Is Dementia Hereditary? Let’s Find Out Now

is dementia hereditary

There is one question that is of concern for family members of an individual who has dementia: is dementia hereditary?

There are two answers to this query and, sadly, it is both a yes and a no.

The majority of dementias are not passed down by family.

There are, however, some rare cases where there may be a strong genetic link that could see children and grandchildren inherit the condition.

Nonetheless, this is only a small proportion of the overall dementia cases.

It is vital to note that genes are basic heredity units that pass on characteristics like height, hair color, or the tendency to develop a certain disease.

We find them in chromosomes and can contain mutations or changes which can be beneficial or harmful.

Does dementia run in families?

To date, researchers still do not have adequate details about the human genes that are associated with dementia.

While several genes may lead to different forms of dementia, mostly the illness does not develop because of changes to a specific gene.

Dementia genetics are quite complex, with several other factors weighing in.

This aside, let’s look at some of the reasons why most people do not inherit dementia.

Risk Factors

risk factors
One of the top risk factors for dementia is age.

The disease is common in seniors who are above the age of seventy, although some people experience it when they are younger.

You may be relieved to learn that having grandparents or parents with dementia at this age (70+) does not necessarily mean that you will also end up with the condition when you are older.

Your risk of getting the disease remains the same as the rest of the population.

On the flip side, studies show that if your loved one has dementia when they are younger, say less than sixty years, there is a higher chance that this type of illness passes on.

This goes to show that while genetics may be a risk factor, it is certainly not the only one.

Other risk factors that contribute to the development of dementia include:

Now check out some of the factors that could increase your chances of ending up with dementia because it is in your family line.

These support the yes part of the answer when you ask if dementia is hereditary.

Underlying Health Issues

underlying health issues
There are some scenarios where dementia will not be inherited. But, there are some health issues that, at times, crop up because of this condition.

These may include conditions like diabetes, heart diseases, high blood pressure, or stroke. Such illnesses can pass from one generation to the next.

Note that such diseases are also considered risk factors for illnesses such as dementia.

This simply means that when a person has one or more of the aforementioned diseases, they may also end up with dementia when they get older.

Specific Genes

specific genes
When looking at the cases of inherited dementia, you may notice that only 1% of the cases are passed on from parents.

Another aspect that may increase your chances of getting the disease simply because your parents also have dementia is the types of genes that your parents give you.

It is not the dementia gene but others that increase the risk of you getting the illness.

These types of genes that can give you dementia are typically the same ones that increase the risk of stroke, high blood pressure, heart disease, and diabetes.

It is one of the reasons it is essential to stay physically active and eat well. This can reduce the risk of developing certain types of dementia, such as vascular dementia.

Scientifically, two types of genes can affect whether a person ends up inheriting a disorder or disease. These are:

1. Risk Genes – These are the genes that you carry putting you at risk of developing a particular disease. You should also know that with the gene in your body, it does not mean you will end up with the illness.

2. Deterministic Genes – These are the genes that are responsible for causing the onset of disorders and diseases. They are quite rare and have been linked directly to the development of dementia in adults.

Genes are a broad topic for anyone who is interested in finding out the answers to is dementia hereditary.

Below is a summary of some of the genes that researchers claim are associated with the development of dementia in different stages:

1. Mutations in APP (A4 protein precursor), PSEN2 (presenilin2), and PSEN1 (presenilin1)

These genes are responsible for producing abnormal protein amounts that can trigger damage in the brain, which links to the onset of early dementia.

2. Variations in the ApoE4 gene

Also known as the apolipoprotein E, this offers instructions for protein production as well as aids in the transportation of cholesterol through the bloodstream.

About a quarter of the population that has one copy of the gene of a variation of ApoE has been known to have a higher risk of getting dementia.

Even though they do not directly cause the disease, they can contribute to some of the brain changes that result in cognitive decline.

Many people with ApoE4 also experience faster loss of nerve cell functioning.

This happens at the frontal lobe, which is crucial when it comes to maintaining mental functioning.

Studies also conclude that individuals who have the ApoE4 gene usually grow older at a faster rate. This acceleration can enhance the chances of dementia becoming worse over time.

There is also evidence that people who have two copies of ApoE4 have a much higher risk of developing dementia than the people who only have a single copy.

3.CDC2 gene

Cell division of the cycle 2 gene (CDC2) associates with the production of more tau protein This controls the deposit, gathering, and degradation of several proteins that relate to different types of dementia.

4. SORL1 gene

There is a high chance that the sortilin related receptor may play a role in the uncharacteristic production of beta-amyloid plaque in the brains of individuals who experience the late onset of dementia.

Rare Types of Dementia

rare types of dementia
There are some unusual types of dementia that parents can pass down to their young ones.

It mainly happens when a person develops the illness at an early age, like in their 50s or 60s.

In the majority of these cases, there is a high chance that a faulty gene was passed down to the children from their parents. This is also the case when an individual ends up developing dementia in their 30s or 40s.

Generally, while a high percentage of people will not pass dementia to their kids, they can pass faulty genes that will be the cause of the disease in younger individuals.

Examples of the rare dementia types that parents pass on to their offspring include Familial Prion Disease and Huntington’s disease.

Such disorders present a 50/50 chance of being inherited because they are brought about by a faulty “dormant” gene.

What this means is that if you get one faulty gene from one parent and another healthy one from the other parent, the faulty one is the one that the body will use.

This is because the body sees it as the “dominant” gene.

If your doctor suspects that family history has anything to do with your condition, he or she may recommend genetic testing.

Relatives at this point may also have to go through genetic testing.

When the results are out, genetic counseling is normally offered to all the persons who carry the illness-related changes.

Inheritance Pattern

inheritance pattern
If you are asking if dementia is hereditary, it helps to look into the inheritance pattern of the disease.

When people develop the illness at an early stage, that is before celebrating their 70th birthday, the link to an autosomal dominant pattern is not unusual.

This simply means that a single copy of an altered gene is enough to cause dementia. In most cases, the affected individual gets this gene from one of their parents.

It is still not clear what the inheritance pattern for late-onset dementia is. Persons who inherit just one copy of the ApoE4 allele are usually at higher risk of developing the condition.

The risk is even greater for the individuals who have two copies of the same.

Astonishingly, it is not everyone who has this gene that will end up with dementia. Similarly, not everyone who has dementia has the E4 allele.

