop around the edges of the grocery store for fresh produce and healthier options.

14. Diet

Find a food plan that works for you, practice portion control, and avoid fasting as it can slow your metabolism.

15. Genes

You can’t change your genes, but be aware of your family’s health habits. These are their habits, not your genes.

16. Sleep

Get 7-8 hours of sleep each night on a comfortable mattress. Good sleep is essential for brain health.

17. Cardiovascular Risk Factors

Make sure your diet and physical activity keep your heart in good shape.

18. Chronic Diseases

Manage any chronic diseases well. This is crucial for reducing dementia risk.

19. Mild Cognitive Impairment

We all forget things sometimes, especially under stress. Work on balancing your days to minimize stress.

20. Family History

You can’t change your family’s health history, but you can learn from it and take better care of yourself.

21. Loneliness

Stay active and social. Even small outings or talking to someone in a store can help keep your mind engaged.

Starter Tips to Lower Your Risk

  1. Move Regularly: Aim for at least 30 minutes of physical activity, like walking or stretching, three times a week.
  2. Eat Healthily: Follow a balanced diet rich in fruits, vegetables, lean proteins, and whole grains while avoiding processed foods.
  3. Stay Social: Engage in social activities, join clubs, or simply chat with friends and family to keep your brain active and healthy.

If you’re concerned about dementia or have specific questions, talk to a healthcare professional. If you don’t get the answers you need, ask to see a neurologist for further testing. Catching dementia early can make a big difference, but preventing it? Priceless!

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Vitamin D Slash Dementia Risk by 40%
Social & Mental Health: Creating great memories

Vitamin D Slash Dementia Risk by 40%: New Study Links Supplements to Lower Rates

Recently Medical News Today reviewed a new study:

Over 55 million people live with dementia worldwide, which is expected to rise to 139 million by 2050, Interventions that can affect dementia risk factors are being explored to slow disease progression. One such risk factor is vitamin D deficiency.

Some studies have found that vitamin D may aid the clearance of amyloid beta aggregates—one of the hallmarks of Alzheimer’s disease (AD). However, studies have produced conflicting results on whether vitamin D improves cognitive function.

Other studies show that low vitamin D levels are linked to a greater risk of dementia and AD.

It has been known for years that perhaps Vitamin D was originally mislabeled.  In light of new evidence, Vitamin D may act as a hormone. This means it is used to regulate our biology or chemical reactions instead of just acting as a supplement. It is shown to have multiple functions throughout the brain. WARNING: Vitamin D can become toxic if taken in larger than recommended doses. 

Recently, researchers assessed the link between vitamin D supplementation and incident dementia. They found that vitamin D supplementation is linked to lower incidence of dementia.

The study was published in Alzheimer’s and Dementia: Diagnosis, Assessment & Disease Monitoring

Testing 3 types of vitamin D

For the study, the researchers analyzed data from 12,388 people from the National Alzheimer’s Coordinating Center, who were dementia-free at the start of the study. Their average age was 71 years old.

Altogether, 37% of the cohort took at least one of three vitamin D supplements: calcium-vitamin D, cholecalciferol, and ergocalciferol. These researchers also evaluated folks for depression and other genetic predisposing factors. 

5 years later...

After five years, the researchers found that 83.6% of those exposed to vitamin D supplements were alive and dementia-free. The same was true for 68.4% of those not exposed to vitamin D.

Next 10 years...

Within 10 years, the researchers found that 22% of participants developed dementia, of that percent, 74.8% were not exposed to vitamin D supplements.

After adjusting for factors mentioned above,, they found that vitamin D exposure was linked to a 40% lower incidence of dementia compared to no exposure.

Women see more benefit

The effects were strongest among women: women exposed to vitamin D were 49% less likely to develop dementia than those without exposure. Vitamin D-exposed men were 26% less likely to develop dementia than non-exposed men.

The researchers also found that depression was linked to a 35% higher incidence of dementia.

While findings were consistent for each vitamin D formulation, they noted that vitamin D supplements had the greatest effects on individuals with normal cognition.

How Vitamin D may help dementia 

When asked how vitamin D supplements may be linked to lower dementia incidence, Dr. Dario Zagar, associate professor at Yale School of Medicine, who was not involved in the study, told MNT:

“Prior studies have shown that low vitamin D levels are a risk factor for developing dementia, such as AD [Alzheimer’s disease]. Vitamin D has many functions in the body besides maintaining bone health, which is what most people think of.

”From the standpoint of memory disorders, vitamin D plays a role in clearing a protein called beta-amyloid, which accumulates in the brain in people with AD. It may also help to protect nerve cells from injury, including from other abnormal proteins that play a role in dementia.”— Dr. Dario Zagar

Dr. Jacob Teitelbaum, a board-certified internist and author of books including From Fatigued to Fantastic!, who was not involved in the study, said immunity might be involved behind vitamin D’s benefits for dementia:

“My suspicion is that if vitamin D lowers dementia risk, it does so by balancing immunity. It is suspected that amyloid deposition may simply be a response to excess inflammation, being like a ‘band-aid’ that the body puts on brain inflammation. If so, this would account for why women are one-third more likely to get Alzheimer’s.”

