Alzheimer's Diagnostic Guidelines Updated for First Time in 27 Years
The first new diagnostic guidelines for Alzheimer's disease in nearly 30 years expand the definition to include patients with earlier stage symptoms, emphasizing that the disorder begins wreaking havoc on the brain years before it can be detected. The recommendations, issued today by the National Institute on Aging and the Alzheimer's Association, recognize two new categories of the disorder: a preclinical phase that occurs before patients show any memory loss or thinking problems, and "mild cognitive impairment," defined by subtle symptoms that don't interfere with daily functions. "We're redefining Alzheimer's disease and looking at this in a different way than has ever been done," Creighton Phelps, director of the National Institute on Aging's Alzheimer's Disease Centers Program, told The New York Times. "I think we're going to start to identify it earlier and earlier." The guidelines are a stark contrast from the last set of recommendations, published in 1984, which only recognized the full-blown dementia phase of the disease. The shift encourages early screening for Alzheimer's, as well as continued research into drugs that could halt early brain changes and into ways to identify people who would most benefit from such treatment. "We've been an advocate for early diagnosis for many years," William Thies, chief scientific officer of the Alzheimer's Association, told Bloomberg. "It allows people to anticipate what will happen and plan their lives to minimize the impact of what's coming for them."
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Preventing Alzheimer's Disease: 7 Risks to Consider
Ask most folks to name their biggest fear about growing old and chances are they won't say gray hair and wrinkles, but the devastating loss of their mental capacity. Alzheimer's disease accounts for 60 to 80 percent of all dementias, striking as many as 5 million Americans. While the disease has genetic underpinnings, it's also associated with certain lifestyle factors including diet, exercise, and level of education. So what steps can you take to help prevent it?
Some studies suggest that eating more fruits and vegetables and less saturated fat may be the ticket. Others point to folic acid or fish oil supplements as beneficial. Still others have found that drinking moderate amounts of alcohol confers some protection. But an expert panel convened by the National Institutes of Health says there's not enough evidence from any of these studies to warrant making lifestyle changes to lower your risk of Alzheimer's.
"The primary limitation with most of these studies is the distinction between association and causality," write the NIH experts in their "state of the science" paper published last year in the Annals of Internal Medicine. For instance, people with a higher level of education have a lower risk of Alzheimer's, but that doesn't mean going to grad school will protect you. It could be that those individuals read more books and play more chess in their lifetime than other folks, which continually challenges their brains and has a disease-preventing effect. [Read more: Preventing Alzheimer's Disease: 7 Risks to Consider.]
Family Caregivers: Exhausted, Stressed—and Abusive?
Bearing the responsibility for an aging parent or spouse can become an increasingly thorny task—and not necessarily because of the need for more and more complex care. Caregivers themselves can sustain emotional, mental, and physical blows that may go unattended in the name of duty to their loved one. Sleep is lost; stress mounts steadily; and something just might give. In the case of caring for someone with dementia, says research published in the British Medical Journal, sometimes that lapse comes in the form of psychological—or even physical—abuse. More than half of family caregivers surveyed in the study reported some abusive behavior toward the person they cared for.
The burden felt by caregivers is real and can manifest itself in a constellation of ways. Phyllis Brostoff, president of the National Association of Professional Geriatric Care Managers, suggested ways to cope with caregiving.
1. Acknowledge what's going on. It's not always apparent to caregivers how they're being affected by their responsibilities or their loved one's changing condition. Particularly in cases of early dementia, when someone's mental faculties may initially wax and wane in and out of lucidity, a caregiver may feel irritated at having to answer the same question multiple times. "Sometimes the person doesn't realize they're being [verbally] abusive," says Brostoff. Adjusting to and mourning the decline of someone you rely on can be very sad and emotionally taxing, she adds. So if you find yourself feeling as if you hate the person you're caring for, says Brostoff, take it as a sign to get some assistance. [Read more: Family Caregivers: Exhausted, Stressed—and Abusive?]
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