More Evidence Sleep Linked to Alzheimer's, Parkinson's

It's time to revisit a popular topic: sleep. Specifically what happens to our brains when we don't get enough of it. We've talked about links to productivity, stress, depression and other ailments.

But Sunday's New York Times had a piece that shows a stronger link to Alzheimer's. You see, when you sleep your brain performs a service similar to what your lymphatic system does to other organs -- it cleans out the waste that builds up from exercise and other strenuous work. But the lymphatic system doesn't help the brain, so nature had created other ways to help flush the build up of "litter" that comes from how we use our brain during the day. A major component is getting ample sleep.

From the article:

MODERN society is increasingly ill equipped to provide our brains with the requisite cleaning time. The figures are stark. Some 80 percent of working adults suffer to some extent from sleep deprivation. According to the National Sleep Foundation, adults should sleep seven to nine hours. On average, we’re getting one to two hours less sleep a night than we did 50 to 100 years ago and 38 minutes less on weeknights than we did as little as 10 years ago. Between 50 and 70 million people in the United States suffer from some form of chronic sleep disorder. When our sleep is disturbed, whatever the cause, our cleaning system breaks down. At the University of Pennsylvania’s Center for Sleep and Circadian Neurobiology, Sigrid Veasey has been focusing on precisely how restless nights disturb the brain’s normal metabolism. What happens to our cognitive function when the trash piles up?

At the extreme end, the result could be the acceleration of neurodegenerative diseases like Alzheimer’s and Parkinson’s. While we don’t know whether sleep loss causes the disease, or the disease itself leads to sleep loss — what Dr. Veasey calls a “classic chicken-and-egg” problem — we do know that the two are closely connected. Along with the sleep disturbances that characterize neurodegenerative diseases, there is a buildup of the types of proteins that the glymphatic system normally clears out during regular sleep, like beta-amyloids and tau, both associated with Alzheimer’s and other types of dementia.

“To me,” says Dr. Veasey, “that’s the most compelling part of the Nedergaard research. That the clearance for these is dramatically reduced from prolonged wakefulness.” If we don’t sleep well, we may be allowing the very things that cause neural degeneration to pile up unchecked.

A Dad Explains Parkinson's Disease to His Children

Earlier this month a freelance writer wrote about talking to children about dementia. Some forms of Parkinson's Disease include dementia, but not all. Our Hillcrest Center program director, Marge Galante, sent us this wonderful short video that won a big prize recently. We think you'll enjoy it too.

New Findings About Preserving Mobility, Parkinson’s Trigger

The August issue of the Harvard Health Letter includes a news brief about the benefits of regular exercise for people with Alzheimer’s disease. Here’s an excerpt on the finding of Finnish researchers that was first published in May in JAMA Internal Medicine:

“People with Alzheimer’s who took part in one hour of supervised exercise twice a week, either privately in the home or in a group setting, had slower deterioration in physical functioning than people with Alzheimer’s who didn’t exercise. Participation had to last at least one year to be effective.

“Alzheimer’s patients who exercised also had far fewer incidences of falls that htose who did not exercise, and lower overall health care costs for the year. It’s useful information if you’re a caregiver for someone with Alzheimer’s But it’s also a good reminder of the importance of maintaining physical fitness in good health as well, so that you can stay active and protect your mobility and independence.”

In the same issue, another news item taken from the May issue of Neurology notes that expore to pesticide may increase the risk for Parkinson’s disease. Researchers examined more than 100 worldwide studies and found exposure to bug and weed killers was associated with a 33% to 80% increase in the risk of developing Parkinson’s disease.

Some Surprising Causes of Dementia

A University of Pittsburgh study widely reported by news media yesterday showed similar brain scans between those with a concussion and those experiencing Alzheimer's Disease.