Dr. Teitelbaum also touched on the reasons behind the finding that women were more likely to benefit from vitamin D supplements.

“Women are much more prone to autoimmune conditions, being three times more likely to have lupus, rheumatoid arthritis, fibromyalgia, and a host of other immune and autoimmune problems,” he told MNT.

“It is suspected that this is because a woman’s immune system is different from a man’s. A woman has 2 X chromosomes, whereas a man only has one. And much of the genes regulating immunity are on the X chromosome,” he explained.

“So that women were more likely to benefit from vitamin D in the study suggests that it helped balance immunity, and that it was actually taking the vitamin D that caused the benefit,” he noted.

Short term vs long-term inflammation

Inflammation is a key aspect of the body’s immune defenses. It can be acute or chronic. Symptoms can include swelling, heat, pain, redness, and more. Treatments can depend on the underlying cause.

Acute Inflammation

Basically this comes on quick and has a short duration so it doesn't damage the tissues for so long that they can never recover. 

Chronic inflammation

Experts believe inflammation may contribute to a wide range of chronic diseases. Examples of these are metabolic syndrome, which includes type 2 diabetes, heart disease, and obesity.

People with these conditions often have higher levels of inflammatory markers in their bodies.

Chronic inflammation if a person has:

  • Sensitivity: Inflammation happens when the body senses something that should not be there. Hypersensitivity to an external trigger can result in an allergy.
  • Exposure: Sometimes, long-term, low-level exposure to an irritant, such as an industrial chemical, can result in chronic inflammation.
  • Autoimmune disorders: The immune system mistakenly attacks normal healthy tissue, as in psoriasis.
  • Autoinflammatory diseases: A genetic factor affects the way the immune system works, as in Behçet’s disease.
  • Persistent acute inflammation: In some cases, a person may not fully recover from acute inflammation. Sometimes, this can lead to chronic inflammation.

Factors that may increase the risk of chronic inflammation include:

  • older age
  • obesity
  • a diet that is rich in unhealthy fats and added sugar
  • smoking
  • low sex hormones
  • stress
  • sleep problems

Long-term diseases that doctors associate with inflammation include:

  • asthma
  • chronic peptic ulcer
  • tuberculosis
  • rheumatoid arthritis
  • periodontitis
  • ulcerative colitis and Crohn’s disease
  • sinusitis
  • active hepatitis

Inflammation plays a vital role in healing, but chronic inflammation may increase the risk of various diseases, including some cancers, rheumatoid arthritis, atherosclerosis, periodontitis, and hay fever.

Chronic inflammation can lead to tissue death, thickening, and scarring of connective tissue.

So, look at the things you can control, like diet, exercise, stress, and a good night's sleep.  Ask your doctor about Vitamin D and how much you should be taking. And don't forget to know the side effects of toxicity so you can recognize it right away! 

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staying mentally healthy
Social & Mental Health: Creating great memories

My Journey Keeping My Parents Mentally Active

[Every once and awhile a member writes in and shares their amazing story of a journey they took through the rough terrain of caregiving.  I cannot begin to express what I felt when I read her experience so with her permission, here it is...]

"For most of us, watching our parents age is a natural part of life. But it can also be a time of worry, especially when it comes to their cognitive health. Like many families, I started noticing some concerning changes in my own parents. My forgetful but ever-punctual dad was occasionally missing appointments. My normally social mom seemed content to spend most days at home. These subtle shifts sparked a fire in me – I wouldn't let their minds fade without a fight.

My initial fears mirrored many caregivers' concerns. "Forgetting Things" became a reality. Dad misplaced his keys more often, and Mom struggled recalling details from recent conversations. This forgetfulness wasn't just inconvenient, it hinted at a deeper issue. The possibility of them "Needing More Help" loomed large. Managing finances, remembering medications – tasks they handled effortlessly were becoming a source of stress. I envisioned the burden this could place on our family, potentially leading to "Feeling Lonely" and isolation for my parents.

But fear wouldn't solve anything. I knew I had to overcome my own limiting beliefs. "I want to encourage my parents to try new activities," I thought, "but what if they're not interested?" This was a common concern. "Brain-training games" might seem childish to them, and suggesting them could feel patronizing. Social outings, while beneficial, could be overwhelming. Technology, a potential goldmine of mental stimulation, might be intimidating for them to learn. Even involving them in daily decisions, a strategy to keep them engaged, could lead to resistance.

However, I replaced those doubts with a new perspective. "Dad's so set in his ways" became an opportunity to discover new interests together. "He might get frustrated" became a chance for me to offer patient support. "I barely have time" became a call for creative solutions and shared responsibility with siblings. And "it scares me to see him struggle" became a motivator to find ways to empower him, not coddle him.

