ALZHEIMER - Para comprender mejor a las personas que lo padecen

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MEMORY AND EMOTIONS

Patients With Amnesia Still Feel Emotions, Despite Memory Loss

A new University of Iowa study offers some good news for caregivers and loved ones of individuals with Alzheimer's disease. Patients might forget a joke or a meaningful conversation -- but even so, the warm feelings associated with the experience can stick around and boost their mood.

For the study, published this week in the Early Edition of the Proceedings of the National Academy of Sciences, researchers showed individuals with memory loss clips of happy and sad movies. Although the participants couldn't recall what they had watched, they retained the emotions elicited by the clips. Justin Feinstein, lead study author and a student in the UI graduate programs of neuroscience and psychology, says the discovery has direct implications for Alzheimer's disease.

Feinstein conducted the study with UI neuroscience faculty members Daniel Tranel, Ph.D., UI professor of neurology and psychology, and Melissa Duff, Ph.D., UI assistant professor of communication sciences and disorders. The researchers studied five rare neurological patients with damage to their hippocampus, a part of the brain that's critical for transferring short-term memories into long-term storage. Damage to the hippocampus causes new memories to disappear. This same type of amnesia is an early sign of Alzheimer's disease.

Journal Reference:

Justin S. Feinstein, Melissa C. Duff, and Daniel Tranel. Sustained experience of emotion after loss of memory in patients with amnesia. PNAS, April 12, 2010 DOI: 10.1073/pnas.0914054107

ScienceDaily (Apr. 13, 2010)

WHAT IS GOING ON INSIDE OF ME (YOU, HIM, HER, THEM)

Richard Taylor, a retired Psychologist, was diagnosed with Alzheimer's-type dementia in 2001 at the age of 58. Originally, he started to write to better understand for himself what was going on inside of him. When he isn't out speaking, he writes for two or three hours every day. Even as the disease progresses, he thus far has maintained his ability to look at and attempt to understand himself. Richard is an articulate, thoughtful, and thought-filled speaker to caregivers. Hundreds of them have used his insights as the basis for conversations and insights into what might be going through their loved one's minds. While Richard still leads a vibrant life, control of his concentration is sometimes elusive. His language facility is still mostly intact, although he increasingly searches for the right word.

A book has been written by Richard Taylor:

Alzheimer's from the Inside Out

Receiving a diagnosis of Alzheimer’s disease profoundly alters lives and creates endless uncertainty about the future. How does a person cope with such a life-changing discovery? What are the hopes and fears of someone living with this disease? How does he want to be treated? How does he feel as the disease alters his brain, his relationships, and ultimately himself? Richard's book provides illuminating responses to these and many other questions in this collection of provocative essays. He shares an account of his slow transformation and deterioration and the growing division between his world and the world of others.

With poignant clarity, candor, and even occasional humor, more than 80 brief essays address difficult issues faced by those with Alzheimer’s disease, including:

• the loss of independence and personhood
• unwanted personality shifts
• communication difficulties
• changes in relationships with loved ones and friends
• the declining ability to perform familiar tasks

This rare, insightful exploration into the world of individuals with Alzheimer’s disease is a captivating read for anyone affected personally or professionally by the devastating disease. Individuals with early-stage Alzheimer’s disease will take comfort in the voice of a fellow traveler experiencing similar challenges, frustrations, and triumphs. Family and professional caregivers will be enlightened by Taylor’s revealing words, gaining a better understanding of an unfathomable world and how best to care for someone living in it.

CONNECTING WITH THE INNER SELF: ALZHEIMER AND YOGA

Local Alzheimer's patients are one with a new yoga class

Instead of focusing on what they cannot remember, residents at the Newton and Wellesley Alzheimer Center are learning something new: Yoga.

"Yoga is new to all of them," said instructor Maggie Sky of Roots & Wings Yoga and Healing Arts in Natick, which offers the classes at the center. On a recent afternoon, 15 people chatted, laughed and happily anticipated a yoga class. Sky turned on soft music and encouraged the group to relax and breathe slowly. Everyone began to focus. "Often they don't remember the poses between classes," she said. But there's repetition in the postures and breathing, and the structure of the class repeats itself each time, helping the residents to remember. "We focus on what they can do," added Sky. "Everything is modified, even the deep breathing. The essence of it is the same as any yoga class."

