Tag Archives: dementia

Why women are at an increased risk of dementia

March is Women’s History Month, so it’s a good time to dive into research regarding women and dementia. We know that women are more likely to develop Alzheimer’s than men, but why?

One commonly cited factor is a simple one: age. Women on average live longer than men, therefore, they have an increased risk of developing conditions like Alzheimer’s, in which advanced age is a top factor. According to the Alzheimer’s Association, about two-thirds of those living with Alzheimer’s in America are women. However, the UK-based Alzheimer’s Society points out that not all studies support this theory.

One interesting data point is that the gender differences are specific to Alzheimer’s risk, and not risk of other forms of dementia, according to Harvard Health Publishing.

There are other factors, both physical and cultural, that may play a role in increased Alzheimer’s risk for women. The hormonal impacts of menstruation, pregnancy, and menopause and dementia risk is being studied, but more research is needed to reach any definitive conclusions. The Alzheimer’s Society discusses the current state of hormone replacement therapy (HRT) and dementia risk. Early research suggested that HRT may increase the risk of dementia, but newer research disputes that, and suggests that HRT may even have a protective effect. STAT also explored the latest studies on hormone therapy and dementia risk for women, with researchers focusing on the timing of hormone treatment. Harvard Health Publishing points to women’s immune systems, which are considered to be stronger than men’s immune systems, and that the robust immune response may deposit more amyloid plaque in the brain.

Genetics likely plays a role too. The Alzheimer’s Society points out that while men and women are both about as likely to have the ApoE4 gene variant, the related dementia risk seems to be greater in women that men. I have the the ApoE4 gene variant. Cases of Alzheimer’s appear on both sides of my family tree, but more of my female relatives were diagnosed. Unfortunately, I don’t know their ApoE4 gene status.

For the current elder population, gender norms of yesteryear may have limited women’s ability to receive higher education and work in more complex jobs, or have careers at all for that matter. Education levels are believed to play a role in reducing the risk of Alzheimer’s.

Moving forward, women need to advocate for more research to better understand the potential for increased Alzheimer’s risk, as well as steps women can take to reduce their risk of this terrible disease.

Looking for caregiving books? It’s Read an Ebook Week and I’m participating in the Smashwords sale. Get my award-winning personal essay collection, The Reluctant Caregiver, for half-off through March 8. Use the code EBW50 at checkout.

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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.

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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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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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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.

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A sobering reminder for those on the dementia caregiver journey

I hope those dementia caregivers who wonder if they are doing enough or doubt their capabilities of caring for their loved one take the time to read the above post, “Dementia Does What It Does” on the When Dementia Knocks blog. Elaine captures quite eloquently the progressive march that dementia eventually takes, no matter what cures or solutions you throw at it. Elaine’s message may sound pessimistic, but its intention is to give yourself a bit of grace and self-compassion. When you accept the current reality of a dementia diagnosis, you may blame yourself less when your loved one continues to decline, in spite of your best efforts.

There is some tentative hope of more effective treatments on the horizon, but for now, just know that you are doing your best as a caregiver.

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How color plays a role in dementia care

After learning about colors as a child, we may take their appearance for granted, unless you are an artist. But colors can take on different meanings for those with dementia, and understanding those changes can be helpful as a dementia caregiver.

I remember seeing the visual impact of dementia in person when visiting my parents. We were in a building with an elevator, and my father took a very large step across the threshold of the elevator, where a black mat was placed. As Linda Slaton Anderson points out in this article published in Today’s Caregiver, “some therapists recommend placing black mats in front of doors or stairs since Alzheimer’s patients perceive them to be holes and thus tend to avoid walking on them.” Clearly, my father experienced that “black hole” visual disruption.

While some changes in processing colors can be frightening for both those with dementia and their caregivers, colors can also be used in positive ways. For example, those with dementia with diminished appetite may benefit from using red dishes on a white tablecloth, due to the higher contrast attracting attention to the food on the plate.

“Colors are processed by our brains more quickly than words,” Anderson notes. As those with dementia lose their language abilities, colors may remain a way to convey feelings and encourage engagement.

Color choice can impact mood, which those with an interest in interior design understand well. This applies to those with dementia as well. Blues and greens can provide a calming, soothing effect, while orange and yellow are cheerful colors that can lift one’s mood.