According to a Time magazine piece,the study looked at 64 patients who experienced concussions and compared their MRI brain scans a year after their injury to those of 15 healthy patients over the same time period. "The images picked up white matter, which is made up of nerves and their protective coating, myelin, which facilitates connections between nerves in different regions of the brain. Networks of these nerves are responsible for cognitive functions such as memory, planning and reasoning. The scans revealed that the damage to the white matter in the concussion patients was similar to that of Alzheimer’s patients, whose nerves gradually died after being strangled by expanding plaques of amyloid proteins."

Furthermore, researchers found similar sleep distrubance patterns between the two groups, which could contribute to memory lapses. “When we sleep, the brain organizes our experiences into memories, storing them so that we can later find them. The parahippocampus is important for this process, and involvement of the parahippocampus may, in part, explain the memory problems that occur in many patients after concussion,” Dr. Saeed Fakhran, an assistant professor of radiology at the University of Pittsburgh, said in a prepared statement.

Head trauma is just one of many ways dementia can occur. According to Dr. Danel Sewell, a psychiatrist who specializes in geriatrics at UCSD, some other ways involve changes in the body's chemistry. During yesterday's Town Hall Forum by ActivCare Residential Living, Dr. Sewell briefly mentioned numerous other causes, such as ALS, "mad cow" disease, HIV/AIDS, Huntington's, multiple sclerosis, neuropsyphilis, normal pressure hydocephalus and Parkinson's.

Some others, however, relate to chemical exposure, irregular organ function or a nutritional deficiency. Here among Dr. Sewell's list are some other causes of dementia (and Alzheimer's is just one type of dementia accouting for 55% to 60% of cases).

• Alcoholism
• Carbon Monoxide Poisoning
• Heavy metal poisoning
• Hypothyroidism
• Irradiation
• Major depression
• Thaimine deficiency
• Vitamin B12 deficiency

If you have any of these conditions, it doesn't mean you will experience dementia later in life. But it's a good idea to work with your healthcare provider to improve any deficiencies and reduce the risk of exposure to harmful chemicals linked to brain disease.

Mayo Clinic Links Sleep and Dementia Risks

Researchers at the Mayo Clinic have found a link between a specific sleep disorder and men who later develop dementia with Lewy bodies -- the second more common form of age-related memory impairment after Alzheimer's Disease.

When most of us enter into a stage of sleep known as Rapid Eye Movement (REM), our bodies are still while our minds dream. But for some with a disorder called REM Sleep Behavior Disorder, their bodies actually move as if they are acting out their dream while they are asleep. And often those dreams are more like nightmares.
In the Mayo Clinic study, researchers looked at 75 patients with the sleep disorder and found those who acted out their dreams were more likely decades later to also develop symptoms associated with Lewy Body, including parkinsonisms and hallucinations. Those characteristics often help distinguish Lewy Body dementia from Alzheimer's.

From a U.S. News & World Report article:

"While it is, of course, true that not everyone who has this sleep disorder develops dementia with Lewy bodies, as many as 75 to 80 percent of men with dementia with Lewy bodies in our Mayo database did experience REM sleep behavior disorder. So it is a very powerful marker for the disease," study lead investigator Melissa Murray, a neuroscientist at Mayo Clinic in Florida, said in a Mayo news release.

She said these findings could improve diagnosis and treatment of this type of dementia.

"Screening for the sleep disorder in a patient with dementia could help clinicians diagnose either dementia with Lewy bodies or Alzheimer's disease," Murray said. "It can sometimes be very difficult to tell the difference between these two dementias, especially in the early stages, but we have found that only 2 to 3 percent of patients with Alzheimer's disease have a history of this sleep disorder."

Children, You Must Intervene

Just before the holidays, a friend asked us to recommend an in-home senior service for her parents. Her father had been diagnosed several years earlier with Parkinson's Disease, and she had begun to see her stepmother's health decline because of her total dedication to her husband's growing needs.

My friend wanted to provide them "the gift" of in-home assistance, and the holidays finally presented that opportunity for which they could not refuse the help. She herself also is caring for a terminally ill spouse, so family couldn't just step in to assist.

The professional assistance was indeed a big help, but it was short-lived. Last week we learned my friend's stepmother had passed.

