Blog - ReaDementia

Can a Geriatrician Diagnose Dementia?

Porsche Lee Blog, Prevention April 18, 2021October 15, 2021dementia, geriatrician

A geriatrician is a practitioner that specializes in treating elderly patients.

Yes, geriatricians can diagnose dementia but often have a patient visit a neurologist to confirm the type of dementia.

Dementia is caused by damage to brain cells resulting in their inability to communicate with each other.

There are more than 100 types of dementia but the 4 most commonly discussed are Alzheimer’s disease, Lewy Body dementia, Frontotemporal dementia, and Vascular dementia.

These four types of dementia account for 98% of the cases of dementia. Alzheimer’s disease is the most common type of dementia, making up 60-80% of the cases.

Geriatrician’s Dementia Diagnosis

Diagnosis of dementia involves a thorough history, physical examination, and laboratory studies.

It is important for geriatricians to rule out other medical conditions that can mimic dementia such as emotional stress, excessive intake of alcohol, side effects of medications, and head injuries.

Geriatricians will perform laboratory studies to ensure the patient isn’t exhibiting memory issues due to an underlying condition such as vitamin deficiency or thyroid issues.

Imaging studies include CT, MRI, and PET brain scans. These imaging studies can detect strokes, tumors, and changes in the brain’s structure.

Cognitive Tests

Cognitive testing such as Mini Mental State Examination, Abbreviated Mental Test Score, Clock Drawing, and Mini-Cog are just a few of the mental status tests performed to aid in the diagnosis of dementia.

The Mini-Cog test is most common. It is a 3-minute test that involves incorporating the clock drawing test with a 3-item recall.

Patients are asked to draw a clock face with numbers and hands indicating a specific time. They are also given 3 words and later asked to recall them, usually within 3 minutes.

Lastly, psychiatric evaluation is performed to rule out depression or other mental health conditions causing memory issues.

Examples of other health conditions that can cause memory issues include strokes, Parkinson’s disease, and buildup of fluid on your brain.

What Follows Diagnosis?

Once a diagnosis has been established, a geriatrician will treat dementia in a variety of different ways.

Treatment depends on the type of dementia a patient has as well as the symptoms stemming from that particular type of dementia.

Patients may display a wide range of symptoms from emotional volatility to problems with cognitive reasoning.

Treatment of dementia involves a combination of pharmaceutical and non-pharmaceutical interventions.

Treatment for Different Dementia Types

Donepezil and Memantine are commonly used in the treatment of Alzheimer’s disease.

These two medications help boost acetylcholine, a neurotransmitter essential for memory and learning.

Other drugs and vaccines that inhibit the production of toxic tau or amyloid protein are currently being tested in trials.

The results haven’t been promising as they are not yielding significant results in patients with dementia.

Different dementias

Lewy body dementia, although similar to Alzheimer’s disease has additional traits such as hallucinations, problems with speaking coherently and alertness.

This type of dementia often involves the addition of antipsychotic medications as patients with this type of dementia tend to be more physically aggressive.

Frontotemporal dementia, which usually results in extreme mood changes, usually involves antipsychotic treatment specific to the behavior of the patient as the emotions can range from extreme happiness to deep depression.

Methylene blue, a drug in development for Alzheimer’s disease, may prove to be beneficial in patients with Frontotemporal dementia in the future. Methylene blue inhibits the aggregation of tau protein.

Tau, which is associated with many brain diseases, is a protein misfolded and abnormally shaped in patients with Alzheimer’s disease (Ellison, n.d.).

Vascular dementia, which results from one or several strokes, involves treatment focused on cardiovascular health.

Many patients who get strokes have high cholesterol so statins (Atorvastatin) are often prescribed to lower cholesterol levels. Blood pressure medications are given to lower blood pressure.

Low-dose aspirin (Aspirin 81mg daily) or blood thinners such as Coumadin or Plavix are also given to prevent clotting of the blood which often causes a stroke.

Patients who use tobacco or alcohol are often encouraged to cease their use to decrease their stress as well as lower blood pressure.

Although depression, anxiety, and hallucinations which often develop in patients with dementia are managed with medications, dementia patients are better aided by having a supportive physical and emotional environment.

Non-Pharmaceutical Interventions

Ideal non-pharmaceutical interventions for treating dementia include 24/7 caregivers for patients with dementia, especially advanced dementia.

Caregivers can help patients with dementia perform their daily activities while helping them maintain their sense of independence.

Preferably, you’d want to have a caregiver possessing experience working with dementia patients.

Also ensuring a therapeutic physical and social environment is of utmost importance. A therapeutic setting includes a patient living with family members or living in specialized memory care homes.

Patients with dementia have also been found to benefit from exposure to support animals as well as arts & crafts activities.

Establishing a daily routine is essential for patients with dementia. An example of what an ideal daily routine would look like is below.

Daily routine

Patient wakes up same designated time daily
Breakfast
Performs a mind stimulating activity (walking, puzzles, reading)
Nap
Lunch
Social activity (visit from family or friends) or chore (folding laundry, feeding pets)
Dinner
Bed

Ideally the mind stimulating, social activity, or chore would be performed for at least 45 minutes.

Another way to establish a daily routine would include taking your loved one to a senior daycare center.

Extra cognitive exercises

Additional ways to perform cognitive exercises in dementia patients include listening to music, “I remember when” stories, repeating the same phrase several times, looking through old photo albums, and having pictures of close family members and friends along with the names attached to these pictures aid memory in dementia patients.

A calm, quiet environment is ideal for dementia patients. Too much noise often causes agitation in them. Speak slowly and don’t ask too many questions at one time in dementia patients.

Safety is an important factor in patients with dementia.

In advanced dementia, an artless mentality is often displayed as the person forgets the purpose of things and how they are used.

Some things you can do to keep a patient with dementia safe at home include securing household items by placing childproof locks on drawers containing dangerous items, preventing falls by placing shower chairs in the bathroom with rails, and having the patient walk with a cane or walker to avoid falls.

Insomnia is common in patients with dementia.

Because of this, it’s important to have night lights throughout the home in order to prevent accidents.

Conclusion

Most importantly, establishing a support group for you as well as your loved one with dementia is important to ensure a safe and therapeutic environment for the patient.

Taking care of a loved one with dementia can be a rewarding but stressful task at times. Research home health agencies that provide flexible caregiver placement so you can take breaks as needed.

Lastly, enlist the help of other family members and friends.

Probiotics and Dementia – Is there a Link

Petra Boh Blog, Prevention April 14, 2021September 9, 2023dementia, probiotics

As research continues into the diagnosis and treatment of dementia, there has been growing interest in the link between probiotics and dementia.

We can describe probiotics as living microorganisms or “good” bacteria that offer numerous health benefits when ingested.

When it comes to enriching our gut with probiotics, we can do it either through supplements or foods like yogurt, kefir, kimchi, tempeh, and sauerkraut.

Furthermore, probiotics help balance friendly bacteria in the digestives system.

Other health benefits associated with probiotics include:

Reducing symptoms of various digestive disorders
Preventing and treating diarrhea
Reducing eczema and the severity of certain allergies
Helping with loss of belly fat and weight
Enhancing some mental health conditions
Keeping the heart healthy by lowering blood pressure and bad cholesterol
Boosting the immune system and protecting against infections

Can probiotics help with dementia?

In addition to the above probiotics and dementia benefits, there may be a possibility that probiotics can help boost cognitive function and mood while enhancing brain function indirectly.