For caregivers trying to decode or address negative behavior in their loved one with dementia, consider the role color may be playing.

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Snow day in Atlanta

We had the rare snow day in Atlanta on Friday. It snowed a bit more than expected intown, and upon waking one walked into a winter wonderland.

It’s always fun to see how pets react to snow, especially when they don’t see it very often. My dog Murphy was braver than expected. My girl kitty Serena, who on a sunny day loves to try to bolt out the door to explore the yard, approached the snow with extreme caution and immediately regretted her decision, haha. And Dorian, my boy cat, the daredevil of the bunch, flat out refused to even put a paw into the snow.

Growing up in southern California, I never saw snow until I moved away for college, but I remember my mother having fond memories of snow days on the farm in Tennessee where she grew up. While there were still farm chores to be done, school was out. The family would make snow cream from the freshly fallen snow. Of course nowadays, with all of the pollutants in the environment, this wouldn’t be safe to do, but back in the day, my mother had fond memories of this rare, special treat.

Of course, winter weather can bring challenges to those with health issues and their caregivers. Last year around this time I wrote about keeping your loved ones with dementia warm and comfortable during winter weather events. I notice that as I age, the cold tends to bother me more so I’m using some of the tips on the list as well, such as layering and paying attention to my hands, which can be a challenge to keep warm.

Hope you are staying warm and cozy this winter season.

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Helping elders build community connections

Happy New Year. I hope you were able to enjoy time with family over the holiday season.

Once the holidays are over, our elder loved ones may miss the social interaction and companionship. I know my mother deeply missed the daily companionship of my father after he moved into the memory care center and then died a year later. There was an active senior community center where she lived, but my mother refused to go, saying she didn’t want to be around “old people.”

Home Care Matters had good tips on helping elders connect with community in their newsletter. They also offered additional tips about keeping elders engaged during the winter months when it may be difficult to leave the house for socializing. Some churches offer transportation service for those who need assistance to and from services. Volunteer work is another great way to connect with the community. How one socializes and stays engaged with their community may take some creativity on the part of family, but the mental, emotional, and health benefits are well worth it. You’ve likely seen the reports about the health consequences of the loneliness epidemic, including an increased risk of dementia.

What about our elder loved ones who are introverted or don’t enjoy the typical senior community center activities? As an introvert myself, I’m not a big fan of in-person group activities, but I found that I do enjoy online activities like virtual book clubs. An online women’s healing circle has been beneficial in supporting my emotional wellbeing during the pandemic. I also enjoyed an in-person knitting group I attended last year a couple of times and may return to that in the future. For me, the key is to use my hobbies and interests to find communities where we share a common interest.

What about those who are resistant like my mom? Sometimes, you have to let your loved ones follow their own way. For example, my mother used errands to socialize with everyone from the bank manager to the Mexican restaurant server to the shuttle driver. I appreciate those people who took extra time to interact with my mother. They probably don’t realize how much of a positive difference they made in my mother’s life.

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Marking the anniversary of my father’s death

Posing with the bears outside of the Ruidoso Public Library, 2004.

My father died 13 years ago today. Having spent time recently going through the final batch of my father’s possessions, I feel his spirit even closer this year.

I didn’t have down time while I was cleaning out my parents’ condo, so I got up extra early on the day I was leaving to visit the library. I took a photo with one of the bear statues. It was too early for the library to be open but I was glad I squeezed in the time to take in the sights and sounds of nature along the picturesque walking trail to the library, as my father did so many times.

Posing with the bears again, Nov. 2024.

It was my father’s favorite spot. He spent countless hours there, and even as his dementia progressed and his reading skills diminished, he still made his way to the library out of habit.

I don’t visit libraries myself anymore, having adopted the convenience of e-books, but as I mentioned in my last blog post, libraries will always hold a special place in my heart.

Even though it’s been well over a decade since my father’s passing, marking the somber anniversary still does have an impact on my holiday spirit. For those who have experienced loss during the holiday season, allow yourself the space and self-compassion to adjust expectations.

Reflection and remembrance can take many forms, and your preferences may change over time. Be authentic and don’t try to force emotions.

I know this can be easier said than done when it comes to demands from others, who may not appreciate the complexities and individuality of the grieving process. My wish for you this holiday season is that others will be supportive and understanding.

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