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March 9, 2016
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Scientists Report Finding ‘Gray Hair’ Gene

Researchers say they’ve pinpointed the first gene linked with gray hair.Arcadia-Image - 006

They said the discovery, culled from a genetic analysis of more than 6,000 people of mixed ancestry in Latin America, proves that genes play a role in graying hair.

“We already know several genes involved in balding and hair color, but this is the first time a gene for graying has been identified in humans, as well as other genes influencing hair shape and density,” said study author Kaustubh Adhikari, from University College London, in England.

“It was only possible because we analyzed a diverse melting pot of people, which hasn’t been done before on this scale. These findings have potential forensic and cosmetic applications as we increase our knowledge on how genes influence the way we look,” he said in a college news release.

The gene linked with gray hair is called IRF4. The international team of researchers said it was known to play a role in hair color, but this is the first time it has been connected with the graying of hair.

Along with possibly helping find ways to delay hair graying, the gene might improve understanding of aging, the researchers said.

The researchers also found that another gene called PRSS53 seems to  influence hair curliness.

“It has long been speculated that hair features could have been influenced by some form of selection, such as natural or sexual selection, and we found statistical evidence in the genome supporting that view,” Adhikari said.

“The genes we have identified are unlikely to work in isolation to cause graying or straight hair, or thick eyebrows, but have a role to play along with many other factors yet to be identified,” he said.

The study was published March 1 in the journal Nature Communications.

SOURCE: http://www.medicinenet.com/script/main/art.asp?articlekey=194039

February 29, 2016
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When brain injury becomes a family affair

Arcadia-Image - 040Right now, more than 5 million people across the nation are living with the effects of a brain injury. Even more startling,  nearly 1.5 million people will acquire a new brain injury before the end of the year.

While these estimations alone are frightening, consider the many more millions of family members and loved ones left in the wake. March is Brain Injury Awareness Month — the perfect time to open a meaningful dialogue about the devastating effects of a brain injury on family dynamics and social relationships.

As a neuropsychologist with one of the premier brain injury treatment facilities in the region, I have both researched and seen the impact of moderate to severe brain injury on family functioning.

After a moderate to severe brain injury, an individual may experience physical symptoms such as residual pain and fatigue, and challenges with cognitive abilities such as language, memory and problem solving. Caregivers often experience depression, anxiety, somatic symptoms, social isolation and lower life satisfaction.  Furthermore, both the caregiver and the person with brain injury impact each other’s well-being.

Following the injury, family roles and relationships change.  Many family members grieve the loss of their loved one’s personality. The behavioral and emotional symptoms are often most difficult to manage, and each family member can be affected differently. Parents of adult children often resume the parental role. Spouses and siblings develop a new caregiving role.

About 75 percent of post-brain-injury caregivers are women, and more than two-thirds hold a job in addition to caring for a loved one. The pressure to properly rehabilitate a child, parent or spouse, on top of the individual’s cognitive and emotional challenges, creates the perfect storm for caregiver burnout and an unhealthy family dynamic.

Family needs change across the spectrum of care, from acute treatment to post-acute rehabilitation.  These needs include obtaining more information, managing uncertainty about the future, adapting to changes, finding more services or resources, coordinating care, and increasing peer and professional support.

With the right tools and knowledge of healthy recovery, families can improve quality of life for themselves and the individual with brain injury. The following may help a caregiver and his or her family adjust to the “new normal” after a loved one suffers a brain injury:

  • Become active in support and intervention groups. These groups provide families with tools for education, communication and problem-solving as well as crisis intervention and caregiver referrals for respite. Caregivers in support groups show declines in distress, lower levels of depression and greater self-esteem, and they report fewer trips to their physician for physical and mental illness.
  • Establish a strong and therapeutic relationship with your loved one’s clinical team. Successful and thorough brain injury treatment requires an interdisciplinary team including a neuropsychologist, medical physician and physical, occupational and speech therapists, to name just a few. Establishing open and frequent communication with a patient’s care continuum will reduce caregiver stress and allow a family to focus on strengthening their relationships rather than deciphering complex medical information.
  • Practice self-care and remain committed to favorite pastimes. It’s easy for a caregiver and his or her family to become consumed with their loved one — caregiving is a tall task, and a family will need to navigate many immense changes and obstacles at once. However, it’s crucial for family members to continue in activities they enjoyed before a brain injury. Did you have a standing coffee night with a colleague? Book club? Shopping with friends? To the best of your ability, maintain things you love and don’t neglect your own needs during this period of change and adjustment.

