, Author at ReaDementia

What is Pseudodementia? [Diagnosis, Treatment]

Trevor Howitt Blog, Causes September 3, 2023November 19, 2023depression, pseudodementia

What is pseudodementia? Pseudodementia is a mental illness of cognitive decline that has a number of the same symptoms that are found in people with dementia and does resemble dementia.

In this article we delve deeply into the question, what is pseudodementia, looking at the history of the condition, diagnosis and treatment.

Usually, pseudodementia has other underlying causes – with depression being a very common one. The patient’s symptoms must be carefully assessed so that they get the correct diagnosis and treatment.

Interestingly, treating some of the underlying causes can effectively reduce some of the symptoms and with continued support, the person’s condition can greatly improve . So, what are the causes of pseudodementia?

What is Pseudodementia?

When was the term pseudodementia first used?

Leslie Gordon Kiloh was an Australian doctor who was born in London in 1917. He completed his medical training at King’s College, London and after the Second World War he returned to the hospital and worked in the Neurology Department with some of the UK’s most eminent neurologists.

Kiloh wrote a number of influential papers on depression and the classification of depressive illnesses during his time at King’s College .

‘The term pseudo-dementia (PDEM) was coined by Kiloh (1961) to describe the cases, which closely mimicked the picture of dementia’. The National Library of Medicine

The National Library of Medicine continues by explaining that the term –

‘has been used a little loosely for describing the cognitive deficits in depression, especially, which is found in old age’.

What is pseudodementia? – understanding the symptoms

Pseudodementia can certainly appear very similar to dementia, but importantly, is not caused by neurological degradation. Commonly it has its roots in a mood-related condition such as depression and these conditions can be treated.

A patient with pseudodementia can have the following symptoms:

Difficulties with speech and words
Lapses of memory or memory loss
Difficulty keeping focused on something
Difficulty moderating their emotions
Struggle with being organized and unable to plan

All of the above symptoms are also commonly found in people with dementia which makes it very difficult for a doctor to make an accurate diagnosis.

If a person is presenting with these symptoms, but they are linked to depression, they may well have some of the following symptoms too:

A loss of interest in their favourite activities and pastimes
Period of feeling blue that last for a number of weeks each time
No interest in being sociable and seeing friends
Have suicidal thoughts
Suffer from insomnia or hypersomnia (excessively tired during the day and
sleeping many hours at night)
A marked loss of appetite

This medical condition does occur in people as they age. Many doctors believe that depression can also cause cognitive impairment. It is well known that dementia can also cause depression.

As well as depression, there are several other mental conditions that can cause similar symptoms that need careful diagnosis.

What is pseudodementia? – getting a diagnosis

Not surprisingly, doctors find it incredibly difficult to differentiate between dementia and pseudodementia. As they are often trying to make the diagnosis with an older patient, this can make it even harder. In addition, some doctors feel that the term ‘pseudodementia’ describes the symptoms and is not the correct name for the condition.

Doctors usually try to rule out all other medical conditions before they consider whether their patient could have pseudodementia. This usually takes time as the doctor wants to discount a number of cognitive impairments first.

To make the diagnosis even more challenging, their patient could have both dementia and depression at the same time. So, a number of tests need to be carried out.

‘Pseudodementia is a term used to describe patients who appear to be demented but are actually severely depressed.

Differences from genuine dementia can be subtle; patients with pseudodementia usually have a pre-existing history of depression with acute onset (often after a specific event), emphasize and appear more distressed about the cognitive deficits, and have preserved attention.

If the diagnosis of depression is suspected, patients should be asked about thoughts of suicidality and their social support structure.

Appropriate consultation and follow-up with a psychiatrist or social worker or hospitalization may be necessary to ensure the patient’s safety’

Source: Sciencedirect.com

Diagnostic tests

The tests that the doctor will want to complete usually include :

The use of speech and language
Visual perception
Problem solving skills and other cognitive tests
Attention span and difficulties
Movement and balance

Blood tests are usually carried out to ensure that the patient does not have an underactive thyroid or Vitamin B12 deficiency. Both of these conditions can cause a number of similar symptoms to pseudodementia.

A brain scan is the most important test to have done as the results for dementia or pseudodementia will be very clearly different because of the changes in brain structure and function found in people with dementia.

According to the Healthline website, in people with dementia, there can be 10-50% loss of brain volume.

Interestingly, family members may spot a difference in their loved ones behaviour. People with dementia usually try to hide any memory loss. However, people with pseudodementia may well highlight their difficulties.

Treating pseudodementia

Once the doctor has made the diagnosis of pseudodementia, they will be keen to start treatment to address the underlying cause which is usually depression.

Depression can be successfully minimised but the treatment must be tailor-made for the individual and usually comprises of both psychotherapy sessions and medication.

A popular type of therapy used is Cognitive Behavioural Therapy (CBT) and the suggested medication may be a course of antidepressants.

Unfortunately, at present there is no cure for dementia, but the symptoms of dementia can be managed for a while.

With cases of pseudodementia, treatment of the underlying depression, often results in a significant improvement in the patient’s condition if not a total reversal in their symptoms.

‘Across multiple studies, between 10%- 90% of people who were at one time diagnosed with pseudodementia were later found to have irreversible or neurodegenerative forms of dementia’. Healthline .com

If you enjoyed reading our blog on ‘What is Pseudodementia’ then you may also find value in our other article that gives an overview of pseudodementia.

Dementia Wandering (Tips For Caregivers)

Trevor Howitt Blog August 26, 2023September 6, 2023dementia wandering, wandering

People with dementia often feel the need to walk about – even though they do not know where they are going and may have no purpose in their walk. They simply feel the need to walk. Researchers have given this type of behaviour the name ‘Dementia wandering’.

How common is dementia wandering?

According to the Practical Neurology website, wandering is common in people with Dementia-

‘Wandering is a complex behavioural phenomenon that is frequent in dementia. Approximately twenty percent of community-dwelling individuals with dementia and sixty percent of those living in institutionalized settings are reported to wander. Most definitions of wandering incorporate a variety of dementia-related locomotion activities, including elopement (i.e., attempts to escape), repetitive pacing, and becoming lost’.

The article continues with a stark fact. It explains that the terms ‘critical wandering’ and ‘missing incidents’ are being used to describe when a person with Dementia wanders and becomes lost.

The main concern this brings is that the mortality rate in these situations is 20% – which makes dementia wandering the most dangerous problem linked with this disease.

