Why it’s important to get an early diagnosis when cognitive problems appear

Doctor talking with patient

There were several indications that something was wrong with my husband two years before he was diagnosed. This tall, good-looking man, a graduate of the Wharton School of Business at the University of Pennsylvania, was having trouble calculating how much tip to leave a waitress. When we went to Spain for our twenty-fifth anniversary, Morris couldn’t figure out how much money the hotel would cost in dollars. This man, who once memorized trains and airplane schedules without even trying, followed me around the city like a puppy dog as we boarded a subway or bus enroute to tourist attractions.

That following fall — our daughter’s last year in high school — Morris couldn’t give directions to a friend who was taking the SAT at the high school my husband had attended. I got out the map to help him, but he couldn’t read the map. That was the moment I knew something was very wrong. When he left for a road trip to California without our son and forgot his suitcase, I sat on the stairs and cried. I couldn’t deny it any longer. I had a strong suspicion that Morris had Alzheimer’s disease, and although I pleaded with him for two years to see a neurologist, he refused.

What if he had gotten an early diagnosis? Would it have helped?

There’s no way to know for sure, but probably it would have. Because as soon as he started taking Aricept he stopped getting lost driving around our small city. And I started giving him nutritional supplements, which also seemed to help. Read “5 Things that Help Dementia that your Doctor Probably Hasn’t Mentioned.” https://barbracohn.com/2019/09/25/5-things-that-help-dementia-that-your-doctor-probably-hasnt-mentioned/

Professionals, both researchers and physicians and the Alzheimer’s Association, recommend that an early, accurate diagnosis is the key to living a less stressful life for both the patient and the family.

Here’s why:

  1. Cognitive problems can be caused by a number of physical conditions other than Alzheimer’s disease, vascular cognitive impairment, Lewy Bodies dementia and Frontotemporal dementia (FTD). These include thyroid problems, hydrocephalus, a brain tumor, and even depression. When my mother was severely dehydrated and hospitalized with a urinary tract infection (UTI), a psychiatrist called to tell me that she had full-blown dementia. “No she doesn’t,” I said. And sure enough, after being put on an IV saline drip Mom regained her full mental capacity. Memory problems can result from dehydration, severe diabetes and some forms of Parkinson’s disease, traumatic brain injury, HIV, and Huntington’s disease.

Certain medications can affect mental clarity and balance. Be sure to ask your pharmacist about drug contraindications, and interactions with natural supplements. Alcohol abuse and binge drinking can destroy brain cells that are critical for memory, thinking, and decision making and mimic or lead to dementia.

2. Cognitive symptoms may be reversible. There are a number of holistic doctors who claim that their protocol can treat the root cause of cognitive decline and Alzheimer’s disease. Please read my blog ” Significant study points to MIND diet for improving brain health and preventing Alzheimer’s disease.” https://barbracohn.com/2018/11/09/significant-study-points-to-mind-diet-for-improving-brain-health-and-preventing-alzheimers-disease/

Dale Bredesen, MD, a physician scientist in the Department of Pharmacology at UCLA who’s published more than 220 papers on Alzheimer’s, has spent 30 years looking at the root causes of the neurodegenerative phenomenon in hopes of eradicating it. In 2018, Bredesen published the case studies of more than 100 patients in cognitive decline in the Journal of Alzheimer’s Disease & Parkinsonism. https://www.omicsonline.org/open-access/reversal-of-cognitive-decline-100-patients-2161-0460-1000450.pdf

In her editorial in the Lancet Neurology, published in May 2020, Joanna Hellmuth, MD, of the UCSF Memory and Aging Center, said the “Bredesen protocol” – named by neurologist Dale Bredesen, MD – has reeled in patients and their families seeking hope outside of the physician’s office for a disease that is currently incurable.

The Bredesen protocol is propounded in his 2017 bestseller The End of Alzheimer’s Program and can be accessed for $1,399, which includes protocol assessments, lab tests and contact with practitioners, who provide the regimen for additional fees. Online support and cognitive games are available for an additional monthly charge. This protocol is timely, costly and requires steadfastness. But if you have the time and means, it’s probably worth a try.

3. An early diagnosis is empowering. Before the disease has progressed to the point where decision making is difficult, the patient can be included in financial and estate planning, creating end-of-life wishes and durable power of attorney decisions, etc.

4. An early diagnosis is easier for the physician to make when the patient is able to answer questions. Later in the progression of the disease, the patient isn’t able to make observations or answer accurately.

5. Family and loved ones who might be confused by particular behaviors such as anger, depression, disinterest, can better understand why their parent or spouse or significant other is behaving the way they are. This helps to preserve the person’s dignity rather than have someone close to them yell at them, treat them poorly, or want to distance them self, etc.