With newfound resolve, I embarked on a mission to keep my parents' minds sharp. The key? Making it fun and engaging. Instead of forcing brain-training games, I found brain teasers disguised as crossword puzzles in the newspaper, or trivia nights at a local restaurant. We dusted off old board games, turning game night into a family tradition. Learning a new language felt daunting, so we started with simple apps that focused on vocabulary related to their hobbies. For social interaction, we joined a walking group that catered to seniors, combining exercise with conversation. Technology remained a hurdle, but with small steps, we mastered basic online tasks like checking email or video chatting with friends.

The results have been nothing short of amazing. My parents' memory has shown improvement. Dad rarely loses his keys anymore, and Mom can easily recall details from conversations. More importantly, they're engaged and active. They look forward to game nights and walking group outings. Technology, once a barrier, has become a tool to connect with friends and family who live far away.

But the biggest reward? Our family bond has grown stronger. These activities have become shared experiences, creating new memories and laughter. They feel empowered by their continued mental agility, and their sense of independence and self-worth has soared.

This journey hasn't been without its challenges. There were days of frustration and moments of resistance. But by focusing on fun, finding creative solutions, and celebrating small victories, we've navigated those bumps in the road.

My experience isn't unique. Many of my friends face similar challenges. Sure, it's easier to attend to their bath, hygiene, or meal preps, but their cognitive health? Well, it's a lot more effort. Tell your members to not give up!  Here are some nuggets my friends and I found easy to tackle:

  • Focus on Fun: Frame activities as enjoyable experiences, not just mental exercises.
  • Start Small: Don't overwhelm them – introduce new things gradually.
  • Find Common Ground: Tailor activities to their interests and hobbies.
  • Celebrate Victories: Acknowledge and celebrate even small improvements.
  • Be Patient & Supportive: There will be setbacks, offer encouragement and support.
  • Seek Help & Resources: Talk to their doctor, research online resources, or join support groups with them."
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Social & Mental Health: Creating great memories

When Seniors Don’t Eat: 3 Facts You Have to Look At First

Can I let you in on a little secret?

If you’re stressing over your mom or dad not eating, you’re not alone. You can’t figure out what’s wrong. You cook for them. You prepare their favorite foods. You ask them what they would like. When it’s put in front of them., they just sit there.

You then let them eat whatever they want and still…they don’t eat.

As you worry about their health and nutrition, you begin to feel helpless. You start to second-guess yourself. Maybe, you think, I’m not the best person for this. Maybe she eats for others but not you. 

You really don’t have time to sit and feed them. Is it your company they really want?  Is that why they wait for you?

Perhaps she really doesn’t know what she likes or doesn’t like anymore. 

You find yourself saying, “It’s such a chore. I dread this time of the day.”  

Now what?

I know how you feel.  I spent years helping sons and daughters just like yourselves.  One daughter came into the office and just burst into tears when she saw her mom’s weight on my scale.  Mom has lost another 3 pounds. 

She was becoming frail and weak. There was no doubt in my mind that her daughter loved and worried about her mom.  Mom was not trying to hurt her daughter. She just was not eating and we had to figure out why. 

How to get them to eat

Fast forward six weeks later. We covered the 22 items in this eBook.  Together mom, daughter, and I formed a team. We reached out to others who could help. As we went through and eliminated each of these 22 items, we finally figured out why Mom (my patient) wasn’t eating. 

I saw a change in this daughter, too.  She no longer felt it was her fault. She rid herself of worry. She felt confident and with the courage I rarely see, she pressed on to find a solution both mom and she could live with. Seeing her smile again made me realize why I loved medicine so much.

3 Facts You Want to Understand

Because I know this is a common occurrence, this not eating, refusing to eat, and the frustration and worry that comes through every family member who cares for their seniors, I want to share with you 3 things you need to understand. 

  1. This is not your senior's fault or your fault. Seniors do not intentionally get up every morning and think, “I’m going to make my son or daughter’s life miserable today by not eating.”  They truly want to please you.  It’s just that food is not in their “joy” category. 

Once you realize this is not on you, you will begin to feel a weight off your shoulders. You will come to understand that this is your senior’s choice.  Yes, she may eat for others but not for you, but that has nothing to do with you. It’s her own world and she enjoys where she’s at so let it go. You’re not going to change it from the outside looking in. We’re going to change it through the inside looking out. And her doctor can help you do this.

  1. Seniors lose their taste buds. This is also true of their hearing and sight.  It may even be true in their balance. But we notice these latter things more.  We don’t think about the taste buds becoming compromised. So now that you know this, ask yourself this, “Do you blame yourself for their loss of eyesight or hearing?”  Of course not! So there you are. Know that we can work around this and find what works and how it works for you and your senior. 
  1. I find that most seniors looked like they were losing weight but in reality, their body shape was just changing. What was once broad shoulders were now sagging. What was once eating with our backs straight is now stooped over. Clothes no longer fit properly. Pants sagged where there was once a backside. Blouses that fit nicely are now failing forward. And food? There just seemed to be more on their clothes and the floor than there needed to be. 