Family dynamics may shift and change as you adjust to a new life post-injury, but patients and their families often discover new ways to enjoy their time together. Go easy on yourself — especially during the first year in a caregiving role — and never be afraid to ask for help and advice from your loved one’s care team.

SOURCE: http://www.courierpostonline.com/story/life/2016/02/26/when-brain-injury-becomes-family-affair/81001326/

Dr. Alison Tverdov is a neuropsychologist at Bancroft NeuroRehab whose research was recently published in Brain Injury, the research journal of the International Brain Injury Association. Learn more by calling (844) 234-8387 or visiting www.bnrinfo.org to connect with an expert.

February 9, 2016
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9 Tips for Coping with Agitation and Aggression

Arcadia-Image - 109As Alzheimer’s progresses, people may become more agitated or aggressive. Check out 9 tips for handling it.


Agitation means   that a person is restless or worried. He   or she doesn’t seem to be able to settle   down. Agitation may cause pacing,   sleeplessness, or aggression, which   is when a person lashes out verbally or   tries to hit or hurt someone.

Causes of Agitation and Aggression

Most of the time, agitation and aggression happen for a reason. When they happen, try  to find the cause. If you deal with the causes, the behavior may stop. For example, the  person may have:

    • Pain, depression, or stress
    • Too little rest or sleep
    • Constipation
    • Soiled underwear or diaper
    • Sudden change in a well-known place, routine, or person
    • A feeling of loss—for example, the person may miss the freedom to drive
    • Too much noise or confusion or too many people in the room
    • Being pushed by others to do something—for example, to bathe or to remember

events or people—when Alzheimer’s has made the activity very hard or impossible

  • Feeling lonely and not having enough contact with other people
  • Interaction of medicines

Look for early signs of agitation or aggression. If you see the signs, you can deal with  the cause before problem behaviors start. Try not to ignore the problem. Doing nothing  can make things worse.
A doctor may be able to help. He or she can give the person a medical exam to find any   problems that may cause agitation and aggression. Also, ask the doctor if medicine is  needed to prevent or reduce agitation or aggression.

Tips for Coping

Here are some ways you can cope with agitation or aggression:

  1. Reassure the person. Speak calmly. Listen to his or her concerns and frustrations. Try to show that you understand if the person is angry or fearful.
  2. Allow the person to keep as much control in his or her life as possible.
  3. Coping with changes is hard for someone with Alzheimer’s. Try to keep a routine, such as bathing,  dressing, and eating at the same time each day.
  4. Build quiet times into the day, along with activities.
  5. Keep well-loved objects and photographs around the house to help the person feel more secure.
  6. Try gentle touching, soothing music, reading, or walks.
  7. Reduce noise, clutter, or the number of people in the room.
  8. Try to distract the person with a favorite snack, object, or activity.
  9. Limit the amount of caffeine, sugar, and “junk food” the person drinks and eats.

Here are some things you can do:

  • Slow down and try to relax if you think your own worries may be affecting the person with Alzheimer’s.
  • Try to find a way to take a break from caregiving.

Safety Concerns

When the person is aggressive, protect yourself and others. If you have to, stay at a safe  distance from the person until the behavior stops. Also try to protect the person from  hurting himself or herself.

SOURCE:

  • ADEAR The Alzheimer’s Disease Education and Referral (ADEAR) Center is a service of the National Institute on Aging,  part of the National Institutes of Health. The Center offers information and publications for families, caregivers,   and professionals about Alzheimer’s disease and age-related cognitive changes.

