Are you putting yourself at risk for dementia with OTC medications and prescription drugs?

Reading Instructions from PharmacyA new study links the increased risk of dementia with certain medications. (Anticholinergic drugs and risk of dementia: case-control study) The focus of the study was on drugs that have anticholinergic effects. Acetylcholine is vital to memory and learning. There are lower levels of this neurotransmitter in the brains of people with Alzheimer’s disease. Additionally, animal studies have shown that anticholinergic drugs may contribute to brain inflammation, another risk factor for dementia.

It’s estimated that approximately 50% of adults in the U.S. take one or more medications with an anticholinergic effect. Some of the most common are:

  • amitriptyline (Endep, Elavil), paroxetine (Paxil, Pexeva), and bupropion (Aplenzin, Wellbutin). These drugs are commonly taken for depression)
  • oxybutynin and tolterodine, taken for an overactive bladder, found in Ditropan, Oxytrol.
  • diphenhydramine, a common antihistamine found in: Advil PM, Aleve PM, Bayer PM, Benadryl, Excedrin PM, Nytol, Simply Sleep, Sominex, Tylenol PM, Unisom, etc.
  • Chlorpheniramine, found in Actifed, Allergy & Congestion RElief, Chlor-Trimeton, Codeprex, Efidac-24 Chlorpheniramine, etc.

According to Shelly Gray, professor pharmacy at the University of Washington, and author of  Cumulative Use of Strong Anticholinergics and Incident Dementia” (March 2015, JAMA Internal Med.), the longer people took the drugs and the higher the dose, the higher the risk of dementia, although it’s important to note that short-term use was not linked to higher risks.

Gray suggested that people, especially seniors, who have trouble sleeping find a non-drug therapy for insomnia Celexa and Prozac for depression and Claritin for allergies.  She emphasized that it is important to speak with one’s doctor before stopping a medication that you have been taking.

Natural alternatives

Help for depression

  1. Get some physical exercise every day; even just a 20 minute walk helps tremendously.
  2. Use aromatherapy oils. For more information about the use of aromatherapy to reduce stress, improve immunity, reduce agitation, and to promote relaxation read chapter 18 “Aromatherapy” in “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” by Barbra Cohn
  3.  I gave my husband Ginkgo biloba for depression (and also took it myself). It helped right up until he was in late stage Alzheimer’s. One word of advice, not all brands are efficacious, so pick one carefully. Also note that it takes about 6 weeks to notice an effect. This is a typical difference of taking a pharmaceutical versus a natural remedy.
  4. Vitamin B complex optimizes cognitive activity and brain function, has a positive effect on memory, learning capacity and attention span, and supports a healthy nervous system and a stable mood. Vitamins B6 and B12, in particular, play a role in the synthesis of serotonin, the neurotransmitter linked to improving memory, lifting mood and regulating sleep.
  5. Omega-3 fatty acids are rich in DHA, the major unsaturated fat in the brain. This long-chain fatty acid provides the necessary fluid quality to the membranes of the nerve cells so that electrical nerve impulses can flow easily along the circuits of the brain. One study found that Alzheimer’s patients given an omega-3-rich supplement experienced a significant improvement in their quality of life.
  6. Maintain your social connections. Loneliness can actually lead to health problems and mental decline. Join a group—any kind of group: worship,  hiking, scrabble, table tennis, knitting, discussion group, or book club. Volunteer at a food bank, soup kitchen or animal shelter. It’s important to stay connected and to feel as though you are a contributing member of society.

Natural sleep aids

  1. Try valerian, passion-flower or skullcap herbal tea at least a couple of hours before bedtime.
  2. A cup of warm milk with a small pinch of cardamom, coriander, cinnamon, turmeric and cumin, and an 1/8 of a tsp of ghee is a tasty and relaxing bedtime drink. The calcium in the milk is a muscle relaxant and the Indian spices help induce relaxation. Experiment to see which spices you like.
  3. Eat a banana. Bananas contain potassium and magnesium that help reduce risk of muscle cramps. These two minerals also support heart health and cognitive function.
  4. A drop in blood sugar during the night can cause us to wake up. Although it’s better to not go to sleep on a full stomach, a small protein snack such as a slice of cheese or smear of peanut butter on a cracker can help maintain balanced blood sugar.
  5. Melatonin supplements help some people, but you might have to experiment with the dosage. I like Natural Vitality’s Natural Calm, a powdered calcium supplement that you put in water or juice. I also like the homeopathic remedy Hyland’s Calms Forte.
  6. Spritz lavender oil on your pillow or put a sachet of lavender flowers under your pillow.