Your Road to Success

So we knew, once again, that this was only about change, not food. It was such a feeling of relief to know that as family caregivers we are not the ones who need to worry. This is all part of a process bringing us to the scary edge of our own worry and frustration. 

So now that we have these facts out of the way, let’s look at why they are not eating in a new light. 

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Is it memory loss or depression
Social & Mental Health: Creating great memories

Is it Memory Loss or Depression?

There can be subtle differences between memory loss and depression, but treatments will vary a lot. First, we have to look at the causes and see if any of these pertain to you.  Then we will look at the signs and symptoms and see if you are experiencing any of these. 

Let’s dive into the causes of depression or memory loss.

Causes of memory loss:

Normal Aging: These memory changes are typically mild and don't interfere significantly with daily life.

Stress and Anxiety: When our minds are preoccupied with worries or under high levels of stress, it can be challenging to concentrate and encode new information effectively.

Sleep Deprivation: During sleep, the brain consolidates and stores memories, so insufficient sleep can impair this process, leading to memory deficits.

Nutritional Deficiencies: Certain vitamins and minerals, such as vitamin B12 and folate, are essential for brain health and memory function.

Medication Side Effects: Some medications, particularly those that affect the central nervous system, can have side effects that impair memory. 

Alcohol and Substance Abuse: Excessive alcohol consumption and substance abuse can lead to memory impairment. 

Underlying Medical Conditions: Certain medical conditions can cause memory loss as a symptom. These may include: Alzheimer's Disease and other Dementias, Tumors, and Mental Health Disorders like depression, bipolar disorder, and schizophrenia can affect memory.

Causes of depression:

Brain Chemistry: Imbalances in neurotransmitters, such as serotonin, dopamine, and norepinephrine.

Genetic Factors: Depression tends to run in families, suggesting a genetic component. 

Biological Factors: Certain medical conditions, such as thyroid disorders, chronic illnesses, hormonal imbalances, and neurological conditions.

Psychological Factors: Past traumatic experiences, abuse, neglect, or other adverse childhood events can increase vulnerability to depression later in life. 

Stress and Anxiety: Ongoing stress, relationship difficulties, financial problems, or significant life changes (e.g., loss of a loved one, job loss, divorce)

Personality Traits: Certain personality traits, such as pessimism, low self-esteem, perfectionism, or a tendency to worry excessively.

Social and Environmental Factors: Social isolation, lack of social support, or living in a stressful or abusive environment can contribute to feelings of loneliness, hopelessness, and despair, increasing the risk of depression. 

Alcohol and Substance Abuse: Substance abuse and addiction can often co-occur with depression. 

Hormonal Changes: Fluctuations in hormones, such as those occurring during puberty, pregnancy, menopause, or certain medical conditions (e.g., polycystic ovary syndrome, thyroid disorders).

You will see that some causes are found in both memory loss and depression. Write down which ones pertain to you. 

Now let’s dive into the symptoms and either rule out depression or memory loss.

Signs or Symptoms of Memory Loss:

Forgetfulness: Forgetting recently learned information or important dates, events, or appointments is a common sign of memory loss. 

Difficulty Concentrating: Memory loss can make it challenging to maintain focus or concentrate on tasks. Individuals may have trouble following conversations, reading, or completing tasks that require sustained attention.

Misplacing Items: Memory loss may lead to frequently misplacing objects or putting them in unusual places. 

Confusion: Memory loss can cause confusion, especially in unfamiliar or complex situations. Individuals may become disoriented, have difficulty following instructions, or struggle to recognize familiar places or faces.

Struggling to Recall Words: Difficulty finding the right words or experiencing word-finding difficulties during conversations can be a sign of memory loss. 

Signs or Symptoms of Depression:

Persistent Sadness or Hopelessness: Feeling persistently sad, empty, or hopeless, regardless of circumstances, is a hallmark symptom of depression. This emotional state may linger for weeks or months and can significantly impact daily functioning.

Loss of Interest or Pleasure: Individuals may no longer find pleasure in activities they used to enjoy.

Changes in Sleep Patterns: Depression can affect sleep patterns, leading to either insomnia (difficulty falling or staying asleep) or hypersomnia (excessive sleeping). Sleep disturbances may worsen mood and energy levels.

Fatigue or Loss of Energy: Feeling persistently tired, lethargic, or physically drained, even after adequate rest, is another symptom of depression.

Difficulty Concentrating or Making Decisions: Depression can impair concentration, remembering details, or making decisions.

You will see that some causes are found in both memory loss and depression. Write down which ones pertain to you. 

So which is it?

Show this blog to your primary care physician and point out the ones you that pertain to you. They will first look at the medications you are on to see if any of these could be causing memory loss or depression. 

They will then ask you about the ones you have written down so they can get a better idea and diagnosis. Once the diagnosis is determined, memory loss or depression, they will treat with what they and YOU feel is best. 

NOTE:  If you have concerns about this being a form of dementia or Alzheimer’s Disease, see my article February 8, 2024, Memory Loss vs Dementia: A Guide for Seniors and Caregivers.