Research indicates that the brain and gut are connected in a partnership that is known as the gut-brain axis.

Below is a brief description of the connection between the brain and the gut.

Link between the Gut and the Brain

The brain and the gut are linked through biochemical signalling between the central nervous system that includes the brain and the nervous system in the digestive tract.

The longest nerve in the body (vagus nerve) is responsible for information connection between the two.

Moreover, the gut is often referred to as the “second brain” because it produces many neurotransmitters like dopamine, serotonin, and gamma-aminobutyric.

The brain also produces the same neurotransmitters. These play a major role in regulating mood.

What affects the brain affects the gut

Probiotics for Dementia — The researchers found that when participants with mild cognitive impairment received the probiotic Lactobacillus rhamnosus GG (LGG) for 3 months, their cognitive scores increased.

Because of this connection, experts explain that what affects the brain affects the gut and vice versa. When the brain senses trouble, it will send warning signals to the gut.

This is why during stressful events; a person may experience digestive issues like an upset or nervous stomach.

On the other hand, gastrointestinal problems like Crohn’s disease, irritable bowel syndrome, or chronic constipation may trigger depression or anxiety.

The brain-gut axis also works in the opposite direction.

For instance, the gut helps to regulate appetite by letting the brain know it is time to stop eating. When a person finishes eating, the gut microbes produce proteins that can suppress appetite after about twenty minutes.

The timing corresponds with the period people take to start feeling full. With this information in hand, it is prudent to ask how probiotics fit in the gut-brain axis concerning the connection between probiotics and dementia.

Some studies claim that probiotics can help boost cognitive function, mood, and lower anxiety and stress.

A small study done in 2013 reported in the Journal Gastroenterology discovered that ladies who consumed yogurt with a mix of probiotics two times a day for 4 weeks were calmer when exposed to images of frightened and angry faces compared with a control group.

MRIs also revealed that the group on yogurt has lower activity in the insula. This is the part of the brain that processes internal body sensations such as those emanating from the gut.

A Study on the Relationship between Probiotics and Dementia

Trials with mice have also recorded that probiotics can improve memory and learning and may also reduce depression and anxiety.

A study from Kashan University of Medical Sciences and Islamic Azad University in Iran states that it was the first to demonstrate the effects that probiotics have on people.

The team carried out a small clinical trial that went on for 12 weeks. The researchers observed 52 women and men aged between 60-95 years.

All the participants in the study were diagnosed with Alzheimer’s disease one of the most common causes of dementia.

The group was divided into two. One group was given around seven ounces of milk enriched with four types of probiotics daily. Individuals in the other group were only given plain milk.

All the participants in the study went through a test measuring various mental abilities including attention, memory, and language skills.

The highest score people could get on the test was 30.

As the study was going on, researchers uncovered that the average score of the participants taking milk enriched with probiotics rose from 8.7 to 10.6. This was different from the group that was taking plain milk as their scores dropped from 8.5 to 8.0.

Probiotic supplementation can show improvements

Researchers agreed that all the participants performed poorly in the test, but they acknowledged that the difference in results between the two groups was quite huge.

The researchers concluded that they thought metabolic changes might be responsible for the difference in results.

For example, participants who were on probiotics also showed improvements in lipid profiles and insulin metabolism.

This is one of the studies that has raised questions about the link between the brain and the gut and how they relate to dementia.

The results of the study will be repeated in bigger studies before experts can understand the real benefits that the brain gets when a person consumes probiotics.

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Closing Thoughts – Probiotics and Dementia

The relationship between probiotics and dementia is still not clear.

The few studies that have been conducted on the topic show promising results. It is possible that in the future probiotics may be instrumental in the diagnosis and treatment of dementia.

More research needs to be done to find out how probiotics can help individuals with dementia. This will give more insight into whether probiotics can support a healthier brain.

Explaining Dementia to Children – Here’s How

Petra Boh Blog April 11, 2021October 15, 2021dementia, dementia and children, explaining dementia to children

When a loved one develops dementia, you may be tasked with the responsibility of explaining dementia to children.

While it may not be the easiest of tasks, it is important to let the young ones know what is happening in the lives of their grandparents, parents, or any other relative they are close to.

This is because the illness can bring about some challenges that may affect the kids.

If a child is not aware of what is going on, they can make a joke out of the disease, be frightened of their relative, or distance themselves thinking that the illness is contagious or their loved one does not want to spend quality time with them anymore.

Explaining Dementia to Children

It is, therefore, prudent that the little ones know about the illness as soon as possible.

If you are stuck on how to approach such a situation, you can use the practical tips below on how to talk about dementia to the youngsters.

Be Honest

Anyone who has the job of explaining dementia to children needs to understand that honesty is key.

You need to start having the conversation as soon as the ill person gets a positive dementia diagnosis.

Never lie to a kid that the person with dementia is just being silly or they are acting the way they are because of old age.

It is also crucial that you package this information in a way that the child will digest depending on their age.

If it is a grandmother who has the disease, sit them down and tell them that she has an illness that is hurting their memory and ability to do daily activities.

As you keep the conversation going, the child will most likely guide you on the direction to take.

Stick to age-appropriate and truthful answers as questions arise.

Talk about How They Can Get Involved

While talking about the illness, assure the young one that they can still have a relationship with the affected individual.

Let them know that the loved one is still a person despite their present condition.

Explain to them that while some things may change, they can still have some good times with the ill individual.

Have a list of things that they can still do with the person they love and how they can offer a hand.

Keep in mind that this needs to be an on-going conversation. This will allow you to make the necessary adjustments as the disease progresses.

Most importantly, the kids’ interactions with impaired individuals need to be supervised to make sure that everything stays in place.

Offer Guidance on Appropriate Behavior

As you go about the business of explaining dementia to children, you need to teach acceptance.

This is where you let the youngsters in on how to behave when they are around a person with dementia. This will generally be about practicing patience and acceptance.

Prepare the children for any angry outbursts that the persons with dementia may have from time to time.

Tell them not to take any mean comments or reactions to heart because it is the disease that makes their loved one act like that.

They should also know that if the affected person is always asking the same question, it is because the part of the brain that holds answers is not working well.

They should, therefore, not get tired of repeating themselves when need be.

Do not force the youngsters to spend time with the ill individual when they do not want to. Just continue talking about the illness in small doses.

Offering resources such as appropriate videos and books can also help them get a better understanding of the illness in a way that will make them change their mind.

Let The Children Know that The Disease is Not Contagious

Many people who have had a conversation about dementia with teens and younger kids report that most minors will not want to associate with the person with dementia because they are afraid they might catch it.

In such a case, you must emphasize that dementia is not a type of flu or any other infection that affected people pass around.

Tell them that it is okay to spend time with their loved one who has dementia at close range and they will not get the disease from being around the person.

If they are young they might be sad thinking that they did something to cause the disease. Comfort them and reassure them time and again that they are not to blame for what is going on.

Let the Young One’s Express Their Feelings

While you are explaining dementia to children, do not be the person who does all the talking. Allow the young one to express their feelings about the situation.

When you first have the conversation, they may not be as responsive as they soak in all the new information.

As time goes by, however, you can approach them to talk about their feelings and concerns.

You may also have to carefully observe the child because they can change their behavior after learning about their loved ones’ health condition.

Problems at home, school, or with friends may be a sign that they are upset.

When you feel like it is hard to reverse this errant behavior you can seek help from a social worker or a school counselor.

The professionals can help the kid to further understand the recent changes and teach them how to cope.

