WITH A BULLET IN HER gut, her voice choked with pain, Dee Hill pleaded with the 911 dispatcher for help.
“My husband accidentally shot me,” Hill, 75, of The Dalles, Oregon, groaned on the May 16, 2015, call. “In the stomach, and he can’t talk, please …”
Less than four feet away, Hill’s husband, Darrell Hill, a former local police chief and two-term county sheriff, sat in his wheelchair with a discharged Glock handgun on the table in front of him, unaware that he’d nearly killed his wife of almost 57 years.
The 76-year-old lawman had been diagnosed two years earlier with a form of rapidly progressive dementia, a disease that quickly stripped him of reasoning and memory.
You’ve turned 65 and exited middle age. What are the chances you’ll develop cognitive impairment or dementia in the years ahead?
New research about “cognitive life expectancy” — how long older adults live with good versus declining brain health — shows that after age 65 men and women spend more than a dozen years in good cognitive health, on average. And, over the past decade, that time span has been expanding.
By contrast, cognitive challenges arise in a more compressed time frame in later life, with mild cognitive impairment (problems with memory, decision-making or thinking skills) lasting about four years, on average, and dementia (Alzheimer’s disease or other related conditions) occurring over 1½ to two years.
Machine learning has detected one of the commonest causes of dementia and stroke, in the most widely used form of brain scan (CT), more accurately than current methods.
New software, created by scientists at Imperial College London and the University of Edinburgh, has been able to identify and measure the severity of small vessel disease, one of the commonest causes of stroke and dementia. The study, published in Radiology, took place at Charing Cross Hospital, part of Imperial College Healthcare NHS Trust.
Researchers say that this technology can help clinicians to administer the best treatment to patients more quickly in emergency settings — and predict a person’s likelihood of developing dementia. The development may also pave the way for more personalised medicine.
I had hoped that by now most adults in this country would have completed an advance directive for medical care and assigned someone they trusted to represent their wishes if and when they are unable to speak for themselves. Alas, at last count, barely more than one-third have done so, with the rest of Americans leaving it up to the medical profession and ill-prepared family members to decide when and how to provide life-prolonging treatments.
But even the many who, like me, have done due diligence — completed the appropriate forms, selected a health care agent and expressed their wishes to whoever may have to make medical decisions for them — may not realize that the documents typically do not cover a likely scenario for one of the leading causes of death in this country: dementia. Missing in standard documents, for example, are specific instructions about providing food and drink by hand as opposed to through a tube.
Advanced dementia, including Alzheimer’s disease, is the sixth leading cause of death overall in the United States. It is the fifth leading cause for people over 65, and the third for those over 85. Yet once the disease approaches its terminal stages, patients are unable to communicate their desires for or against life-prolonging therapies, some of which can actually make their last days more painful and hasten their demise.
A new computer programme developed by scientists at the Universities of Edinburgh and Glasgow can assess whole brain deterioration and help predict cognitive function after stroke up to ten times more accurately than current methods.
The new approach, published today in the International Journal of Stroke, can quantify visible brain injury from cerebral small vessel disease (SVD) and brain atrophy by translating the million plus bits of information stored in brain scans into a single measure, the “brain health index.”
SVD features and brain tissue atrophy both increase with age, are often present together, and are risk factors for stroke and dementia.
The diagnosis is one that a family never wants to hear: Your father has Alzheimer’s disease. Your mother has stroke-related dementia.
A recently released study, included in a special supplement to the Journal of Gerontology, indicates that dementia’s impact might be compressing a bit. That is, people might be developing dementia later and living with it for a shorter period of time.
Sudha Seshadri, M.D., professor of neurology and founding director of the Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases at UT Health San Antonio, is the senior author on the study, which draws evidence from the Framingham Heart Study.
Researchers have developed a new imaging agent that could help guide and assess treatments for people with various neurological diseases, including Alzheimer’s, Parkinson’s, and multiple sclerosis. The agent, which is used in positron emission tomography (PET) scans, targets receptors in nerve cells in the brain that are involved in learning and memory. The study is featured in the April issue of The Journal of Nuclear Medicine.
Swiss and German scientists developed the new PET radioligand, 11C-Me-NB1, for imaging GluN1/GluN2B-containing N-methyl-D-aspartate (NMDA) receptors (a class of glutamate receptor) in nerve cells. When NMDA receptors are activated, there is an increase of calcium (Ca2+) in the cells, but Ca2+ levels that are too high can cause cell death. Medications that block NMDA receptors are therefore used for the treatment of a wide range of neurological conditions from depression, neuropathic pain and schizophrenia to ischemic stroke and diseases causing dementia.
“The significance of the work lies in the fact that we have for the first time developed a useful PET radioligand that can be applied to image the GluN2B receptor subunit of the NMDA receptor complex in humans,” explains Simon M. Ametamey, PhD, of the Institute of Pharmaceutical Sciences, ETH Zurich, in Switzerland. “The availability of such a PET radioligand would not only help to better understand the role of NMDA receptors in the pathophysiology of the many brain diseases in which the NMDA receptor is implicated, but it would also help to select appropriate doses of clinically relevant GluN2B receptor candidate drugs. Administering the right dose of the drugs to patients will help minimize side-effects and lead to improvement in the efficacy of the drugs.”
Alzheimer’s disease is among the most expensive illnesses in the U.S. There’s no cure, no effective treatment and no easy fix for the skyrocketing financial cost of caring for an aging population.
Spending on care for people alive in the U.S. right now who will develop the affliction is projected to cost $47 trillion over the course of their lives, a report issued Tuesday by the Alzheimer’s Association found. The U.S. is projected to spend $277 billion on Alzheimer’s or other dementia care in 2018 alone, with an aging cohort of baby boomers pushing that number to $1.1 trillion by 2050.
Research so far has been stymied by clinical failures. By one count, at least 190 human trials of Alzheimer’s drugs have ended in failure. No company has successfully marketed a drug to treat it, though many big pharmaceutical companies, including Merck & Co. and Pfizer Inc., have tried. Biogen Inc., a company based in Cambridge, Massachusetts, saw its shares dive last month after it said it was expanding the number of participants in its trial for the drug aducanumab.
Nursing homes in the U.S. are administering antipsychotic drugs to tens of thousands of elderly residents each week who do not have the diagnoses for which the drugs are prescribed and who are not giving their “free and informed consent,” according to a new Human Rights Watch report.
In a report released Monday titled, “They Want Docile,” the group states that some 179,000 residents of long-term nursing homes across the country are given antipsychotic drugs each week that are not appropriate for their condition. The report says the drugs are used for their sedating side effects, which make patients with dementia and Alzheimer’s disease easier to manage.
“People with dementia are often sedated to make life easier for overworked nursing home staff, and the government does little to protect vulnerable residents from such abuse,” Hannah Flamm, a New York University law school fellow at Human Rights Watch told The Guardian.
For families of stroke victims, dementia patients and even those recovering from surgery or in rehabilitation, there’s an ever-present fear that something will happen when you aren’t around. What if there’s an accident? What if they fall and can’t call for help? Fortunately, new smart home technology offered by your internet service provider allows families to keep an eye on their loved ones even when they may not be physically present, bringing priceless peace of mind. Here’s how.
1. Video cameras can help ensure safety during home health visits and exercises.
Joint replacement surgeries require regular physical therapy and exercises, much of which must be done at home on a regular basis. Limited mobility can raise concerns about falls, but a video camera placed in a living room or exercise room allows family members to check in during physical therapy routines and make sure their loved one hasn’t fallen or injured themselves.