February 9, 2016
by adminWordpress1
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7 Ways to Lower Your Risk of Alzheimer’s

 

There are some easy things you can do to prevent developing Alzheimer’s:

  1. Add cinnamon to your diet – consuming a teaspoon of this spice has been shown to block the production of proteins in the brain that contribute to the onset of Alzheimer’s.
  2. Drink apple juice – it boosts the production of a chemical compound in the brain associated with learning, memory, mood and muscle movement.
  3. Drink coffee – it acts as an anti-inflammatory that can block cholesterol buildup in the brain. One large study showed that men and women who drank three to five cups of coffee a day reduced their chances of dementia by 65 percent.
  4. Socialize more – studies show that a busy social life can improve your cognitive abilities.
  5. Protect your vision – your eyes are a good indicator of how your brain is functioning. Preserving your vision can actually cut your dementia risk by 63 percent.
  6. Meditate – this will lower your blood pressure and reduce stress, and it increases blood flow to the brain, which is why researchers believe it helps us retain mental acuity as we age.
  7. Eat a Mediterranean diet – a diet rich in leafy greens, fish, fruit, nuts and a little red wine can cut your dementia risk in half because it’s chock full of brain-protecting antioxidants.

Taking steps to prevent dementia now will help cut your risk of developing Alzheimer’s disease as you age.

SOURCE: ALZHEIMER’S AND DEMENTIA WEEKLY

January 13, 2016
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6 Steps to Help Keep a Lid on Your Prescription Drug Costs

Rising medicine prices are a pain for many, but experts have a prescription to help you keep the cap on your costs. Arcadia-Image - 366 Almost half of U.S. residents take at least one prescription drug each month, up from 4 in 10 about 20 years ago, according to the Centers for Disease Control and Prevention. For people ages 55 to 64, 1 in 5 takes five or more prescription drugs. It’s no wonder the CDC estimates we spent more than $271 billion on prescribed medicines in 2013, the latest year for complete figures. That’s more than double the dollars spent in 2000. Most of that was spent at retail drug stores, estimates the Kaiser Family Foundation. And that’s where consumers can start to save money, Consumer Reports says. Those covered by insurance often don’t notice, but the price retailers charge can vary widely, even within the same ZIP code, CR said after secret shoppers surveyed more than 200 pharmacies nationwide. They checked prices for one-month supplies of five common generic drugs. The results:

  • Actos (pioglitazone), for type 2 diabetes: Price ranged from $9 to $150.
  • Cymbalta (duloxetine), an antidepressant also used to treat muscle and bone pain: From $11 to $220
  • Lipitor (atorvastatin), for high cholesterol: $11 to $146
  • Plavix (clopidogrel), a blood thinner: $9 to $150
  • Singulair (montelukast), for asthma: $15 to $144

CR also reported that to save money, many people split pills or skip medication doses, don’t bother filling prescriptions or forgo medical appointments and treatments altogether. The CDC says nearly 1 in 10 did not take their medication as prescribed, 1 in 7 asked a doctor for a lower-cost medication, fewer than 2 in 100 bought prescription drugs from another country, and nearly 5 in 100 used alternative therapies. But, if you want to save money on prescriptions, there are better strategies. Try these instead, says CR:

  1. Skip chain drugstores. For all five drugs CR priced, the big pharmacy chains consistently charged the most. Among all of the walk-in stores, Costco offered the lowest prices.
  2. Support independents. CR found some real bargains at local independent pharmacies, where pharmacists might have more flexibility to match or beat competitors’ prices. You have to be able to haggle. It also found wide fluctuations at supermarkets, another place you might not expect to save.
  3. Don’t always use your health insurance. Many chain and big-box stores offer hundreds of common generics at prices as low as $4 for a 30-day supply and $10 for a 90-day supply for people who pay out of pocket. Sam’s Club even fills some prescriptions for free for members. Check the fine print.
  4. Always ask, “Is this your lowest price?” A Costco spokesman told CR that its contracts for Medicare Part D plans prohibit pharmacists from offering a better cash price to a customer unless a customer asks. And Rite Aid told CR its pharmacists process prescriptions through insurance unless customers tell them to do otherwise. Asking can prompt the person on the phone to dig a bit for any available discount programs, cards and coupons.
  5. Seek a 90-day prescription. For drugs you take over the long term, it can be more convenient and even cheaper. For example, if you use insurance, you’ll pay one co-pay rather than three. And for discount generic drug programs, paying $10 for a 90-day supply works out to less than $4 every 30 days.
  6. Look online. If you’re paying out of pocket, check GoodRx.com to learn its fair price and use that to negotiate if a pharmacist quotes you a higher price. You can also fill a prescription with an online pharmacy, but be careful. The one CR shopped, HealthWarehouse.com, had the lowest prices overall. Just be careful about the one you choose. Only use an online retailer that clearly operates within the United States and displays the VIPPS symbol to show that it’s a Verified Internet Pharmacy Practice Site.