Closing Remarks

As seen above, genetics do not play a major role when it comes to the development of dementia.

That said, there are specific forms that you can inherit from your parents.

However, these mostly have to do with developing the disease when you are younger. It is evident that there is no one answer to the query; is dementia hereditary?

Even though it may not be possible to control genes, there are other factors you can control to help reduce the risk.

It includes things such as eating a balanced diet, staying active, not smoking and managing other health conditions, like diabetes.

Dementia and Eyesight – How Vision Changes

dementia and eyesight

When talking about how dementia affects a person’s life, it is important to touch on one crucial topic, which is dementia and eyesight.

In addition to causing multiple changes in the brain, dementia also affects how the brain processes information the eyes deliver as well as how the eyes see.

This implies that some behavioral changes in people with dementia may be as a result of vision changes.

Five common changes that happen to the eyes when a person has dementia explained below.

How Vision Changes With Dementia

1. The Field of Vision Becomes Narrow

the field of vision becomes narrow
One of the changes that occur when a person has dementia is the fact that the field of vision becomes narrow.

This is common with old age because, by the time a person is in their mid-70s, the normal vision peripheral reduces a little so that a person does not notice or see as much as they were able to when they were younger.

With dementia, the field of vision narrowing is not the same as what happens when a person becomes older.

The disease causes the field of vision to decrease by about 12 inches.

Experts compare this to a person who wears binoculars. It is not possible to move about normally when you are putting on binoculars.

2. Blurring

blurring
A person with dementia may not be able to see things as sharply as before because the illness causes them to experience blurring.

Because of this, everyday and familiar objects become more challenging to recognize.

3. The brain does not Effectively Process Information from the Eyes

brain does not effectively process information from the eyes
Worth noting when talking about dementia and eyesight is that someone with the illness may find it challenging to see the things that are in front of them.

This normally happens as the disease advances, and the brain starts shutting down information that comes from the eyes.

At some point, the brain finds the details from the eyes overwhelming; thus, it cannot begin processing the information.

When this happens and you have dementia, you may be forced to only see through one eye.

As a result, you will end up losing perception of depth where you can’t tell if something is two or three-dimensional.

This makes it difficult for an individual to know different things like whether they are looking at a picture of an apple of the real fruit, whether there is a print on a fabric, or whether there is an object on a surface.

4. Pupils React to Light Slowly

pupils react to light slowly
Persons with dementia and eyesight problems may also have slow reactions to light that makes it difficult for them to move from a light to a dark space and vice versa.

Going out when it is sunny can also be an overwhelming experience.

5. Changes That Don’t Make Sense to “Healthy People”

changes that don't make sense to healthy people
When it comes to the effects of dementia on eyesight, you may start seeing a person doing things that you consider strange.

For instance, a person may be trying to flip something in the air.

While this may not make sense to you, the person with the illness may be thinking that they are switching on the lights because the switch appears to be closer than it is.

Because the persons with dementia lack the perception of depth, they will respond to the world as they see it in the best way they know-how.

Causes of Vision Problems in People with Dementia

causes of vision problems in people with dementia
There are several reasons thousands of people with dementia will experience issues with vision, such as:

  • Development of eye conditions like macular degeneration and cataracts
  • Health conditions like stroke
  • Dementia itself
  • Normal aging of the eyes

The above causes damage to the visual system which can lead to sight loss.

Symptoms of Eyesight Issues for People with Dementia

symptoms of eyesight issues for people with dementia
People with dementia can exhibit certain symptoms that show they have problems with their eyesight. This is where they can have challenges with things like:

  • Reading
  • Avoiding obstacles
  • Recognizing familiar faces
  • Finding personal items
  • coping with bright lights, dim lights or both
  • Seeing well even when they have glasses
  • Locating food on plates

To confirm that the symptoms are a result of dementia, a person with the neurodegenerative illness needs to go through eye-tests.

Eye-specialists can adapt the eye tests for individuals with dementia if need be to get the proper results.

Coping with Dementia and Eyesight Problems

coping with dementia and eyesight problems
A person with eyesight issues because of dementia is likely to experience more problems with mobility, expansive disorientation, and increased risk of falls.

They may also have increased problems communicating, learning new tasks, lack of motivation, and the need for more social isolation.

Some of the tips caregivers can work with to make the people with dementia as comfortable and productive as possible include:

Taking care of the eyes

The suffering individuals and their carers need to make the most of the individual’s sight.

This means having regular eye rests and making sure that if a person wears glasses, they are correct, current, and clean at all times.

Making adjustments to the environment

This might need simple projects like improving the lighting, keeping areas clutter-free and familiar, as well as the use of contrasting colors. In short, making a dementia-friendly home.

You might also have to go the tech-way and use equipment like audio labels and automatic lights.

Enhancing communication techniques

This might include speaking clearly to a person who has dementia and eyesight issues.

You may have to introduce yourself when talking to the person, practice patience as they try to figure out what you are saying, and even using pictures and charts for ease of communication.

Extra help

When you are at a loss of how to help, there are numerous resources online as well as support groups where you can get ideas on how to move forward without harming the person with dementia.

Professionals like occupational therapists and visual rehabilitation workers can also offer help.

Closing Thoughts

A person may become more confused and fearful when suffering from dementia and eyesight problems.

Their behavior might also change because of the alterations happening in the brain.

It is important to accord people with illnesses as much support as possible so that they can live long quality lives.

Air Pollution and Dementia Risk

air pollution and dementia

There is strong evidence developing in regards to exposure to air pollution and dementia risk.

Some researchers claim that small air pollution particles can enter the brain and contribute to the development of dementia.

Before looking at the possible link between dementia and air pollutants, first, check out what air pollution is.

Does Pollution Cause Dementia?

Air Pollution

air pollution
Air pollution is made up of various components that may include:

  • Chemical compounds
  • Gases
  • Tiny particles/ particulate matter
  • Metals

Exposure to high levels of long-term exposure to air pollutants has been known to be harmful leading to the development of many health conditions that majorly affect the heart and the lungs.

Does Air Pollution Harm the Brain? (Different Studies)

does air pollution harm the brain
One of the factors that led scientists to look into the relationship between air pollution and dementia is the existence of the magnetite particle in the brain.

These are particles that fill the air after the burning of fuel. The human brain also produces magnetite naturally.

