A UTI, fall or a cold can lead to cognitive decline and even death in a person with Alzheimer’s disease

Dementia disease and a loss of brain function and memories

November is Alzheimer’s Awareness Month 

People with Alzheimer’s who get even a mild respiratory or gastrointestinal infection, or a bump or bruise are at risk for having a significant, permanent memory loss, according to a report that was published in the September 8, 2009 issue of the journal Neurology. These patients can have high levels of tumor necrosis factor—alpha (TNF-a)—a protein that is linked to inflammation and is associated with memory loss and cognitive decline.

In the study, which was done at the Clinical Neurosciences Research Division at the University of Southampton, United Kingdom, 222 Alzheimer’s patients were followed for six months. Of those, 110 people had an infection or injury that resulted in inflammation. These individuals had twice the memory loss during that period of time as the individuals who did not have an illness or injury. Researchers attribute the memory loss to inflammation. In patients whose TNF-a levels were high to begin with, an infection increased their memory loss to 10 times more than those who had low TNF-a levels.

Clive Holmes, PhD, lead researcher, said that this population should be vaccinated against the flu, and infections and injuries should be treated as soon as possible.

It is not uncommon for an elderly person to die from a urinary tract infection, especially someone who has dementia. Even a mild cold can develop into a serious pneumonia and lead to death in an elderly person. My husband developed a kidney stone, and died six weeks later. He progressed from a person in mid- to late-stage Alzheimer’s to someone in the final stage of Alzheimer’s, unable to walk or talk.

Tips for keeping you and your loved one healthy and safe

  • Inoculate against flu, pneumonia and shingles
  • Boost immunity with zinc, vitamin D and vitamin C
  • Prevent falls and accidents (recommended: Complete Guide to Alzheimer’s Proofing Your Home by Mark L. Warner
  • Reduce systemic inflammation with a curcumin (turmeric extract) supplement
  • Use a humidifier to moisturize nasal passages and mucous membranes to help keep them healthy
  • Engage in gentle exercise to reduce inflammation
  • Keep hydrated by drinking at least 6-8 glasses of water each day
  • Reduce risk of urinary tract infections with D-Mannose powder and cranberry extract 
  • Use essential oils (lemon, peppermint, lavender, frankincense, bergamot, thyme, sandalwood, vetiver, myrrh) to boost immunity. 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
  • Eat yogurt. 70% of your immune system lies in your gut. Probiotics are live bacterial microorganisms that populate the human gastrointestinal tract. They combat the daily bombardment of toxins and pathogens (bacteria, fungus, parasites, and viruses) that enter our digestive system every day through contaminated food and other toxins. Recent studies show that the bacteria in your gut can also affect your mental health, mood and stress levels. Fermented foods such as kombucha, Greek yogurt, kefir, sauerkraut, miso, cottage cheese are probiotics. Probiotic bacteria colonize the digestive tract with good bacteria. Prebiotics are the food and nutrients that feed probiotics. Prebiotic fiber is found in fruits and vegetables such as artichokes, jicama, wild yams, onions and garlic, asparagus, beans, oats, chicory root and Jerusalem artichokes. Prebiotics support mineral absorption, vitamin utilization, and healthy blood sugar levels. Your gut needs both pro- and prebiotics in order to stay healthy and keep you healthy.
  • Drink mineral broth. It helps alkalinize the body and warm the system. It also helps counter the negative effects of stress. Have it as a bowl of soup or sip it throughout the day. Use your vegetables scraps or chop 2 cups yams, 1 medium potato, 1 cup zucchini, 1 cup cabbage, 1 cup green beans, 2 cups celery, 1 cup onions. Add herbs, garlic, parsley–anything you like. Place in a large pot, cover with water, bring to a boil, turn down to a simmer, and cover for 3-5 hours. For more information read chapter  31 “Nutrition” in “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” by Barbra Cohn

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How lack of sleep can lead to osteoporosis . . . and what to do about it.

Radiography

May is Osteoporosis Awareness Month, and just when we thought we didn’t need one more thing to worry about, The Endocrine Society has published a new study linking prolonged sleep disturbance with bone loss in men.

The study researchers found that healthy men had reduced levels of a marker of bone formation in their blood after just three weeks of restricted sleep and circadian disruption similar to that seen in jet lag or night shift work. A biological marker of bone resorption, or breakdown, was unchanged.

“This altered bone balance creates a potential bone loss window that could lead to osteoporosis and bone fractures,” said lead investigator Christine Swanson, M.D., an assistant professor at the University of Colorado in Aurora, Colorado.

“If chronic sleep disturbance is identified as a new risk factor for osteoporosis, it could help explain why there is no clear cause for osteoporosis in the approximately 50 percent of the estimated 54 million Americans with low bone mass or osteoporosis,” Swanson said.

Inadequate sleep is also prevalent, affecting more than 25 percent of the U.S. population occasionally and 10 percent frequently, the Centers for Disease Control and Prevention report.

The 10 men in this study were part of a larger study that some of Swanson’s co-authors conducted in 2012 at Brigham and Women’s Hospital in Boston, Mass. That study evaluated health consequences of sleep restriction combined with circadian disruption. Swanson defined circadian disruption as “a mismatch between your internal body clock and the environment caused by living on a shorter or longer day than 24 hours.”