What are the causes of dementia wandering?

Whilst research continues to establish the reasons and wandering patterns occurring in people with Dementia, some scientists believe that they are searching for something they once treasured or trying to get back to a moment in time when they were particularly happy – such as a favourite holiday destination or job.

Other scientists believe that dementia wandering patients do so because they are feeling agitated and restless.

On its website, The Alzheimer’s Association explains –

‘Alzheimer’s disease causes people to lose their ability to recognize familiar faces and places. It’s common for people living with dementia to wander or become lost or confused about their location, and it can occur at any stage of the disease. Six in ten people living with dementia will wander at least once; many do so repeatedly. Although common, wandering can be dangerous — even life-threatening — and the stress of this risk weighs heavily on caregivers and family’.

If your loved one is inclined to wander, it is important to know the reasons that may trigger their need to do so-

Common reasons people with dementia wander:

They have not retained the fact that you asked them to stay in the house or car.
They are feeling agitated and unsettled.
The wandering has been prompted by a change in routine.
It could have been triggered by something they overheard.
They are searching for a favourite place or time from the past.

You may be able to pick up on some subtle signs that your loved one could start wandering. In conversation, they may express to you the need for them to go somewhere – like to work or shopping.

It could be that they no longer recognise their surroundings, even if it is the home that you have shared for many years. Sometimes a person with Dementia can wander because they get confused and disoriented.

They may be searching for a certain place such as the bathroom and not find it. You may well find that you have to regularly remind them where different rooms are – picture signs pinned on the door can help.

You may discover that when they are feeling restless or agitated they may not simply be able to keep still.

Devices to assist caregivers with loved ones who wander

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What can be done to prevent your loved one wandering?

There are a number of practical things that should be put in place to ensure that it is difficult for your loved one to wander.

These are important to initiate because of the serious risk that they could fall and injury themselves on one of their ‘walkabouts’.

The most important thing you can do is to create a safe and secure environment for them. You will need to install locks on all doors leading outside and windows. Locks using a security number are best.

Make sure you have somewhere safe to keep your house and car keys. Your loved one may forget that they no longer drive.

Child proof catches can prove useful on bathroom cabinets and drawers containing medication and sharp kitchen utensils.

It is sensible to make sure that furniture in your home is easy to navigate and that there is plenty of lighting – including at night if your loved one tries to reach the bathroom.

It is practical to ensure that your loved one has enough to eat and drink during the day. This is so that you can take the practical step of offering them their last drink about two hours before bedtime. This will reduce their need to get up at night to use the bathroom.

Can restless behaviour be managed?

It is quite a challenge to keep your loved one engaged throughout the day and certainly requires plenty of good planning. However, keeping them occupied will help them to feel calmer and less agitated.

Avoid busy places such as shopping malls where they may well quickly feel disorientated. If they are in new surroundings, do not leave them on their own

Ensuring that your love one gets adequate sleep can also really help. A good way to help this is by getting daily exercise together.

If the weather is good, nothing is better than enjoying a walk in the countryside. If your loved one has an interest in swimming or gardening these are ideal pastimes too and will help tire your loved one.

For the final hour before bed, sitting together listening to music as this will help prepare your loved one for bed.

Make sure that the lighting in your lounge is not too bright. Being soft and mellow will send the signal that bedtime is approaching.

If you find that your loved one seems more confused than normal or is restless and agitated, it is well worth having a word with their doctor.

What to do in case of emergency

Keep a list with the telephone number for the Police and family and friends who live by on the wall by the telephone. Think through an emergency plan – should the worse happen – and discuss with key friends and neighbours.

Ask them to always contact you should they see your loved one out and about on their own.

Compile a list of the likely places that your loved one could try to find. Such places as favourite places/restaurants, your old home, where they used to work etc.

Make sure you have a recent photograph of your loved one that you can show Police officers.

If your loved one has wandered and you cannot speedily locate them within 10-15 minutes, contact the local Police. Tell them that your loved one has Dementia.

Contact your key neighbours and friends and get them to help you search the locality. It is interesting to note that the direction that your loved one probably wandered is the same as their dominant hand.

Check the local vicinity really well as most wanderers are found within two kilometres/ one mile of home.

Closing Thoughts – dementia wandering

As cognitive decline increases, it may become unsafe for your loved one with dementia to live at home — especially if they are at risk of wandering.

Although dementia wandering is one of the most dangerous behaviors that people with memory loss will face, there are ways to prevent or manage the risk.

Our aim is to educate and inform caregivers in order to help you remain confidence in the face of this challenging disease.

Medication to Help Dementia Patients Sleep

Trevor Howitt Blog August 15, 2023November 19, 2023sleep medication

This article will help you understanding challenges dementia patients may have with sleep. We will look at solutions, including when is medication to help dementia patients sleep necessary.

Medication To Help Dementia Patients Sleep

Many dementia patients have problems, both getting to sleep and staying asleep. Some experience changes in their sleep patterns too.

At present, scientists do not fully understand the reasons for this but believe they are linked to the changes in memory and behaviour and the impact dementia has on the brain.

Trying to manage these sleep changes in your loved one is challenging. It is important to try coping strategies that do not use medication.

Although many doctors prefer not to prescribe medication to help dementia patients sleep, in some cases it becomes necessary.

Natural Medications to Help Dementia Patients Sleep

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Are sleeping problems common in dementia patients?

Many people who do not have dementia do experience changes in their sleeping patterns as they get older. Many find that they need less sleep.

Older dementia patients often incur sleeping problems too. However, these tend too be more frequent and more severe.

Some dementia patients have sleep problems in the early stages of the disease, but sleeping problems become much more common in the later stages.

Persons with dementia experience excessive daytime sleepiness associated with fragmented sleep at night. As a result, persons with dementia often have frequent, short duration naps throughout the day to make-up for lost sleep at night. Additionally, other medically-diagnosed sleep disturbances occur frequently in persons with dementia’. Source

Difficulty getting to sleep and staying asleep

Many dementia patients find it hard to settle down to sleep at night. If this is the case with your loved one, it is important not to give them any caffeine drinks (coffee, tea, cola etc.) for several hours prior to bedtime.

Television can also prove too stimulating. It may well be best to turn it off for the hour before bedtime and listen to relaxing music instead.

Staying asleep can be very difficult for dementia patients too. Many will repeatedly wake during the night and stay wake for long periods of time.

Unable to get back to sleep, the dementia patient may call out or start to wander around the house. The results is a disrupted night for everyone.