Natural antihistamines

  1. Quercetin is a bioflavonoid that is naturally found in plant foods such as apples, cruciferous vegetables (like broccoli or cauliflower), onions/shallots, green tea and citrus fruits. It stabilizes the release of histamines and helps to naturally control allergy symptoms.
  2. Apple cider vinegar is my new “go to” remedy for almost everything. I take 1 Tablespoon everyday by pinching my nose and drinking water to flush it down. It helps alkalize the body and supports immune function.
  3. Butterbur is a natural herb that is sold as an extract. A study published in August 2005 in Phytotherapy Research found that when compared to an antihistamine, the butterbur extract worked just as well, without the side effect of drowsiness.
  4. Remember that Claritin does not contain diphenhydramine, so use it by all means if these other remedies do not do the trick.

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Do you worry about developing digital dementia?

Cropped Group of friends standing on table and browsing in their divices in modern roomI recently listened to a lecture about the dangers of digital dementia, and I think it’s an important topic to explore on the healthycaregiverblog. Essentially, it’s a condition that develops overtime after becoming addicted to and overusing digital technology. This includes smart phones, computers, reading devices, and tablets. The term was coined by German neuroscientist Manfred Spitzer and describes how the result of overuse of digital technology is resulting in the breakdown of cognitive abilities, which first appear as something similar to attention disorder.

Our kids are on their phones too much, they play video games for hours, and studies have shown they are having an increasingly harder time concentrating on schoolwork. An article in Psychology Today (Susan Greenfield Ph.D., 7.1.15) says “We know that action video gaming is linked with greater brain volume in the striatum (1) but this may be at the expense of a reduction in hippocampal volume. (2) Although this proposal requires further investigation, previous research has shown that reduced grey matter in the hippocampus is associated with an increased risk for schizophrenia, post-traumatic stress disorder, depression and dementia, amongst other disorders.”

According to the Kaiser Foundation’s shocking report, elementary-age children use entertainment technology for an average of 7.5 hours a day.

  • 75% of these children have televisions in their bedrooms
  • 68% of two-year-olds regularly use tablets
  • 59% have smartphones
  • 44% have game consoles.

While occasional digital screen time may be okay, many parents rely on them for babysitting and some peace and quiet. An ASHA Survey of the U.S. states that:

“…more than half of parents surveyed say they use technology to keep kids ages 0–3 entertained; nearly 50% of parents of children age 8 report they often rely on technology to prevent behavior problems and tantrums.”

However, just because something is common doesn’t mean it’s okay. What exactly should we be worried about?

Spitzer proposes that short-term memory pathways will start to deteriorate from underuse if we overuse technology. I know for my self that I am addicted to checking my email and friends’ Facebook posts. I have also realized that it is more difficult for me to concentrate on reading the newspaper because I can get the nugget of information more quickly online than reading an entire article. I’m just thankful my overuse of technology hasn’t gotten in the way of my love for reading hand-held old-fashioned books.

But what about putting myself at risk for dementia? Should I worry? Should you worry?

YES!

Here’s why: All digital devices emit high levels of blue light and blue light has been proven to increase cortisol levels.  Cortisol is the stress hormone.  Chronically elevated cortisol levels can lead to shrinkage in some brain areas, most notably the hippocampus, which is what is associated with memory and recall. This is the area first affected in Alzheimer’s disease.  Elevated cortisol is also a major contributor to obesity and Type II Diabetes.  It also disrupts our normal circadian rhythm leading to sleep disorders. Over 25,000 articles have been published in scientific journals over the last 30 years about the effects of EMF’s (electromagnetic fields) on human health.

I think we all need to be cognizant of how much time we spend behind the screen–any screen, including TV. Here are some ways to turn of the technology, re-establish healthy social interaction and get healthier at the same time.

Include your family in setting these parameters

  1. Get outside as much as possible. Walk more. Get a dog so you have to go outside and walk. Exposure to natural sun light is much preferred over sitting in front of a digital device that emits blue light.
  2. Limit the time digital technology is used in your home. Set a specific time and limit that time.
  3. Read more, read together.
  4. Enjoy a joint or individual project. Have a game night or an ongoing puzzle set up in the family room.
  5. Make it a strict rule: no phones or TV at the dinner table. That includes at  restaurants.
  6. Learn games on non-electronic formats. For instance, instead of learning how to play chess on a computer, get a chess set and set up the board. Leave it out; don’t put it away. It’ll encourage your family to play more often.
  7. Write a play and then act it out for the family or neighborhood
  8. Learn how to play a musical instrument.
  9. Join a sports team.
  10. Walk a neighbor’s dog or babysit.