A study conducted in 2016 confirmed that magnetite can make its way to the brain through air pollution. This was after studying the brain tissues of people from Manchester and Mexico City.

a study

Researchers used a unique electron microscope to look at the surface properties of magnetite. They did this to prove that the brain did not produce the particles naturally.

Instead, they were produced by high temperatures.

The conclusion from the study was that it is possible that fine particulate material can enter the brain through the thin lining of the nose and the bloodstream as well.

Researchers observed that the particles were present inside amyloid plaques, which are the protein deposits common in the brain cells of a person with Alzheimer’s, one of the most common forms of dementia.

Magnetite can cause dementia

This is what led to the assumption that magnetite could be somehow involved in the development of dementia.

The study was, however not conclusive because it did not prove that magnetite was responsible for killing brain cells or the formation of the protein deposits.

There is a possibility that the particles might find their way into the brain and because of the organ’s waste disposal process find their way in the amyloid plaques.

In line with this Pektus, an assistant professor of clinical neurology working at Keck School of Medicine, led another study to try and add evidence linking air pollution and dementia risk.

clinical neurology

The study focused on 998 female participants between the ages of 73-87.

The participants underwent two brain scans that were 5 years apart. Researchers studied the brains of the participants to give them a cognitive decline score.

They then combined the results with data on where the ladies lived with details about the pollution levels in the areas.

After analyzing this data, the researchers found that people who had higher exposure to fine air particle solutions were more likely to experience cognitive function impairments like memory problems.

A different study trying to prove the link between air pollution and dementia risk followed 130,000 people living in London for a couple of years.

The adults were aged 50 to 79. During the study period, at least 2181 people developed dementia. The results reported that the participants who were exposed to higher levels of air pollutants specifically nitrogen and fine particles from fossil fuel combustion had a higher risk of developing dementia.

The researchers stated that people living in London exposed to the highest levels of air pollution were around 11/2 times likely to develop some form of dementia.

Long-term exposure to air pollution can increase risk

A study conducted in 2017 studied adults for over a decade. The participants were quite many (about 6.5 million adults).

The study that was published in The Lancet found that the people who lived near high-traffic major roads were more likely to develop Alzheimer’s disease.

This was regardless of their socioeconomic and health status. The study claimed that about 6-7% of all dementia cases were attributed to exposure to air pollutants.

Another study followed residents in Stockholm, Sweden. They followed individuals who were exposed to air pollution at relatively low levels.

The research that was published in JAMA (Journal of the American Medical Association) found that even exposure to low levels of air pollution contributes to greater dementia risk specifically for persons who have heart diseaseshttps://readementia.com/signs-of-early-onset-alzheimers/.

scientists

Giulia Grande the lead author states that their findings suggested that air pollution plays a role in the development of dementia.

This is mainly through the intermediate step of cardiovascular illnesses and strokes. The researchers were studying about 3,000 adults for more than 11 years. The average age of the participants was 74.

Stroke and air pollution are most harmful

The study explained that while long-term exposure to air pollution was linked to dementia risk, this risk was higher for persons who suffered from a stroke.

About half of the dementia cases that they linked to air pollution exposure was explained by stroke. Researchers also noted that participants were residing in the Kungsholmen district where pollution levels are safely below international limits.

Scientists further extended their studies into mice. They found that there was a similar effect in the brain of mice after exposure to air pollution. The researchers exposed mice to air pollutants collected near busy roads.

This led to biological changes that usually cause brain damage and an increased level of protein amyloid.

This is still not enough to make a solid conclusion about the link between air pollution and dementia development.

It, however, shows that exposure to air pollution can lead to cognitive impairment. It is after the exposure brought forth symptoms like poor learning abilities, motor, and memory skills.

This is because, in the human brain, it is not automatic that amyloid protein on its own causes the development of dementia.

Closing Remarks

To give conclusive results on the issue of air pollution and dementia risk, scientists continue to conduct more studies to answer this question comprehensively.

The experts are taking into consideration pollution from different parts of the globe while using sophisticated techniques to try and establish if there is a direct link between air pollutants and dementia development.

Meanwhile, it is best for countries to start working on air quality to avoid some of the problems that are associated with air pollution.

Can Sauna Help Alleviate Dementia?

sauna and dementia

Researchers have conducted several studies to find out if there is a link between the use of sauna and dementia risk.

One study reported that frequent use of the sauna could help to reduce the risk of developing dementia.

This was conducted by researchers from UEF (University of Eastern Finland). They filed their findings in the journal Age and Ageing in 2016.

Does Sauna Protect Against Dementia?

The study assessed the weekly sauna bathing habits of the participants. After this, the experts divided the study participants into three groups”

1. Those who spent about 15 minutes in the sauna 4-7 times in a week (200)
2. Participants who used the sauna 2-3 times a week (1513)
3. Those who only used the sauna once a week (601)

Basis of the Study

basis of the sauna and dementia study
The participants of the study included 2,315 healthy men aged between 42-60 years. The study went on for more than two decades.

During the study period, the researchers diagnosed 123 cases of Alzheimer’s disease and 204 dementia cases. The sauna use research analyzed different types of data from the participants, such as:

  • Age
  • Body mass index
  • Smoking status
  • Systolic blood pressure
  • Alcohol consumption
  • Resting heart rate
  • Type 2 diabetes
  • Previous myocardial infarction
  • Serum low-density lipoprotein cholesterol

The participants in the study used traditional Finnish saunas.

These are the versions that have dry air and recommended temperatures of about 80-100 degrees Celsius. The saunas also increase humidity temporarily by throwing water on the rocks installed inside the sauna heater.

Findings

findings sauna and dementia
The researchers stated that there was a link between the use of sauna and dementia risk. They concluded that using the sauna frequently helps to lower the risk of dementia.

The report indicated that the group that was using the sauna about 4-7 times in a week had a 66% lower chance of developing any dementia type.

Additionally, the risk of Alzheimer’s disease was 65 % lower in comparison to the group that was only using the sauna once a week.

Previously, there was a study from KIHD that reported that Finnish men who used 175 degrees dry heat sauna for 4-7 days a week had significantly low death rates resulting from cardiovascular diseases.

According to Jari Laukkanen, the professor who led this sauna research, frequent exposure to heat during sauna bathing not only protects memory, but it also protects the heart.

This is through similar mechanisms that experts do not clearly understand.

He continued to state that it is known that cardiovascular health also has effects on the brain in a statement the professor made to UEF.