It's a scenerio we see all too frequently, especially with seniors in the throes of dementia care. Women of a certain generation are resistant to outside help because they have always been able to handle the demands and even pride themselves on their decades of selflessness. Men too can be stubborn, believing their marital vows override their own limited abilities to properly care for their loved one.

There's growing research to show that sometimes caregivers' best efforts are not good enough. A piece in today's Yale Daily News underscores this point. Researchers focused on Alzheimer's patients "found that inconsistent or detached caregiving can cause Alzheimer’s patients to lose trust in their loved ones, exacerbating physical symptoms of the disease." At some point, roles reverse in life and adult children must take charge of their parents' care. This is never easy. But my friend's approach - to provide the gift of respite care that best fits their needs and lifestyle - is an excellent start.

It may be in-home care; it may be adult day care so both of them get out of the house and interact with others, which is critical to anyone's well-being. Isolation is common as the caregiving role evolves and the couple becomes more co-dependent and fearful of being in public. They no longer wish to attend social functions and even shut out family that may be urging them to make a big change.

Every adult child should be aware of what options are available for aging parents and have frank, honest discussions early on - such as when discussing advanced directives or living wills - to find out a parent's preferences and then help them receive those services when needed. If a couple is childless, than a close relative can fill that role. This, of course, is much easier for some sandwich families than others, but searching for financial assistance is another way to help.

Upcoming Free Workshops for Family Caregivers

Living with Alzheimer's for Caregivers: Early Stage
This two-part series provides practical answers to the questions that arise in the early stage of Alzheimer's Disease. The classes are presented by the Alzheimer's Association and will be held noon to 2 p.m. on Wednesday, February 6 and 13, at Somerford Place Encinitas (1350 South El Camino Real, Encinitas CA 92024). Register at (800) 272-3900.

The Power of Touch
This is a free two-hour workshop from 1:30 to 3:30 p.m. on January 3, February 7 and March 7 is designed to provide caregivers with essential tools for self-care and relaxation. The sessions take place at the Herrick Community Health Care Library (9001 Wakarusa Street, La Mesa, CA 91942). Learn simple techniques to manage caregiver burnout, increase relaxation and promote healing. This program includes lecture, demonstration and experiential learning. Please dress comfortably. Registration is required by calling (800) 827-4277 or www.sharp.com.

Help! I'm a Caregiver
Are you helping a loved one with socialization, finances, transportation, meals or other activities? Find out about resources for family caregivers, placement options, support groups and more. This free class also covers emotional issues about caring for a loved one. The class, led by Andrea Holmberg of the Sharp Senior Resource Center, takes place from 2 to 4 p.m. on Thursday, February 7 at Sharp Grossmont Hospital's Brier Patch Campus (9000 Wakarusa Street, Room 13/14, La Mesa CA). To register call (800) 827-4277 or visit www.sharp.com.

Addressing Behavior Through Compassionate Communication
Learn ways to imrpove communication with memory-impaired individuals from 10 a.m. to noon on Thursday, February 7 at the Escondido Senior Center (210 Park Avenue, Escondido CA 92025). Call the Alzheimer's Association to register at (800) 272-3900.

Planning for Future Health Care Needs
This dynamic one-hour workshop will provide participants with the tools to help identify values, goals of care and the communication skills required to select the appropriate health care agent. Led by Colleen Linnertz, LMFT, the workshop will be held 10 to 11:30 a.m. on Saturday, February 9 at Sharp Memorial Outpatient Pavilion (3075 Health Center Drive, San Diego CA). Registration required by calling (800) 827-4277 or visiting www.sharp.com.

Living with Alzheimer's for Caregivers: Middle Stage
This two-part series will be held 11 a.m. to 1 p.m. on Thursday, February 14 and 28, 2013 at Silverado Senior Living Escondido (1500 Borden Road, Escondido, CA 92026. Learn practical answers to the questions that arise in the middle stage of Alzheimer's Disease. To register, contact the Alzheimer's Association at (800) 272-3900.