Without a good night’s sleep, you may well find that your loved one is struggling to stay awake during the day.

A short nap early on can certainly help. However, sleeping longer and later in the day will compound their problems of trying to sleep at night.

Some dementia patients also become agitated and anxious as the sun begins to set. This is called ‘late day confusion’ and is caused by the changing amount of natural daylight. The clever use of indoor lighting using dimmers can help ease the problem.

Experts estimate that in late stages of Alzheimer’s, individuals spend around 40% of their time in bed at night awake and a significant part of their daytime sleeping. In extreme cases, people may have a complete reversal of the usual daytime wakefulness-night-time sleep pattern’. Source

Why the non-drug approach is best

In the first instance, it is definitely best to use the non-drug approach to resolving sleep issues in your loved one.

According to the Alzheimer’s Association, many studies that have been conducted have proved that –

‘sleep medications generally do not improve overall sleep quality for older adults. Use of sleep medications is associated with a greater chance of falls and other risks that may outweigh the benefits of treatment’.

There are many practical things to try to help your loved one to sleep. These include:

Ensuring the bed and the bedroom are comfortable and at the right temperature.
The way to the bathroom is safely lit at night.
That you adhere to a good routine throughout the day and evening.
Your loved one takes some exercise every day.

Medication to help dementia patients sleep

Unfortunately, if none of the ‘natural remedies’ work and if you as the carer are getting too tired and unable to fulfil your daytime role for your loved one, it is time to speak with your doctor.

The problem needs to be discussed fully because of the risks of using sleep inducing medication for older patients with dementia.

Your loved one will have a greater risk of falling, could suffer from greater confusion and there will be a noticeable decline in their ability to care for themselves.

You need to clearly understand the balance between the risks and potential benefits of the suggested medication.

The type of medication that may be prescribed by your doctor will probably be dependent on other behavioural problems experienced with your loved one.

All medication to ease sleeping problems in dementia patients should only be used in the short-term and discontinued as soon as your loved one has a regular sleeping pattern once more.

There are a range of medications used to treat sleep changes in dementia patients and these include include:

Tricyclic antidepressants
Benzodiazepines
Different types of ‘Sleeping pills’
“Atypical” anti-psychotics

Your doctor will only prescribe medication after an in-depth discussion with you as to the side-effects. These may be impaired alertness and coordination, worsening of their depression, more complex sleep issues and respiratory problems.

Final Thoughts – Medication to Help Dementia Patients Sleep

You may find that your doctor will not prescribe medication for sleep disorders in dementia and will refer you to a specialist such as a psychiatrist who specialises in dementia.

This is only likely to happen if the sleep problems are severe and none of the natural treatments have helped.

It is important to remember that if your loved one is given sleep medication that they will be more confused than before and that you will have to be extra vigilant throughout the day…

Helping Alzheimer’s Patients Sleep [Solutions]

Trevor Howitt Blog August 14, 2023November 19, 2023alzeimer's and sleep, sleep problems

Helping Alzheimer's Patients Sleep Easily

Sleeping problems and changes in sleeping patterns are common in people with Alzheimer’s. Scientists are still unsure why, but know that they are often linked to the changes in the brain that are caused by Alzheimer’s. Helping Alzheimer’s patients sleep is an ongoing challenge for medical professionals because the periods of broken sleep tend to be more frequent and more severe.

Getting adequate sleep is important for your loved one but will also benefit you, as you will be able to enjoy a relatively peaceful night’s sleep too.

Helping Alzheimer’s Patients Sleep

What type of changes in sleeping occur?

The common sleep problems include difficulty in getting to sleep and staying asleep at night, and sleepiness during the day.

Many Alzheimer’s patients are awake frequently during the night and then wake prematurely early in the morning. This is all very challenging – and exhausting for the carer.

Many Alzheimer’s patients also find it difficult to get back to sleep if they do waken during the night.

Unfortunately, this often leads to them becoming fidgety in bed and some call out for help, whilst others begin to wander around the house.

All of these things lead to disrupted sleep for everyone in the house. Sleep disturbances do tend to get worse as the Alzheimer’s progresses.

‘Experts estimate that in late stages of Alzheimer’s disease, individuals spend about 40% of their time in bed at night awake and a significant part of their daytime sleeping. In extreme cases, people may have a complete reversal of the usual daytime wakefulness-night-time sleep pattern’. Source

Your loved one may be experiencing a difference in their normal sleep pattern and may want to take a daytime nap, but when this occurs happens, they find that they cannot sleep at night.

It is important to remember that many older people who do not have Alzheimer’s find that they require less sleep and experience changes in the times they fall asleep and wake in the morning.

Later in this article we do provide suggestions for helping Alzheimer’s patients sleep.

Changes due to medical problems

If your loved one is depressed, this could well affect their sleeping problem and is best discussed with your family doctor.

Other problems that can disturb sleep include Obstructive Sleep Apnoea which is a potentially serious condition and is when the breathing pattern alters and the person stops breathing numerous times during the night.

This medical condition is more common in people with Alzheimer’s.

‘Restless Legs Syndrome’ is another cause of broken sleep and this is when the legs twitch and tingle involuntarily.

Sometimes sleep problems can occur when your loved one is suffering from mental and physical exhaustion after a particularly busy day.

Feeling disorientated can also cause sleep difficulties and changes in their body clock.

A number of Alzheimer’s patients become restless and agitated late in the afternoon.

This is a well known problem and is called ‘late day confusion’ and can cause confusion and agitation.

It is triggered by the changing amount of daylight, but luckily can be addressed with the clever use of subtle indoor lighting using dimmer switches or your doctor may advise the use of a Melatonin supplement.

Natural medications

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Ways to get better sleep for those with Alzheimer’s

Helping Alzheimer’s patients sleep: if you are finding that your loved one is getting broken nights, it is well worth trying some of these natural remedies:

● Try and establish a routine and keep mealtimes and bedtime at the same times each day. Make sure the evening meal is at least four hours before bedtime.

● If the sun is shining spend time outdoors together first thing in the morning.

● Enjoy some exercise during the day – walking, swimming and gardening are all good. Do not exercise in the evening within two hours of bedtime.

● Ensure that the bed is comfortable and at the bedroom is at the right temperature and has night lights so they can find their way easily to the toilet during the night.

● Avoid stimulants and do not offer your loved one alcohol or caffeine or let them have nicotine.