The sense of relaxation and well-being that a person experiences during sauna might also play a crucial role.

the sense of relaxation

The researchers, while conducting the study, also note that previous research also suggested that oxidative stress and inflammation were some of the factors that contributed to dementia development.

They explained that their findings were “biologically plausible” because using the saunas regularly reduces inflammation by enhancing vascular endothelial function.

The endothelium is the thin membrane lining found in the blood vessels.

Furthermore, the researchers also explained that their study addresses the use of sauna and dementia reduced risk because bathing in a sauna helps in lowering systemic blood pressure as well as elevated pulse pressure.

These two are well-known dementia risk factors.

Professor Laukkanen also added that while he thought the results of the study were generalizable to other populations in the northern part of the world like North America and Europe, he did not think the same in warmer countries.

Can Everyone Use Saunas?

can everyone use saunas
Because there might be a beneficial link between the use of sauna and dementia risk, you may be wondering whether everyone can use a sauna facility.

While the saunas may be great for a wide range of conditions, they are not appropriate for everyone.

It is necessary that you consult your doctor before starting sauna bathing. This is especially important if you are pregnant or have an underlying medical condition.

Closing Remarks

The benefits people get from using the sauna might be a game-changer in the way the world views dementia.

Experts agree that while sauna use does not substitute exercise, it is a great way to complement a person’s workout routine.

The latest evidence supports the link between the use of sauna and dementia lowered risk because the exercise helps to enhance cardiovascular health reducing the risks of stroke and heart disease.

It also benefits blood vessels, factors that contribute to brain health, which can starve the development of dementia.

More research, however, still needs to be done to determine whether using saunas should be included in the recommendable interventions for preventing different forms of dementia.

Seeing that the study only focused on men, perhaps there also needs one on women to make the studies more inclusive and conclusive.

13 Huntington’s Disease Symptoms

huntington's disease symptoms

Before getting a positive diagnosis for Huntington’s disease, you must showcase a couple of Huntington’s disease symptoms that the doctors will observe or test.

This helps the professionals to confirm whether or not you have developed the illness that causes progressive degeneration of brain nerve cells.

A majority of people with Huntington’s disease will start to develop these signs in their 30’s or 40’s even though the signs can start at any age from the early stages to old age.

Let’s look at some of the warning signs associated with Huntington’s disease below.

If you are also interested in learning what’s the best Huntington’s disease treatment, we made a comprehensive look into it for your convenience.

Common Huntington’s Disease Symptoms

1. Chorea

Huntington's disease symptoms
Huntington’s disease can make a person experience physical symptoms like random, uncontrollable, and jerky movements known as chorea. Initially, chorea is usually exhibited as restlessness, lack of coordination, uncompleted motions or abnormal eye movements.

After about three years, these minor motor abnormalities blow up to become noticeable motor dysfunction signs.

2. Depression

depression a symptom of Huntington's disease
If you are susceptible to Huntington’s disease, you may also experience depression as one of the early warning signs of the illness.

Depression is a serious illness that affects people in different ways. You might experience being in a low mood for extended periods.

Some people will feel like they are drowning in a sense of hopelessness while others will lack interest in the things they once loved. Body aches and pains, lack of appetite, fatigue, and bad sleeping patterns are other symptoms of depression.

3. Difficulties in Swallowing and Eating

Huntington's disease  creating difficulties in swallowing and eating
Problems with eating and swallowing are among Huntington’s disease symptoms.

A person goes through this when the muscles in the diaphragm and mouth cease to function properly.

Persons with these symptoms risk choking especially in the later stages. They also lose weight because they do not eat properly.

4. Personality Changes

personality changes due to Huntington's disease
Changes in personality are common with people who have Huntington’s disease. This is where a person becomes highly irritable, has mood swings, apathy, and anger outbursts.

Many people also become socially withdrawn where they want to spend time alone. Some even have frequent thoughts of suicide and dying.

5. Communication Problems

Huntington's disease communication problems
Issues with communication are prominent in persons with Huntington’s disease. They usually vary from person to another both in severity and nature.

One person may have a hard time initiating a conversation while another will struggle to find the right words to speak clearly.

Another communication problem that may arise is having difficulties understanding what people are saying.

6. Problems with Memory

problems with memory
Issues with memory also make part of Huntington’s disease symptoms. These affect both short-term and long-term memory.

A person may have trouble recalling memories of their lives.

Some experience deficits in procedural memory where they cannot remember how to perform a certain activity they could handle before.

The disease also affects working memory which is common in the later stages.

7. Emotional Changes

Huntington's disease emotional changes
Huntington’s disease can also affect how a person functions emotionally. In most cases, the emotional changes do not occur consistently but they alternate.

These can include stubbornness and lack of emotion. A person may be very happy one instant, and the next they are wallowing in sadness.

8. Obsessive-Compulsive Behaviors

obsessive compulsive behaviours hd
This is another common symptom of Huntington’s disease. It is a disorder that features unwanted fears and thoughts that can lead a person to do repetitive behaviors also known as compulsions.

The compulsions and fears result in significant distress and can interfere with daily activities.

For example, a person can develop a fear of germs which makes them wash their hands over and over until they are chapped and sore.

9. Lack of Awareness

Huntington's disease causing a lack of awareness
Lack of awareness is worth mentioning when talking about Huntington’s disease symptoms. It is where a person lacks awareness of their abilities and behaviors.

This can make the affected person not see mistakes that are evident to those around them.

Most people with the illness will refute the fact that they have Huntington’s disease.

10. Difficulty Organizing

difficulty organizing
Having problems with organization is another symptom that relates to Huntington’s disease. This affects functions like planning, rule acquisition, and initiation of appropriate actions.

A person may become disoriented because the illness affects their ability to make the right decisions.

The ability to multi-task also becomes difficult because a person has trouble concentrating on more than one task.

11. Diminished Visual Partial Ability

diminished visual partial ability
Another symptom of Huntington’s disease worth mentioning is diminished visual-spatial ability.

This is where a person is not able to perceive the position of their body in an environment.

It can result in having difficulties with things like following directions or reading a map properly.

12. Seizures

seizures
Some people with Huntington’s disease will also develop other medical conditions like seizures.

These can be described as uncontrolled and sudden electrical brain disturbances. It can lead to changes in behavior, feelings, levels of consciousness, and movement.

A majority of seizures will last between 30 seconds and two minutes although they vary in severity from person to person.

