Over the past couple of years in my conversations with people with dementia, I’ve come across a lot of confusion over MRI’s and the diagnosis of Alzheimer’s. Many were surprised to learn that their brain MRI’s were perfectly normal AND they had Alzheimer's Disease. One woman was told by her physician that because her MRI was normal, she couldn’t possibly have dementia.
The truth is, especially if you’re in the early stages of Alzheimer’s, there will likely be no cellular loss visible on your MRI. You can be forgetting how to drive home a mile from your house and the MRI image of your brain can look completely normal. How can this be?
It used to be the standard thought that amyloid plaques and/or neurofibrillary tangles got deposited in the brain, and these deposits “gunked” up the neurons and caused them to die. And this neuronal death caused Alzheimer’s.
Here’s the new thinking.
The cognitive deficits–the symptoms of dementia–occur BEFORE the plaques form, before the neurons die. In the brain of someone with Alzheimer’s, there is too much of a soluble protein called Amyloid Beta 42. Either too much is made or not enough is cleared away. When too much is present in the synapse, these individual little peptides stick together and form small oligomers. These oligomers of Amyloid Beta 42 lodge in the synapses and interfere with synaptic transmission—the ability of neuron #1 to give it’s electrochemical information to neuron #2. Through a complex molecular cascade, these oligomers are specifically impairing neurotransmission through NMDA receptors, a very important kind of transmission necessary for something called Long Term Potentiation.
So these oligomers of Amyloid Beta 42 lodge in synapses and prevent good neurotransmission from neuron #1 to neuron #2. And behaviorally, new information isn’t learned. Or old information can’t be accessed. Synaptic plasticity suffers. Over time, because these synapses aren’t working properly and because of inflammation and other problems, those nerve axon terminals will retract. Eventually, unable to function, the neurons will die, leaving behind empty space (the atrophy seen on an MRI) and possibly heaps of Amyloid Beta 42 in amyloid plaques.
So it all starts as an attack on the synapses. The degree of dementia correlates only with synapse dysfunction, not with neuronal loss, not with number of plaques, not with atrophy on an MRI.
The cure for dementia then, the kind of treatments that will be disease-altering, will
1. Impede production of Amyloid Beta 42, or will
2. Increase clearance of already-produced Amyloid Beta 42, or will
3. Prevent Amyloid Beta 42 from sticking to itself so it can’t form oligomers, or it will
4. Rip these already-formed oligomers apart.
The beauty and the hope in all of these treatments—people suffering from symptoms of dementia can be treated BEFORE they’ve experienced any neuron death. If the synapses are fixed, neurotransmission can work again. Function can be restored!
Thursday, September 6, 2007
Sunday, September 2, 2007
New book helps those with dementia
New book helps those with dementia
by Myrna Fearer DANVERS HERALD
Thursday, January 18, 2007 - Updated: 05:00 PM EST
Susan Berg loved taking pictures of her two sons when they were babies. Now, the activity director at Hunt Nursing and Retirement Home on Lindall Street has found a way to turn some of those pictures into a learning tool for people with dementia.
“Adorable Photographs of Our Baby: Meaningful, Mind-stimulating activities and More for the Memory Challenged, Their Loved Ones, and Involved Professionals,” is a book that is designed to stimulate interactive conversation between those with dementia and Alzheimer’s disease and caregivers, therapists and anyone else who has the patience to work with this population.
“I’ve used photographs before; they love babies,” said Berg, who has cut out pictures from magazines and other sources for picture books she’s made for the dementia residents at the nursing home. “Even these people with dementia are hard-wired for emotions. They love babies and kids. Put them in a room and they react.”
Berg’s book, however, isn’t a book of just 14 colorful pictures of cute babies. Each picture was chosen for a purpose. Each one is accompanied by suggestions for its use, just like a manual for classroom teachers. Berg has included ideas for getting the folks involved in the activity pictured and also encouraging those with dementia to come up with their own reasons and comments. She stresses there are no right or wrong answers. Berg has shared ideas she has employed successfully in her own work.
“It took me about two years to do this,” said Berg, who went through thousands of baby photos before she arrived at the 14 she chose. “I tried to pick pictures highlighting the primary colors, pictures that are colorful and large.
“I also thought about a day, going through daily activities, pictures that stimulate conversation and thinking. It’s important that you keep them mentally active so their cognitive decline is lessened.”