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Parkinson's Disease
Social & Mental Health: Creating great memories

Parkinson’s Disease (April is Awareness Month)

Let’s look at everything you need to know about Parkinson’s Disease. 

Parkinson's disease is a progressive* neurological disorder that affects movement. It develops gradually, and the signs and symptoms can vary from person to person.

You must know these 3 facts about Parkinson's Disease so you can easily recognize it and get immediate treatment.   

  1. If you see these signs and symptoms, you will keep a journal and then contact your physician. 
  2. Here is also a list of items the neurologist will perform based on the signs and symptoms you discuss with them. 
  3. Then we will look at the stages of Parkinson’s Disease and move on to the medications you or your loved ones may be placed on.

Signs & Symptoms of Parkinson's Disease

Tremor: One of the most recognizable symptoms of Parkinson's is a tremor or shaking, usually starting in the hands or fingers. The tremor often occurs when the affected limb is at rest and may decrease or disappear with movement.

Bradykinesia: This refers to slowness of movement. People with Parkinson's disease may find it difficult to initiate and execute movements. Simple tasks such as buttoning a shirt or walking may become slow and challenging.

Muscle rigidity: Stiffness or rigidity in the muscles can occur in any part of the body. It can cause discomfort and limit the range of motion, making it difficult to perform daily activities.

Postural instability: Parkinson's disease can affect balance and coordination, leading to difficulties with posture and an increased risk of falls. People with Parkinson's may have trouble maintaining their balance while standing or walking.

Impaired coordination: Coordination problems may arise as Parkinson's progresses, making it harder to perform tasks that require precise movements, such as writing or typing.

Speech changes: Parkinson's can affect speech by causing slurring, softness, or monotone. Some individuals may also experience difficulty in initiating speech or a decrease in voice volume.

Mask-like expression: Reduced facial expressions, also known as hypomimia or "masked face," is another common symptom of Parkinson's disease. This can make the affected person appear expressionless or less animated.

Micrographia: Handwriting may become smaller and more cramped, a condition known as micrographia, which can make writing difficult to read.

Freezing episodes: Some individuals with Parkinson's may experience freezing episodes, where they feel as if their feet are glued to the floor and have difficulty initiating movement, especially when starting to walk or turning.

Non-motor symptoms: Parkinson's disease can also cause non-motor symptoms, including cognitive changes (such as difficulty with memory and concentration), mood disorders (such as depression and anxiety), sleep disturbances, constipation, loss of sense of smell (anosmia), and urinary problems.

Diagnosis Criteria - what the neurologist should do!

Neurological Examination: A thorough neurological examination by a healthcare professional, often a neurologist specializing in movement disorders, is crucial for evaluating the presence and severity of motor symptoms associated with Parkinson's disease, such as tremor, bradykinesia (slowness of movement), muscle rigidity, and postural instability.

Medical History Review: A detailed review of the patient's medical history is essential to identify any symptoms suggestive of Parkinson's disease, as well as to evaluate for potential risk factors and other medical conditions that could contribute to or mimic Parkinsonian symptoms.

Response to Levodopa Challenge: In some cases, a trial of levodopa medication may be conducted to assess the patient's response to treatment. Improvement in motor symptoms following administration of levodopa can support a diagnosis of Parkinson's disease.

DaTscan Imaging: DaTscan is a type of nuclear medicine imaging test that can help differentiate Parkinson's disease from other conditions that cause similar symptoms, such as essential tremor or drug-induced parkinsonism. It works by measuring dopamine transporter levels in the brain, which are typically reduced in Parkinson's disease.

MRI or CT Scans: Magnetic resonance imaging (MRI) or computed tomography (CT) scans of the brain may be performed to evaluate for structural abnormalities or other conditions that could cause Parkinsonian symptoms. While these imaging tests are not typically diagnostic of Parkinson's disease, they can help rule out other potential causes of symptoms.

Blood Tests: Blood tests may be ordered to assess for specific biomarkers associated with Parkinson's disease or to rule out other medical conditions that could contribute to similar symptoms.

Other Assessments: Additional assessments, such as neuropsychological testing to evaluate cognitive function, autonomic function testing, and sleep studies, may be conducted to assess for non-motor symptoms commonly associated with Parkinson's disease.

It's important to note that the diagnostic process for Parkinson's disease can vary depending on the individual patient's symptoms, medical history, and the expertise of the healthcare provider.

A very thorough evaluation by a neurologist or movement disorder specialist is typically recommended for accurate diagnosis and appropriate management of Parkinson's disease. Early diagnosis and intervention can help improve outcomes and quality of life for individuals living with Parkinson's disease.

Which Stage Am I?

Parkinson's disease is a progressive neurological disorder that typically progresses through stages, although the rate and severity of progression can vary widely among individuals. While there is no universally agreed-upon staging system for Parkinson's disease, healthcare professionals often use the Hoehn and Yahr scale or the Unified Parkinson's Disease Rating Scale (UPDRS) to assess and categorize the progression of the disease.

