Not All Dementia Is Alzheimer's Disease

Generally speaking, when a person develops an Alzheimer’s type of dementia, they are presumed to have Alzheimer’s disease, the most common dementia. Jim was diagnosed with “dementia, most likely, Alzheimer’s,” but an autopsy showed that he had corticobasal ganglionic degeneration, a rare disorder. I had never heard of the disease, so imagine my surprise when I discovered that it usually begins as a movement disorder.

The symptoms of corticobasal degeneration:

1)           1)            Movement. One side of the body can be hard to move because of muscle stiffness, spasms, and tremors. Balance problems can lead to falls. A lack of coordination can cause a shuffling gait. Jim had what is known as an “alien” limb and balance problems later in the disease.

2)            Speech. Halting speech and difficulty forming words. Jim had aphasia.

3)            Cognition.  The damaged and shrinking brain causes a person to have memory loss, confusion, difficulty performing daily tasks, and problems finding correct words. Jim often used to say the exact opposite of what he meant and used repetitive phrases instead of meaningful conversation.

4)            Personality. Jim’s personality changed drastically. Sometimes he would be extremely agitated or aggressive, especially if he wasn’t feeling well. When he could walk unassisted, he tended to pace or wander. Other times, he was docile and quiet.

You can probably see how corticobasal degeneration could be mistaken for Alzheimer’s. An inherited gene is usually the cause of younger or early-onset Alzheimer’s. Corticobasal degeneration is not considered an inherited disease, but can run in families. The most common cause is a buildup of the protein tau. The hallmarks of Alzheimer’s are beta-amyloid protein plaques, and neurofibrillary tangles that form when tau protein accumulates inside the neurons and impairs the communication between cells.

I recently read an interesting article about Alzheimer’s and a related dementia in elderly persons. Three studies have focused on HS-Aging (hippocampal sclerosis in aging people), a type of dementia typically found in persons 85 and older.

HS-Aging is often misdiagnosed as Alzheimer’s disease. The reason for the misdiagnosis is simple—Alzheimer’s is the most common of the hundreds of types of dementia. A large study disclosed that at autopsy, about 20% of elderly persons with dementia had HS-Aging. Almost none of the study group had received a diagnosis of HS-Aging during life.

Arteriolosclerosis is a form of hardening and loss of elasticity of small arteries in the brain.  Hypertension, diabetes, high cholesterol, and aging are risk factors. People used to refer to this disease as “hardening of the arteries.”  Persons with HS-Aging generally have higher cognitive ability than those with Alzheimer’s disease and are more fluent verbally than those with frontotemporal degeneration.

A healthy lifestyle reduces your risk of developing dementia and/or cardiovascular disease. Change is never easy, but implementing some healthy habits can help you physically and mentally.

Physical Activity: Get up out of your chair and move! Aerobic activity can be a brisk walk, riding a bike, doing yard work, or getting a workout at the gym. Lifting small weights or resistance training can strengthen your muscles.

Healthy Diet: Follow the Mediterranean diet guidelines and increase vegetables, fruits, nuts, whole grains, and beans. Eat moderate amounts of poultry, seafood, eggs, and dairy. Limit sweets and sugary beverages.

Social Engagement: People who are socially active are healthier and happier than loners. Play cards, enjoy outings with friends, volunteer, or join a club. Spend time with people who raise your spirits.

Health and Safety: Get a checkup annually and visit your doctor when you notice a new condition or symptom. Watch your numbers: blood pressure, blood sugar, and weight. Clear your home of tripping hazards and use grab bars or walking aides as needed.

You may have celebrated 70, 80, or 90 birthdays, but your spirit can be as young as you want it to be. The power of positive thinking can overcome the negatives that life may throw at you.

 

sources: https://alzheimersweekly.com

ncbi.nlm.nih.gov/pmc/articles/PMC3946156/

 

Copyright © July 2024 by L.S. Fisher

http://earlyonset.blogspot.com

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To Plan or not to Plan

 

Recently, I reached into the freezer to get a container of cheese and bumped a package of ground pork. The pork fell to the floor and knocked off the plastic piece at the bottom of the freezer. I tried bending over (not recommended) to snap it back in place.

Finally, I decided to sit on the floor so I could see what I was doing. After I put the piece back, I looked around and realized that I had nothing to hold onto to get back up. After a few failed attempts, I scooted down the hallway to the bedroom where I thought Harold was still sleeping. Fortunately, he was awake and gave me a hand so that I could get back to my feet.

 “I heard something, but didn’t know you fell,” he said. I had to admit that I hadn’t fallen, but was foolish enough to sit on the floor without a plan to get back on my feet.

Sitting on the floor was ironic, since I’m a “fly by the seat of my pants” type of person. Harold, on the other hand, is such a planner that by the time he plans how we are going to do something, I’m worn out and don’t want to participate.

I know that he thinks I don’t do anything since I don’t talk about what I’m going to do, or have finished. I can write to-do lists all day long, but 99 percent of what I plan to do is inside my head waiting for the signal to activate.

I cherish the days I can sleep late because they are rare. Invariably, on a day I can sleep in, I wake up at five a.m. Last Monday morning, I slept until eight. The bad thing about sleeping late is that it takes longer for me to walk normally. Anyway, around 9:30, we decided to fix biscuits and gravy for breakfast. Of course, just as we started Harold’s phone rang. I didn’t get to it in time and mine started ringing. It was the alarm company saying we had an overhead door alarm going off at the shop by the rental house.