Berg, a native of Wisconsin, earned her bachelor’s degree in medical technology from the University of Wisconsin at Milwaukee. Marriage to Stanley Berg, a mortgage loan officer, brought the couple to this area. They’ve made their home in Danvers for 34 years, where they’ve raised two sons: Joe, 27, works in a law firm, and Alex, 25, is graduating from George Washington University Law School.
Berg spent many years volunteering at the Great Oak School when her sons were young. She also taught after-school classes. When the family moved into a house with a pool, Berg took swimming lessons at the Danvers YMCA, earned her lifeguard certification — one of the oldest in the class — and for a time, was a lifeguard at Bally Fitness.
“I had worked in a lab for 12 years and I knew I didn’t want to be in a lab,” said Berg, who also was a computer instructor. “I decided to look into the COTA (certified occupational therapy assistant program) at North Shore Community College. It was a long wait to get in; it’s a very popular program.”
Berg finally gained admission to the two-year program, adding an associate’s degree to the bachelor’s degree she already held. Her first job, in 2000, was at Peabody Glen, which has a certified dementia unit. When there was an opening at Hunt Nursing and Retirement Home in 2001, Berg accepted it and has been there 5 1/2 years.
“I really take this job very seriously,” Berg said. “I also do a lot of work at home.”
Through the years, Berg has become expert on working with people with dementia and willingly shares her knowledge. She says keeping them mentally active is a must, keeping them from undergoing a catastrophic event is important. It’s also important to remember that everybody has something good about them and always build on their strengths.
“They have no reality orientation,” she explained. “If they think it’s 1960 and they’re 35, that’s fine. This is a happy place. We don’t talk about bad news. It does absolutely nothing for the person and they end up feeling bad but they don’t know why. Emotions are the last thing to go.”
Ever attuned to current resources for Alzheimer’s and dementia patients, Berg realized there was still something missing, a book like hers. Berg has taken her knowledge and all the expertise she has amassed through the years and self-published, “Adorable Photographs of Our Baby.” She also has published large flash cards to accompany the book as another teaching tool.
Books, at $15.95each, are available at the Hunt Nursing & Retirement Home, through the author, Sea Bay Game Co. and Amazon.com. Flashcards are $12.95. A portion of the proceeds from the sales will go to the Alzheimer’s Association.
by Myrna Fearer DANVERS HERALD
Thursday, January 18, 2007 - Updated: 05:00 PM EST
Susan Berg loved taking pictures of her two sons when they were babies. Now, the activity director at Hunt Nursing and Retirement Home on Lindall Street has found a way to turn some of those pictures into a learning tool for people with dementia.
“Adorable Photographs of Our Baby: Meaningful, Mind-stimulating activities and More for the Memory Challenged, Their Loved Ones, and Involved Professionals,” is a book that is designed to stimulate interactive conversation between those with dementia and Alzheimer’s disease and caregivers, therapists and anyone else who has the patience to work with this population.
“I’ve used photographs before; they love babies,” said Berg, who has cut out pictures from magazines and other sources for picture books she’s made for the dementia residents at the nursing home. “Even these people with dementia are hard-wired for emotions. They love babies and kids. Put them in a room and they react.”
Berg’s book, however, isn’t a book of just 14 colorful pictures of cute babies. Each picture was chosen for a purpose. Each one is accompanied by suggestions for its use, just like a manual for classroom teachers. Berg has included ideas for getting the folks involved in the activity pictured and also encouraging those with dementia to come up with their own reasons and comments. She stresses there are no right or wrong answers. Berg has shared ideas she has employed successfully in her own work.
“It took me about two years to do this,” said Berg, who went through thousands of baby photos before she arrived at the 14 she chose. “I tried to pick pictures highlighting the primary colors, pictures that are colorful and large.
“I also thought about a day, going through daily activities, pictures that stimulate conversation and thinking. It’s important that you keep them mentally active so their cognitive decline is lessened.”
Berg, a native of Wisconsin, earned her bachelor’s degree in medical technology from the University of Wisconsin at Milwaukee. Marriage to Stanley Berg, a mortgage loan officer, brought the couple to this area. They’ve made their home in Danvers for 34 years, where they’ve raised two sons: Joe, 27, works in a law firm, and Alex, 25, is graduating from George Washington University Law School.
Berg spent many years volunteering at the Great Oak School when her sons were young. She also taught after-school classes. When the family moved into a house with a pool, Berg took swimming lessons at the Danvers YMCA, earned her lifeguard certification — one of the oldest in the class — and for a time, was a lifeguard at Bally Fitness.