Stay connected (playing fun games)

Even though this may be a tough time for the child to comprehend the condition his loved one is going through, they can still stay connected.

And playing different games and activities is best for both.

Below, you can find some of the fun game ideas that a child can play with an older adult with dementia (and vice versa).

Painting and drawing
Gardening, planting or watering flowers
Watching cartoons or movies
Walking the dog
Pottery
Reading fairy tales and picture books
Singing songs, listening to music
Viewing old photos and albums (reminisce therapy)
Memory games, dominoes, puzzles, stacking lego cubes

Granny Mary Thinks Differently

As mentioned earlier, books are an excellent way of getting your children familiar with dementia.

To make it even easier, we released an exclusive educational children’s eBook, “Granny Mary Thinks Differently,” which will help you interact with the little ones conveniently.

The book introduces dementia through seven-year-old Anna’s curiosity, who is sensing the mysterious change in her grandmother.

Closing Remarks

Many people will agree that explaining dementia to children can be quite difficult.

This is, however, something that needs to be done so that the young ones are not locked out of what is happening.

You can use the tips above to help you when conversing about dementia to the little ones. Keep in mind that this is not something you will do in one sitting and do away with it.

The communication lines need to stay open so that you can handle any concerns as they arise.

You should also expect new challenges as the disease progresses; thus, be prepared to help the child deal with the on-going changes.

What Helps With Dementia Mood Swings?

Petra Boh Blog, Prevention, Signs April 9, 2021October 15, 2021dementia, mood swings

Since rapid mood swings are common symptoms of dementia, this guide will help you understand what helps with dementia mood swings and how to handle them.

Many persons with the progressive illness at some point will become moody, switching between various emotions fast for no reason.

On the other hand, some people with dementia will show less emotion than they used to in the past.

Handling Dementia Mood Swings

When it comes to expressing emotions, dementia may lower an individual’s inhibitions which can result in an increase in angry outbursts or crying.

Mood swings can start happening even in the early stages of the disease.

Some people with the illness will have mood swings because they are having trouble coping with losing their abilities as they try to understand their new terrifying and bewildering world.

Mood swings may also be happening because of the physical changes that are happening in the brain.

Sometimes, mood swings can be a result of pain, hunger, boredom, or feeling too hot or too cold.

Other possible causes of mood swings include:

Diet
Untreated psychiatric disorders
Caffeine
Clutter
Feeling rushed
Overstimulation
Too much noise

Coping with Mood Swings

Coping with mood swings can be hard for the person experiencing them as well as those around them.

Below are some of the tips that caregivers can use to help a person with the illness.

Trying to Understand the Affected Individual

One of the things to do when wondering what helps with dementia mood swings is to accept that the changes are caused by the illness and the affected person is not acting out on purpose.

It is important to identify a person’s likes and dislikes because this can help reduce the severity of the mood swings as well as their frequency.

Additionally, it may also help to know what makes the affected person feel relaxed, their favorite music, activities they like to participate in, things that upset them, or the times when the person mostly acts out.

Gathering this type of information allows caregivers to predict when the problems with mood swings may occur to prevent them or know what to soothe them.

Other coping mechanisms that can work include:

Consulting a Doctor

The professional will assess the person with dementia to find out if they have depression or any other psychiatric issues.

The physicians can also prescribe medication in case the mood swings seem excessive or dangerous.

These can include anti-anxiety drugs, antidepressants, and antipsychotics that can make the mood swings more manageable.

Creating a Calm Environment

Minimizing noise and distractions is another option available for people who are looking for what helps with dementia mood swings.

When a person has dementia loud noises including background noises from a TV or radio might be too much to handle.

An open space or glaring light may make an individual feel insecure or unsafe. Creating a peaceful environment might help to lessen mood swings that are primarily caused by overstimulation.

Putting on relaxing music or even building a sound machine can help promote a restful mood.

Ensure that the lighting around the living areas is soft and pleasant.

Assessing Physical Needs and Comfort

If a person who has dementia is uncomfortable and they cannot express it, it can trigger mood swings.

It is, therefore, important to ensure the individual is not too cold or hot by adjusting clothing and room temperatures as deemed necessary.

Check to see that the person is not hurt, hungry, thirsty, and is sleeping well.

Keeping track of the number of trips to the bathroom might also help in case a person wants to go and they do not even realize it.

Re-Direct Attention

If an individual becomes anxious and irritable, try and change the subject by gently introducing happy memories, asking about a loved one they are fond of, or playing an interesting song or home video.

Redirection can prove to be very helpful when it comes to ending an outburst.

It is, therefore, vital to have the tools and ideas ready so that they can be easily accessed when needed.

Practice Patience

Lots of patience is needed when exploring options carers need in regards to what helps with dementia mood swings.

Dementia may make a person argumentative and angry. At this point, avoid being confrontational, but try and acknowledge their frustrations.

Avoid correcting a person even when they are wrong.

Caregivers are supposed to support and recognize the emotions and the realities of the suffering person regardless of how “unrealistic” they may be.

Get Support

Taking care of a person who has dementia and is experiencing mood swings can be quite challenging and draining.

Caregivers need to take breaks and get all the support they need so that they can be energized to properly look after their loved ones.

There are plenty of local support groups one can join to interact with other people who are in similar situations.

Support groups are a great place to discuss what works when it comes to what helps with dementia mood swings.

Pneumonia and Dementia: Causes, Symptoms, Treatment

Rok Krivec Blog, Prevention, Signs April 6, 2021October 15, 2021dementia, pneumonia, pneumonia and dementia

There is a close correlation between pneumonia and dementia, which we need to be aware of to take action accordingly.

Persons with dementia are prone to different types of infections one of the most frequent being pneumonia.

This is a serious respiratory infection that is common in seniors with or without dementia.

Types of Pneumonia

There are three types of pneumonia.

Bacterial Pneumonia

This is the most severe form of pneumonia that needs a person to take antibiotics for treatment.

Elderly people living in care homes or hospitals are at a greater risk of catching bacterial pneumonia.

Unfortunately, hospital-acquired pneumonia tends to be more resistant to treatment.

The primary reason why it is common for seniors to get pneumonia while in the hospital is because they spend a lot of time in bed.

Vital Pneumonia

This is typically caused by the viruses responsible for flu and colds and tends to be prevalent during cold weather.

It is mainly responsible for mild pneumonia that children get.

Aspiration Pneumonia

This is another type of pneumonia that is common in older people with dementia. This develops when liquid or food goes down the windpipe instead of the food pipe.

It is the case because some people with dementia usually have trouble swallowing which increases their chances of breathing foods and drinks.

Sadly, this is also among the leading causes of death among golden-agers with dementia.

Knowing the different types of pneumonia let’s explore other aspects of pneumonia and dementia below.

Causes of Pneumonia in Persons with Dementia

Pneumonia will mostly attack people who have dementia because of a compromised immune system.

The progressive disease weakens the immune system which paves the ways for the development of other medical conditions.

Symptoms of Dementia

When talking about pneumonia and dementia, it is important to know how to spot the disease. Signs that might indicate a person has pneumonia include:

A cough that has brownish, green, or yellow phlegm. Sometimes this may even have bloodstains
Rapid heartbeat
Difficulty breathing
Shivering, sweating, and generally feeling ill
Fever
Fatigue
Wheezing while breathing

Rib and chest pain

Pneumonia in the elderly can be painful. Chronic coughing can lead to rib pain.