● Limit the length of your loved one’s daytime nap.

● Television in the hour before bedtime can prove a problem. Playing soft, soothing music instead will be more beneficial.

● No medication – especially cholinesterase inhibitors- should be given within two hours of bedtime.

● If your loved one wakens and cannot get back to sleep easily, it is best that they get up.

The use of medication

Sometimes if all the above suggestions have failed, medication for Helping Alzheimer’s patients sleep will be prescribed.

However, this is unusual as it comes with many increased risks for older people such as falling and added confusion.

If medication is used, it will be for a very limited time in order to re-establish the sleeping routine.

If this is the path suggested by your doctor, it is important to fully understand both the benefits and the risks of the suggested medication.

Final Thoughts – Helping Alzheimer’s Patients Sleep

It is very important that you get plenty of quality sleep and rest so that you can cope with the demands of caring for your loved one during the day.

Perhaps you have a family member who can regularly step in and cover for you at night or else there may be help available if you contact your local dementia association.

Our hope is that you now have a better understanding of what causes sleep apnoea with Alzheimer’s. The important point is not to suffer in silence and try and manage by utilizing the tips we’ve suggested with helping Alzheimer’s patients sleep.

Dementia and Bowel Incontinence

Trevor Howitt Blog August 13, 2023August 13, 2023bowel incontinence, dementia and incontinence, incontinence

There is a direct link between dementia and bowel incontinence. A person with dementia is much more likely to have accidents, suffer from incontinence and generally have more difficulties using the toilet.

Often these problems get worse as the condition progresses. Unfortunately, incontinence is not a topic that people talk easily about – but we do! Here we bring you the full low-down on dementia and bowel incontinence plus tips and advice for you to try….

Dementia and Bowel Incontinence

What is the link between dementia and bowel incontinence?

Sometimes incontinence develops in dementia patients because the messages between the brain and bladder and bowel are not working properly or can be triggered by a medical problem such as urinary tract infection (UTI), constipation or – for men – prostate problems.

Sometimes bowel incontinence can be caused by Irritable Bowel Syndrome (IBS). Certain medications for dementia can also trigger bowel incontinence.

What is incontinence?

Incontinence is the term given to when a person does not make it to the toilet in time and experiences a leakage of urine (pee) or faeces (poo). If they are having problems with both, this is described as ‘double incontinence. Urinary incontinence is the most common kind.
When either occurs, it can be very upsetting for dementia patients.

According to Healthline-
‘About 50% of people living with dementia have urinary incontinence. Specifically 60-70% of people with Alzheimer’s disease develop this condition. In addition, 30-50% of nursing home residents living with dementia or memory problems also have faecal incontinence’.

What are the different types of incontinence?

Urinary incontinence

This is the most common type of incontinence and ranges from small, occasional leaks to continuing to pee after leaving the toilet or the total emptying of the bladder away from the toilet..

People with dementia often develop an over-active bladder. They will suddenly feel that their bladder is full and will have an urgency to go to the toilet. They will also want to visit the toilet much more often than they did in the past.

Some dementia patients do suffer from stress incontinence which can cause small, regular leaks.

Faecal incontinence

Again, this type of incontinence ranges from a small leakage of poo to having no control over the emptying of the entire bladder.

This situation is not only distressing for the dementia patient but can be very difficult for their carers to deal with too.

Dementia and bowel incontinence – Why does it develop?

As well as the medical reasons given above, incontinence can develop in a dementia patients for the following reasons too:

They may not recognise the sensation of needing the toilet in adequate time.
As well as not recognising the sensation, they may not be able to alert their carer in time to reach the toilet.
If they have mobility problems, the dementia patient may not reach the toilet in time.
They may not understand a prompt that it is time to visit the toilet.
Dementia patients often resist help to use the toilet.
They get confused when looking for the toilet.
They can feel embarrassed because they have already had an accident.

How can you ease the situation?

There are ways that help minimise the problems of incontinence in dementia patients.

The most important point to remember is that you need to include toilet visits into your routine, but you do need to ask your loved one sensitively if they need the toilet regularly – every two hours.

Also watch for any signs that they might need the toilet. It could be an advantage to install a reminder for you both on your smartphone.

Keep bladder and bowels working well

Encourage your loved one to drink plenty– eight glasses a day is the recommended amount. If they are not drinking enough they will be prone to constipation. If they have an overactive bladder, avoid, coffee, tea and alcohol. Offer water, herbal teas and fresh fruit juices diluted 50/ 50 with water as these will be more soothing.
Get daily exercise together – walking or swimming are both good and will ensure that your loved one’s bowels work well.
Built toilet breaks at certain times into your daily routine and when you go out together, make sure you know in advance where toilets are located.
If your loved one is constipated, gentle laxatives can help and gently massaging their stomach can ease discomfort.

Make your toilet dementia-friendly

Even if you have been living where you are for a number of years, it is important to make the toilet easily identifiable and easy to use for your loved one.

Make the toilet easy to spot with a sign on the door with a picture at eye level. If there are several of you in the house, install a simple sign with red and green sides to show when the toilet is free or occupied.
Ensure that it is easy to reach the toilet – move furniture out of the way and ensure the area is well lit.
Consider investing in a coloured toilet seat so that it is easy for your loved one to recognise. Invest in a raised toilet seat if it will be easier to use and fix some handrails.
Disable the door lock so that your loved one cannot accidentality lock themselves in the toilet.
Avoid confusion with mirrors. Your loved one may not recognise their reflection in the mirror and think there is already someone using the toilet.

And for night-time use too….

Install good lighting from the bedroom to the toilet that is triggered by motion sensors.
If night-time use of the toilet becomes tricky, consider using a commode close to the bed with night lighting.

How best to cope with dementia and bowel incontinence accidents

This is a difficult situation for you both to deal with. Your loved one will feel that they are not in control of their body and that they are losing their dignity.

Many dementia patients find it difficult to accept help with such a private part of their lives.

Needless to say, how your loved one reacts to an accident can vary and they may find it very upsetting.

Be understanding and practical and add a little humour if you think it will help to ease their embarrassment. Having nice easy pull on trousers and shorts with elasticated waists will help too.

Do not be negative in any way- the accident was totally unintentional. If you find it hard to cope with the situation, talk with your GP.

Incontinence and the support you give your loved one will change your relationship and it will become stronger – if you do not let it get in the way.

Personal hygiene is very important

Following an accident, it is important that your loved one cleans themselves properly and you may well need to help them. Remind them gently to wash their hands well.

