Blogs » High Blood Pressure Puts Strain on Brain
Blogs » High Blood Pressure Puts Strain on BrainOver the years, multiple studies have shown links between deteriorating brain health and high blood pressure. One such study recently published in the journal Stroke found that older people with high blood pressure tended to have a greater accumulation of white matter on their brains. Past studies on people with various forms of dementia—including Alzheimer’s disease—have found that people with the most severe forms of dementia have this so-called white matter. White matter is basically scarring that’s formed on the brain.
Dementia and end of life
Sobering reading but I am 100% behind palliative care and a "good death" rather than aggresive intervention near end of life..
@Times - Inside NYTimes.com by E-Mail: "Dementia is often viewed as a disease of the mind, an illness that erases treasured memories but leaves the body intact.
Health Guide: DementiaBut dementia is a physical illness, too — a progressive, terminal disease that shuts down the body as it attacks the brain. Although the early stages can last for years, the life expectancy of a patient with advanced dementia is similar to that of a patient with advanced cancer.
The lack of understanding about the physical toll of dementia means that many patients near the end of life are subjected to aggressive treatments that would never be considered with another terminal illness. People with advanced dementia are often given dialysis and put on ventilators; they may even get preventive care that cannot possibly help them, like colonoscopies and drugs for osteoporosis or high cholesterol.
The continued focus on treatment to prolong life often means that pain relief is inadequate, and symptoms like confusion and anxiety are worsened. A new study suggests that family members would be far less likely to subject their loved ones to such treatment if they had a better understanding of dementia as progressive, debilitating illness that ultimately shuts down the body after years of mental deterioration.
Harvard researchers recently followed 323 residents of 22 nursing homes. All had end-stage dementia, meaning that they no longer recognized family members, could speak fewer than six words and were incontinent and bedbound. During the 18-month study period, more than half of the patients died.
During the last three months of life, 41 percent of the patients received at least one “burdensome” treatment, like transport to the emergency room, hospitalization, feeding tubes or intravenous treatments. Advanced dementia patients are particularly prone to infections because of incontinence, risk of bedsores, a depressed immune response and inability to report symptoms.
When the investigators looked more deeply into the reasons for treatment decisions, they discovered stark differences based on what family members knew about dementia. When they understood its progressive and terminal nature, only 27 percent of the patients received aggressive care. For family members who did not understand the disease, the figure was 73 percent.
“When family members understood the clinical course of dementia and the poor prognosis, the patients were far less likely to undergo these distressing interventions,” said the study’s lead author, Dr. Susan L. Mitchell, senior scientist at the Institute for Aging Research of Hebrew SeniorLife in Boston. “Dementia is a terminal illness and needs to be recognized as such so these patients receive better palliative care.”
The study also found that pain control was often inadequate. One in four subjects were clearly suffering from pain, but that number may understate the problem, because the patients were unable to talk about their pain.
Dr. Sachs, at Indiana, notes that care for patients with dementia has changed very little in the past 30 years. As a teenager, he watched his grandmother decline from Alzheimer’s disease. During her final months, she was repeatedly treated for infections and put in restraints or sedated to control agitation. "
A 2005 report from the Alzheimer’s Association showed troubling trends in care at the end of life. In a sweeping review of the medical literature, the investigators found that 71 percent of nursing home residents with advanced dementia died within six months of admission, yet only 11 percent were referred to hospice care, which focuses on comfort rather than active treatment.
Simply transferring a dementia patient from the nursing home to a hospital can lead to confusion, falls or a decline in eating — which in turn, often leads to further aggressive treatment.
Geriatricians say a large part of the problem is that the patients are unable to make their wishes known. In the absence of a living will, family members often struggle with guilt and are afraid to stop aggressive treatment because they do not want to be seen as abandoning a loved one in mental decline.
Dr. Sachs says doctors need to spend more time explaining the prognosis for advanced dementia, making it clear that palliative care does not mean less care.
“We’re not talking about aggressive care versus no care,” he said. “Palliative care is aggressive and attentive and focused on symptom management and support of the patient and family. It’s not any less excellent care.”
Latest news - The leading UK research charity for dementia: "Number of people with dementia worldwide to double every 20 years 21st September 2009
The number of people with Alzheimer’s and other dementias will nearly double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050, according to a new Alzheimer's Disease International (ADI) study, released this World Alzheimer’s Day.
The 2009 report, published by Alzheimer’s Disease International (ADI), was prepared by a research team headed by Professor Martin Prince from the Institute of Psychiatry at King’s College London. It covers the global prevalence of dementia, the impact of dementia worldwide, and a detailed analysis of the challenges faced by governments and healthcare systems worldwide."
Latest news - The leading UK research charity for dementia: "Government under pressure to publish antipsychotic review 7th October 2009
10 leading dementia organizations, including the Alzheimer’s Research Trust, are demanding that the government publishes its long-delayed review into the widespread misuse of antipsychotic – or ‘chemical cosh’ – drugs.
Earlier this year, an Alzheimer’s Research Trust-funded study published in Lancet Neurology found that antipsychotic drugs double risk of death for many patients if used over a three year period. As many as 100,000 people with dementia are routinely prescribed antipsychotics in UK care homes. This could mean 23,500 people dying prematurely, according to a 2008 report by Paul Burstow MP."
News about mental health on the Mental Health Foundation website: "Neural networks mapped in dementia patients Full StoryDifferent types of dementia show dissimilar changes in brain activity. A network mapping technique described in the open access journal BMC Neuroscience has been applied to EEG data obtained from patients with Alzheimer's disease (AD) and frontotemporal lobar degeneration (FTLD, a less common type of dementia with more prominent behavioral symptoms)."
Curry a day could keep dementia away - Yahoo! News UK: "Having a curry once or twice a week could stave off Alzheimer's disease, it has been claimed. Skip related contentCurcumin, an ingredient in turmeric, which is used widely in Indian cuisine, is believed to prevent changes in the brain by blocking the spread of amyloid plaques - toxic protein deposits thought to play a key role in Alzheimer's.
Members of the Royal College of Psychiatrists were told at their annual meeting in Liverpool that laboratory and animal studies have already produced strong evidence that curry combats dementia.
A clinical trial is now under way in California to test the effects of curcumin on a group of Alzheimer's patients."
TV series lifts curtain on Alzheimer's - MayoClinic.com HBO Documentary Films and the National Institute on Aging at the National Institutes of Health lift a curtain on the lives of those impacted by Alzheimer's disease, as well as the most cutting edge advances from those who treat and study the disease, in a new documentary project.
The "Los Angeles Times" wrote that the 4-part HBO documentary is "an ambitious, disturbing, emotionally fraught and carefully optimistic film exploring virtually every angle of Alzheimer's disease that can be explored on television."
If you haven't already, I invite you to watch these films and offer your reaction, beginning with "The Memory Loss Tapes." After watching, consider sharing your thoughts. What affected you the most and why?
The series is available on HBO, HBO on Demand, or you can watch for free on your computer at www.hbo.com/alzheimer's, where many other resources are available.