After heavy coughing, a senior might fracture their ribs or in some rare circumstances cause spinal issues like vertebra alignment problems or slipped disk.

Increased confusion

With older people, pneumonia can be the cause of disorientation and confusion. Some people may complain about having challenges thinking or have a hard time explaining things that would have been easier.

This can be made worse by the fact that they are already suffering from memory loss because of dementia.

If you spot any of the above, it is important to see a GP immediately. It may be hard to ascertain for a fact that your loved one has the infection.

A professional doctor will use a stethoscope to check for any rattling or crackling sounds in the chest.

The medic can also arrange for several tests including sputum, blood, and x-rays to identify the virus or bacteria that is causing the infection.

When pneumonia is caught early and proper treatment administered it can clear from a person’s system within 7-10 days.

People, however, feel tired and weaker for longer.

Treatment

In the case of viral pneumonia, a person may need to take antiviral drugs. This is, however, not common because bouts of viral pneumonia may heal without the use of medication.

Taking fluids in plenty, eating healthy and resting can see a person heal after some time.

Most doctors will recommend antibiotics and plenty of rest to treat bacterial pneumonia. Studies show that persons who are take antibiotics get at least six more months to live.

There is, however, still a huge debate as to whether the antibiotics work as they should in regards to pneumonia and dementia.

This is because about 40% of seniors who die from dementia are usually found to be taking antibiotics a short while before they pass one.

Research suggests that caregivers should determine the goal of care before they go ahead and administer the antibiotics.

Antibiotics may sometimes cause inconvenience

Studies reveal that while antibiotics may give an individual more time to live, they can also be the case of a decrease in comfort rates.

Antibiotics may cause adverse side effects like severe digestive upset and multiple allergic reactions.

This means that if the goal is to offer as much comfort as possible, antibiotics can be out of the question.

Aggressive administration of antibiotics should only happen when the goal is to help the individual live longer.

This is one of the reasons persons with dementia need to have advance medical directives. They need to be asked what treatment techniques they prefer later on in the disease before severe mental and physical decline.

This way, anyone taking care of the person will execute the wishes of the ill person correctly. These wishes can be highlighted in a living will.

The individuals also have the option of appointing one of their friends or family members to serve as the power of attorney for their healthcare decisions.

These are crucial documents that guarantee protection to the affected person when they can no longer make “sane” decisions.

How Antibiotics are Administered

If the doctor agrees to antibiotics treatment for pneumonia and dementia the drugs can be administered in two major ways.

1. Pills to swallow
2. Injections

The strongest antibiotic types are given by an IV (intravenous) infusion or injection. This sends the medicine to the veins directly through a tube or needle.

Anyone subject to IV antibiotics may require frequent hospitalization and blood tests.

As an alternative, the person taking the drugs can work with a nurse at home who will be administering the antibiotics when necessary.

In some cases, restraining the person taking the medicine may be inevitable.

This is because dementia in the middle and later stages can make an individual confused; thus, may not understand why they need the IV and want to get rid of it.

Ways to Prevent Pneumonia

Seeing that pneumonia can cause tragedies, it is better to focus on preventive measures. This will help older people with pneumonia and dementia to prevent loads of suffering.

Some of the ways to prevent pneumonia are:

Vaccines

Some vaccines can prevent some types of pneumonia from attacking people with dementia. The pneumococcal vaccine is the most common which helps to prevent over 20 bacterial pneumonia strains.

Experts reckon that the vaccine is only effective for a short period when given to older persons.

Doctors recommend that a person gets their first dose after they turn 50 and the other one at 65. They should then get new doses after 5 years.

This said, it is important to mention that the vaccine does not always engender excellent immune response in grown-ups; thus, it will not always work well.

An influenza vaccine can also help adults get milder flu attacks.

Get the person to move about

This is especially important if one is in the hospital and spends most of their time lying in bed.

Moving around and exercising as much as possible can help reduce the risk of getting the infection.

If the affected person is not fit to do a lot of walking simply sitting upright on a chair can do a lot of good.

This will help the lungs expand so that it is easier to clear the lungs and cough.

Quit smoking

Smoking causes damages to the lungs; hence, it makes pneumonia more likely.

Persons with dementia should stay away from smoking because it also decreases the body’s ability to fight the infection.

Limit alcohol

Alcohol misuse is one of the factors that increase the risk of not only developing pneumonia but also making it more severe.

It has been known to make swallowing challenging which can lead to aspiration pneumonia. If a person does not want to quit drinking, let them limit it to a pint or glass of wine.

Good hygiene

This can also help keep pneumonia at bay since the infection also spreads by inhalation and contact. It is advisable for people to frequently wash their hands or use sanitizer.

Dispose of used tissues immediately is also highly recommended. Individuals with pneumonia should also use a handkerchief while coughing to avoid spreading germs.

Healthy diet

While eating right will not cure pneumonia studies show that individuals who eat a diet rich in vegetables and fruits are less likely to develop respiratory infections.

Dark leafy greens, berries, tomatoes and citrus fruits are examples of food rich in antioxidants that can help the body recover from infections quicker.

Ensuring a person is awake and upright while eating

This will majorly prevent aspiration dementia. When a person concentrates on eating and drinking, it will reduce the chances of the food going down the wrong pipe.

At some point changing the texture of food by pureeing or mincing may be necessary. Thickening fluids can also make them easier to safely swallow.

Pneumonia and Dementia Final Thoughts

A huge percentage of people with dementia end up dying when they develop pneumonia.

It is vital to pay close attention to pneumonia and dementia in a bid to maximize life quality and expectancy.

Is Tripping a Sign of Dementia?

Petra Boh Blog, Signs April 5, 2021October 15, 2021dementia, tripping

It is common for people to ask, “is tripping a sign of dementia,” when looking after seniors or other individuals who are susceptible to developing the progressive illness.

While “healthy” individuals may trip now and then, a person with dementia may start to trip over their feet constantly which can lead to serious falls.

Research indicates that falling frequently could be one of the early warning signs for Alzheimer’s disease one of the most common causes of dementia.

The Risk of Falls Affects People with Dementia

A 2011 study in Age and Aging reported that hip fractures and the risk of falls affect people with Alzheimer’s disease (AD) three times more than people without the illness.

Another study published in the journal Neurology in 2013, concluded that presumptive preclinical Alzheimer’s disease is a risk factor for falls in the elderly.

The study revealed that persons with AD dementia have an increased risk of falls. The study primarily observed the rate of falls of community-dwelling cognitively normal seniors.

Some of the participants of the study had preclinical AD that was detected through imaging biomarkers and CSF.

After 12 months, the researchers found out that older adults who had preclinical AD had more cumulative fall incidences when compared to the older adults who did not have preclinical Alzheimer’s.

Losing balance while walking or standing in the early stages or even before other dementia symptoms show up may be an indication of an increased risk of developing Alzheimer’s disease.

It may also be a sign that a person is suffering from a different type of dementia other than Alzheimer’s like vascular dementia.

The cerebellum is the part of the brain that controls body movement.

Illnesses that affect the cerebellum end up affecting an individual’s balance. Several types of dementia fit this bill.

An example is a vascular dementia that is caused by a lack of blood flow to the cerebellum.

What Causes People with Dementia to Trip and Fall?

Several factors have been associated with the risk of tripping and falling among persons with dementia and some of them include:

Poor Balance, Physical Weakness, and Changes in Gait

Some people will start developing mobility issues as soon as memory problems begin while others will remain in great physical shape during the early stages of the diseases.