The Diagnosis, Management and Treatment of Lewy Body Dementia
Do you have a family member or friend with dementia with Lewy Bodies or Parkinson's Disease with dementia? if so, the Southern Caregiver Resource Center, UCSD Parkinson's Disease Research Consortium and Parkinson's Association of San Diego invite you and your loved ones to a free conference. The event takes place 8:30 a.m. to 12 noon on Friday, February 15 at First United Methodist Church's Linder Hall (2111 Camino del Rio South, San Diego CA 92108) and includes breakfast, resource fair and free care for your loved one upon request. Keynote speaker is Dr. Jody Corey-Bloom, M.D., Ph.D, a professor of neurosciences at UCSD. To register, call (800) 827-1008.

Town Hall Forum: Making a Plan, The Smart Approach to Future Alzheimer's Care Needs
This caregiver forum presented by ActivCare will focus on how to plan for the future as Alzheimer's disease or another dementias progress. The sessions takes place from 8:30 a.m. to 12:30 p.m. on Thursday, February 21, at the Lake San Marcos Resort Conference Center (1121 La Bonita Drive, San Marcos CA 92078). Speakers include Drs. Neil Levine and Dan Sewell from the Glenner Memory Care Advisory Council and board member Judi Copeland of AALL CARE In-Home Services. Geriatric Care Manager Jean Alton rounds out the speaker roster. Free day care provided by the Glenner Center Encinitas with at least a week's advanced registration by calling (760) 635-1895. To register for the Town Hall Forum, call (888) MEM-LOSS or visit ActivCareLiving.com.

Know the 10 Signs: Early Detection Matters
This workshop provides attendees with information about the difference between normal aging and Alzheimer s Disease, the benefits of early detection, as well as tips to follow up on any concerns that attendees may have about themselves or someone they care about. Presented by Holly Probst of the Alzheimer's Association, the workshop runs 1 to 2 p.m. on Monday, February 25 at the Sharp Memorial Outpatient Pavilion, Classroom A. Register at (800) 827-4277 or (800) 272-3900.

Raised Risks for People with Parkinson's

Last month a study advised people with degenerative nerve disease to undergo regular skin cancer screenings.

While it's a good idea for anyone considered at risk of skin cancers to be screened regularly for abnormalities, researchers at the University of Nebraska Medical Center in Omaha urge those with Parkinson's disease to be especially vigilant. That's based on their findings that melanoma occurs more often in patients with Parkinson's than in the general population.

The study was conducted at 31 different North American centers and included 2,106 patients with Parkinson's disease, who undersent various examinations and, when applicable, biopsies of suspicious moles or growths. Of that group, 20 had localized melanomas and another 68 had a history of melanoma, according to the Archives of Neurology (March, 2010).

Interestingly, the study noted that 85 percent of patients had taken levodopa, but researchers found no evidence this related to melanoma risks.

'What Caregiving Taught Me'

Our George G. Glenner Alzheimer's Family Centers, Inc., are all about caregiving. When we discover an article to aid caregivers of dementia patients, we like to pass it on. The same goes for authors like Carol O'Dell of the blog Mothering Mother and More. She's the author of a memoir about her time caring for a parent, and her insights are both accurate and encouraging for anyone who is or will be in her position.

Today she's written a particularly poignant post called What Caregiving Taught Me. We highly recommend you head over a view her list of lessons. Here's an excerpt to whet your appetite:

After a decade of caring for my mother who had Parkinson’s, Alzheimer’s and heart disease, then brought her into our home the last 2+ years of her life, this is the distilled version of what caregiving taught me. I am profoundly grateful for these lessons.

1.To stand up for myself, and caregiving will give me plenty of opportunities to do so.
2.There is a time in life in which you sacrifice for someone you love–and a time to stop sacrificing.
3.It takes humor to tackle the big scary things in life, like caregiving, disease, and death.
4.Caregiving will inevitably bring out the worst–and the best in me.
5.Caregiving will change me, but it’s up to me to determine how.

Now, head over to read the other 15 lessons included in the post.