Monthly Archives: February 2025

February 24, 2025 · 8:00 am

When home can no longer be found

One common behavior in those with Alzheimer’s disease is to ask to “go home.” It seems like the simplest of requests, but caregivers are often stumped because their loved one may make this request when they are already home. That’s because the meaning of “home” can change as the disease progresses.

My father asked to go home almost every time my mother visited him at the memory care center during the last year of his life. But my mother didn’t get the sense that my dad meant home as the condo they had purchased. Home seemed to be a more vague destination. In fact, my dad and his roommate reportedly hatched a plan to escape the memory care center and catch a bus to … somewhere undefined. The memory care center had secured access and the escape plan was quickly forgotten.

The last time I saw my father alive, he also expressed a desire to go home. This time, it was clear that home meant to Belfast, his birthplace, because he mentioned wanting to see his sisters. There is some evidence to suggest that those with dementia hold on to their earliest memories longer than more recent ones.

For caregivers, the “going home” request can be difficult to navigate. This recent article in Self has some good tips and strategies. Once physical discomforts are ruled out, caregivers can implement a variety of strategies to engage with their loved one and help them move on from the “going home” obsession loop. These strategies may need to be adjusted over time; be prepared for a period of trial and error.

Loved ones with dementia who express great distress about their current surroundings may attempt to wander. In these cases, making sure home are adapted to prevent escape attempts is essential. Specialized door locks and high-tech tracker tags can help in these situations.

Losing a sense of home must be frightening, as our homes are often our sanctuaries. Helping loved ones with Alzheimer’s navigate this disturbing yet common behavior takes compassion, patience, and creativity.

Image by DALL-E 3 via ChatGPT.

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February 17, 2025 · 8:00 am

How common is it to receive a misdiagnosis of dementia?

A diagnosis of dementia can be devastating, but the damage of an incorrect diagnosis has its own fallout. But how common is it to receive either a false diagnosis of dementia or a misdiagnosis for a specific type of dementia? As those who have dealt with dementia, there are several different types, each with its own set of treatment protocols and expected disease progression.

A recent study conducted by Australian researchers looked specifically at the frequency of misdiagnosis of frontotemporal dementia (FTD), comparing the initial referral data to the final clinical diagnosis, according to SciTechDaily.

The study reviewed the records of 100 patients referred to a memory disorders clinic by specialists. Researchers found that 70 percent of patients initially suspected of having frontotemporal dementia (FTD) were ultimately misdiagnosed.

Insights from the study:

  • 34 patients were accurately diagnosed while 66 were false positive.
  • Researchers determined that misinterpretation of neuroimaging, specifically nuclear imaging, was the primary cause of misdiagnosis of FTD.
  • Cognitive testing also played a factor in misdiagnosis.
  • Patients who presented with prior psychiatric histories were more likely to be misdiagnosed with FTD.

The study was small and based upon cases at a single clinic, so it’s difficult to know how widespread the issue of misdiagnosing FTD is in other countries.

FTD has been in the news this past week due to the ongoing saga of media personality Wendy Williams, who is claiming she doesn’t have FTD after reportedly being diagnosed and assigned a court-appointed guardian. There has been an ongoing controversy about the continued need for the legal conservatorship, and Williams is speaking out, frustrated by the lack of control she now has over her finances and living arrangements. As the above study found in some of the cases it reviewed, it may be possible that Williams was misdiagnosed with FTD and instead experienced alcohol-induced dementia, related to her well-documented struggles with alcohol, or another form of mental illness which had gone untreated. I am not a medical professional, but it seems reasonable that a second opinion and additional testing should be conducted, if it hasn’t already been done. If a celebrity like Wendy Williams can find herself in such a challenging situation, think about regular people like the rest of us who don’t have such a public platform to ask for help.

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February 10, 2025 · 8:00 am

How heart and brain health are connected

February is American Hearth Month, so it’s a good time to learn more about the connection between heart disease and dementia, especially in women.

According to the American Heart Association, “older female heart attack survivors were twice as likely to see declines in memory and cognitive ability.” Multiple factors may contribute to the gender disparity, including blood pressure fluctuations during pregnancy and early menopause, per the American Heart Association. Other risk factors include obesity and diabetes.

A scientific statement published in Oct. 2024 by the American Heart Association noted that “heart failure, atrial fibrillation and coronary heart disease are linked to cognitive impairment and increased risk of dementia.” Heart disease can lead to decreased blood flow, inflammation, and structural brain changes, which can impact cognitive function, according to the American Heart Association report.

We often think of Alzheimer’s and other dementias as a brain disease but there’s a growing body of scientific evidence supporting the connection between the cardiovascular system and cognitive function. A holistic approach is recommended, with regular monitoring of blood pressure, managing stress, routine exercise, a heart-healthy diet, and quitting smoking all ways people can support not only the health of their hearts, but their brains.

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February 3, 2025 · 8:00 am

New sleep study focuses on REM phase onset and Alzheimer’s link

You don’t have to be a medical professional to know that getting a good night’s sleep is important for overall health and wellbeing. A new study, following up on findings from previous studies, finds evidence of a potential link between a particular phase of sleep and Alzheimer’s.

The study, published in the Alzheimer’s Association Alzheimer’s & Dementia Journal found a potential link between Alzheimer’s and a delay in the onset of the rapid eye movement (REM) phase of sleep. The study was small (128 people) and was conducted in a sleep clinic, which could have impacted sleep quality. Still, the findings were notable due to its focus on REM sleep. According to HealthDay, researchers focused on this key phase of the sleep cycle because its during this period that the brain processed memories.

Half the patients in the study had been diagnosed with Alzheimer’s, and another third had mild cognitive impairment (MCI), while the average age of the study participants was 70.

Two groups were created for the study: those who entered the REM sleep phase earlier (less than 98 minutes after falling asleep), or later than average (more than 193 minutes after falling asleep.) The study found that those with Alzheimer’s were more likely to experience delayed REM sleep. This group also had higher levels of amyloid and tau, toxic brain proteins long associated with Alzheimer’s disease., and lower levels of healthy brain proteins than those with an earlier onset REM sleep phase.

I’m fortunate to never have suffered from insomnia, but I’ve seen the negative impact that being unable to get a good night’s sleep has on the lives of others. My mother had chronic insomnia, though she never developed dementia. My father didn’t suffer from insomnia but he had a sleep cycle that was outside the norm. He worked the swing shift most of his work career, so he wouldn’t get home until very late at night, and then stay up until the early morning hours to wind down. My father also suffered from periodic nightmares. Decades later, my father began having disturbing dreams whose effects lingered long after waking, which coincided with his earliest symptoms of dementia.

As insomnia has seemingly become more common in our society, there’s a lot of resources out there for those who are sleep deprived and looking for better quality sleep. Sleep hygiene has become a popular concept in recent years, which can include everything from diet to bedroom setup. Natural supplements like melatonin may help some, while OTC and prescription medication may be necessary for stubborn cases but come with a host of side effects. Non-medication options include meditation and things like the Calm app’s “sleep stories.” (Check with your health care insurer as some offer complimentary Calm subscriptions.)

While researchers haven’t been able to determine whether insomnia is a risk factor and/or an early sign of Alzheimer’s, good sleep comes with a host of health benefits beyond cognitive function. That’s something worth sleeping on.

Image created by DALL-E via ChatGPT.

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