As the illness progresses it causes a decline in strength, balance, and walking which might cause an individual to trip and fall frequently.

Side Effects from Medication

When asking if tripping is a sign of dementia it is critical to want to know what is causing the behavior.

Some drugs a person is taking can increase their risk of tripping.

An example is antipsychotic medications which can have an orthostatic hypotension side effect. This is where an individual experiences a sudden drop in blood pressure after standing up too quickly.

Other medications like the ones that facilitate sleep (hypnotics) can cause lingering drowsiness which can increase the chances of tripping.

Drugs that people take for blood pressure can cause light-headedness or dizziness which can lead to an increased risk of tripping.

Memory Impairment

It can be difficult to prevent a person who has dementia from tripping as the disease continues to progress.

One of the reasons for this is the cognitive decline that is associated with the illness.

For instance, a loved one might tell the person with dementia not to walk about without assistance but they forget and continually want to walk independently even when it is not safe.

Lack of Physical Exercise

A person with dementia may start to trip many times because they are not getting enough exercise.

Exercising can help improve balance by strengthening muscles in various body parts including the spine, legs, torso, and hip enabling a more upright and erect posture.

Maintaining an upright posture implies that an individual will be less likely to overcompensate for imbalances that occur when walking, bending, reaching, and turning.

Visual-Spatial Problems

Dementia is known to affect a person’s visuospatial abilities.

This means that an individual can misinterpret what they see or misjudge uneven terrains, steps, changes in floor color, and shiny spots on the floor.

Fatigue

Some people may end up tripping a lot in the evenings because they are simply too tired from the activities of the day; hence, cannot move about well.

Poor Judgement

At times, tripping may occur as a result of poor-decision skills which are common with persons who have dementia.

This can be anything from walking outside in the middle of winter on ice or walking down the steps without assistance.

Clutter

The home condition of a person with dementia might also increase their risk of tripping. For example, if there is too much clutter, it may be hard for them to navigate around without tripping on something.

Some people with dementia get into the habit of hoarding stuff which can put them at risk of tripping.

Tips for Preventing Falls for People with Dementia

When people with dementia trip and fall, they can end up fracturing their hips which can lead to immobility and surgery.

Death rates following hip fractures are also on the increase.

Thus, it is important to minimize the risk of falls among persons with dementia. Especially now, when we know that tripping can be a sign of dementia.

Some of the steps that can be taken towards this include:

Try and Understand why a Person Falls

Knowing what makes a person with dementia trip and fall can help anticipate their needs which will, in turn, decrease the falls.

For instance, the person with the illness may be restless because their body needs to be exercised and stretched out.

The individual may also be tired of sitting in one position for a long period; thus, want to get up and start moving around even when it is not safe.

To prevent tripping and falling from happening, it is important to ensure a person gets enough exercise and their positions are changed frequently enough so that they are always comfortable.

Pain, discomfort, thirst, hunger, boredom, and a need to use the bathroom may be other factors that cause a person to want to move around unsafely.

This is especially when the individual with dementia cannot communicate their needs well.

If a person is constantly tripping, check some of these factors and ensure their needs are well taken care of to prevent the risk of falls.

Make the Home Safer

To prevent tripping, the house where the individual with dementia lives can be made safer for navigation. We also have an entire guide on how to make a dementia-friendly home.

This can be done in a few steps such as:

Putting away obstacles on the floor like clothes or shoes that a person can trip over
Installing grab bars in bathroom by the tub or shower,and toilet
Ensuring a person has the items they need within reach so that they do not have to strain to get them
Ensuring the entire house is well lit at all times so that the affected person can see things clearly
Installing handrails on staircases
Avoiding shoes or slippers with deep treads. Where possible, it is best to invest in footwear that has thin non-slip soles

Getting rid of clutter outside can also be useful.

The area outside the house should be clear of objects like stones, rocks, and leaves, etc. The uneven ground on an elderly’s path and dips in walkways should also be avoided.

Use of Mobility Aids

Persons with dementia may find mobility aids like walkers and canes quite useful because they can use them to comfortably walk and stand.

It is best to consult a physical therapist or doctor before purchasing a mobility aid because some may increase the risk of tripping depending on the person who is using them.

An individual’s grip strength, gait, and balancing ability are some of the factors that are put into consideration before choosing the mobility aid to purchase.

After getting a walker a crane, it is best to monitor how the person is using them to make sure they are using it properly.

Lowering Noise Levels

Persons who have dementia may be sensitive to loud noises. It is therefore important to reduce loud sounds and white noise around them.

When the noise levels become unbearable to the affected individuals, it can cause anxiety and nervousness which can make the person unsteady on their feet.

Keep Help Close by

It is important for a person who is at risk of tripping to easily and fast call for help when need be.

An individual can invest in remote care technology to help with this.

It can be anything from an auto detector or fall alert bracelet that they can use in the event of an emergency.

Offer Visual Contrast

Using contrast in color is important to help define objects from the background. It is best to use solid colors that do not have any patterns to decrease confusion.

Avoid using black surfaces because they can be misconstrued for a black hole.

For instance, a person can place contrasting colored decals or rubber mats at the bottom of the tab.

If there are light-colored walls, darker handrails can be installed.

The Role of Cognitive Reserve in Dementia

Dr. Yasmin Aghajan Blog April 4, 2021October 15, 2021cognitive reserve, dementia

It is important to understand the crucial role of cognitive reserve in dementia and how it affects diagnosis.

What is Cognitive Reserve?

Many studies are ongoing to determine what risk factors predict development of dementia, as well as to foresee who will more rapidly progress from mild cognitive impairment to dementia.

Cognitive reserve (CR) is a new area of interest in predicting how quickly dementia may worsen.

It is defined as a coping strategy against brain damage. This is the ability to use different brain networks to cope against loss of performance.

One way to think of CR practically is the brain’s capacity to improvise and find other ways of getting the job done to overcome obstacles and challenges.

CR was first thought of in the 1980s, when researchers found brain changes on autopsy consistent with advanced Alzheimer’s disease in people who had no symptoms when they were alive.

This meant these patients continued to function as usual, despite brain damage from Alzheimer’s pathology. This triggered a wide interest in research on whether people with a greater cognitive reserve can cope with brain changes of dementia (or even other disorders such as multiple sclerosis, Parkinson’s disease, or stroke).

“CR protects a person from clinical dementia”

The theory is, the higher a person’s CR, the more protected he or she would be against clinical dementia and loss of functioning.

Studies have tried to link dementia level to variables such as education, literacy, IQ, and engagement in cognitive exercises.

CR is the latest such variable to be added to the list of variables that can influence the development of dementia.

Genetics and exposure to environments (education, cognitively stimulating activities, and occupation) help develop CR.

There are some emerging predictive factors for converting from mild cognitive impairment to dementia.

Higher risk has been found for lack of occupation in the elderly, low formal education level, and difficulty coping with common situations.

Higher CR may be linked to decreased risk for dementia

Although larger studies are needed, a major research study published in JAMA neurology in 2019 of over 1600 patients in the Rush University Memory and Aging Project showed that those who scored in the highest cognitive reserve category had a reduced risk for dementia, even if they had high amounts of Alzheimer’s brain pathology at autopsy.

This strongly suggests that increased CR could reduce dementia risk.

How does one increase Cognitive Reserve?

Researchers propose that being exposed to an enriched environment, meaning high opportunities to participate in physical activity, ongoing learning, and keeping up social interactions may produce structural (and functional) changes in the brain.