SOURCE: http://www.moneytalksnews.com/6-steps-help-keep-lid-your-prescription-drug-costs/?utm_source=newsletter&utm_campaign=email-2015-12-29-am&utm_medium=email

January 12, 2016
by Arcadia Home Care & Staffing
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Tips for caregivers of Alzheimer’s patients

According to the Alzheimer’s Foundation of America, it is estimated one to four family members act asArcadia-Image - 458 caregivers to a loved one with the disease. These numbers are only expected to increase dramatically in the upcoming years, as the baby boomer generation continues to reach retirement age. It is estimated the elderly population will double by 2050 to 88.5 million.

Those who serve as a caregiver to someone with Alzheimer’s disease will have bad days and good, just like the people they are caring for. However, there are ways to make the experience a little bit easier by keeping a few things in mind.

First, it’s important for the caregiver to put themselves in the place of the patient.  Understanding how a patient thinks will help the caregiver deal with their own emotions better.  This way of thinking is no different than how you deal with a child throwing a tantrum.  Once you understand why the child is throwing their fit, it is easier to have empathy and deal with their meltdown.  The same principle applies to a patient with dementia.

Remember that those who have cognitive impairment usually do not dwell on bad events for too long because of their disease. As a result, the caregiver should not focus and become upset about something that happens for a long period of time.  What you’re holding onto out of frustration or anger, the patient has long sense forgotten.

Also, those with the disease tend to adjust to change well, especially those who are in the mid- to late-stages of it. In fact, caregivers tend to suffer more greatly with change than the senior, simply because the patient doesn’t really remember what changed to begin with.

One of the best ways to lower a caregiver’s distress level is to remember the Alzheimer’s patient is not thinking about their future. They are not experiencing any anxiety about what will happen next because they do not have the mental capacity to do so.

For the caregiver, keeping these points in mind when you’re having the best days, or the worst, will help relieve your stress or anxiety.  Thinking this way, especially if you’re a caregiver to a loved one, may not come easy.  This way of thinking may take practice on your part.  Taking a step back, putting yourself in the patient’s mindset and then reminding yourself of these points may have to be done repeatedly until this way of thinking comes more naturally.

January 5, 2016
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4 Ways Seniors Can Stay Young

Retaining youthful exuberance can be quite a steep task for many aging adults. Physical and mental exhaustion both contribute to seniors losing the vibrancy and effervescence that they used to put on display during their younger days. Just because the odds are stacked against them does not mean that aging adults have to resort to a sedentary lifestyle where they are confined to their beds, couches, and chairs, with little or no recreational activity and social interaction. As long as a person has the determination and the enthusiasm to make life enjoyable, he or she can succeed in doing so regardless of the age and the health complications that come along with it. After all, it’s not how old you are, but rather how old you feel. As far as aging adults are concerned, here are 4 simple ways in which they can feel young again:

1) Eating Healthfully

If you are what you eat, then eating healthfully will allow seniors to stay far away from mental and physical disorders. With age, human beings are required to alter their diet in order to eliminate as much unhealthy food from the menu as possible. The ideal diet for an aging adult should consist of cooked fruits, vegetables, yogurt, nuts, and small portions of white meat protein or beans. Regular meals based on these foods will keep their bodies supplied with sufficient energy and allow them to gain the physical strength required to carry out their favorite indoor and outdoor activities. Eating healthfully also reduces the risk of anxiety disorders and untimely mood swings.