You may well find that baby wipes are easy and effective to use and these will help prevent skin irritations and fungal infections. Pat the skin dry gently after use with toilet tissue.

Alternatively, wash the wet or soiled area with soap and warm water and pat the skin dry with a soft towel before your loved ones puts on fresh clothes.

If incontinence is becoming an issue, there are some excellent incontinence briefs on the market that contain a highly absorbent pad.

Both day time and night time pads are available and manufacturers have started producing attractive ones for ladies in different colours and patterns.

Re-usable briefs are also available and these are machine washed after each wearing .

If your loved one prefers to wear their own underwear, absorbent pads that slip inside panties are good and if you loved one has stress incontinence, you mat well find that panty liners are adequate.

Final Thoughts – Dementia and Bowel Incontinence

Incontinence usually develops in middle to late stage dementia, but this does vary from one person to the next. If you are concerned that your loved one is becoming incontinent, a visit to your GP will be reassuring as they can assess what the underlying cause is.

Never struggle in silence with dementia and bowel incontinence, there are different health professionals you can approach for help and some excellent products on the market that will make the situation easier to handle.

Physical Therapy Exercises for Dementia Patients (Guide)

Trevor Howitt Blog August 11, 2023November 19, 2023physiotherapy, physiotherapy exercises, physiotherapy for dementia

Physical therapy exercises for dementia patients is really important as it helps to maintain mobility, improve their health and their quality of life. Exercise can make a tremendous difference to a person’s health. Regular exercise lowers the risk of heart disease, stroke, cancer and Type 2 Diabetes.

It is particularly good for people with dementia as they cannot always explain how they are feeling or any aches and pains they have. With careful assessment, their physiotherapist can locate any problem areas in their body and work to resolve – or at least – minimise their discomfort.

‘Physical therapy, also known as physiotherapy, may include certain exercises, massages and treatments based on physical stimuli (e.g. cold, heat, electrical currents or ultrasound). The purpose of physical therapy is to relieve pain, help you move better or strengthen weakened muscles’ Source

Physical Therapy Exercises for Dementia Patients

Why is physical therapy so important?

Gentle exercise is a holistic treatment as it not only keeps the body strong so that the person can continue everyday activities, but exercise is really good for your loved one’s mental well-being.

In addition, it lowers levels of stress and anxiety and raises a person’s mood. As a person ages and mobility becomes more limited, the importance of physiotherapy increases.

Physiotherapy can help an individual with dementia to remain as independent as possible with mobility and the ability to carry out normal activities of daily living. Source

What exercises does a physiotherapist give dementia patients?

Physiotherapists complete a particular range of exercises and movements with each dementia patient – depending on their individual needs.

Some of the exercises are designed to improve and maintain movement and muscle strength. Others will be focused on a particular problem area.

The physiotherapist will show you certain easy exercises that you and staff at the dementia care centre can encourage your loved one to complete on a daily basis. These exercises will need to be completed regularly if they are to have any success.

Physiotherapists will complete certain passive movements with your loved one targeting a particular part of the body – for example the lower back if they have backache or stiff joints.

They can also advise you on other physical therapy exercises for dementia patients – activities that will be particularly beneficial for your loved one.

Is massage good for dementia patients?

Physiotherapists often use massage for their patients. If your loved one enjoys a massage, it is certainly something you can consider to do at home.

The five senses – especially touch – are of great importance when interacting with a person with dementia. Having a massage will not only benefit them physically to improve stiff and aching joints, but it will also ease feelings of tension and anxiety. Massage also helps a dementia patient to not feel so isolated.

Some dementia patients do not like being given a massage. They become agitated. This is because they feel that the massage is an invasion of their private space.

Physiotherapists closely monitor the effect of the message on their patient. They watch for any non-verbal cues from the patient that indicate that they are finding the massage uncomfortable.

What other therapies are offered?

There are a number of physical therapies that are based on physical stimuli that could be offered to your loved one by the physiotherapist. These include :

Manual lymphatic drainage

This is a special type of massage that helps to drain excess fluid from the tissue. It has been found to be effective for such conditions as rheumatoid arthritis. It can also be used to reduce anxiety and promote sleep.

Electrotherapy

A weak electric current is used in this treatment which is effective for relaxing muscle spasms, and increasing blood circulation in a particular area. Electrotherapy is also used in muscle rehabilitation and in the management of chronic pain.

Heat therapy

There is a variety of different heat treatments used by physiotherapists including warm baths, warm wax or mud packs, heat lamps and ultrasound. The whole body can be treated or just an area or limb. This treatment is used for pain relief and to increase blood flow.

Cold therapy

In contrast, cold therapy is used just for short sessions with cold water, ice and cold air. Cold therapy can be very effective for reducing swelling and pain and other conditions including osteoarthritis, muscle strains, and tendinitis.

Physical therapy exercises for dementia patients that can be done at home

Much physical therapy can be done in the home environment with dementia patients. Exercises range from everyday tasks such as getting washed and dressed, getting in and out of the bath/shower and on and off a chair.

Balance is of key importance so regularly guiding your loved one up and down stairs and steps is beneficial, as well as negotiating slopes. Simple balance exercises completed regularly are also beneficial and these can include standing on one leg.

Getting outside for a walk in the country is excellent exercise. Other activities include swimming, gardening and playing bowls or skittles – which all have the added bonus of being sociable too. Yoga, water aerobics and dancing are other good forms of exercise to consider too.

Regular hand massages bring many benefits…

Giving your loved one a hand massage can be a very special time for you both and something they will enjoy – especially if your use a cream or oil with their favourite fragrance such as almond or coconut.

On the website of The Registered Massage Therapists Association of Ontario the benefits of giving a simple hand massage regularly are explained –

Regularly applied hand massage helps decrease agitation in people with dementia, which includes decreasing the frequency and intensity of agitated behaviours such as wandering. Massage therapy may also offset the social isolation that can lead to this agitation and related behaviour. It can also assist people with dementia feel comforted, especially in a residential care environment, as it may be the only positive physical touch they regularly receive.

Giving a hand massage is straight forward and is something that your loved one can enjoy – especially if you are visiting them in a dementia care home.

The massage should take about five minutes to complete. You massage one hand and then the other. Light massage movements on each of the fingers, thumbs, palms and front of the hands will make a positive difference.