Specifically, the hippocampus is important for memory and becomes impaired in Alzheimer’s disease, may be altered with practicing the above tasks.

Some have theorized learning a second language or doing Sudoku-type puzzles may “train” the brain’s CR, however, this has not yet been scientifically proven to delay or prevent Alzheimer’s disease.

How is Cognitive Reserve measured?

CR can be measured clinically by your doctor; in general, a person’s education level, work activities and activities performed in leisure can help gauge an estimate of CR.

There also exists a Cognitive Reserve Index questionnaire (CRIq) which formally assesses years of education, vocational training, type of occupation (ranging from unskilled to highly intellectual occupation), leisurely activities (reading newspapers, domestic chores, driving, sports, games, and using new technologies), and social activities.

Results are scored and then interpreted as low, medium-low, medium, medium-high, or high cognitive reserve.

It is important to note that these cutoffs have not yet been proven to predict a clinical outcome, but could be a useful tool and certainly an important research tool.

Why is Cognitive Reserve important?

CR may be very important in compensating for progressive brain damage in dementia. Although it doesn’t prevent dementia, high CR could mask the development of symptoms until a certain threshold.

For example, a person with a high CR can go undiagnosed until the damage becomes severe, whereas a person with a low CR may decompensate clinically much sooner.

What, besides increasing cognitive reserve, can be done to reduce the risk of dementia?

Studies show eating a healthy, plant-based diet with fruit, vegetables and legumes may be protective. Regular exercise including cardiac fitness, getting enough high-quality sleep, stress management, and nurturing social connections are all good practices to prevent cognitive issues later in life.

Continuing to challenge the brain with learning new material may be helpful as well.

Other heart-healthy activities such as quitting smoking, controlling high blood pressure and cholesterol, and working with your doctor to reduce the risk of heart disease can prevent vascular dementia as well.

Late Onset Alzheimer’s Disease

Rok Krivec Blog, Causes, Stages April 2, 2021October 15, 2021alzheimer's disease, late onset alzheimer's

It is known that late onset Alzheimer’s disease is the most common one in older adults.

But first, let’s take a look at the bigger picture, causes, factors, symptoms and treatments of Alzheimer’s disease.

Different people develop Alzheimer’s disease (AD) at different stages in their lives. For some, a positive diagnosis happens before they turn 65 years, which is mostly in their 40s or 50s.

This is known as early-onset Alzheimer’s.

Others, on the other hand, will get the disease when they are 65 years or older. This is known as late onset Alzheimer’s, and it is the most common form of the illness responsible for about 90% of Alzheimer’s cases.

The irreversible disease is a leading cause of death in seniors behind heart disease and cancer.

Let’s explore this illness in detail below.

Causes of Late Onset Alzheimer’s disease

To date, scientists and other parties involved have not been able to pinpoint the exact cause of this illness.

The question of why some individuals get it and others do not remain a mystery.

Researchers have not yet identified a particular gene that is behind the development of Alzheimer’s.

While some say that Alzheimer’s is hereditary, the fact cannot be substantiated because it may or may not run in the family.

There are instances where both parents may get the illness and their child does not end up getting it.

What factors are behind the development of the disease?

Experts agree that Alzheimer’s is likely not the result of a single cause, but a combination of environmental, genetic, and lifestyle factors.

For instance, a mutation of the ApoE gene is believed to increase the risk of developing Alzheimer’s after hitting 65 years.

Conversely, it is not the cause of the illness. The National Institutes of Health states that ApoE is responsible for how cholesterol moves in the blood.

Some studies suggest that individuals who have high cholesterol levels and high blood pressure are at a higher risk of developing Alzheimer’s.

Recent research also suggests that viral and bacterial infections play a significant role in the development of the illness.

Because of ongoing research, scientists are positive that soon they will be able to come up with a detailed explanation of the multiple Alzheimer’s causes so that people can have a better understanding of this disease.

Symptoms of Late Onset Alzheimer’s disease

AD affects people in different ways.

The most common symptom pattern, however, usually starts with continuing challenges in remembering new information.

This happens because the neurological disorder affects the hippocampus, which is the part of the brain that is responsible for memory and learning.

Other warning signs

Other warning signs of this disease include:

Repeating statements and questions
Having a hard time making decisions
Issues with visuospatial skills like judging distances
Communication problems
Inability to complete daily living activities like eating, walking, dressing, and maintaining personal hygiene
Hallucinations and delusions especially in the later stages
Misplacing items
Confusion of place or time
Changes in personality such as becoming anti-social, anxious, depressed, aggressive, etc.

Symptoms of Alzheimer’s (late onset) typically begin to show when a person is in their mid-60s.

Because Alzheimer’s is a progressive disease, the symptoms become worse as the neurological deterioration progresses.

During the later stages of the disease, the affected person may have to get into 24/7 care because they are not able to live independently.

Alzheimer’s disease Diagnosis

Experts are continually working on techniques to identify the earliest stages of Alzheimer’s in a bid to offer early intervention effectively.

This, in turn, helps to delay significant impairments.

For the longest time, a thorough post-mortem microscopic brain examination was the definitive way to diagnose Alzheimer’s.

This was not helping too much because the diagnosis needs to be made when a person is alive.

What’s necessary for AD diagnosis

Nowadays, experts can diagnose AD with over 95% accuracy in living humans.

A combination of tools come into play including:

A person’s medical history plus that of their families
Neuropsychologic tests to assess cognitive function
Multiple laboratory tests: medics usually conduct this to identify secondary causes of the illness such as medical conditions that are common with golden-agers. These might include blood count, glucose levels, serum electrolytes, Vitamin B12 Hepatic function panels, creatinine ration, and so forth.
Neuroimaging: this helps to table appropriate details on brain structures to help exclude treatable conditions

The list above is not exhaustive but covers the most essential AD diagnosis tools.

Because people experience the illness differently, a doctor may prescribe more tests to conduct the diagnosis comprehensively.

In regards to diagnosis for late onset Alzheimer’s, it is important to note that misdiagnosis is bound to happen in some cases.

This is because the illness shares symptoms with other medical disorders. It is the reason it is crucial to get a proper diagnosis to manage the disease better.

Treatment for Late Onset Alzheimer’s disease

Despite ongoing research and studies, experts have not come up with a cure for AD. This does not mean that a positive diagnosis implies suffering and immediate death.

People who have this illness can live up to 8 years or more after the development of the disease. A couple of factors can affect longevity such as:

1. Gender

Many studies suggest that women live longer than men after Alzheimer’s diagnosis.

2. Brain abnormalities

Persons who have a combination of Alzheimer’s, brain, and spinal cord issues tend to die faster than those who do not have all these medical conditions.

The same applies to other health problems where individuals with diabetes or heart attacks have shorter lifespans than people who do not have other complicating health factors.

3. The severity of symptoms

Persons who have severe motor impairment like tendencies to get lost or wander and falls tend to have shorter life experiences.

Several coping mechanisms are put in place to help individuals with the disease live fuller, more independent, and satisfying lives for the longest possible time like:

Use of Medication

Certain medicines are available to help reduce symptoms of Alzheimer’s temporarily such as:

AChE inhibitors

Acetylcholinesterase are drugs that help to increase acetylcholine levels in the brain. This is a substance that helps to improve communication between nerve cells.

Only specialists like neurologists or psychiatrists can prescribe the drugs.

A general GP can also do it but it has to be under the direction of the specialists.

Most recent guidelines recommend that the people who should take the medicines are the ones in the middle or severe stages of the illness.