6. Individuals diagnosed early can take advantage of support groups, and caregivers can learn ways to better manage medications, and learn strategies for coping with unexpected and unusual behaviors and the ordinary progression of the disease. The Alzheimer’s Association was a godsend for me. I was able to connect with other caregivers who knew exactly what I was going through. I could talk about what was happening all day with my best friend, but there was no way she would be able to fully understand the stress of caregiving and the grief of losing a partner to Alzheimer’s. https://www.alz.org/alzheimers-dementia/research_progress/clinical-trials/about-clinical-trials

7. Getting an early diagnosis provides the opportunity to possibly enroll in a clinical trial. TrialMatch is a clinical trial matching service for Alzheimer’s and other dementias. It is a free, easy-to-use service that connects individuals living with AD, caregivers, and healthy volunteers with current research studies. Their continuously updated database of AD clinical studies includes hundreds of pharmacological and non-pharmacological studies being conducted at sites throughout the U.S. and online.

8. An early diagnosis allows the patient to prioritize what is important to them, whether it’s creating a masterpiece or traveling the world. There is still time at this point in the disease to enjoy a happy, satisfying life.

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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”—Winner of the 2018 Book Excellence Award in Self-Help—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.

What are you doing for your brain health?

Brain Nutrition

MIND diet includes salmon, beans, greens, nuts, berries

This week is Brain Health Awareness Week, and I’m reposting this piece so you can evaluate your diet and make improvements to support your brain–and heart health. Here’s to your healthy brain and heart!

Have you heard of the MIND diet? It’s the Mediterranean diet and DASH diet slightly remade and combined to form the MIND diet. (MIND is an acronym that stands for the Mediterranean-DASH intervention for Neurodegenerative Delay.)

In a study published in September 2015 in Alzheimer’s & Dementia, the nutritional epidemiologist Martha Clare Morris and her colleagues at Rush University Medical Center borrowed concepts from the Mediterranean diet and the DASH diet. The result is the MIND diet.

The study followed 923 participantsages 58 to 98 years, for an average 4.5 years, and found the MIND diet lowered Alzheimer’s risk by about 35 percent for people who followed it moderately well and up to 53 percent for those who adhered to it rigorously. While more study is needed to better understand the long-term impact of the diet, Morris’s team’s second paper on the MIND diet notes that it’s superior to the DASH and Mediterranean diets for preventing cognitive decline. But it should be noted that high adherence to all three diets may reduce risk of Alzheimer’s disease.

Food to eat on the MIND Diet

  • Green leafy vegetables: a minimum of 6 servings a week (kale, Swiss chard, spinach, collard, etc.)
  • Nuts: a minimum of 5 servings a week (walnuts, pistachios, almonds, cashews, etc)
  • Berries: a minimum of 2 servings a week
  • Beans: a minimum of 3 servings a week (garbanzo, red, black, kidney, white, pinto, etc.)
  • Whole grains: a minimum of 3 servings a day (millet, oats, brown rice, quinoa, wheat berries, etc.)
  • Fish: at least 1 serving a week
  • Poultry (like chicken or turkey): at least twice a week
  • Olive oil as the primary oil used
  • Wine: no more than 1 glass a day

Foods to limit or avoid

  • Red meat: no more than 4 servings a week
  • Butter and margarine: no more than 1 tablespoon (tbsp) daily
  • Cheese: no more than 1 serving a week
  • Sweets: no more than 5 servings a week
  • Fried or fast food: no more than 1 serving a week

To summarize the MIND DIET—

On a daily basis you eat at least three servings of whole grains, a salad and another vegetable, along with drinking a glass of wine. The jury is still out on whether a little alcohol consumption is better for the brain than none at all. I just heard a panel of researchers and neuroscientist address this issue. If you don’t consumer alcohol, there is certainly no reason for you to start now. But if you do, limit your consumption to one glass of wine a day.)

It’s advised that on most days you should snack on nuts, and every other day eat half a cup of beans. At least twice a week eat poultry and a half-cup serving of berries (blueberries are best), and eat fish at least weekly. Olive oil is the preferred cooking oil.

What is the DASH diet?

The healthy DASH diet plan was developed to lower blood pressure without medication in research sponsored by the US National Institutes of Health, Dietary Approaches to Stop Hypertension. The first DASH diet research showed that it could lower blood pressure as well as the first line blood pressure medications, even with a sodium intake of 3300 mg/day!  Since then, numerous studies have shown that the DASH diet reduces the risk of many diseases, including some kinds of cancer, stroke, heart disease, heart failure, kidney stones, and diabetes. It has been proven to be an effective way to lose weight and become healthier at the same time.

The DASH diet eating plan is a diet rich in fruits, vegetables, low-fat or non-fat dairy. It also includes mostly whole grains; lean meats, fish and poultry; nuts and beans. It is high fiber and low to moderate in fat. It is a plan that follows US guidelines for sodium content, along with vitamins and minerals. In addition to lowering blood pressure, the DASH eating plan lowers cholesterol and makes it easy to lose weight. It is a healthy way of eating, designed to be flexible enough to meet the lifestyle and food preferences of most people.