Here's a general overview of the stages commonly observed in Parkinson's disease:

  • Stage 1 - Mild: In the early stage of Parkinson's disease, symptoms are typically mild and may be subtle or easily overlooked. Common motor symptoms, such as tremors, bradykinesia (slowness of movement), and mild muscle rigidity, may be present but are usually not disabling. Symptoms are often confined to one side of the body (asymmetrical).
  • Stage 2 - Moderate: As Parkinson's disease progresses, symptoms become more pronounced and may begin to affect both sides of the body (symmetrical). Bradykinesia, rigidity, and tremor may worsen, making daily activities more challenging. Postural instability may also begin to develop, increasing the risk of falls. 
  • Stage 3 - Moderate to Severe: In stage 3, motor symptoms become significantly more pronounced, and balance and coordination problems become more apparent. Patients may experience more frequent falls and difficulty with activities such as walking and maintaining balance. However, individuals in stage 3 can still typically perform daily tasks independently with some difficulty.
  • Stage 4 - Severe: Stage 4 is characterized by severe motor symptoms and functional limitations. Patients may require assistance with activities of daily living (ADLs), such as dressing, bathing, and mobility. Postural instability and gait disturbances are prominent, increasing the risk of falls and injuries.
  • Stage 5 - Advanced: The most advanced stage of Parkinson's disease is marked by severe motor symptoms and significant disability. Patients may be unable to walk or stand unassisted and may require a wheelchair or assistance for mobility. Cognitive impairment and other non-motor symptoms, such as dementia, hallucinations, and behavioral changes, may also become more prominent in this stage.

It's important to note that while this staging framework provides a general overview of the progression of Parkinson's disease, not all individuals will experience the same symptoms or progress through the stages at the same rate. Additionally, advancements in treatment and management strategies, such as medication, physical therapy, and surgical interventions, can help alleviate symptoms and improve the quality of life at any stage of the disease. A healthcare professional, typically a neurologist specializing in movement disorders, can provide personalized guidance and support throughout the course of Parkinson's disease.

Medications

Parkinson's disease is typically managed through a combination of medications, lifestyle modifications, and sometimes surgical interventions. The choice of medication and treatment approach depends on the individual's symptoms, disease stage, and overall health.

Here are some common medications used to treat Parkinson's disease:

Levodopa (L-DOPA): Levodopa is the most effective medication for managing the motor symptoms of Parkinson's disease, particularly bradykinesia and rigidity. Levodopa is converted into dopamine in the brain, replenishing dopamine levels depleted in Parkinson's disease. It is often combined with carbidopa (a peripheral decarboxylase inhibitor) to prevent levodopa breakdown in the bloodstream before it reaches the brain, increasing its effectiveness and reducing side effects such as nausea.

Dopamine Agonists: Dopamine agonists mimic the action of dopamine in the brain, helping to alleviate motor symptoms of Parkinson's disease. These medications may be used alone or in combination with levodopa. Common dopamine agonists include pramipexole, ropinirole, and rotigotine.

MAO-B Inhibitors: Monoamine oxidase type B (MAO-B) inhibitors help prevent the breakdown of dopamine in the brain, prolonging its effects and improving motor symptoms. Examples of MAO-B inhibitors include selegiline and rasagiline.

COMT Inhibitors: Catechol-O-methyltransferase (COMT) inhibitors help prolong the effects of levodopa by inhibiting its breakdown in the bloodstream. These medications are often used in combination with levodopa/carbidopa. Examples include entacapone and tolcapone.

Anticholinergics: Anticholinergic medications can help reduce tremor and some other motor symptoms of Parkinson's disease by blocking the action of acetylcholine, a neurotransmitter in the brain. However, these medications are generally less commonly used due to their side effects, such as cognitive impairment and dry mouth. Examples include trihexyphenidyl and benztropine.

Amantadine: Amantadine is a medication that can help alleviate dyskinesias (involuntary movements) associated with long-term levodopa use. It may also provide some relief from other Parkinsonian symptoms. Amantadine is sometimes used as an adjunct therapy in Parkinson's disease management.

Antidepressants and Antipsychotics: These medications may be prescribed to manage mood disorders, such as depression and anxiety, or psychotic symptoms that can occur in Parkinson's disease. However, caution must be exercised when using antipsychotic medications due to the risk of exacerbating motor symptoms.

NOTE: Keep this list handy to be sure and ask about these medications and the tests the neurologist want to order or will not order. It's OK for you to ask questions. 

In addition to medication, other treatment approaches for Parkinson's disease may include physical therapy, occupational therapy, speech therapy, and deep brain stimulation (DBS) surgery in advanced cases.

It's important for individuals with Parkinson's disease to work closely with their healthcare providers to develop a personalized treatment plan that addresses their specific needs and goals while minimizing side effects and maximizing quality of life.

Regular monitoring and adjustments to treatment may be necessary as the disease progresses.

*Progressive - once the disease starts it doesn't stop but continues to get worse. Patients and doctors will "manage" progressive diseases. Unlike a cold, which is not progressive, doctors or patients can cure it.