The seizures are normally associated with temporary confusion, loss of awareness, staring spell, uncontrollable jerking movements of legs and arms, and emotional symptoms like anxiety or fear.

13. Clumsiness

clumsiness
Clumsiness also goes on the record as one of the common Huntington’s disease symptoms. It can be defined as poor coordination, action, or movement.

This is where you might find that a person is always dropping things and bumping into furniture.

Their risk of falling also becomes intensified. While this might be a minor issue for most people, it can be profound a well where you increase the risk of severe injuries or accidents such as concussions.

Closing Remarks

If you notice that you have any Huntington’s disease symptoms, it is important to seek medical attention as soon as possible.

This is because some of the symptoms of Huntington’s disease are caused by a wide range of conditions.

Proper diagnosis helps you know how to best manage the progressive disease seeing that currently, there is no treatment to reverse or stop the illness.

Keep in mind that in the later stages of the disease, affected individuals may need full-time nursing care as completing day to day activities becomes extremely difficult.

Doll Therapy Dementia [Know the Pros and Cons]

doll therapy dementia

As a means of lessening the suffering burden for people with dementia, some experts recommend the use of doll therapy for dementia.

This is where caregivers use a baby doll or teddy bear to help a person deal with distress.

Typically used during the middle and late dementia stages, the dolls aim at improving the quality of living, comfort, and engagement.

Doll therapy has proved to be effective and beneficial for weak individuals over the years.

This is because it brings along numerous benefits to persons with dementia, such as:

Benefits of Doll Therapy for Dementia

Initiates Structure to a Person’s Life

Doll Therapy Dementia – Pros and Cons
By introducing doll therapy to a person with dementia, it can help to bring much-needed structure in their lives.

This, however, needs to be done in a controlled atmosphere rather than just giving the ill individual a doll to play with.

As part of taking care of the toy baby, the individual with dementia can wash, fold, and dress their doll. This helps to give responsibility to someone who is generally dependent on others.

Improves Communication

doll therapy dementia improves communication
Some people with dementia normally have problems with verbalizing, something that doll therapy dementia can assist with.

As the person spends time with the doll or bear, they can start to speak again, even though not as fluently as before. This is usually part of a basic process that involves humming, singing, or speaking to the baby (doll) in its arms.

Dolls can also help people to express themselves better, especially in cases where they cannot communicate. It is common for people with dementia to use toys as communication tools.

They can signal that the doll wants some food, or it is cold, while in the real sense, they are cold or need to eat themselves.

Creates a Calming Effect

doll therapy creates a calming effect for dementia patients
Doll therapy can also help to calm someone upset. Many people with dementia become agitated, unhappy, or depressed because they are bored and not engaged.

Doll therapy comes in handy to act as a distraction from upsetting, harmful, or dangerous events because the dolls give them something meaningful to do.

When working with a realistic doll, it can help enhance mood because they are designed to offer endless hours of smiles and hugs.

Increased Activity Levels

increased activity levels
Another perk that may be associated with doll therapy for persons with dementia is that the enjoyment they get from holding or just being with a teddy bear or doll can help them become more active.

This might create pleasant feelings as well as a connection to the outside world.

With a renewed sense of purpose, the person undergoing doll therapy becomes livelier and also increases their activity levels.

Improved Appetite

improved appetite with doll therapy
Some people with dementia will eat and drink better thanks to doll therapy dementia.

In most cases, a person with the illness will not eat because they cannot communicate well, tired, or depressed among others.

Spending time with the doll may help to deal with a majority of the issues so that a person ends up eating better.

Mealtimes with the teddy bears by their side can also be more fun, motivating them to eat well.

Decrease in Wandering

decrease in wandering
Wandering is a problem that many persons with dementia face. Some do it because they are stressed, bored, or because they are afraid of something.

Thankfully, doll therapy can help curb this as it gives someone something valuable to do so that they do not have to be all over the place at all times.

In a way, doll therapy contributes to the safety of persons who are living with dementia.

Reduces Caregiver Stress

doll therapy reduces caregiver stress of dementia patients
A majority of caregivers recommend doll therapy dementia.

This is because it tends to make their work a little bit easier, seeing that the therapy results in happier, and calmer persons who express themselves or communicate more.

The fact that doll therapy is self-administering also gives the caregivers more time to themselves.

Talking, dressing, changing, cuddling, and holding a doll engages and occupies the person who has dementia.

This is crucial because it gives them more energy and psyche to take better care of the persons with the illness.

No Side Effects or Medical Interactions

no side effects or medical interactions
When talking about the perks of doll therapy dementia, it is important to note that this is one of the non-pharmacologic ways of dealing with challenging behaviors or emotions that may develop in the course of the illness.

Persons with dementia benefit significantly from this type of therapy because they do not have to deal with drug interactions or side effects.

Reduces the Need to Take Some Medications

reduces the need to take some medications
Another advantage of using doll therapy on persons who have dementia is the fact that it can help to reduce the number of drugs that they are on.

This has a lot to do with the fact that it helps with calming down a person, which means that they may have less aggressive outbursts.

This implies that they can live without taking drugs that help with behaviors like aggression and agitation.

Cons

doll therapy cons
Although doll therapy dementia comes with loads of benefits, it also presents a few cons for people living with neurodegenerative diseases.

There are times, especially in the beginning where a person with dementia can view the introduction of a teddy bear or doll as an unwanted responsibility.

This is because they can see it as welcoming a sibling or grandchild in their youth.

Some people also think of the dolls or teddy bears as childish. Failed attempts to feed or communicate to the toy babies might also lead to distress, something you want to avoid with persons who have dementia.

Closing Thoughts

There is still a need to do more extensive research on doll therapy dementia. It has shown a lot of promise in offering comfort and purpose to those who have dementia.

Even though it still presents a few cons, it remains an option worth looking into concerning combating challenging behaviors like personality changes, anxiety, aggression, and agitation as well as improving the overall quality of life.

9 Best Therapy Dolls Reviewed 2021

 

‘Buyer’s Guide’, and full review on selected therapy dolls found HERE

Huntington’s Disease Treatment – Best Approach

huntington's disease treatment

Researchers continue to put in the effort to come up with effective Huntington’s disease treatment options.

Currently, there is no cure for this progressive neurodegenerative disorder.

Nonetheless, there are some approved therapies that help to manage symptoms and improve the quality of life for people who have Huntington’s disease (HD).

Check out some of these approved therapies that people with HD can benefit from below.

