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UVA School of Medicine

Families and Caregivers

Levels of knowledge on Alzheimer’s

Demographic and Contextual Factors Related to Knowledge About Alzheimer's Disease discusses the results obtained from 763 participants who completed the Alzheimer’s Disease Knowledge Scale, a 30 question true/false survey adopted from the ADKT designed to assess an individual’s understanding of Alzheimer’s on several dimensions including etiology, risk factors, course of the disease, and prevalence. The questionnaire was created for a wide range of groups including students, health care practitioners, and the general public. In the current study, the participating groups included undergraduate students, caregivers of someone with dementia, senior center staff, and professionals involved in dementia research and service provision. Not surprisingly, the knowledge of Alzheimer’s was highest among professionals working in the field. However, senior center staff and undergraduate students were significantly less knowledgeable on the disease. Overall, it appears that the respondents knew the most about assessment, treatment, and management of Alzheimer’s. They knew the least about risk factors and prevention, with the senior center staff scoring the worst in this category. The differences between Caucasian and African-American respondents were not significantly different, while Caucasian’s scored higher than Asian and multi-racial respondents.

Understanding where the gaps in knowledge about Alzheimer’s exist can help to guide education initiatives to increase awareness and improve supportive services.  Given that a recent survey by the American Society on Aging and Met-Life found that 72% of respondents seek information on brain health from medical professionals, it seems that a tool such as the ADKS would prove useful to practitioners in anticipating and meeting these knowledge needs.

U.Va. Students Reach Out to Community Members with Alzheimer's Disease

January 25, 2011 — Helping some local residents with Alzheimer's disease hang on to their memories for a little longer is the goal of a group of University of Virginia students who are volunteering at a Charlottesville assisted living facility.

Every week while the University is in session, 16 students from the Curry School of Education's communications disorders master's degree program are visiting with residents of the RoseWood Village at Greenbrier Drive Innovations memory care unit. Under the supervision of professors Jane Hilton and Randall Robey, they spend an hour in activities and conversations that stimulate residents to talk about their memories.

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The Vanishing Mind: Giving Alzheimer's Patients Their Way, Even Chocolate

New York Times Article
By PAM BELLUCK

Published: January 01, 2011

A Phoenix nursing home has found that unlimited chocolate, and other comforts, go a long way in reducing patients' distress.

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Prescribing Aspirin for those with Alzheimer’s

The recent review Aspirin in Alzheimer’s Disease points out that Aspirin may not be as beneficial for those with Alzheimer’s as previously believed. These findings are generally due to the 3.2% increase in incidence of intracerebral hemorrhage found in clinical trials looking at the use of low-dose Aspirin in this population. It is possible that cerebral amyloid angiopathy, a common pathological finding in Alzheimer’s patients, may increase their likelihood of ICH. This hypothesis is supported by the high prevalence of Alzheimer’s-associated microbleeds, an expression of amyloid angiopathy on neuroimaging. Signs of these microbleeds could potentially be used to identify patients at risk for developing ICH. Aspirin therefore is not recommended, unless there is a clear cardiovascular indication, such as a history of stroke or myocardial infarction.

Modifiable Risk Factors for Dementia

With the expected dramatic increase in the incidence and prevalence of dementia, articles such as, Promising Strategies for the Prevention of Dementia, which serve to outline successful prevention and treatment strategies are of utmost importance. This is especially true given that a delay in the onset of Alzheimer’s by just five years would reduce the prevalence by more than one million cases. Some of the most promising strategies for this prevention include vascular risk factor control, cognitive and physical activity, social engagement, diet, and treatment of depression.

Vascular risk factor reduction

Although Alzheimer’s and vascular dementia have previously been thought of as distinct disorders, evidence exists that the two rarely occur in isolation. Additionally, the presence and severity of cerebrovascular pathologic findings appear to increase the risk and severity of Alzheimer’s. Therefore, improving ones cardiovascular health may also reduce the risk of dementia. Cardiovascular risk factors include hypertension, dyslipidemia, diabetes, and metabolic syndrome. Most importantly, each of these risk factors appears to be additive. Fortunately, studies indicate that people who receive treatment for hypertension, both in midlife and late-life have a reeducated risk of developing cognitive impairment. Likewise, statin therapy is associated with a reduced risk of Alzheimer’s and other dementias.                          

Cognitive activity

Older adults with higher educational attainment have a lower incidence of dementia, possibly due to cognitive reserve. This is true even in those with Alzheimer’s-related neuropathologic changes. In line with this, cognitive activity has been shown to reduce ones risk of cognitive decline. For instance, people who engage in mentally stimulating activities such as learning, reading, or playing games are less likely to develop dementia. It is now evident that occupation and leisure activities also play a role in improving cognitive reserve.

Physical activity

People who are physically active are at a reduced risk for cognitive decline and dementia. This benefit is seen after just four months of exercise training. With the new understanding of the role cardiovascular health plays in dementia, physical activity may help to alleviate vascular risks associated with Alzheimer’s.

Social engagement

People with limited social engagement may be more likely to develop dementia. Therefore, visits with friends and relatives, going to clubs, senior centers, attending religious activities, or volunteering may be protective against developing cognitive impairment. Interventions that include cognitive, physical, and social components may offer the best outcome in reducing cognitive impairment.

Diet

Many of the cardiovascular risk factors associated with dementia may be modified through diet. Elderly consuming a Mediterranean diet, having higher fruit and vegetable intake, and regular consumption of fish, may have a lower risk of developing dementia. Reasons behind are largely attributed to antioxidants and polyunsaturated fatty acids.

Depression

Many people with dementia also have depression, which in itself has been associated with reduced cognitive performance. It is unclear whether depression is a risk factor for dementia or whether it is a prodromal symptom. However, treatment of depression seems to improve cognitive function.

 

 

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