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senior isolation
Social & Mental Health: Creating great memories

From Isolation to Inclusion: Empower Yourself and Your Family

As we age, staying socially active becomes increasingly important for maintaining overall well-being. 

Yet, many seniors and their caregivers face the frustration of social isolation. 

This isolation can stem from various factors, including mobility challenges, health issues, loss of loved ones, and even societal stigma, meaning seniors don't want to hang out with other seniors. 

Lets face it. A 65-year-old senior does not see herself socializing with folks over 85-years old all the time. Seniors want to be part of a group like themselves. Doesn't everyone? 

See how seniors and their families work though all their years together with people they love, and memories they cherish. Click here. 

How did we get here?

Let's delve into the frustrations we encounter when socialization dwindles, along with practical tips to combat this issue and foster meaningful connections.

Decreased social opportunities because we left our jobs, have physical limitations, or we have relocated away from all our friends to go live near our children or grandchildren. 

Health concerns like chronic health conditions or mobility issues can us from participating in social activities, leading to feelings of loneliness and isolation. For example, we might have a weekly lunch but then we decide to skip one week and soon that leads into two or three weeks and then we forget about the lunch date completely. 

Loss of loved ones means our friends, spouses, or family members leave before us, leaving us in grief, depression, sadness, and lonely. 

Limited Transportation: When transportation becomes a problem and seniors can no longer drive, we often do not want to burden our children with a way to get out to see friends. 

Societal Stigma: Unfortunately, we seniors often face a stigma related to aging, which can lead to feelings of invisibility or unworthiness in social settings. People tend to not come over to our chair and visit. The younger crowd is doing their thing and we are left to watch instead of engage. Sometimes, it makes us feel like we are a burden or shouldn't have gone to the outing in the first place. 

Super Ager's Starter Guide for Seniors

How Super-agers remain active and engaged

They use smartphones, tablets, or computers to open up a world of social opportunities, from video calls with loved ones to online forums and virtual classes.

Seniors explore community programs and remain active in clubs that interest them. 

Seniors who volunteer not only benefit themselves and the community but also provide opportunities for seniors to connect with others who share similar interests and values. It gives them a chance to make change for the better.

Physical activity not only promotes overall health but also provides opportunities for social interaction. Seniors can join walking groups, dance classes, or exercise clubs to stay active while socializing.

Many super-aging seniors match social events with physical, like walking in a park or on the beach and sharing stories. 

How family can help keep seniors engaged

Encourage Participation: Caregivers can encourage seniors to participate in social activities by doing these activities with them.  For example, your senior might not want to go to a senior center, but might like to go to a mall with you. 

Facilitate Technology Use: Caregivers can assist seniors in learning to use technology by providing patient guidance, troubleshooting technical issues, and setting up virtual social interactions.

Organizing family gatherings or outings provides seniors with opportunities to socialize with loved ones and create lasting memories. Have family events.

Family can schedule outings to local parks, museums, or community events, allowing seniors to explore new environments and engage in social interactions. Many caregivers bring their parents along on outings with friends who also have older parents. Everyone has a good time. 

Geriatric counselors ( better said...Counselors who work with Super-Agers😊)  or family counselors are important for both seniors and caregivers who want to avoid depression or loneliness. 

Why must seniors combat social disengagement?

Social isolation has detrimental effects on seniors' physical, mental, and emotional well-being. Research has linked social isolation to increased risk of depression, cognitive decline, and even mortality among older adults. In fact, more research is showing that social interactions are more than one’s own health. It gives us hope, a sense of purpose, identity, and belonging in later life.

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Signs your senior may need help
Social & Mental Health: Creating great memories

7 Signs You or Your Senior Needs Help

It’s a difficult topic to recognize when our super-aging seniors might need a little extra support. It's not always easy to admit that our loved ones need help, but being aware of the signs can make all the difference in ensuring their safety and well-being. 

Learning how to approach a vibrant loving senior is another story. See the FREE Caregiver’s Starter Guide for more information.

7 Quick Sign You Want to Watch For

But for now, let's dive in and discuss seven signs that might indicate it's time to lend a helping hand.

Forgetfulness Beyond the Usual: We all forget things from time to time, but when your senior starts forgetting important details like medication schedules, appointments, or even common everyday tasks, it could be a red flag. Keep an eye out for consistent forgetfulness that seems to be impacting their daily life. All our members keep a composition notebook nearby and start writing down date and what they see. 

Changes in Personal Hygiene: Personal hygiene is often a good indicator of overall health and well-being. If you notice your senior neglecting their personal hygiene, such as skipping showers, wearing the same clothes for days, smelling bad, or neglecting dental care, it could be a sign that they're struggling to take care of themselves independently. These symptoms can be part of bigger problems. See the Senior Freedom Club for more information. 

Difficulty with Mobility: As we age, it's natural for some mobility to decline to some extent. However, if you observe your senior having difficulty with basic movements like getting in and out of chairs, walking, or climbing stairs, it may be time to consider a conversation to see if there is pain or something else. 