Final Thoughts – Physical Therapy Exercises for Dementia Patients

The most important point is, physical therapy is essential for dementia patients for as long as possible as it will certainly have a positive impact on their health, mobility and quality of life.

The physical therapy exercises for dementia patients outlined in this article are easy to do at home.

If you find that encouraging them to exercise is proving challenging, it could be because they are feeling pain which they cannot explain.

Seeing a physiotherapist is the ideal solution as they can help ease any physical problem and give you plenty of good tips and advice on physical therapies that you can complete with your loved one….

Dementia Care Specialist (Advice)

Trevor Howitt Blog August 8, 2023August 8, 2023care services, dementia specialist, specialist

Dementia is a serious neurological disorder that requires expert knowledge and compassion for countering it properly. A dementia care specialist’s role in providing support, not just to the patient but to the families of the patient as well is a crucial one. In this brief, we will analyze the qualities of a good dementia care specialist and see which parameters you must keep in mind when searching for a professional in dementia care.

Furthermore, we will also talk about the importance of dementia care specialist’s role in the management of this neurological disorder. So, without further ado, let us begin!

Who are Dementia Care Specialists?

Let us start by defining their role. Dementia care specialists are professionals who have completed special training, as well as certifications in taking care of dementia patients. These professionals have in-depth knowledge of all the challenges that come with dementia.

Taking care of the challenges that arise from this condition using a wide array of behavioral management techniques is a part of their profession. Their knowledge about strategies which can enhance the quality of life of dementia patients is excellent. This makes them so important in this whole discussion.

3 Roles of a Dementia Care Specialist

Care plan

Primary role of a dementia care specialist is to create a specific individualized care plan for their patient. While creating such a plan, they consider the physical, emotional and cognitive needs of the patient they are taking care of.

The critical elements in such a plan include medical interventions, cognitive exercises and recommendations for creating an environment that caters to the needs of a dementia patient.

Diet plan

These professionals also ensure that their patients are following a very specific diet plan, one that is all about diet for dementia patients.

Family support

A dementia care specialist also brings an overall sense of relief and calm to the family of a dementia patient. They are good at spotting the early signs of dementia in women and men in the family and can provide solutions for vascular dementia and eating problems with ease.

Boxes to Check When Seeking a Dementia Care Specialist

Here are the boxes that you will need to check:

For hiring a dementia caregiver, you can start your search by seeking dementia caregivers who have adequate credentials and certifications. The certification you are searching for is called Certified Dementia Practitioners, i.e. CDP certificates. A CDP, is someone with a certification demonstrating achievement and specialized training in the areas of Alzheimer’s disease and dementia care.
The abilities of a CDP certified expert are often reflected by their referrals and recommendations, look at them closely as well.
Healthcare professionals, support groups or other caregivers in your vicinity can be a great source for finding reputable dementia care specialists. Interestingly enough, women provide 70% of care hours for people living with dementia!

Dementia Care Services at a Glance

Here are the different types of dementia care services:

In-Home Dementia Care

Dementia care specialists can provide in-home service. Providing a support system within the familiar surroundings of the individual’s home can do wonders for their mental health.

In-home dementia care services can enhance comfort and reduce stress for dementia patients greatly. They are considered a valuable tool in combatting dementia.

Memory Care Facilities

Dementia care specialists often provide their services in memory care facilities. They are also a regular feature in assisted living communities that are specifically designed to meet the needs of dementia patients.

The purpose of these facilities is to offer a very safe and supportive environment with trained staff, usually operating all hours, all week.

Behavioral Management

Taking care of the challenging behaviors that often feature in dementia requires specialized knowledge coupled with a lot of patience.

A dementia care professional can employ behavior management techniques to minimize agitation, aggression, and anxiety. They are very good for specific conditions such as Sundowning dementia treatment.

Caregiver Education and Support

A dementia care expert also gives education and support to dementia patients. They equip them with the necessary tools that can help them take care of their loved ones effectively.

Dementia Care Specialist – Final Thoughts

Well then, that would be all from this brief. It goes without saying that when a loved one suffers from such a life-changing condition as dementia, things become quite challenging for the family.

However, if the search for a dementia caregiver is a successful one, a lot of burden is off the shoulders very early.

Before we sign off, we will say this again: don’t compromise on the requirements we have shared in this brief, and you shall be alright!

References

Hum, S., Cohen, C., Persaud, M., Lee, J., Drummond, N., Dalziel, W., & Pimlott, N. (2014). Role expectations in dementia care among family physicians and specialists. Canadian geriatrics journal : CGJ, 17(3), 95–102.
Foster N. L. (2001). Barriers to treatment: the unique challenges for physicians providing dementia care. Journal of geriatric psychiatry and neurology, 14(4), 188–198.

Vascular Dementia and Eating Problems

Trevor Howitt Blog August 7, 2023August 7, 2023eating problems, vascular dementia and eating problems

Mealtime challenges in vascular dementia

Diet for dementia patients is a major aspect of managing the disorder, even more so when the patient is suffering from vascular dementia and eating problems. Vascular dementia is a condition caused by a reduced flow of blood to the brain. The condition leads to various challenges, the most prominent of which are eating difficulties.

As vascular dementia progresses, individuals often suffer from nutrition-related issues, which necessitate a very careful management strategy.

Vascular Dementia and Eating Problems

In this brief, not only are we going to look at the problems that are commonly associated with vascular dementia, but we are also going to give an insight into coping strategies and approaches for these problems.

Eating Challenges in Vascular Dementia

Vascular dementia has the ability to affect various cognitive functions. Most important of these cognitive functions are memory, attention and executive functions – basically the functions which can influence an individual’s ability to eat independently.

Vascular dementia patients often experience difficulties in coordination, swallowing, and even recognizing the food on the plate in front of them. All of these problems snowball to create significant mealtime challenges.

Let us talk a bit more about these mealtime challenges in vascular dementia in detail in the following lines.

Arguably, the biggest challenge that comes with vascular dementia is that it can alter a person’s sense of taste by a significant factor. This eventually results in a diminished appetite or a complete aversion to familiar foods.

Hence, it becomes quite a challenge for a dementia care specialist to provide adequate nutrition. Then, even if the sense of liking a particular meal is there, individuals often suffer from forgetfulness and disorientation. They often tend to forget to eat, drink or have a lot of difficulty in remembering how to prepare their food in the first place.

Naturally, what then follows is an irregular eating pattern, leading to inadequate nutrition. And lastly, vascular dementia is a dreadful condition in the sense that it can impact the muscles that are involved in swallowing. Hence, the risk of choking and aspiration becomes quite pronounced, resulting in respiratory issues and a reluctance to eat.