2) Socializing

One of the simplest and easiest ways of staying and feeling young is by socializing with people of similar ages and backgrounds. If seniors refrain from socializing and keep themselves bound within the four walls of their house, then they are simply asking for a bunch of mental and physical illnesses to infiltrate their bodies. The more they communicate and converse with people, the easier it will be for them to tackle the hardships of aging.

3) Exercising

The benefits of physical exercise cannot be stressed enough, especially in the case of seniors. Exercising keeps the body rejuvenated and the mind refreshed. It prevents seniors from being inflicted with a number of different diseases. Heavy workout sessions are not recommended for aging adults. Rather, light exercises such as brisk walking, slow dancing, and stretching (in the form of yoga, perhaps) can help them rise above the physical restraints and limitations that accompany old age.

4) LearningArcadia-Image - 018

One of the reasons why seniors feel old is because they lose the excitement and zeal that comes with learning something new and discovering something extraordinary. Since most seniors stay detached from the workplace and academic institutions, it becomes difficult for them to come across new sources of learning. Enrolling in a library or joining a book club can solve this problem. There is no end to learning, and the sooner seniors realize this, the faster they will develop the desire to engage in intriguing learning activities. Besides, joining a book club or a library offers a getaway from the monotony and boredom of retirement life. Some say that age is only a number. We like to think of age as a perception of who you are. As long as seniors believe that there is a lot more that they can take from life, and give back to it, they will continue to feel young in their hearts. Ron Burg is a writer for Alreadyhomecare.com and he primarily writes about senior care and home care. SOURCE: http://eldercareabcblog.com/4-ways-seniors-can-stay-young/

December 29, 2015
by Samantha Jeckewicz
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10 Drugs That May Cause Memory Loss

For a long time doctors dismissed forgetfulness and mental confusion as a normal part of aging. But scientists now know that Arcadia-Image - 366memory loss as you get older is by no means inevitable. Indeed, the brain can grow new brain cells and reshape their connections throughout life.

Most people are familiar with at least some of the things that can impair memory, including alcohol and drug abuse, heavy cigarette smoking, head injuries, stroke, sleep deprivation, severe stress, vitamin B12 deficiency, and illnesses such as Alzheimer’s disease and depression.

But what many people don’t realize is that many commonly prescribed drugs also can interfere with memory. Here are 10 of the top types of offenders.

Drugs That May Cause Memory Loss

1. Antianxiety drugs
2. Cholesterol drugs
3. Antiseizure drugs
4. Antidepressant drugs
5. Narcotic painkillers
6. Parkinson’s drugs
7. Hypertension drugs
8. Sleeping aids
9. Incontinence drugs
10. Antihistamines

1. Antianxiety drugs (Benzodiazepines)

Why they are prescribed: Benzodiazepines are used to treat a variety of anxiety disorders, agitation, delirium and muscle spasms, and to prevent seizures. Because benzodiazepines have a sedative effect, they are sometimes used to treat insomnia and the anxiety that can accompany depression.

Examples: Alprazolam (Xanax), chlordiazepoxide (Librium), clonazepam (Klonopin), diazepam (Valium), flurazepam (Dalmane), lorazepam (Ativan), midazolam (Versed), quazepam (Doral), temazepam (Restoril) and triazolam (Halcion).

How they can cause memory loss: Benzodiazepines dampen activity in key parts of the brain, including those involved in the transfer of events from short-term to long-term memory. Indeed, benzodiazepines are used in anesthesia for this very reason. When they’re added to the anesthesiologist’s cocktail of meds, patients rarely remember any unpleasantness from a procedure. Midazolam (Versed) has particularly marked amnesic properties.

Alternatives: Benzodiazepines should be prescribed only rarely in older adults, in my judgment, and then only for short periods of time. It takes older people much longer than younger people to flush these drugs out of their bodies, and the ensuing buildup puts older adults at higher risk for not just memory loss, but delirium, falls, fractures and motor vehicle accidents.

If you take one of these meds for insomnia, mild anxiety or agitation, talk with your doctor or other health care professional about treating your condition with other types of drugs or nondrug treatments. If you have insomnia, for instance, melatonin might help. Taken before bedtime in doses from 3 to 10 mg, melatonin can help to reestablish healthy sleep patterns.