You will enjoy more social interaction, feel happier, healthier and more at peace with yourself and the world around you.

 

  1. Kühn S, Romanowski A, Schilling C, Lorenz R, Mörsen C, Seiferth N, … & Gallinat J. (2011). The neural basis of video gaming. Translational Psychiatry, 1(11), e53
  2. West GL, Drisdelle BL, Konishi K, Jackson J, Jolicoeur P, & Bohbot VD. (2015). Habitual action video game playing is associated with caudate nucleus-dependent navigational strategies. Proceedings of the Royal Society B, 282(1808)

 

 

Keep your cool with these 10 summertime eating tips

20bb6fee-b988-4716-bd91-23dff6882655It’s summertime and the livin’ is easy—or at least we’d like it to be. This summer is especially hot all over the world. If you’re tired and stressed out from caregiving, these tips will help you stay cooler in summer. The same information applies to those we care for. . . and for everyone.

According to the ancient Indian system of Ayurveda our body consists of three main elements or doshas—Vatta, Pitta and Kapha. Pitta consists of water and fire. It’s hot, so during summer when the temperature rises we want to eat cooling foods. Eating cooling foods not only keeps us from overheating, it reduces the tendency to get irritable, impatient and angry.  (Chapters 20 and 31 in “Calmer Waters: The Caregiver’s Journey through Alzheimer’s and Dementia” contain more information about ayurveda and nutrition that calms down the nervous system and supports immunity.)

  1. First and foremost, stay hydrated. It’s especially important to make sure you and your loved ones are getting enough liquids because when we forget to drink we can become dehydrated quickly, which leads to other health problems. It’s also crucial to keep the brain hydrated in order to maintain mental alertness. Drink plenty of water and stay away from carbonated and caffeinated drinks. Herbal teas, and fresh fruit or vegetable juices are great in summer. Just remember that fruit juices are high in sugar and calories. Coconut water is cooling and helps to replenish electrolytes, which is especially important during and after an illness.
  2. Enjoy the bounty of summer fruits. Peaches, apricots, cherries, watermelon, cantaloupe, and berries are especially good for helping the body reduce the fiery heat of summer. Juice them or make popsicles with watermelon juice or any other combination including yogurt. These are especially helpful to keep seniors hydrated and for people who have trouble chewing.
  3. According to Ayurveda, some of the recommended summer vegetables include cucumber, green leafy vegetables, green beans, squash, zucchini, asparagus, beets and eggplant. Juice a leafy green with cucumber and beets for a delicious cooling drink.
  4. Sprinkle on the herbs and spices. They’re easy to use and contribute added flavor and antioxidants to your diet. Cooling spices include cardamom, coriander, fennel and tumeric. Cooling herbs include cilantro, mint and dill.
  5. Avoid hot, sour and salty foods including fermented food, red meat, and greasy and spicy food. Excess pitta aggravates the tendency towards heartburn and gastric hyperacidity.
  6. Here’s some good news—Ayurveda recommends ice cream during the hot summer months! So by all means, enjoy! Dementia patients are especially fond of ice cream. If the person you are caring for refuses to eat or eats very little, try serving ice cream. It contains protein, calcium and calories, and it’s easy to serve and eat. If weight gain or cholesterol is a concern, select a dairy-free version of America’s favorite dessert. Rice Cream, Coconut Bliss and Soy Delicious make delicious non-dairy, frozen desserts.
  7. Cooling grains include amaranth, barley, quinoa, rice, tapioca and wheat. Use them in salads mixed with veggies. One of my favorites is quinoa salad. Cook 1 cup of quinoa. (Be sure to rinse it first to remove saponin, a naturally occurring chemical that coats each grain to ward off insects. It has a strong, bitter flavor. And yes, it is a pain to rinse quinoa. First soak it and then place it in a very fine mesh strainer and rinse.)  Sauté onion and zucchini, add a handful of fresh corn cut off the cob, mix with the quinoa. Add fresh tomatoes, black beans, and a dressing made with olive oil and balsamic vinegar. Delicious!
  8. Make your own granola. Once you do, you’ll never go back to buying store-bought granola, which is typically filled with sugar. Plus, it is expensive. Oats, almonds, and coconut are all cooling. First toast 1/2 cup of slivered almonds on a cookie sheet in the oven. Watch carefully so they don’t burn. Add to 4 cups of oats, along with 1/2 cup coconut flakes, 1/4 cup coconut oil, 1/4 cup maple syrup. Add 1/2 tsp of cinnamon, if desired. (Cinnamon is warming, but a little bit won’t hurt.) Stir and bake at 325 degrees for about 20 minutes. Add raisins if desired.
  9. For added protein, top your salads with these cooling legumes: garbanzo, pinto, white beans, azuki beans, and black-eyed peas.
  10. If you eat meat try to avoid beef, chicken, and pork during the hot months and use cooling meats such as buffalo, turkey rabbit or venison instead.