Coping With the Challenges

As you can see, the challenge in the case of vascular dementia cannot be overlooked easily. But coping with vascular dementia and eating problems isn’t something impossible.

One has to be calm and patient; that is all that matters. Start by creating a structured and supportive mealtime environment. The idea here is to minimize distractions by using the same set of dishes and utensils, maintaining a consistent meal schedule and promoting regular eating habits.

Then modifying the food texture and consistency is also an adaptation that many dementia caregivers adopt. This is particularly useful when a patient suffering from dementia has trouble swallowing food. Purred options that are easier to swallow are the first choice.

However, consultation with a speech therapist and dietitian before switching to this form of meal is important. Also, for the sake of maintaining a sense of dignity and autonomy in individuals suffering from vascular dementia, dementia caregivers often try to encourage feelings of independence in their patients.

Dementia patients are often most comfortable with finger foods and adaptive utensils that they find easy to manage. So, no wonder that caregivers often include them in their routine.

Vascular Dementia Nutrition Management: A Perspective

There are certain sub-constituents of vascular dementia diet management that we will discuss briefly in the following lines:

Consulting with a registered dietitian is of pivotal importance.

Only a registered dietitian with expertise in dementia care has the ability and patience to create personalized nutrition plans. These nutritional plans meet the dementia patient’s needs and preferences admirably.

The most important part of these plans is to address nutrient deficiencies and support the overall health of the dementia patient in question.

Hydration

Hydration management is often overlooked when dementia specialists are not in charge. Ensuring adequate hydration in vascular dementia patients can solve a lot of problems, such as anxiety and restlessness, partially at the very least. Offer fluids frequently throughout the day, and consider offering water in containers of a patient’s choice.

Nutrient-dense foods

Prioritize nutrient-dense foods to provide essential vitamins and minerals. Here, the idea is to add as many fruits, vegetables, whole grains, lean proteins, and healthy fats into the diet as possible.

Supplements

In the case of some vascular dementia patients, especially those who suffer from Sundowning dementia, supplements become important for addressing specific nutrient deficiencies. However, one must consult with a healthcare professional or dietitian before introducing any supplements into their daily routine.

Final Thoughts – Vascular Dementia and Eating Problems

Vascular dementia is a massive challenge in the world, where things often become blurry and confusing. But with just a few tweaks in the right direction, this problem can be managed and mitigated.

Vascular dementia and eating problems can be countered by a clever plan, one that is devised on the lines discussed in this brief. If that can be done at an early stage, especially when one spots early signs of dementia in women and men, things can be a lot easy later!

References

Uwagbai, O., & Kalish, V. B. (2022). Vascular Dementia. In StatPearls. StatPearls Publishing.
Venkat, P., Chopp, M., & Chen, J. (2015). Models and mechanisms of vascular dementia. Experimental neurology, 272, 97–108.

Understanding Sundowning Dementia Treatment

Trevor Howitt Blog, Causes August 6, 2023August 8, 2023sundowning, sundowning and dementia

Sundowning, or to use its other name, sundown syndrome, is one of the most challenging aspects of dementia that affects many individuals. Basically, when a day transitions into night, dementia patients begin to experience a heightened state of agitation and confusion in this condition. The state of restlessness increases in intensity with every passing hour. Because the condition aggravates the already miserable effects of dementia, researchers have tried their best to find strategies and interventions which can help with this condition. Let us have a look at sundowning dementia treatment plans…

Sundowning Dementia’s Symptoms and Effects

It is important to understand the symptoms of sundowning dementia in the first place before we discuss any interventions or strategies to counter it. Usually, this condition is characterized by a set of symptoms that become more pronounced in the later parts of the day. Some of these symptoms include:

Aggression
Confusion
Wandering
Difficulty sleeping

Once these symptoms are observed and the presence of sundowning dementia is affirmed, one can move towards appropriate management techniques.

How to Cope with Sundowning Dementia?

Ok, so let us talk about sundowning symptoms treatment. The first thing to do in such a situation is to establish a calm and soothing environment during the evening hours. This can help in cutting down the intensity of the symptoms associated with this syndrome.

Some of the things that can be done in this regard include dimming the lights, playing soft music and minimizing noise and distractions. As you can sense, the idea is to minimize anxiety and restlessness.

A consistent daily routine for individuals suffering from dementia is often considered quite important. It goes the same for people suffering from Sundowning dementia. By maintaining this consistent routine, a sense of security can be provided to the patients.

Here is another tip for coping with sundowning in dementia. Dementia care specialists often encourage Sundowning dementia patients to engage in daytime activities and exposure to natural light.

The goal of these exercises is to positively impact sleep patterns and overall well-being. Physical exercises can reduce restlessness and improve sleep quality, thereby minimizing the severity of Sundowning dementia’s symptoms.

Also, vascular dementia and eating problems often require a proper diet for dementia patients; take care of that as well.

Interventions to Consider For Sundowning Dementia Treatment

Light therapy:

Talking about sundown syndrome interventions, Light therapy is a technique that involves exposing a patient to bright light during specific periods of the day.

It has been observed that the intervention is quite an effective strategy in regulating circadian rhythms and improving the sleep patterns in individuals suffering from sundowning dementia.

Sleep:

Then, there are melatonin supplements, formulas that can address sleep disturbances in patients suffering from dementia.

However, one must consult their healthcare professional before decision for a melatonin supplement; Melatonin is a hormone that regulates the sleep-wake cycles. It must be used with great caution and care.

Communication:

It so happens that the patients suffering from sundowning treatment often fall prey to communication disorders. They are often in need of proper and effective communication and chats that can minimize their anxiety and frustration.

Feelings:

Hence, dementia caregivers often rely on such techniques to calm down the patients suffering from Sundowning dementia. Also, validating the feelings and experiences of patients suffering from dementia can prove to be quite instrumental in comforting and reassuring them.

Distracting activities:

Activities such as listening to familiar music or scrolling through a photo album they own are often endorsed by caregivers.

Cognitive behavioral therapy:

We would also like to mention the importance of cognitive behavioral therapy here. This type of therapy, also known as validation therapy sometimes, is considered to be quite effective for individuals suffering from Sundowning dementia.

It so happens that often the behavioral patterns are off the normal routine in such patients. Addressing their emotional problems can often help overcome the challenge of Sundowning dementia.