Changes in Mood or Behavior: Pay attention to any noticeable changes in your senior's mood or behavior. Are they more withdrawn, irritable, or easily confused? These changes could indicate underlying issues such as depression, anxiety, or cognitive decline, all of which may require them to see a neurologist for a thorough exam. 

Unexplained Bruises or Injuries: Keep an eye out for unexplained bruises, burns, cuts, limping, or injuries, as these could be signs of falls or accidents that your senior may not be disclosing. I have lost count of the number of seniors who came into our urgent care with skin tears or cuts. When I asked them if they were going to disclose their visit to their adult children, they silently shook their heads “no”. 

Decline in Nutrition or Weight Loss: Changes in eating habits or unexplained weight loss can signal underlying health issues or difficulties with meal preparation. Monitor your senior's nutritional intake and observe whether they're maintaining a balanced diet. Check out their refrigerator.  See what snacks they have. Are they eating fruits and vegetables or processed crackers to fill up?

Neglecting Household Responsibilities: Is the house noticeably messier than usual? Are bills piling up, or are essential tasks like laundry and cleaning being neglected? Again, start documenting in your journal. Ask others if they are seeing these changes. 

Do not be afraid to approach your senior

Recognizing these signs early on can help you take proactive steps to ensure your super aging senior gets the support they need to thrive. Remember, offering to help is not a sign of their weakness but rather a testament to your commitment to keep them healthy.

If you've noticed any of these signs in your super-aging senior, it might be time to have a compassionate conversation about their needs and preferences regarding support and assistance. 

If you're ready to take the first step towards becoming a more confident and empowered caregiver, click the link below to download your Free Caregiver's Starter Guide today!

caregivers starter guide


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memory loss vs dementia
Social & Mental Health: Creating great memories

Memory Loss vs Dementia: A Guide for Seniors and Caregivers

Memory loss and cognitive decline are often associated with dementia, a condition that significantly impacts seniors' lives. However, it's crucial to recognize that memory issues can stem from various factors, including stress, depression, or anxiety. Seniors experiencing memory-related concerns should seek proper evaluation and support tailored to their specific needs.

Memory loss vs dementia

Distinguishing between dementia, depression, and anxiety is vital for seniors and their caregivers. Consulting a neurologist can help in accurately diagnosing dementia, ruling out other potential causes, and exploring suitable treatment options. Additionally, seniors may benefit from visiting a geriatric counselor to address underlying issues of depression or anxiety that could exacerbate memory-related challenges.

Seniors facing dementia encounter a unique set of struggles, characterized by frustration and anxiety stemming from the gradual loss of memory and cognitive function. The fear of forgetting cherished memories, important dates, or everyday tasks can lead to feelings of inadequacy and isolation. As memory lapses become more pronounced, seniors may experience heightened anxiety and distress.

In contrast, seniors dealing with depression, loneliness, or anxiety may experience memory lapses related to everyday forgetfulness. Misplacing items, forgetting recent interactions, or struggling to recall names are common occurrences. While these memory lapses may cause frustration, they typically do not represent the progressive decline associated with dementia.

For seniors diagnosed with dementia, providing cognitive stimulation, memory aids, and emotional support is crucial. Engaging in activities that challenge the mind, such as puzzles or memory games, can help maintain cognitive function and improve overall well-being. Memory aids, such as calendars or reminder apps, assist in organizing daily tasks and reducing stress associated with forgetfulness.

Emotional Health

Emotional support plays a significant role in alleviating the concerns of seniors with dementia. Encouraging meaningful social interactions, reminiscing about past experiences, and fostering a supportive environment can enhance their quality of life. Caregivers and family members should strive to be patient, understanding, and compassionate, acknowledging the challenges faced by seniors with dementia.

For seniors without dementia, addressing stress, depression, or anxiety is essential in managing memory-related concerns. Open communication, journaling, and spending time in self-reflection can help seniors process emotions and alleviate stress. Engaging in activities that promote relaxation and mindfulness, such as meditation or gentle exercise, can also contribute to emotional well-being.

See Chapter 2 of the Super-Ager’s Starter Guide on more about keeping our physical mobility. See the 17 questions and the activities that lead super-agers to lead active vibrant lives.
Super Ager's starter guide

Moreover, maintaining a healthy lifestyle, including regular exercise, a nutritious diet, and adequate sleep, supports overall brain health and cognitive function. Seniors should prioritize self-care practices that enhance mental and emotional well-being, reducing the risk of memory-related issues associated with stress, depression, or anxiety.

Next Steps

Memory loss in seniors can indicate various underlying factors, including dementia, depression, or anxiety. Seeking appropriate evaluation and support is crucial in addressing these concerns and improving overall quality of life. Whether navigating the challenges of dementia or managing stress-related memory lapses, seniors benefit from personalized interventions that address their unique needs. By fostering a supportive environment and prioritizing emotional well-being, seniors can maintain cognitive function and lead fulfilling lives as they age.

Remember, it's never too late to seek help and support on the journey towards optimal brain health and well-being. Get your FREE Super-Ager's Startere Guide today. 

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