Happy eating. . . and stay cool!

Can depression be a sign of dementia?

Depressed Senior Woman Sitting OutsideDepression can affect our memory, and it can result from not being able to do the things that were once easy for us, as in the case of Alzheimer’s or dementia. Depression can result from a number of factors and it often appears differently in different people

Some people are able to hide the fact that they are terribly depressed. I did. I tried to put on a happy face during my husband’s illness, but inside I often felt as though I was dying. Following the recent suicides of Kate Spade and Anthony Bourdain, we have to remind ourselves that we usually don’t know what is happening inside someone else’s head.

Before my husband was diagnosed with younger-onset Alzheimer’s disease he was withdrawn and depressed. I didn’t know what exactly what was going on, and he was unable to articulate how he felt. I eventually realized that he was depressed because the things that were once effortless for him to do, such as driving around town or figuring out how much tip to leave in a restaurant, had become difficult.

Alzheimer’s and depression often occur simultaneously, which often makes it difficult for physicians to make a diagnosis without further testing. According to James M. Ellison, MD of the Swank Memory Care Center, Christiana Care Health System, approximately half of individuals affected by Alzheimer’s disease will experience clinically significant depressive symptoms at some point.  Depression can occur during any phase of the illness.

Symptoms common to Alzheimer’s and depression

  • Loss of interest in things that were once enjoyable
  • Memory issues
  • Sleeping too much or too little
  • Social withdrawal or isolation
  • Impaired concentration
  • Eating too much or too little
  • Crying, feelings of hopelessness, despair
  • Unmotivated
  • Lack of energy, lethargy, apathy
  • Irritability
  • Thoughts of death or suicide

A case of the chicken or the egg: which came first, Alzheimer’s or depression?

Some health professionals think that depression can put one at greater risk for Alzheimer’s. There is also a belief that depression is a symptom of Alzheimer’s. In any case, physicians feel that a person with dementia who is depressed can experience a quicker cognitive decline and need to rely more on caregivers.

What to do?

8 natural ways to combat depression.

Antidepressants may not work as well with people who have Alzheimer’s and are depressed. Before resorting to antidepressants and other drugs,  try these options:

  1. Provide a safe and calm environment. Light candles at dinner, play classical music, have a vase of fresh flowers on the table.
  2. Get some physical exercise every day; even just a 20 minute walk helps tremendously.
  3. Use aromatherapy oils. For more information about the use of aromatherapy to reduce stress, improve immunity, reduce agitation, and to promote relaxation read chapter 18 “Aromatherapy” in “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” by Barbra Cohn
  4.  I gave my husband Ginkgo biloba for depression (and also took it myself). It helped right up until he was in late stage Alzheimer’s. One word of advice, not all brands are efficacious, so pick one carefully. Also note that it takes about 6 weeks to notice an effect. This is a typical difference of taking a pharmaceutical versus a natural remedy.
  5. Vitamin B complex optimizes cognitive activity and brain function, has a positive effect on memory, learning capacity and attention span, and supports a healthy nervous system and a stable mood. Vitamins B6 and B12, in particular, play a role in the synthesis of serotonin, the neurotransmitter linked to improving memory, lifting mood and regulating sleep.
  6. Omega-3 fatty acids are rich in DHA, the major unsaturated fat in the brain. This long-chain fatty acid provides the necessary fluid quality to the membranes of the nerve cells so that electrical nerve impulses can flow easily along the circuits of the brain. One study found that Alzheimer’s patients given an omega-3-rich supplement experienced a significant improvement in their quality of life.
  7. Maintain your social connections. Loneliness can actually lead to health problems and mental decline. Join a group—any kind of group: worship,  hiking, scrabble, table tennis, knitting, discussion group, or book club. Volunteer at a food bank, soup kitchen or animal shelter. It’s important to stay connected and to feel as though you are a contributing member of society.
  8. Sleep well by getting to bed before 11:00 pm, eating your last meal before 8pm, turning off your electronic devices, and eliminating light in your bedroom. Studies have indicated that sleep deprivation can increase risk of dementia and Alzheimer’s disease. If you have trouble sleeping consider using a lavender essential oil spray on your pillow or a sachet of lavender inserted into the pillowcase. There are lots of natural sleep aids available at your local health food store, such as melatonin, calcium/magnesium, valerian, hops, etc. Consult with a nutritional consultant about what might work best for you.

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.