“I had worked in a lab for 12 years and I knew I didn’t want to be in a lab,” said Berg, who also was a computer instructor. “I decided to look into the COTA (certified occupational therapy assistant program) at North Shore Community College. It was a long wait to get in; it’s a very popular program.”
Berg finally gained admission to the two-year program, adding an associate’s degree to the bachelor’s degree she already held. Her first job, in 2000, was at Peabody Glen, which has a certified dementia unit. When there was an opening at Hunt Nursing and Retirement Home in 2001, Berg accepted it and has been there 5 1/2 years.
“I really take this job very seriously,” Berg said. “I also do a lot of work at home.”
Through the years, Berg has become expert on working with people with dementia and willingly shares her knowledge. She says keeping them mentally active is a must, keeping them from undergoing a catastrophic event is important. It’s also important to remember that everybody has something good about them and always build on their strengths.
“They have no reality orientation,” she explained. “If they think it’s 1960 and they’re 35, that’s fine. This is a happy place. We don’t talk about bad news. It does absolutely nothing for the person and they end up feeling bad but they don’t know why. Emotions are the last thing to go.”
Ever attuned to current resources for Alzheimer’s and dementia patients, Berg realized there was still something missing, a book like hers. Berg has taken her knowledge and all the expertise she has amassed through the years and self-published, “Adorable Photographs of Our Baby.” She also has published large flash cards to accompany the book as another teaching tool.
Books, at $15.95each, are available at the Hunt Nursing & Retirement Home, through the author, Sea Bay Game Co. and Amazon.com. Flashcards are $12.95. A portion of the proceeds from the sales will go to the Alzheimer’s Association.
Book helps people talk to dementia patients
Published: January 17, 2007 11:22 pm
Book helps people talk to dementia patients
By Amanda McGregor
THE SALEM NEWS (SALEM, Mass.) and other newspapers throughout the country
DANVERS, Mass. — Jorgelina Zeoli’s elderly mother lit up when she leafed through a new book and flash cards of baby photos, designed for dementia patients.
The “Adorable Photographs of Our Baby” picture book features large print and simple sentences alongside photos of babies splashing in a sudsy bath, lying in a crib, making a mess in a high chair, licking a chocolatey mixing spoon and singing, among other activities.
“I showed the pictures to my mom, and the change in her expression was just extraordinary — it was really a magical moment,” said Zeoli, whose 88-year-old mother suffers from advanced dementia. “This is a response that doesn’t need to involve reasoning or memory.”
The book was self-published last month by Susan Berg, a longtime Danvers resident and employee at the Hunt Nursing and Retirement Home.
Music is one of the most useful tools to stimulate patients with Alzheimer’s and other forms of dementia, but Berg saw a lack of visual, conversation-stimulating exercises — a big problem since 4.5 million Americans currently suffer from dementia.
People often don’t know what to talk about with dementia patients, Berg said.
“What I see, unfortunately all the time, is families pulling out the old family album and saying, ‘Do you know who this is?’ And the person doesn’t, and they feel negative emotion,” said Dr. Paul Raia, director of patient care and family support for the Massachusetts chapter of the Alzheimer’s Association.
“That’s the advantage of this particular exercise, is that it’s open-ended, and it doesn’t depend on the person remembering something.”
Each flash card has a different picture with an “idea page” on the reverse side, listing possible questions.
For example, the flash card of a toddler kissing his baby brother has questions like, “Does the baby’s brother love him? Who else loves the baby? What else do you love? If the participant needs help, say: ‘I love ice cream, do you?’ Sing one or more songs about love. Recite a poem about love: something as simple as ‘Roses are Red, etc.’”
Berg and her colleagues have piloted her book and flash cards at the Hunt Nursing Home.
“Anything to do with babies really seems to brighten their days,” said Catrenia Joly, nurse manager for the dementia unit.
“It’s a wonderful opportunity to ... generate a lot of their own ideas and creativity, which they still have,” said Victoria Morrow, an activities aide who runs the music program at Hunt. “One of the most valuable things you can offer people with dementia, besides music, is a decent conversation.”
For Berg, 57, “Adorable Photographs of Our Baby” is her first foray into writing. Originally from Milwaukee, she moved to Danvers in 1973 with her husband, Stanley, and worked in hospital laboratories and then as a volunteer computer teacher in the Danvers schools, among other jobs. In 2000, she graduated from North Shore Community College’s occupational therapy assistant program, and started working at Hunt the following year.