The concentration of the residents in the yoga class defied stereotypes about people with this common form of dementia. "It's good for the memory. It's good for the body," said Sky. "Doing the breathing and the postures, they are connecting with the inner self and each other. "The class members sat in chairs and on couches. Some had walkers; one was in a wheelchair. They listened. They moved their arms and legs with Sky's encouragement. They breathed deeply.

Dr. William Wiener, a neurologist with MetroWest Medical Center, said while Alzheimer's patients can continue with activities they were involved in before their symptoms began, it's unusual for them to learn a new activity because of their memory impairment. "I have Alzheimer's patients who swim every day, but they did that before," he said. He was intrigued to hear that yoga was new for these patients. "This is unique, at the very least. I'm an open-minded doctor. I don't immediately shut out alternative (therapies)." Weiner said it is important to keep Alzheimer's patients active. Patients with the disease often display impaired cognitive function but their bodies are sometimes still healthy and strong, and need exercising. "(They) should be encouraged to do anything that's safe to do within their capacity," he said.

The idea to offer yoga classes at the Newton and Wellesley Alzheimer Center was spearheaded by activities director Louise Arreano. "Corporate (Kindred Healthcare) wanted more exercise" for the residents, Arreano said. Some exercise programs in the past have been successful, others have not. "With this, they really participate," she said. Arreano called Roots & Wings director Karen Kuhl to ask if there was a teacher who could provide classes at the center. Kuhl and Sky wanted to give it a try and decided, with Arreano, to offer a bimonthly class through the summer. There are already plans to continue the classes in the fall. "We've been developing classes for underserved populations," said Kuhl, explaining that Roots & Wings offers varied programs, such as chair yoga for multiple sclerosis patients and therapeutic yoga for youngsters with special needs. "This was such a good match."

At the class, the residents listened intently to Sky. "Notice how the music feels in your body," she said. Encouraging them to breathe slowly and deeply "from your belly," she said, "(notice) the belly expands when you breathe in and falls when you breathe out." As the participants stretched their arms over their heads, Sky told them to "reach for the stars....This keeps your back flexible." Sky said sometimes the participants are engaged and active, other times they sleep or doze through the class, depending on medication they might be taking or other activities or treatments they had that day. Wiener said some patients with Alzheimer's may remember the poses or the breathing exercises better than others. And some may not remember them at all. "If the patients don't carry over the skill, it's not so bad because they have the benefit of the experience," he said.

Back in the class, Sky encouraged the participants to give lots of love to themselves and to "give yourself a hug, give yourself a kiss." Perhaps not moves found in a conventional yoga class but ones that suited these patients and their needs. "A lot of this is touch with them," said Arreano, the center's activities director. "That's the most important thing with them is the touch."

Sky has received positive feedback from caregivers, too. Some participate in the class with their elders. "It gives them a connection," Sky said. "That's my observation. Several of them are expressing interest" in yoga for themselves. But the widest smiles belong to the residents. "It's like yoga was made for them," Arreano said. "They know, they know, they really do, that it is good for their bodies and minds. And they love, love Maggie."

Newton and Wellesley Alzheimer Center is at 694 Worcester Road (Rte. 9), Wellesley. For more information, visit www.nw-alzheimer.com.

Roots & Wings Yoga and Healing Arts is at 317 North Main St., Natick. For more information, visit www.rootsandwingshealingarts.com or call 508-315-8088.

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Framingham, MA - The MetroWest Daily News

SIGNS OF PRE-DEMENTIA

Small signs of pre-dementia can do much to address in time a better diagnosis of the neurodegenerative diseases.

A study done by a team of researchers at the University of Oxford, studied, for 20 years, a group of 241 healthy elderly volunteers with specially designed tests to measure their intellectual abilities and cognitive skills. After reviewing the results, the researchers realized that there were small signs on some of those people who betrayed a subsequent health problems.
There is apparently little indicative factors that are easy to detect. These are related to language. In particular, patients who developed mild cognitive impairment or predemencia "had problems with tasks requiring speech, language learning and memorization.
Simple things like difficulty remembering the names of common objects or problems in terms of expressing an idea or meaning of a word are evidence to consider. The fact is that this takes its meaning: in Alzheimer's disease, the first symptoms start with these little details. Hence the importance of locating early in order to start as soon as possible the appropriate treatment.