Huntington’s Disease Treatment Options

Medication

Huntington's disease treatment
If you have Huntington’s disease, your doctor may prescribe some medications that can help to manage some of the symptoms you suffer from.

A majority of the medications people use for Huntington’s disease symptoms work by modulating neurotransmitters or the chemical messages that move between neurons.

Some of the drugs that can help with movement disorders include:

Xenazine

This is one of the drugs that medics give people who have movement issues like chorea. It has been approved by the EU in 2008 to suppress involuntary writhing and jerking movements.

Antipsychotic Drug

Medicines like chlorpromazine, haloperidol, quetiapine, and risperidone may also help to suppress involuntary movements.

Other Medications

Clonazepam, levetiracetam, and amantadine are other examples of medicines that can help deal with chorea.

Drugs for psychiatric disorders

drugs for psychiatric disorders
There are several medications like antidepressants, antipsychotics, and mood-stabilizing medicines that a person with HD can take to treat psychiatric issues depending on the symptoms and specific disorders.

Note that some of the above medications have severe side effects like making the illness or symptoms worse, triggering depression and other psychiatric conditions, nausea, restlessness, drowsiness, skin discoloration, or leg swelling amongst others.

Drugs like clonazepam also have a high risk of abuse and dependence. This is why is important to follow the doctor’s directives when taking the medication.

Avoid self-medicating and report and serious side effects to your GP to see if there is a need to change the current medication.

Physical Therapy

physical therapy treatment for Huntington's disease
When exploring Huntington’s disease treatment options, you may need to work with a professional physical therapist.

The specialist will recommend some non-medication and non-invasive ways that you can use to manage physical symptoms.

The expert will guide you on safe and appropriate exercises that can improve coordination, strength, balance, and flexibility.

These are beneficial because they can enhance the mobility of your body and reduce the risk of falls.

Note that it is extremely vital for anyone with HD to remain physically fit as long as the course of the illness permits.

People who remain active do better than the ones who don’t. Getting instructions on the proper use of supports and appropriate posture can also help to reduce the seriousness of movement disorders.

Additionally, professionals can also help with airway clearance techniques and breathing exercises if you have any respiratory issues.

The experts can also help with stretching and moving your joints as well as relaxing massages.

Speech and Language Therapy

Huntington's disease speech and language therapy
If you have Huntington’s disease and have trouble with speaking, it is wise to consult a language and speech therapists.

The expert can help you learn alternative communication ways like the use of picture charts or electronic speech devices.

This helps improve your communication abilities so that you can remain active in family and community life for the longest possible time.

The therapists may also address any problems you may have with the muscles for swallowing and eating.

Working with Dieticians

working with dieticians
At some point, you may also need to work with a dietician to help with Huntington’s disease treatment. The professional will offer advice on the right diet that will ensure you do not end up losing too much weight.

Proper nutrition is crucial because there are some people with HD that burn thousands of calories a day due to involuntary movements. They, therefore need to eat more meals to have the necessary calories.

Dieticians can also offer guidance on practical ways to make food easier to chew and swallow. Some foods may require to be thinned while others need thickeners so that the weak person can eat well.

When serious problems arise, swallowing therapy exercises can help because it combines direct treatment strategies and compensatory techniques that can enhance oral intake safety by decreasing aspiration risks to maintain quality of life.

Occupational Therapy

occupational therapy for Huntington's disease
Because many people who have HD develop memory and concentration issues, occupational therapy is an important part of the Huntington’s disease treatment process.

The therapists can help come up with effective strategies for coping with memory and concentration problems. They can also help develop solutions that can make the home safer for persons with HD.

These can include assistive devices for daily activities like dressing, handrails in the house, and drinking and eating utensils specifically designed for individuals with limited fine motor skills.

In a bid to make your life easier, the therapists can also recommend the use of voice-controlled lights or software on your PC.

Experimental Therapies

experimental therapies
Away from the approved therapies that help with HD symptoms, experts have recognized other avenues to explore in regards to Huntington’s disease treatment.

A majority of these are already in the clinical trial stages while others are still in the development stage.

An example is gene silencing therapies that seek to decrease the levels of toxic HTT proteins that are produced. If successful, these will not only manage the symptoms, but they will also help to slow the progression of the illness.

Neuroprotective therapies are also being developed to curb neuroinflammation that damages and kills brain cells.

Soon, these may be added to the list of approved therapies for treating HD.

Huntington’s Disease Treatment Closing Thoughts

Despite the fact that there is no Huntington’s disease treatment, several approved therapies can help manage a majority of the symptoms associated with the illness.

What’s more, is that research is also ongoing studying the mechanisms of HD something that might result in the development of innovative new treatments.

Dementia Praecox – Definition, Causes, Symptoms

dementia praecox

Previously referred to as precocious madness or premature dementia, dementia praecox was a term used to describe a chronic deteriorating psychotic disorder.

It was popularized by Emil Kraepelin, a German psychiatrist in 1896. The psychotic disorder that begins during late teens or early childhood is characterized by rapid cognitive disintegration.

Over time, the term “schizophrenia” replaced dementia praecox, and it remains the current diagnosis label.

Dementia Praecox: Definition, Causes and Symptoms

According to R.Warner, in the International Encyclopedia of the Social & Behavioural Sciences, schizophrenia is a psychosis – severe mental disorder where a person’s grasp of reality, emotions, judgment, thinking, and are affected resulting in severe impairment of functioning.

Causes of Dementia Praecox

causes of dementia praecox
To date, it is still not clear what causes schizophrenia exactly. Scientists, however, suggest that a combination of environmental, genetic, psychological, and physical factors can increase a person’s risk of getting the disorder.

Seeing that it is not easy to pinpoint the exact causes of schizophrenia, experts have identified some risk factors that are common with individuals who have the condition that includes:

Genetics

genetics dementia praecox
Dementia praecox tends to run in families even though there is no specific gene that has been identified to be responsible.

You will most likely end up with schizophrenia if your identical twin has it, the risk goes up by about 50%.

If both parents have it – the chances of getting it to go up by at least 40% or if a sibling or one parent has it – your chances of getting it is are around 10%.

Birth and Pregnancy Complications

birth and pregnancy complications
Some studies indicate that a percentage of people who develop schizophrenia went through some complications before and during birth.

This accounts for factors like premature labor, low birth weight, and lack of oxygen during birth.