Persons on these medications need to be aware of some side effects they may experience.

The most common ones include loss of appetite, nausea, and vomiting. For most people, side effects get better after some time of taking the medication.

Memantine

This is a drug that has been designed to block the effects of excess glutamate a chemical in the brain. Persons can use this for moderate and severe Alzheimer’s.

It comes in handy for individuals who cannot tolerate AChE inhibitors.

Additionally, people who are on AChE inhibitors can also take the drugs. The known side effects of these medications include temporary constipation, headaches, and dizziness.

To get more fine points about the side effects, consult a professional or doctor for an individual consultancy.

Physicians might also prescribe other medicines like antidepressants that can help deal with behavioral changes.

Therapies

Treatment can also involve different types of therapies that are beneficial when caring for a person with Alzheimer’s. These can include:

Cognitive rehabilitation

This is where the ill person works closely with an occupational therapist or any other professional to achieve a personal goal.

This can be anything from learning how to use a phone, computer, or completing a daily task.

This rehabilitation aims at getting the parts of the brain that are working to assist the ones that are not functioning as they should.

Reminiscence

This involves talking about events and things from a person’s past.

The use of props such as music, photos, and other possessions, can make this exercise more productive.

You can combine this with life story works that involve a collection of notes, photographs, and keepsakes from the suffering individual’s childhood through old age.

Studies show that these are effective when coping with late onset Alzheimer’s because it helps to enhance good mood and wellbeing.

Preventing Late Onset Alzheimer’s

Similar to the cure situation of Alzheimer’s, there is still no sure way of preventing the development of the disease.

Experts continue to conduct multiple studies on preventive measures, but the results are usually inconsistent.

However, several lifestyle factors might help to reduce the risk of the illness, such as:

Diet

Studies suggest that earing right might help keep the disease away.

You should purpose to always indulge in a balanced diet that mainly constitutes fruits, vegetables, healthy fats, and whole grains.

Physical Movement

Evidence puts forward the benefits of exercise for the brain, which may help reduce the risk of suffering from progressive disease.

Intellectual activities

Research suggests that exercising the brain through activities like writing, reading, playing games, and doing puzzles help stimulate the brain health.

Anyone who has Alzheimer’s must consult a healthcare professional first before making any key lifestyle change to be on the safe side.

Closing Remarks

More elderly people are getting a positive diagnosis of late onset Alzheimer’s disease. Management of the illness is quite complex because there is no cure.

There is a need for a comprehensive care approach that not only focuses on the person with the disease but caregivers as well.

Early diagnosis is beneficial because affected individuals can then work closely with their relatives and doctors to lead fuller and more gratifying lives.

Sadly, it may reach a point where persons with Alzheimer’s may need to move to care facilities or have professional caregivers at their beck and call at home.

Do Dementia Patients Know What They Are Saying?

Petra Boh Blog, Signs April 1, 2021October 15, 2021dementia and communication

Communicating with a person who has dementia may be confusing and challenging at times leading to the question: do dementia patients know what they are saying?

Most of the time especially in the later stages of the disease, they may not know what they are saying.

This is because communication becomes more difficult for persons with dementia as the illness progresses.

After all, it affects sections of the brain that are responsible for controlling memory and language.

As dementia continues to destroy brain cells, most people experience a symptom referred to as aphasia.

This can be described as losing the ability to speak as well as understand speech.

Several factors may affect an individual’s ability to communicate “normally” such as:

Memory Loss: inability to remember events that have happened or topics to discuss
Challenges finding the right words or phrases to say
Difficulties understanding language
Sight or hearing impairment
Distractions; for instance, being distracted by the environment or finding it hard to concentrate on a single topic
Hallucinations

Coping with Communication Challenges

In regards to the query do patients with dementia know what they are saying, it is important to learn some communication strategies to adapt when communicating with individuals who seem not to know what they are saying.

This is because persons with dementia are bound to have communication hiccups which can lead to multiple misunderstandings.

For instance, a person can point to a computer and call it a picture or say that they want to eat worms referring to their favorite food only that they cannot voice out the proper words.

Some of the ways to deal with communication issues include:

Speaking the First Language

Many people with dementia usually go back to their first language as they lose their ability of speech.

If a person grew up speaking a certain language, get ready to speak the language at some point.

Minimize Distractions

When talking to a person with the progressive illness, try and create a calm and quiet environment.

It is best to sit face-to-face with the person you are talking to.

Minimize distractions like noise from the TV or radio or any sights that may be causing distractions.

Sing Along

Most individuals with dementia will remember songs because melodies and music are stored in the parts of the brain that the disease does not affect.

Singing, thus, is one of the ways to connect with the affected individuals. An alternative to singing is just relaxing and listening to the person’s favorite tunes.

The Right Approach

People with dementia generally do not like surprises. If they do not see other people coming, it might elicit aggression or anxiety.

It is, therefore, advisable to always approach them from the front which gives the affected person time to process an individual’s arrival.

It is also recommended that a person identifies themselves before engaging in conversation.

This is done to create awareness and attention reminding the affected person of who their loved ones are.

Have a Caring Attitude

when seeking answers to the query do patients with dementia know what they are saying it is vital to understand that individuals retain their emotions and feelings even when they do not understand what is being said.

For this reason, it is crucial to always maintain the self-esteem and dignity of persons with dementia when talking to them.

Allow plenty of time for responses and remain flexible. Avoid arguing or becoming controlling even when the person with the illness is in the wrong.

Communicating without Words

At times, words are not sufficient when communicating with a person who has dementia.

Body language, touch, hand gestures, eye contact, and facial expressions are other communication options available when words are not enough.

For instance, when asking a person what they want to eat, pointing to the refrigerator can help reinforce the message.

Nodding the head indicates a person agrees while shaking the head shows an individual is not in agreement.

A hug or warm smile can also convey the message you want to pass across strongly.

Remember to only use touch when it is appropriate to grab the person’s attention while communicating affection and warmth.

Understanding the Disease Makes People Say Harmful Things

It is common for persons with the disease to use hurtful words, make mean comments, or accuse their loved ones of terrible untrue things.

While it may be devastating to hear such things, it is important to remember that the affected individual is not saying these bad things on purpose but it is the disease that is causing them to say such things.

Closing Remarks

When a person with dementia loses their ability to communicate it can be hard and frustrating not only to the affected individual but their families, friends, and carers as well.

When this happens, it is important for loved ones are carers to change the way they communicate with the affected person.

Keep in mind that communication is made up of three parts:

1. 55% Body Language: This is the message that people send with their gestures, facial expression, and posture.
2. 38%: It represents the pitch and tone of the voice.
3. 7%: these are the words people use.

The statistics above show the importance of how carers and families should present themselves with people who have dementia.

It is easy for people with dementia to pick up negative body language like raised eyebrows and sighs.

Cognitive Stimulation Therapy for Dementia

Laura Herman Blog, Prevention March 31, 2021October 16, 2021alternative therapies, alternative therapies for dementia, cognitive stimulation therapy, dementia

If you would like to understand the link between cognitive stimulation therapy and dementia, I cover it all in this extensive article.

What if there was a treatment for mild to mid-stage dementia that could improve cognitive functioning as effectively as dementia medications, but without side effects? What if it was inexpensive, accessible and enjoyable for the person with dementia? In fact, what if there already is?

If you live in England, chances are you’re already familiar with Cognitive Stimulation Therapy.