A GLOBAL APPROACH :::: ATTENDING SUBJECTIVITY

In 2050, 115 million of people could be affected by Alzheimer's Disease

A GLOBAL APPROACH ON ALZHEIMER IS NEEDED

Next year, 35,6 millions of people will suffer Alzheimer. According with Daisy Acosta, Alzheimer's Disease International's president, Goverments and Health Systems arround the wold must face up to social, medical and economic issues related to this disease.
But, from my point of view, they should be in mind not only these macro-dimensions but the people who make up these dimensions as well (micro-dimension). I mean, people affected by AD (person, family, caregivers...) should be approached in a global way by researchers and all those who are involved in understanding this reality.

- The cause of the disease,
- How the life style of the person living with AD was before the diagnosis and how it is after,
- How he/she feels (physically and psychologically) in a pervious and a mild stage,
- How the person interact with others and with his/her environment
- How his/her memory is but also how the person is able to do and to feel at present (the real abilities in the right moment)
- What the caregivers and family need and feel
- How they should be interact with people with AD

We should have in mind all the dimensions of the people affected by AD, in order to understand the needs of all them or even in order to contribute modestly to know why AD is developed and in this way to be able to prevent it.

SUBJECTIVITY REFLECTION::::TAKING ADVICE FROM A PERSON WITH ALZHEIMER

PASQUAL MARAGALL INTERVIEW
(La Vanguardia, 20th October 2009)

¿Pero cree que a la investigación del alzhéimer le hace falta una revolución conceptual, que por el camino marcado no se avanza lo suficiente?
Ya hace cien años que se conoce el alzhéimer, y como no hay mal que cien año dure, ya toca que llegue un gran avance. Si se fija, las personas que tenemos alzhéimer nos refugiamos mucho en refranes, como no hay mal que cien años dure, podemos olvidar dónde hemos dejado las llaves, pero no olvidamos las poesías, las canciones, los refranes… Esto se nos queda en el hipocampo, aquí en el cerebro subiendo a mano izquierda.

Por su experiencia personal, ¿qué consejos daría a una persona que se enfrenta a un diagnóstico de alzhéimer?
Le diría que no deje de hacer cosas. Que disfrute. Que no lo convierta en una tragedia porque no lo es, pero acaba siéndolo si uno se empeña. Que se lo tome con humor. Que se interese por los demás. Y que se ejercite, tanto físicamente como mentalmente. Yo, personalmente, casi cada martes juego a ping pong. Camino mucho. Hago sudokus, y los acabo. Y psicológicamente me ha ocurrido una cosa curiosa.

¿Qué le ha ocurrido?
Me he convertido en un enfermo de la captura de imágenes. Capturo el momento con la cámara del móvil y puedo guardarlo. O enviarlo y compartirlo. Es un entretenimiento fantástico. Pero no creo que tenga que ver con el alzhéimer. Esta afición por los gadgets me viene de hace mucho tiempo.

Y a los familiares de una persona con alzhéimer, ¿qué consejos les daría?
Que no sean sobreprotectores, que dejen un grado de libertad. Sufren, le protegen en exceso y, sin querer, le perjudican. La familia debe ayudar al paciente a ser tan autónomo como pueda.

To read the complete interview click here
You can translate this post on the bottom of this weblog

WITHOUT MEMORY, IS THERE NOTHING OR IS THERE EVERYTHING? LIFE IS FOR LIVING

Alzheimer Person Reflection

HIS WORDS... It's full of these things... it's not good to just sit there and do nothing, because... well... it's going down... yeah... it's terrible all that...ohh forget it! (laughters)... life is for living

From my point of view, living with this condition brings you to enjoy the present, the now... We must reinforce this aspect when communicate with people with AD. We should talk with and listen to people with Alzheimer because they can teach us a lot about what living means. Why traveling back or foreward all time? Why not enjoy what we are and we have at present? We are not just memory, but subjective human beings that need memory to survive daily, to communicate with others... but we are still able of being ourselves, of enjoying life in spite of not having past memories... the person is still here, his subjectivity.

Let's learn about Alzheimer and humanity from another approach!

To watch the clip click here
Again... thanks Lucas!