Her two sons — whose baby pictures are the fodder for the new book — went through the Danvers schools starting at Great Oak. Now Joe, 27, lives in Brighton, and Alex, 25, is in his final year of law school
Q&A
How did you get the idea for the book?
I had been doing things like this on an informal basis with the residents here.
Why write a book?
Oftentimes, when people come to visit someone with dementia, they don’t know what to talk about. The first thing out of their mouth is, ‘Do you remember?’ That is the worst thing to say.
What should people say?
Say, ‘Hi, my name is so-and-so. Look at what I have to show you.’ Then you look at pictures and have a nice conversation.
Where did you get the photos?
They are all my two sons. I had to weed through lots of pictures, and I took out the ones that would be more embarrassing.
Why babies?
People are hard-wired to like babies.
Book helps people talk to dementia patients
By Amanda McGregor
THE SALEM NEWS (SALEM, Mass.) and other newspapers throughout the country
DANVERS, Mass. — Jorgelina Zeoli’s elderly mother lit up when she leafed through a new book and flash cards of baby photos, designed for dementia patients.
The “Adorable Photographs of Our Baby” picture book features large print and simple sentences alongside photos of babies splashing in a sudsy bath, lying in a crib, making a mess in a high chair, licking a chocolatey mixing spoon and singing, among other activities.
“I showed the pictures to my mom, and the change in her expression was just extraordinary — it was really a magical moment,” said Zeoli, whose 88-year-old mother suffers from advanced dementia. “This is a response that doesn’t need to involve reasoning or memory.”
The book was self-published last month by Susan Berg, a longtime Danvers resident and employee at the Hunt Nursing and Retirement Home.
Music is one of the most useful tools to stimulate patients with Alzheimer’s and other forms of dementia, but Berg saw a lack of visual, conversation-stimulating exercises — a big problem since 4.5 million Americans currently suffer from dementia.
People often don’t know what to talk about with dementia patients, Berg said.
“What I see, unfortunately all the time, is families pulling out the old family album and saying, ‘Do you know who this is?’ And the person doesn’t, and they feel negative emotion,” said Dr. Paul Raia, director of patient care and family support for the Massachusetts chapter of the Alzheimer’s Association.
“That’s the advantage of this particular exercise, is that it’s open-ended, and it doesn’t depend on the person remembering something.”
Each flash card has a different picture with an “idea page” on the reverse side, listing possible questions.
For example, the flash card of a toddler kissing his baby brother has questions like, “Does the baby’s brother love him? Who else loves the baby? What else do you love? If the participant needs help, say: ‘I love ice cream, do you?’ Sing one or more songs about love. Recite a poem about love: something as simple as ‘Roses are Red, etc.’”
Berg and her colleagues have piloted her book and flash cards at the Hunt Nursing Home.
“Anything to do with babies really seems to brighten their days,” said Catrenia Joly, nurse manager for the dementia unit.
“It’s a wonderful opportunity to ... generate a lot of their own ideas and creativity, which they still have,” said Victoria Morrow, an activities aide who runs the music program at Hunt. “One of the most valuable things you can offer people with dementia, besides music, is a decent conversation.”
For Berg, 57, “Adorable Photographs of Our Baby” is her first foray into writing. Originally from Milwaukee, she moved to Danvers in 1973 with her husband, Stanley, and worked in hospital laboratories and then as a volunteer computer teacher in the Danvers schools, among other jobs. In 2000, she graduated from North Shore Community College’s occupational therapy assistant program, and started working at Hunt the following year.
Her two sons — whose baby pictures are the fodder for the new book — went through the Danvers schools starting at Great Oak. Now Joe, 27, lives in Brighton, and Alex, 25, is in his final year of law school
Q&A
How did you get the idea for the book?
I had been doing things like this on an informal basis with the residents here.
Why write a book?
Oftentimes, when people come to visit someone with dementia, they don’t know what to talk about. The first thing out of their mouth is, ‘Do you remember?’ That is the worst thing to say.
What should people say?
Say, ‘Hi, my name is so-and-so. Look at what I have to show you.’ Then you look at pictures and have a nice conversation.
Where did you get the photos?
They are all my two sons. I had to weed through lots of pictures, and I took out the ones that would be more embarrassing.
Why babies?
People are hard-wired to like babies.
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