How is it different from the Mediterranean diet? It can be considered to be an Americanized version of the Mediterranean diet, and to be easier to follow, since it has more specific guidelines. But if you love tabouli, hummus, and olives, you might prefer the Mediterranean diet.

Although there are similarities among all three diets, the MIND diet is the only one that encourages the consumption of foods that have been found to promote cognitive health.

There is a saying that “what’s good for your heart is good for your brain.” So please start switching over to the MIND diet while eliminating foods high in calories and low in nutrients. You will feel better and your brain will stay healthier longer.


image

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”–winner of the 2018 Book Excellence Award in self-help– 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.

Significant study points to MIND diet for improving brain health and preventing Alzheimer’s disease

Brain Nutrition

MIND diet includes salmon, beans, greens, nuts, berries

 

Have you heard of the MIND diet? It’s the Mediterranean diet and DASH diet slightly remade and combined to form the MIND diet. (MIND is an acronym that stands for the Mediterranean-DASH intervention for Neurodegenerative Delay.)

In a study published in September 2015 in Alzheimer’s & Dementia, the nutritional epidemiologist Martha Clare Morris and her colleagues at Rush University Medical Center borrowed concepts from the Mediterranean diet and the DASH diet. The result is the MIND diet.

The study followed 923 participantsages 58 to 98 years, for an average 4.5 years, and found the MIND diet lowered Alzheimer’s risk by about 35 percent for people who followed it moderately well and up to 53 percent for those who adhered to it rigorously. While more study is needed to better understand the long-term impact of the diet, Morris’s team’s second paper on the MIND diet notes that it’s superior to the DASH and Mediterranean diets for preventing cognitive decline. But it should be noted that high adherence to all three diets may reduce risk of Alzheimer’s disease.

Food to eat on the MIND Diet

  • Green leafy vegetables: a minimum of 6 servings a week (kale, Swiss chard, spinach, collard, etc.)
  • Nuts: a minimum of 5 servings a week (walnuts, pistachios, almonds, cashews, etc)
  • Berries: a minimum of 2 servings a week
  • Beans: a minimum of 3 servings a week (garbanzo, red, black, kidney, white, pinto, etc.)
  • Whole grains: a minimum of 3 servings a day (millet, oats, brown rice, quinoa, wheat berries, etc.)
  • Fish: at least 1 serving a week
  • Poultry (like chicken or turkey): at least twice a week
  • Olive oil as the primary oil used
  • Wine: no more than 1 glass a day

Foods to limit or avoid

  • Red meat: no more than 4 servings a week
  • Butter and margarine: no more than 1 tablespoon (tbsp) daily
  • Cheese: no more than 1 serving a week
  • Sweets: no more than 5 servings a week
  • Fried or fast food: no more than 1 serving a week

To summarize the MIND DIET—

On a daily basis you eat at least three servings of whole grains, a salad and another vegetable, along with drinking a glass of wine. The jury is still out on whether a little alcohol consumption is better for the brain than none at all. I just heard a panel of researchers and neuroscientist address this issue. If you don’t consumer alcohol, there is certainly no reason for you to start now. But if you do, limit your consumption to one glass of wine a day.)

It’s advised that on most days you should snack on nuts, and every other day eat half a cup of beans. At least twice a week eat poultry and a half-cup serving of berries (blueberries are best), and eat fish at least weekly. Olive oil is the preferred cooking oil.

What is the DASH diet?

The healthy DASH diet plan was developed to lower blood pressure without medication in research sponsored by the US National Institutes of Health, Dietary Approaches to Stop Hypertension. The first DASH diet research showed that it could lower blood pressure as well as the first line blood pressure medications, even with a sodium intake of 3300 mg/day!  Since then, numerous studies have shown that the DASH diet reduces the risk of many diseases, including some kinds of cancer, stroke, heart disease, heart failure, kidney stones, and diabetes. It has been proven to be an effective way to lose weight and become healthier at the same time.

The DASH diet eating plan is a diet rich in fruits, vegetables, low-fat or non-fat dairy. It also includes mostly whole grains; lean meats, fish and poultry; nuts and beans. It is high fiber and low to moderate in fat. It is a plan that follows US guidelines for sodium content, along with vitamins and minerals. In addition to lowering blood pressure, the DASH eating plan lowers cholesterol and makes it easy to lose weight. It is a healthy way of eating, designed to be flexible enough to meet the lifestyle and food preferences of most people.

How is it different from the Mediterranean diet? It can be considered to be an Americanized version of the Mediterranean diet, and to be easier to follow, since it has more specific guidelines. But if you love tabouli, hummus, and olives, you might prefer the Mediterranean diet.

Although there are similarities among all three diets, the MIND diet is the only one that encourages the consumption of foods that have been found to promote cognitive health.

There is a saying that “what’s good for your heart is good for your brain.” So please start switching over to the MIND diet while eliminating foods high in calories and low in nutrients. You will feel better and your brain will stay healthier longer.


image

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”–winner of the 2018 Book Excellence Award in self-help– 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.