Sunday, July 27, 2014

Good News for Boomers: Decline in Alzheimer’s Risk

The Silver Tsunami moves ahead with full force, alarms blaring and warning whistles screeching. What will be the plight of the aging Boomer generation? Will we pound the final nail into the coffin of Medicare and Medicaid as we reach the age of vulnerability for Alzheimer’s disease?

Until now, the answer to these questions has been yes—Alzheimer’s will increase at an alarming rate. What has changed? The cure for Alzheimer’s is still that elusive goal that motivates researchers and advocates to keep applying pressure. The Silver Tsunami builds momentum at the rate of 10,000 boomers turning sixty-five each day—and will continue until 2030 when all have turned that age.

I am a boomer and quite distressed at our future as the generation whose defining disease is Alzheimer’s. Nope. Not what I want for my future.

Then a glimmer of real hope for boomers comes from the Alzheimer’s Association  International Conference in Copenhagen. When comparing late 1970’s data, the Framingham Heart study showed a forty-four percent decline in new cases of Alzheimer’s, especially in people in their sixties.

Overall better cardiovascular health is contributing to this new trend. Routine blood work gives us the options to make adjustments to our health destiny. By treating high blood pressure, cholesterol, and diabetes, we control conditions that otherwise would rob us of good health. Other contributing factors to the good news for boomer’s health: a decline in smoking and an increase in education. Researchers believe that education builds up a neurocognitive “reserve” that helps compensate for brain damage.

It seems that it is harder to avoid helpful information about ways to decrease Alzheimer’s than it is to find it. This morning as I was skimming through old magazines before taking them to the recycle bin, I saw an interesting article on anti-aging that focused on brainpower. I had seen the suggestions before, but, hey, it never hurts to reinforce prior learning. I sped-read through the benefits of omega-3 fatty acids (note to self: eat more fish!), eat fruits and vegetables (food, yay!), and exercise (clears throat—trying again to get back on track).

Then, in place of the normal “exercise your brain,” it was worded in a new way: Find a purpose in life. If nothing else, I have a good handle on this one! I believe that a purpose in life is where we boomers excel. And get this good news—having a purpose in life means you are two and a half times less likely to develop Alzheimer’s as your friends, relatives, and acquaintances who just drift aimlessly through life.

Other interesting facts I gleaned from these old “worthless” magazines included a weight reduction program based on the percentage of fresh fruits and vegetables you ate each week. According to an article in First, you could lose three pounds a week by making fifty-percent of your food raw fruits and vegetables. The theory is that you increase fat burning enzymes. Hmmm. Not so sure that would agree with my digestive system.

After reading the good news about boomer’s health, I was inspired to complete a thirty-minute workout based on exercises I found in an old Reader’s Digest.  After I gathered up my weights, a quilt for the floor, and a kitchen chair I was ready to start. I turned on the TV to a thirty-minute show—Joel Osteen—for a half-hour of perspiration and inspiration. I was not disappointed! As I lifted weights and huffed and puffed through floor exercises, I listened to Joel Osteen talk about the life-changing value of…purpose.

Joel Osteen, the workout, and good news from AAIC helped me face the day with optimism for my personal health future—and for that of other aging boomers.

copyright © July 2014 by L. S. Fisher  

Saturday, July 19, 2014

PTSD and Combat Increase Alzheimer’s Risk

When it comes to war, we often worry about our loved ones safety and pray they will come home unharmed. It doesn’t usually happen that way. Some come home with outward injuries, but appearances can be deceptive. Those who appear uninjured often suffer the invisible scars of PTSD (posttraumatic stress disorder) or TBI (traumatic brain injury).

I saw firsthand the effects of PTSD and how life-disrupting it can be. Vietnam changed Jim. I could see some of those changes immediately—sudden loud noises could send him to the ground. While on R&R from Vietnam, the drums from a luau on the beach threw him into instant combat mode. Later, it would be fireworks, gunshots, nightmares, flashbacks, or mental breaks that ripped the scabs off the scars.

Of course, Jim went on to develop dementia, and I couldn’t help but wonder if his PTSD or exposure to Agent Orange could have been an underlying factor. At the time, I found an article linking PTSD to shrinkage of the hippocampus, the brain’s gateway for new memories. VA doctors dismissed the possibility of PTSD playing any part in his memory loss.