Alzheimer's Association: list of warning signs for Alzheimer's disease and related dementias

The warning signs of Alzheimer’s disease

How to understand the difference between typical age-related changes in memory and those derived from Alzheimer’s disease.

click here

IDENTIFYING MILD COGNITIVE IMPAIRMENT

to see the film click the link bellow:

HBO: Documentaries: The Alzheimer's Project: Watch the Films: The Supplementary Series: Identifying Mild Cognitive Impairment

Ronald Petersen, MD, Ph.D-Mayo Clinic

Topic: This film highlights the importance of distinguishing among the various dementias that can occur with aging.

COMMUNICATIVE INTERACTION: GRANDPA, DO YOU KNOW WHO I AM?

to see the film click the link bellow:

HBO: Documentaries: The Alzheimer's Project: Watch the Films: Grandpa, Do You Know Who I Am? With Maria Shriver

Topic: This film tells five stories of children, ages 6-15, who are coping with grandfathers or grandmothers suffering from Alzheimer's Disease.

YOGA, COGNITIVE FUNCTIONS AND DEMENTIA

Yoga therapy can be used to treat those suffering from dementia, since there are no other effective means to counter this disease properly.

This point was highlighted during a support group meeting on Saturday at Sandhya Kirana, an old-age home, to help family members of persons with dementia. The meeting was organized by Alzheimer's and Related Disorders Society of India.

Hari Prasad from Nimhans spoke on how yoga can be used as a therapy, and he gave a presentation on using this method properly. "Currently, there is no single approved treatment method for dementia. I suggest yoga may work," he said.
He highlighted two forms of yoga for dementia patients. One is the preventive method, which addresses risk factors, reduces depression, hypertension and memory impairment. The other is curative, which prevents progression of the disease, improves quality of life and cognition in mild and moderate stages. Depending on the patient and the person's background, the yoga method can be moderated. "Yoga has an overall benefit through various methods like asanas, pranayama, kriya, mudras and meditation. It helps strengthen muscles, improves respiration, etc. It leads to a tranquilized state of mind," he explained. Caretakers of dementia patients were also asked to do yoga. This is because they may get irritated and depressed while taking care of unresponsive patients.

"Yoga is open for all ages," he added.

Source: BANGALORE, Karnataka / The Times of India / April 12, 2009

YOGA AND PSYCHOLOGY Language, Memory and Mysticism by Harold G. Coward

In part one of the book, Coward establishes the centrality of language to yoga. Here his thesis is bold and clear - that language has inherent within itself the power to convey knowledge both of a sensuous and a super sensuous kind, and to realize release. In the second part he discusses Freud, Jung and some transpersonal psychologists' perspectives on yogic issues like dualism and the possibility of an almost immaterial, ego-less knowing, the eradication of desires and of the unconscious, and free will.

The most relevant for our research issue is that Coward establishes in detail the centrality of trustworthy linguistic communications: the importance of testimony. According to Coward, there are divisions of Indian schools depending on the "degree of revealing power allowed to words" (p12). Verbal communication (agama) is one of three sources of valid knowledge (pramana) in Indian thought, (along with perception (pratyaksa) and inference (anumana)). Verbal communication functions when a trusted observer (apta), transfers his or her knowledge to us and is valid "if it is not deceptive, confused or barren in knowledge" (p. 12). The apta has to be "skilled and compassionate in the passing on of knowledge" (p.12), and not prone to any twisting of the knowledge for fame or fortune. Of course, the verbal communication may still fail if the mind of the hearer is too 'covered with karmic impurity' or too distracted to pay attention.

Yoga is thus a set of techniques for permitting the committed yogin to become one with Isvara (Isvara is defined as pure sattva (transparent consciousness) by a special kind of self or purusa that is beginninglessly untouched by the taints of karmas), a mystical fusion that entails losing one's impure personal ego. Language is central to this mystical experience since in it sound and meaning become one. "It is Isvara who is expressed by the word AUM: the sound of the word evokes its meaning" (p17). The relation between word and meaning here is not by convention" the relationship between Isvara and the word AUM is fixed like a lamp and its light" (Vyasa cited in p. 17).