Talking helps:

If there is a family member or friend that you know suffers from Sundowning dementia, talk to them. Sometimes, their agitation is quite visible as they watch the day transition from dawn to dusk.

Be with them, chat with them, and spend time with them. It is said that our friends are those who stay close to us in periods of darkness; well, you have to be that friend.

Final Thoughts – Sundowning Dementia Treatment

That would be all from this brief. As you read in these lines, sundowning dementia presents itself as a unique challenge for both dementia patients and caregivers.

The usual strategies that are employed to counter dementia are somewhat modified in the case of Sundowning dementia treatment. However, the important thing to note here is that it is not something that cannot be tackled.

The best sundowning dementia treatment includes a clean environment, consistent routine, daytime activities and support during the darkest hours, can create a big difference.

Light therapy and melatonin supplements can also be relied upon. However, a healthcare professional’s opinion must be sought before relying on these techniques.

If all of this is done in a careful and coordinated manner, the life of Sundowning dementia patients can be improved by a great deal!

In fact, if one can keep a lookout for early signs of dementia in women and men, a lot of problems later can be avoided.

References

Burney-Puckett M. (1996). Sundown syndrome: etiology and management. Journal of psychosocial nursing and mental health services, 34(5), 40–43.
Khachiyants, N., Trinkle, D., Son, S. J., & Kim, K. Y. (2011). Sundown syndrome in persons with dementia: an update. Psychiatry investigation, 8(4), 275–287.
Canevelli, M., Valletta, M., Trebbastoni, A., Sarli, G., D’Antonio, F., Tariciotti, L., de Lena, C., & Bruno, G. (2016). Sundowning in Dementia: Clinical Relevance, Pathophysiological Determinants, and Therapeutic Approaches. Frontiers in medicine, 3, 73.

Healthy Diet For Dementia Patients

Trevor Howitt Blog August 5, 2023August 7, 2023dementia diet, dementia food, healthy diet

The importance of a well-balanced diet in managing dementia cannot be denied. It boosts cognitive health and promotes overall well-being. In this brief, we are going to explore the significance of a healthy diet for dementia patients, one that is designed with a special focus on including memory-enhancing foods.

A Guide to a Healthy Diet For Dementia Patients

Understanding the connection between diet and cognitive function helps caregivers create a suitable meal plan for people who suffer from dementia.

How Diet Affects Dementia?

Nutrition’s impact on cognitive function is well established by research studies. Hence, it makes the dietary choices for patients suffering from dementia extremely important.

There exists certain evidence that suggests that certain dietary patterns can either promote brain health or contribute to cognitive decline.

Hence, if one can make informed food choices at the right time, enhancing memory, focus, and overall brain function seems a lot more realistic than it might otherwise. And in any case, leaving everything to meds is probably not the best idea either!

Brain-healthy nutrition is certainly the way forward.

Components of a Diet for Dementia

So, what are the components of a brain-boosting diet?

Well, nutrients that are known to benefit brain health must be in there; at the top of that list are Omega-3 fatty acids. Fatty acids are found in fish like salmon and trout. They have been associated with improved brain functions and a reduced risk of cognitive decline.

Then, the importance of antioxidants such as vitamins C, E and beta-carotene cannot be denied either. Antioxidants protect brain cells from damage that is often caused by free radicals.

Also, don’t forget folate, which is very important for cognitive development and maintenance. Folate is often present in leafy greens and legumes.

Also, dementia patients must drink an adequate amount of fluids throughout the day, even if they don’t express their thirst regularly.

Creating a Dementia-Friendly Diet Plan

Starting the day with a proper breakfast is important, especially for dementia patients. An example of a nutritious breakfast for dementia patients could be a bowl of oatmeal topped with berries and nuts.

Such a breakfast can serve as a rich source of antioxidants and omega-3 fatty acids. If this one sounds a little less appealing, then one can opt for scrambled eggs with spinach and whole grain toast as well, which has enough essential nutrients to start the day properly.

A well-balanced lunch must feature lean proteins, whole grains and vegetables to ensure cognitive support and sustained energy.

A diet for cognitive health, if you will have it that way! So what is it going to be? Well, we would say go with grilled chicken and steamed broccoli. Otherwise, you can fish with quinoa as well.

These types of meals can provide a very nourishing and satisfying meal for dementia patients. The idea is to include foods that are enriched with vitamins and minerals, elements that are so important for overall health and general well-being.

Dinners should be flavorsome and nutritious; the satiety value of a dinner meal must be adequate enough to ensure a proper night’s sleep.

Baked salmon with sweet potatoes and asparagus can provide a combination of brain-boosting nutrients and delicious flavors. The more variety there is, the greater the chance of dementia patients receiving a wide array of nutrients to support their cognitive health.

Special Considerations for Alzheimer ’s disease

Alzheimer’s diet for patients requires special consideration when it comes to nutrition. One of the best options for these patients is a Mediterranean diet. Key elements of a Mediterranean diet include fish, nuts, olive oil and fresh produce.

These elements are linked with a reduced risk of cognitive decline and Alzheimer’s disease. Healthy fats that support brain health are dominantly present in this diet.

It goes without saying that promoting a healthy diet throughout life can reduce the risk of developing Alzheimer’s disease and related dementias by a significant factor. Especially for females, the early signs of dementia in women necessitate a switch to a healthy diet for dementia patients straightway.

Final Thoughts – Healthy Diet For Dementia Patients

Well, folks, that would be all from this brief. There are more than 10 million new cases of dementia each year worldwide, indicating one new case every 3.2 seconds.

A healthy diet for dementia patients is essential. A balanced diet that is enriched with fruits, vegetables, whole grains, lean proteins and healthy fats can do wonders for long-term brain health, thereby minimizing the risk of dementia.

Of course, dementia care specialists can face plenty of challenges when it comes to providing a dementia diet to patients. Some of these eating problems challenges include difficulties with chewing, swallowing and changes in taste preferences, or in some cases, even a lack of interest in food.

It requires special effort to take care of vascular dementia and eating problems. But if one is patient, creative and flexible, these challenges can be easily overcome.

References

• Dominguez, L. J., & Barbagallo, M. (2018). Nutritional prevention of cognitive decline and dementia. Acta bio-medica : Atenei Parmensis, 89(2), 276–290.
• Gómez-Pinilla F. (2008). Brain foods: the effects of nutrients on brain function. Nature reviews. Neuroscience, 9(7), 568–578.