Various studies have shown that PTSD is indeed a risk factor for dementia. In addition to PTSD studies are now underway to examine the risk of combat TBI. Brain injury isn’t always caused by a blow to the head; it can also be caused by blasts. In fact, blasts are the cause of most combat traumatic brain injuries.

The Alzheimer’s Neuroimaging Initiative is being used to compare PTSD and TBI as dementia risk factors in Vietnam veterans over age 65. They will be broken down into groups with PTSD only, TBI only, and veterans with both PTSD and TBI. Cohorts should be fully recruited by October 2014. This is the beginnings of a comprehensive study in dementia risk factors in veterans.

Vietnam veterans are being used because of their age because dementia development may take decades. The wars in Iraq, Afghanistan, and acts of terrorism have contributed to more cases of TBI.

Although I’ve focused on TBI in veterans, some of the other causes are sports, vehicle crashes, and the number one cause of TBI: falls. In the United States, 1.4 million suffer TBI each year. The three classifications of TBI are (1) mild—doesn’t knock you out, or less than thirty minutes; (2) moderate—unconscious for more than thirty minutes; and (3) severe—unconscious for more than twenty-four hours.

TBI increases dementia risk. In older adults, moderate TBI more than doubles the risk of Alzheimer’s and severe TBI increases the risk to 4.5 times that of a person who has not had a brain injury. Mild TBI does not increased risk unless it is repeated, such as that caused by contact sports or being exposed to blasts over a period of time.

Adding to the risk factors of TBI is the presence of the apolipoprotein E genotype (APOE). In a study of boxers, all of those who developed severe dementia had at least one copy of APOE-e4.  Another interesting observation with the boxers was that the greatest risk was determined by the number of rounds boxed rather than the number of times a boxer was knocked out. This would indicate that repeated mild TBI was as much of a risk factor as a small number of severe TBIs.

Part of the link between Alzheimer’s disease and TBI is the presence of the hallmarks of Alzheimer’s disease—the proteins beta-amyloid and tau. After a severe brain injury, beta-amyloid will increase within hours. Repeated mild TBI increases the protein tau and sometimes also increases beta-amyloid deposits.

As I worked my way through the statistics, I was struck by a few thoughts. One was that genetic testing on Jim showed that he had one copy of APOE-e4. One copy slightly increased the risk of Alzheimer’s, but not nearly as much as two copies would have. The other thing that struck me was that Jim died at fifty-nine which would have been too young for any study with the age sixty-five threshold. Ironically, if he had not died from dementia, he would have been old enough now. Next month, he would have celebrated his 69th birthday.

Copyright © July 2014 by L.S. Fisher 

Wednesday, July 9, 2014

Never Underestimate the Power of Love

The puppy came to his door on a cold winter night, shivering, whimpering, and voicing a few timid barks. She knew she needed help, but was afraid she would get a boot in the side rather than a helping hand.

He turned on the porch light and saw her sitting there, a little puff of fur, big eyes. “I don’t want a puppy,” he said.

“Maybe she belongs to one of your neighbors and just got lost,” I said.

He turned the light off and tried to forget the puppy, but the look in those big eyes just wouldn’t go away. Back to the porch, light on, the puppy was gone. He breathed a sigh of relief.

Then a sound from the back deck let him know the puppy had merely moved to a different door. “What do I do?” he asked.

“At least give her food and water,” I suggested. “She’s too little to make it on her own.”

Once we went outside, the puppy shied away. She hid behind the barbeque grill. Finally, we coaxed her out, but she surprised us by ignoring the food and water we had put out for her. She didn’t seem to know how to eat or drink. The puppy was listless, and I had doubts that she could be saved, and if she was, would she always be timid and afraid of people?

The puppy finally took a little nourishment. He fixed a box with blankets to shelter her from the wind and weather.  The puppy settled down and went to sleep.

After calls to the neighbors, it became obvious that someone had dumped this puppy to die along the roadway. Although she was settled temporarily with some of the basics: food, water, shelter, the puppy would need a lot of patience, medical care, and most of all, love, in order to survive.