If your mother was malnourished when she was pregnant with you, you might end up with the disorder. Being exposed to a certain viral infection before you were born can also be a risk factor.

Drug Abuse

drug abuse
While drugs do not directly cause dementia praecox, research shows that drug abuse might increase the risk of developing the disorder.

Drugs like LSD, cocaine, or cannabis might trigger schizophrenia symptoms.

Chemical Imbalances in the Brain

Some experts believe that the imbalance of dopamine and serotonin, as well as other neurotransmitters, may be involved in the development of schizophrenia.

Trauma

trauma dementia praecox
The frequency of schizophrenia is also higher in adults who underwent different kinds of trauma in their childhood, such as physical or sexual abuse.

Triggers

triggers dementia praecox
These define things that can cause people who are at risk of developing schizophrenia. They include stressful life events such as losing a job, house, relationship, or a loved one.

Note that although these stressful events can be life-changing, they do not cause schizophrenia. Instead, they can trigger schizophrenia development in a person who is already vulnerable to the condition.

Symptoms of Dementia Praecox

symptoms of dementia praecox
A person usually experiences dementia praecox symptoms between the ages of 16-30. In some rare cases, young children also get a positive diagnosis for the disorder.

Schizophrenia symptoms are typically divided into three categories, namely: positive symptoms, cognitive symptoms and negative symptoms.

Let’s look at these categories individually below.

Cognitive Symptoms

cognitive symptoms
The cognitive symptoms refer to the issues that arise when people with schizophrenia develop thinking problems. Most people with the disorder will have a hard time processing or understanding information, which can affect their ability to make decisions.

A huge percentage of affected persons will also have a hard time concentrating on something.

Some will also have trouble with working memory where they cannot use the information they have just learned. Because of all this, communication also becomes a problem.

Positive Symptoms

positive symptoms
The positive symptoms are categorized as signs that showcase abnormal perceptions and delusions. These have a lot to do with the inability to determine what is real. This is where a person may have:

1. Hallucinations, false beliefs, or delusions: these are quite common with people with schizophrenia and can be related to auditory, visual, or any of the other human senses. These may become too real to a person to the extent that they are not even aware that they are ill.

Affected individuals might refuse to take medicine, thinking that it is poison or will subject them to adverse side effects.

2. Some people may also go through unusual thought disorders or disorganized and illogical thinking, which results in dysfunctional ways of thinking.

3. A certain percentage of people with the disorder may also showcase agitated physical movements.

4. Inappropriate behavior.

Negative Symptoms

negative symptoms
Schizophrenia’s negative symptoms refer to the behavioral and emotional changes that the people with the disorder experience. These can include signs such as:

  • Reduced facial expressions
  • Flat affect which explains changes in voice tones
  • Some persons with the disorder do not feel the daily pleasures of life
  • Speaking very little
  • Inability to begin or even continue activities
  • Depression
  • Mood changes
  • Social withdrawal
  • Absence of normal thoughts
  • Loss of drive

There are other symptoms that some professionals use, which cannot fit into the three main categories. These include signs such as:

  • Sleep disturbances
  • Weight gain
  • Restless leg syndrome
  • Dropping performances especially for students
  • Suicidal thoughts

Worth noting is that the dementia praecox symptoms start gradually develop at the onset of young adulthood and persist for as long as one lives.

The chronic condition also demands that most affected people go through lifelong treatment.

Closing Thoughts

Schizophrenia, which was known as dementia praecox, is among the most devastating neuropsychiatric diseases.

With this in mind, you should also note that experts are still working on ways to prevent and treat the condition.

There is a lot of hope that soon medics will be able to deal with the symptoms of the disease so that affected individuals can live “normal” lives functioning well in day to day activities while enjoying the little pleasures of life.

What is Primary Progressive Aphasia?

primary progressive aphasia

There are a few rare diseases that a person can develop one of them being primary progressive aphasia (PPA).

This refers to a neurological syndrome that slowly and progressively impairs language capabilities. It is a result of damage to the sections of the brain that control language and speech.

According to the National Aphasia Association, this is different from the other kinds of aphasia that result from brain injury or stroke.

In other words, it is a rare case of frontotemporal dementia.

This is because neurodegenerative diseases like Frontotemporal Lobar Degeneration and Alzheimer’s disease can also cause PPA.

After all, they lead to the deterioration of brain tissues that are responsible for language and speech.

Primary Progressive Aphasia: Diagnosis, Symptoms and Treatment

We can divide primary progressive aphasia into three categories namely:

1. Semantic PPA: This is where affected people can no longer voice out certain words. Their ability to recognize words may also start to decline.

2. Agrammatic/nonfluent PPA: Persons with this type of PPA have a hard time forming complete sentences.

3. Logopenic PPA: It is where a person may struggle to locate the right words to speak but still retain the ability to comprehend what other people say.

Diagnosis

diagnosis of primary progressive aphasia
When medics suspect that a person has primary progressive aphasia, they usually look at the signs and symptoms that a person is showcasing.

This can include progressive loss of language abilities as well as some behavioral changes.

Doctors may then thoroughly examine family and medical history to see if they can catch the signs of the illness. MRI or CT scans may be done to confirm the diagnosis through brain imaging.

Sadly, with some cases, doctors may not be in a position to determine the specific disease until a person passes on.

Symptoms of Primary Progressive Aphasia

symptoms of primary progressive aphasia
Problems with language and speech are among the most common symptoms of PPA.

They typically show up between the ages of 50-70. These can include:

  • Difficulties naming familiar objects
  • Trouble understanding the meaning of words
  • Struggling to comprehend written or spoken language
  • Searching for words resulting in lots of pauses when speaking
  • Hard time repeating sentences and phrases
  • Struggling to find word substitutions and retrieve words
  • Poor grammar when speaking and writing

Worth noting is that symptoms of PPA are usually dependent on the extent of damage to the left hemisphere.

Additionally, other problems associated with the disease can show up later such as memory loss.

Other complications like depression or social and behavioral problems may also crop up as the disease progresses.

Some people have been known to experience poor judgment or develop neurological symptoms like issues with movement to an extent that they need help with day to day living.

How does Primary Progressive Aphasia Progress?

how does primary progressive aphasia progress
PPA tends to start as a subtle language disorder. For some people, this can be fluent aphasia where they have normal or an increased word production rate.

Others begin with non-fluent aphasia where they produce fewer words and they have challenges with speech.