Study subjects stayed in a lab, where for three weeks they went to sleep each day four hours later than the prior day, resulting in a 28-hour “day.” Swanson likened this change to “flying four time zones west every day for three weeks.” The men were allowed to sleep only 5.6 hours per 24-hour period, since short sleep is also common for night and shift workers. While awake, the men ate the same amounts of calories and nutrients throughout the study. Blood samples were obtained at baseline and again after the three weeks of sleep manipulation for measurement of bone biomarkers. Six of the men were ages 20 to 27, and the other four were ages 55 to 65. Limited funding prevented the examination of serum from the women in this study initially, but the group plans to investigate sex differences in the sleep-bone relationship in subsequent studies.

After three weeks, all men had significantly reduced levels of a bone formation marker called P1NP compared with baseline, the researchers reported. This decline was greater for the younger men than the older men: a 27 percent versus 18 percent decrease. She added that levels of the bone resorption marker CTX remained unchanged, an indication that old bone could break down without new bone being formed.

“These data suggest that sleep disruption may be most detrimental to bone metabolism earlier in life, when bone growth and accrual are crucial for long-term skeletal health,” she said. “Further studies are needed to confirm these findings and to explore if there are differences in women.”

What to do about it?

The first line of defense is to improve sleep hygiene. Find more ways to get a good night’s sleep in my book “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia,” (Blue River Press) available wherever books are sold.cropped-front-cover-42316.jpg

  1. Exercise early, not in the last two hours before going to bed. Regular exercise has been shown to help people fall asleep faster and benefit from deeper and more restful sleep.
  2. Alleviate the stress and fatigue of the day with safe, proven herbs such as passion flower, magnolia, and valerian, and amino acids taurine, theanine and GABA, and melatonin which have been scientifically shown to produce a gentle calming effect on the whole physiology.
  3. Get thyself outside! Researchers found that bright light in the early morning and avoidance of light in the evening promotes a healthy circadian rhythm, whereas bright light in the evening disrupts the sleep cycle. And make sure you sleep with the lights off in you room.
  4. People with stressful lives often take their stress into bed with them and are unable to turn off the mental chatter. Eat dinner earlier, and don’t watch an exciting or scary movie before bed (that goes for reading matter as well), and certainly do not smoke, or drink alcohol or caffeine in the evening.
  5. Go to bed earlier. Research shows that the hours of sleep before 2 a.m. are more rejuvenating than all the hours after.
  6. Take a warm bath with soothing lavender oil to help you unwind.
  7. Establish a regular bedtime, but don’t go to bed if you feel wide awake.
  8. Once in bed, use creative imagery and relaxation techniques to pacify your mind.
  9. Avoid staying in bed for long periods of time while awake, or going to bed because of boredom.
  10. Take your TV or computer out of your bedroom. If not, your brain becomes used to the stimulation and starts to expect it when you are there. This makes it harder for you to fall asleep.
  11. A snack before bedtime helps many people. Foods such as warm milk, turkey, tuna, nuts, banana, grapefruit, dates and figs are high in the amino acid L-tryptophan, which promotes the production of serotonin, a natural relaxant. Avoid eating heavy meals at least two hours prior to going to sleep.
  12. Sex can be a natural sleep inducer for some people.
  13. Avoid emotional upset or stressful situations prior to bedtime.
  14. Relax with an inspirational book, soft music, and a cup of herbal tea.
  15. Talk with your health care provider if you’ve tried the above and are still having difficulty falling asleep, awaken several times throughout the night, have early morning awakenings or have marked difficulty getting out to bed in the morning.
  16. Good night, sleep tight.

10 Stress-relieving Holiday Tips for Caregivers

  1. Drink a glass of water every other hour to keep hydrated. Staying hydrated helps support immunity, and reduces stress and irritability. It’s important to remember that your brain needs water, too. A dehydrated brain doesn’t think clearly, which can contribute to stress and anxiety.
  2. Include a protein with every snack. It’s difficult to stay away from sweets this time of year. But including a protein with every snack helps maintain healthy blood sugar levels. Try apple slices smeared with almond butter or topped with a cheese slice. A small handful of almonds or walnuts and a couple of dates satisfy the sweet tooth and provides vitamins, minerals and protein.
  3. Plug in an aromatherapy diffuser and inhale the relaxing scent of lavender, nernoli (orange blossom) or any scent you like.
  4. Pour some Epsom salt into a hot bath, light a candle, put on soothing music, and soak away your stress and anxiety.
  5. Turn off the TV, phone, iPad, computer, and other electronic devices an hour before bed. Instead, listen to relaxing music while sipping a cup of chamomile tea.
  6. Journaling is a wonderful, inexpensive way to release your concerns and worries on paper. It’s available when your therapist and best friend are not, and you can do it anywhere at your leisure.
  7. Move your body. Exercise is one of the very best stress relievers. You don’t have to buy a special outfit or go to a gym. Put on a pair of walking shoes and make a habit of walking 1/2 hour every day. If it’s too cold outside, put on your favorite dance music and move as though no one is watching.
  8. Fill half of you plate with green leafy vegetables. They contain magnesium, “the mood mineral,” which supports healthy blood sugar and blood pressure, decreases food cravings, and nourishes and calms the nervous system.
  9. Laugh to reduce anxiety and produce endorphins, the feel-good hormone. Look at funny family photos, reminisce with a high school friend, or watch a comedy. Whatever tickles your funny bone will definitely lift your spirits.
  10. Aim to be in bed before 10pm and make a habit of going to bed and rising at the same time every time. You’ll sleep better and have more energy and resilience.