Cognitive Stimulation Therapy and Dementia

It is considered a standard of care in the UK, and it is recommended and provided for most or all British individuals with dementia who choose to participate.

The word — and research — on CST is getting out to other countries, and cognitive stimulation therapy programs are growing around the world.

At least, that is, they were growing until the pandemic put a stop to group gatherings, especially for older adults.

However, there are adaptations being developed for this exciting therapy as scientists, experts, and group leaders explore how to best translate the program to an online format.

What is Cognitive Stimulation Therapy?

Cognitive stimulation therapy is an evidence-based group treatment modality designed for people with mild to moderate dementia.

It was developed in the United Kingdom by Dr. Aimee Spector and a team of dementia specialists after rigorously researching the efficacy of various non-drug dementia interventions.

Since its inception in 2003, an abundance of evidence has shown that CST significantly improves participants’ cognitive functioning, mood and quality of life.

CST Aims to Improve Cognitive Functioning

The evidence shows that CST is as effective as dementia medication for improving cognitive functioning.

CST is the only non-medical intervention that the British government for the treatment of dementia endorses.

In fact, it is considered a standard of care in the UK to be referred to a CST group upon being diagnosed with dementia.

Few barriers interfere with the implementation of cognitive stimulation therapy. CST groups can be led by essentially anyone who works with people with dementia.

It’s not restricted to highly credentialed medical professionals. There is no extensive training or special equipment necessary, so the cost of the program is low.

All that’s needed is a manual, a modest training program, and a few simple supplies.

Who can Administer Cognitive Stimulation Therapy?

Cognitive Stimulation Therapy is designed to be successfully administered by anyone who works with people with dementia.

This includes care workers, psychologists, occupational therapists and nurses.

A basic CST training program ensures that facilitators understand the guiding principles of the program. Also to understand how to apply them in a standardized, yet person-centered, and effective way.

Available training manuals offer instruction on how to lead a CST group.

They discuss the key principles of the therapy, include detailed session plans, and other instructions on how to monitor participants’ progress.

What is a CST Session Like?

Traditional Cognitive Stimulation Therapy sessions utilize a group format to capture the benefits of social interaction.

It is a set series of sessions, usually given twice per week over seven weeks.

CST sessions can occur in a variety of settings, from private homes to hospitals, facilities or day programs.

They should take place in a comfortable environment that is conducive to learning and social engagement.

CST stimulates particular cognitive skills

CST sessions are designed to exercise and stimulate specific cognitive skills. The first session begins by having the members designate a name for their group.

The same participants join throughout the series of sessions.

Attention to consistency throughout the sessions is an important feature. For example, each session begins with the same warm-up activity.

Each session has a different theme, such as “Physical Games”, “Childhood”, “Food”, “Current Affairs” or “Number Games”. Sessions typically last an hour.

A reality orientation board is posted throughout the series of sessions, which displays information about each participant.

As the participants interact with each other, they get to know one another, which contributes to feelings of friendship and support.

What are the Benefits of CST?

The benefits of Cognitive Stimulation Therapy are well documented and include a significant improvement in cognitive functioning.

In order to quantify data, researchers often use tools that measure memory, orientation, language and visuospatial abilities. These tools include:

The Mini-Mental State Examination (MMSE)
The Alzheimer’s Disease Scale-Cognitive Subscale (ADAS-COG)

Because these standardized forms are also often used to measure the efficacy of Alzheimer’s drugs and other modalities, it is easy to directly compare the results.

CST shows an improvement in cognitive areas measured by these tools comparable to anti-dementia drugs.

Other noted benefits of CST include a significant improvement of language skills (such as naming objects, word-finding, comprehension) and quality of life.

Quality of life is determined by the participants using the QoL-AD tool.

Caregivers of CST participants with dementia consistently report an improved quality of life for themselves, as well as for their loved ones.

They report improvements in their loved ones’ moods, confidence and ability to concentrate.

Both the participants and caregivers describe participation in the groups as feeling supportive and positive.

What are the Variations of CST?

As Cognitive Stimulation Therapy matures and becomes more widespread, more variations are innovated to meet more specific cultures or preferences of individual participants.

For example, Saint Louis University’s Geriatric Education Center in Missouri, USA has developed several variations of CST of their own, including an exercise-based group, a spiritual group and a caregiver-assisted group.

Individual Cognitive Stimulation Therapy (iCST)

Individual Cognitive Stimulation Therapy (iCST) is a newer variation of this modality.

It is designed to provide the therapeutic benefits of CST on a one-to-one basis, rather than a group setting.

It can be administered to the person with dementia by a friend or family member with iCST training.

An iCST program includes 75 activity sessions which are intended to be provided over three 30-minute sessions for 25 weeks.

Each iCST session begins with five minutes of orientation information, followed by five minutes of current news and events, and then twenty minutes of the main activity.

The main activity themes include topics such as “Life Story”, “Word Games”, “Art”, “Reminiscence” and others.

In one research study, individuals with dementia participating in iCST programs did not experience the same cognitive gains of the traditional group-based sessions, but there were significant benefits nonetheless.

The individual and their carer reported a much better quality of the relationship. The carers also reported a measurably better quality of life and fewer symptoms of depression.

Both the individuals with dementia and their carers expressed enjoying the program and felt that it ignited an interest in mentally stimulating activities.

Individual Cognitive Stimulation Therapy is an excellent alternative when group sessions aren’t available or practical. During the COVID-19 pandemic, this need has become especially widespread.

It’s also useful anytime those who don’t enjoy group interaction and people who can’t get to group sessions for reasons such as compromised health or mobility.

Maintenance CST

While Cognitive Stimulation Therapy is typically designed as a series that concludes after 14 sessions, an adaptation for ongoing “maintenance” therapy is in the works.

Designed for longer-term treatments, Maintenance CST can extend the period of benefits. One research study concluded that long term benefits of maintenance CST were especially powerful in terms of improved quality of life, with the cognitive improvements tapering off over time.

Virtual Cognitive Stimulation Therapy (vCST)

Virtual Cognitive Stimulation Therapy (vCST) was born in response to an urgent need created by the COVID-19 pandemic. Still in its early stages, vCST is taking shape in various ways.

Adapting group sessions to an online format, providing iCST to an individual online (with in-person support from a family member), and training family caregivers to provide individual CST in-home sessions are areas that have been explored, and are ripe with potential.

Individual cognitive stimulation therapy sessions are now being offered online through Washington University Physicians Occupational Therapy.

Their goal is to train carers to administer sessions at home with their loved ones.

A therapist works with the individual with dementia and their caregiver over seven virtual sessions and supports them as they work through the process.

A binder of material is provided with this program.

Researchers at the University College of London and Hong Kong University have been collaborating to adapt CST into virtual sessions so people with dementia can experience the best possible benefits of the program in the alternate format.

What is Next for CST?

Already being used in at least 33 different countries, scientists are developing ways to introduce and grow Cognitive Stimulation Therapy sessions across different cultures and different socio-economic populations.

International train-the-trainer programs exist in Denmark, Norway, Germany, China, New Zealand and USA.

A three-year study is currently investigating how to best implement CST in low to middle income nations, including Brazil, India and Tanzania.

A similar program, called SAIDO Learning, exists in Japan and demonstrates comparable results.

An adapted model of CST intended for people in the moderate to severe stages of dementia is also currently under development in London.

Where to Learn About Online CST Training

To learn more about CST training opportunities, including access to a series of free online training video modules, visit the Saint Louis University website.

To learn about opportunities for online iCST training visit the iCST website.