In rare cases, a person will start by having a difficult time finding the right words to use coupled with progressive deterioration of comprehension and naming.

Over time, the situation becomes worse and in its severe stages, a person is not able to speak nor understand written or spoken language.

The progression patterns are different for different people. It is important to note that while Alzheimer’s causes PPA, it is not a neurodegenerative disease.

A huge percentage of people who have PPA remain independent can stay employed, and can also pursue hobbies and other interests.

Primary Progressive Aphasia Treatment Options

primary progressive aphasia treatment options
There is still no treatment approved for persons who have PPA.

This is primarily because there is still a lot of research that needs to be done on this illness.

Treatment is mostly geared towards helping a person adapt to the changes that will happen. For instance, anyone with this condition can benefit from learning new communication strategies during the disease.

Professional speech-language pathologists can help with this.

Aphasia Community Groups can also help with teaching new strategies to communicate. Communication assistive devices may also come in handy.

Speech therapists can also help persons with PPA to maintain language skills for the longest possible time.

Non-verbal modes of communication like pointing pictures or gesturing can also be helpful when a person with PPA wants to express themselves.

Doctors in some cases may prescribe SSRIs (selective serotonin reuptake inhibitors) to treat some of the behavioral changes that PPA causes.

These medications are also in use to treat depression and anxiety symptoms.

More studies are underway to identify more effective treatments for primary progressive aphasia.

Risk Factors

risk factors of primary progressive aphasia
Certain factors can increase your risk of developing primary progressive aphasia like

Learning disabilities

People who had learning disabilities while growing up specifically developmental dyslexia might be at higher risk of PPA.

Gene mutations

In a few cases, PPA might be hereditary where a person may end up getting it if their family member had it thanks to rare gene mutations.

Prognosis

Many people who have primary progressive aphasia will typically live with the illness for about 3-12 years after diagnosis.

Subcortical Dementia – What Is It?

subcortical dementia

There are different types of dementia, one of them being subcortical dementia.

According to many studies and researches, this is a type of dementia that affects the white matter of the brain affecting structures below the cortex.

This type of dementia is a clinical syndrome that includes multiple diseases that primarily affects the subcortical structures that include:

  • The midbrain (mesencephalon)
  • Cerebellum
  • Thalamus & hypothalamus (diencephalon)
  • Basal ganglia

The above are responsible for various functions, including procedural learning, eye movement, voluntary motor movement control, arousal, emotions, visuospatial skills learning of habits, and cognition.

History of the Clinical Syndrome

history of the clinical syndrome
In 1817, James Parkinson wrote an essay where he recognized depression as one of the symptoms of the disease named after him.

He described a man who was once a confident with an active mind and cheerful disposition appearing dejected, emancipated and stopping.

Despite all this, the power of his mind and his senses remained unimpaired.

He remained attentive, was able to listen to conversations and had a desire to join in though he was struggling with speech, and he could even read and write.

Years later, in 1861, Vulpian and Charcot observed cognitive impairments in persons who have Parkinson’s and Huntington’s diseases.

However, it was not until 1912, when Wilson became the first person to observe a distinction between dementia that involve subcortical structures, and other kinds of cognitive impairments.

Wilson described the impairment of Wilson’s disease as one that showed the narrowing of mental horizons.

He went on further to state that the impairment did not include agnosia and apraxia. Wilson also compared this pattern to the one presents in Huntington’s disease.

As research went on by other experts on the subject, the concept of subcortical dementia was finally crystallized into a clinical entity in the mid-1970s.

Examples of Subcortical Dementia

examples of subcortical dementia
This dementia type is in connection with numerous diseases. These include Parkinson’s disease, Huntington’s disease, Wilson’s disease, Multiple System Atrophy, and progressive supranuclear palsy, etc.

The conditions fall into the category of subcortical processes that are characterized by deterioration of mental abilities.

The concept of this type of dementia has led to a lot of debate where researchers are seeking to divide cognitive dysfunction into the subcortical and cortical dichotomy.

Over the years, experts have been collecting evidence that supports the idea of the clinical syndrome being classified as its clinical entity.

The evidence touches base on distinct patterns of neuropathology, neurological, and neuropsychological profiles.

Symptoms of Subcortical Dementia

symptoms of subcortical dementia
Various symptoms may suggest a person has this type of dementia. Some of them include:

  • Slowness when it comes to mental processing
  • Depression
  • Abnormal movements
  • Tremors
  • Lack of initiation
  • Apathy
  • Loss of social skills
  • Mild intellectual impairment
  • Inertia
  • Difficulties solving problems

In a majority of cases, the clinical entity does not affect perception and language. Although persons with the illness may experience forgetfulness, amnesia is usually not severe.

Looking at a Neurobehavioral Perspective of This Dementia

looking at a neurobehavioral perspective of this dementia
Subcortical dementias have a common neurobehavioral change pattern even though the subcortical structures usually affect different areas of the subcortical pathology.

This is because of the disruption that happens to the frontal-subcortical systems. The clinical presentations include abnormalities in different areas like:

Memory

With this type of dementia, it appears like the ability to retain information, which can also be referred to as immediate memory is spared while it affects the ability to recall information.

Personality and Mood

Personality and mood changes have been recognized in persons with this clinical syndrome. About 90% of persons with Parkinson’s experience depression at one point in the illness.

General Appearance

Because of significant extrapyramidal motor deficits, the general appearance of people with this type of dementia is different from that of cortical dementia. For example, Parkinson’s disease is often marked by a shuffling gait, hypomimia, and tremor.

Chorea is common with Huntington’s disease while a “surprise” look is seen with people who have supranuclear palsy.

Language

language
There is no record of significant changes in language when talking about subcortical dementia. People with the illness may, however, experience deformities with speech.

For instance, an individual with Parkinson’s disease may have reduced phrase length and dysarthria.

Subcortical Dementia Treatment Options

Although this kind of dementia remains highly controversial, some researchers believe that they are part of the dementias that can be treated. This is because most disorders that are associated with dementia respond to appropriate treatment and some may be reserved completely.

Consulting your physician will give you a better idea of which treatment route to take while dealing with this dementia type.

Closing Remarks

While some physicians will use the classifications of subcortical or cortical dementia, others argue that it is not worth categorizing the neurodegenerative illness into groups depending on the location of brain damage.

As new evidence emerges, it is only a matter of time before the experts can put the matter into rest as to whether it is important to classify dementia into two major groups.

RSS
Follow by Email