The alarm company offered to send the sheriff’s department, but I told them I’d go check it. We have had several false alarms—no real ones. Imagine my surprise when I saw the overhead door was standing wide open. Even better, imagine the thieves’ surprise when they activated the alarm siren. They had thrown gravel making a rapid get-away. I stood in the heat, hot, sweaty, and hungry, while I waited for help to arrive, to lower the door and place a temporary lock.

Fast forward to yesterday when the overhead door company arrived to fix the door. At least I’d had breakfast, but almost had heatstroke while I gathered up old items to throw in the dumpster. This is one time I planned ahead—we need help and a cool fall day to clear the junk out of the shop.

Jim was a planner too in some ways and seat-of-the pants in others. He loved to plan a trip since travel was one of his favorite activities. Whether it was a trip to Colorado or “out West” to visit family, he was all about stocking the van with all the equipment necessary.

When he was in the early stages of dementia, we still traveled to Colorado, but we made hotel reservations instead of camping. On the day we were leaving, I told Jim to go pack his duffle bag. He was gone just a few minutes and carried his bag into the kitchen. I was suspicious of the speed, so I opened the duffle. Jim had emptied out his underwear drawer and had completely filled the bag with underwear and socks.

Although Jim loved to plan trips, he was famous for his impromptu jam sessions at our house. Most of the time, I had little or no notice. I’ll admit they were usually fun and back in those days, I didn’t have other outside activities taking up my time.

To plan or not to plan, that is the question. I guess the answer depends on the type of person you are. I do make plans—that’s why my calendar is covered with important appointments, and the dry erase board is covered with reminders.

I’ll admit that it doesn’t bother me too much to scratch the plans and instead go with the impromptu jam session. Life is too short to have an inflexible schedule.

 Copyright © July 2024 by L.S. Fisher

http://earlyonset.blogspot.com

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Wildflowers

Recently I watched Blue Valley Songbird, a 1999 Dolly Parton movie where she sang several songs I had never heard, including “Wildflowers.” As with many of the songs Dolly wrote, this song held a special truth for her.

In the song, she talks about how wildflowers are plentiful and grow anywhere, but she wasn’t content to be part of the crowd. In the movie, and in real life, Dolly had more ambition that the people who had influence over her. In the movie, her manager/boyfriend took on the role of holding her back, discouraging her from playing to larger audiences. I believe this fictional character represented the conflicted feelings Dolly had about breaking away from Porter Wagoner.

I loved the song, and added it to my song list for our family band. The song makes me think of the wildflowers that I picked throughout the hills around the old home place. I would gather up bouquets of purple phlox, Indian paintbrush, brown-eyed susans, and other wildflowers I came across. One of the hills was covered with tiny white flowers that we all knew would transform into wild strawberries later in the summer.

The Wildflowers song is more about a person who feels different from the crowd than it is about flowers. I think that most of us feel different from our peers. We may be different in significant ways, or in ways that are insignificant, but some of us can’t tell the difference.

My brother Donnie was definitely a person who traveled to the beat of a different drum. He was different, and he didn’t care. In fact, he thrived on being wild and free.

Jim was a person who had a strong sense of self. He had principles that he wouldn’t compromise for anyone. Just because everyone around him thought or acted in a predictable way, Jim was not influenced by their behavior. Jim was intelligent, thoughtful, and hardheaded when it came to what he considered to be his path to follow. He loved his family with all his heart, and he would have laid his life on the line for any of us.

Many of us feel safest if we don’t stand out from the crowd, finding safety in numbers. Fear of how others may perceive us, keeps most of us in line. Really, how funny is it that some who want to be different, fall prey to cultish behavior when they find other like-minded people and blindly follow the leader.

We all have challenges to face in life, and watching a loved one withering away with dementia is a big one. How we handle adversity defines our character, faith, and fortitude. Tragedies that break some people make others stronger. 

I’ve noticed that people who have the least are often the ones who give the most to others. Some who don’t have monetary wealth, have riches of spirit, and give the gift of time. To be completely present in the moment is a trait that many of us do not have. We can be witnessing an important celebration or event, and the first thing we do is send a text or browse reactions on our smart phones.

Life used to be simpler. Once we had time to gather wildflowers in the woods and found time to visit with our neighbors. We used to play card games, have big dinners, and go for Sunday drives. We used to sit on the porch and drink coffee or tea.

When we talked religion or politics, we had thoughtful discussions, not angry words. After we watched a thirty-minute news program, we turned off the TV and went on with our lives.

Now, we look at wildflowers and think of them as weeds and contemplate how to get rid of them. In the song “Wildflowers,” the flowers represent people. Unfortunately, in today’s world, we seem to be trying to get rid of people who aren’t like us, or who don’t think like us. Instead of looking for the hundreds of opinions we agree on, we focus on one disagreement.

We no longer notice the beauty of the wildflower blooms, and instead wait for the pesky weeds to wither and die. Maybe it’s time to take a step back so that we can move forward in unity. 

 Copyright © July 2024 by L.S. Fisher

http://earlyonset.blogspot.com

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