Humans, too, need this type of emotional support. When a family member has dementia, and you can no longer care for them at home, you may have to find another place for them to stay. You choose a home that will take good care of your loved one and will provide the basics and medical care they need.

Placing a loved one in long-term care doesn’t mean you walk away thinking now it is out of your hands. I believe the thing that disturbed me most when Jim was in a nursing home was the lack of visitors for some of the residents. It not only disturbed me, it disturbed the employees. They saw the loneliness, the listlessness, as day after day passed and no family member came with smiles and hugs. No one to say, “I love you.” No one to show their love by the simple act of being there, cheerful and caring.

Jim had daily visitors and family that loved him. Sometimes he didn’t really show much of a reaction—other times, his blue eyes would light up. Regardless, he knew someone would be there to spend time with him. To make him feel loved.

Love makes a life-changing difference with people—and with puppies. The puppy that had been abandoned has turned into a rambunctious, happy, healthy member of the family. Never underestimate the power of love.

copyright © by L.S. Fisher, July 2014

Wednesday, July 2, 2014

Summer Begins and Starts to End

I sat out on the deck last night looking at the stars and rubbing my arms because the breeze was just a wee bit chilly. That seemed a little strange since earlier in the day, the hot, muggy air clung to my skin and made me feel like I was trying to breathe underwater.

When I was young, summer vacation always seemed to be hot, humid, and long. We lived in the country in the middle of nowhere. Playing outside meant dealing with the full blast of heat and sun. Even swimming in tepid lake water only provided temporary relief. It didn’t take long to be just as hot or hotter. There was no place to cool off except beneath a shade tree. During the hot summer months, I read a lot of books and spent most of my time trying to stay cool. I’d sit in front of the box fan, dressed in tank tops and shorts, reading a book.

Nighttime didn’t always bring relief. Windows were left open and a fan would blow the cooler night air in, or on some nights, it might be reversed to blow hot air out.

Yes, summer in Missouri can be a scorcher, if you’re not loitering under the air conditioner. Of course, that’s the very reason that outside can seem unbearable. It’s hard to acclimate to a twenty degree change in temperature by simply stepping over the doorsill.

I find myself chilly inside and uncomfortably warm outside. A few times, I’ve been caught off guard when I step outside wearing sweatpants and a flannel shirt.

The thing I thought about when I was looking at the stars last night is that now summer doesn’t seem to be nearly as long as I remember it from my youth. If I want to go somewhere, I walk out of my frigid house, jump in an air-conditioned car, drive to an air-conditioned store. In other words, I can pretty much avoid the heat. Not only that, but as I get older it seems that time goes by much faster. June was here and gone before I had time to turn the pages in all my calendars at home. It just zipped past.

With June being my birthday month, it kind of seems like maybe life is flashing before my eyes at times. It doesn’t help that two wonderful men I had the pleasure of knowing passed away during the final days of June. One was struck down by the cruelest of diseases—Alzheimer’s. I had been in contact with family members as they went through the day-to-day stresses, quandaries, and grief that watching a loved one fade away brings with it. Now their grief takes a new direction as they learn to live without him.

While I was still adjusting to his death, I learned of author Jory Sherman’s death. I knew Jory was not doing well and that he made the decision to go home “to die.” He wanted to spend his final days in the place he loved.

Jory was an inspiration to me when I first started writing. He critiqued my work, and I subscribed to his “story of the month.”

As soon as I learned of his death, I pulled out the Sadness of Autumn, Tales of the Ozark Hills. I knew that in Jory’s lyrical words, I would find some words of wisdom and comfort. It only took about two minutes before I came upon a passage in “Summerend” a story Jory wrote about his father’s death. Jory Sherman wrote: “There was the voice of him in the stark yellow wind that blew in my face and took my voice out of my dry throat. There was the gentle hand of him in fallow earth where he would have kneaded the soil and its seeds to a fine and green growing. There was his spirit scattered all over acres of sky and his heart moving the blood through my own and my children’s and their children’s lives. It is a sad thing when the summer begins to end.”

It seems to me that summer starts to end almost before it begins.

copyright © July 2014 by L.S. Fisher