Yoga teaches freedom and release from the individual ego rather than the cultivation of ego-strength or uniqueness endorsed in the west, entails a loss of individual ego. Yoga entails the belief that the true nature of objects can be encountered when we have transcended all of the material apparatus of body, senses and to some extent individual mind. Yoga is not about control of the object, but of changing the subject. It has a very precise array of techniques and practices to achieve that, involving postures, breath-control, taming of the fluctuations of the mind as a result of wandering senses, and an exquisite attention to the role that habits of mind and perception play in distorting our grasp of reality so that we can counter these habits, and be open to what is. With meditative practice one becomes so subtly aware of the way that past traces, emotions and a kind of sloth or heaviness marks one's consciousness that one can root out those tendencies to an ever-increasing degree. Coward suggests that Yoga assumes that when 'egoity' (sic) is overcome there is no further duality between subject and object, only immediate intuition.

From my point of view, through all this knowledge we can try finding an alternative and complementary way to investigate what the "tipping point" is in which communication/interaction breaks off in people with Alzheimer and how cognitive functions (memory, attention) are involved and interact with language.

Click Book Reference: Yoga and Psychology Language, Memory, and Mysticism by Harold G. Coward SUNY Press, 2002

ALZHEIMER'S DISEASE: ADVANCES AND CHALLENGES

One of the most frightening and devastating of all neurological disorders is the dementia that occurs in the elderly. The most common cause of this illness is Alzheimer’s disease (AD). World over it is estimated that 26 million people are living with Alzheimer's and by 2050 the number is expected to quadruple.

The earliest symptoms of AD include forgetfulness; disorientation to time or place; and difficulty with concentration, calculation, language, and judgment. As the disease progresses, some patients have severe behavioral disturbances and may even become psychotic. The diagnosis depends on medical history, physical and neurological examinations, psychological testing, laboratory tests, and brain imaging studies. At present, however, final confirmation of the diagnosis requires examination of brain tissue, usually obtained at autopsy. ate caution must be taken.

The causes and mechanisms of the brain abnormalities underlying AD are not yet fully understood. Reductions occur in levels of markers for many neurotransmitters, including acetylcholine, somatostatin, monoamines, and glutamate, that allow cells to communicate with one another. Damage to these neural systems, which are critical for attention, memory, language, learning, and higher cognitive abilities, is believed to cause the clinical symptoms. Currently approved treatments do not modify the course of the disease and offer only temporary mitigation of some symptoms of AD, such as agitation, anxiety, unpredictable behavior, sleep disturbances, and depression.

Within the past three to five years, greater appreciation has developed for the surprisingly important roles that diet and lifestyle play in determining risk for AD. Cognitive activity, physical activity, and heart-healthy diets lower the risk for AD, while obesity, high blood pressure, high cholesterol, metabolic syndrome, and diabetes raise the risk. Some evidence indicates that successful management of these cardiovascular risks can delay the onset or
slow the progression of dementia.

Society for Neuroscience

RECOMMENDED BOOKS

- Davis, Boyd (ed.). (2005). Alzheimer Talk, Text, and Context: Enhancing Communication. New York: Palgrave-McMillan.
- Guendouzi, J. and Müller, N. .(2006). Approaches to Discourse in Dementia. Mahwah, NJ: Lawrence Erlbaum.
- Hamilton, Heidi E. (1994). Conversations with an Alzheimer's Patient: An Interactional Sociolinguistic Study. Cambridge: Cambridge University Press.
- Hamilton, Heidi E. (2003). Glimmers: A Journey Through Alzheimer's Disease. Ashland, OR: RiverWood Books.
- Radvansky, G. A. (2006). Human Memory. Allyn & Bacon.
- Ramanathan, V. (1997). Alzheimer discourse: Some sociolinguistic dimensions. Mahwah, NJ: Lawrence Erlbaum.
- Sabat, S. (2001). The experience of Alzheimer's Disease: Life through a tangled veil. Oxford: Blackwell.
- Stemmer, B. (1998). Handbook of neurolinguistics. San Diego: Academic Press.
- van Dijk, Teun A. (2008). Discourse and Context: A Sociocognitive Approach. Cambridge: Cambridge University Press

- van Dijk, T.A. (1997) ‘Cognitive Context Models and Discourse’, in M. Stamenov (ed.)
Language Structure, Discourse and the Access to Consciousness, pp. 189–226. Amsterdam:
John Benjamins.