Be sure to consult your health care professional before stopping or reducing the dosage of any benzodiazepine. Sudden withdrawal can trigger serious side effects, so a health professional should always monitor the process.

2. Cholesterol-lowering drugs (Statins)

Why they are prescribed: Statins are used to treat high cholesterol.

Examples: Atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor) and simvastatin (Zocor).

How they can cause memory loss: Drugs that lower blood levels of cholesterol may impair memory and other mental processes by depleting brain levels of cholesterol as well. In the brain, these lipids are vital to the formation of connections between nerve cells — the links underlying memory and learning. (The brain, in fact, contains a quarter of the body’s cholesterol.)

A study published in the journal Pharmacotherapy in 2009 found that three out of four people using these drugs experienced adverse cognitive effects “probably or definitely related to” the drug. The researchers also found that 90 percent of the patients who stopped statin therapy reported improvements in cognition, sometimes within days. In February 2012, the Food and Drug Administration ordered drug companies to add a new warning label about possible memory problems to the prescribing information for statins.

Alternatives: If you’re among the many older Americans without known coronary disease who are taking these drugs to treat your slightly elevated LDL (“bad”) cholesterol and low HDL (“good”) cholesterol), ask your doctor or other health care provider about instead taking a combination of sublingual (under-the-tongue) vitamin B12 (1,000 mcg daily), folic acid (800 mcg daily) and vitamin B6 (200 mg daily). 

3. Antiseizure drugs

Why they are prescribed: Long used to treat seizures, these medications are increasingly prescribed for nerve pain, bipolar disorder, mood disorders and mania.

Examples: Acetazolamide (Diamox), carbamazepine (Tegretol), ezogabine (Potiga), gabapentin (Neurontin), lamotrigine (Lamictal), levetiracetam (Keppra), oxcarbazepine (Trileptal), pregabalin (Lyrica), rufinamide (Banzel), topiramate (Topamax), valproic acid (Depakote) and zonisamide (Zonegran).

How they can cause memory loss: Anticonvulsants are believed to limit seizures by dampening the flow of signals within the central nervous system (CNS). All drugs that depress signaling in the CNS can cause memory loss.

Alternatives: Many patients with seizures do well on phenytoin (Dilantin), which has little if any impact on memory. Many patients with chronic nerve pain find that venlafaxine (Effexor) — which also spares memory — alleviates their pain.

4. Antidepressant drugs (Tricyclic antidepressants)

Why they are prescribed: TCAs are prescribed for depression and, increasingly, anxiety disorders, eating disorders, obsessive-compulsive disorder, chronic pain, smoking cessation and some hormone-mediated disorders, such as severe menstrual cramps and hot flashes.

Examples: Amitriptyline (Elavil), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil) and trimipramine (Surmontil).

How they can cause memory loss: About 35 percent of adults taking TCAs report some degree of memory impairment and about 54 percent report having difficulty concentrating. TCAs are thought to cause memory problems by blocking the action of serotonin and norepinephrine — two of the brain’s key chemical messengers.

Alternatives: Talk with your health care provider about whether nondrug therapies might work just as well or better for you than a drug. You might also want to explore lowering your dose (the side effects of antidepressants are often dose-related) or switching to a selective serotonin/norepinephrine reuptake inhibitor (SSRI/SNRI). Of the drugs in this category, I find venlafaxine (Effexor) to have the fewest adverse side effects in older patients.

5. Narcotic painkillers

Why they are prescribed: Also called opioid analgesics, these medications are used to relieve moderate to severe chronic pain, such as the pain caused by rheumatoid arthritis.

Examples: Fentanyl (Duragesic), hydrocodone (Norco, Vicodin), hydromorphone (Dilaudid, Exalgo), morphine (Astramorph, Avinza) and oxycodone (OxyContin, Percocet). These drugs come in many different forms, including tablets, solutions for injection, transdermal patches and suppositories.

How they can cause memory loss: These drugs work by stemming the flow of pain signals within the central nervous system and by blunting one’s emotional reaction to pain. Both these actions are mediated by chemical messengers that are also involved in many aspects of cognition. So use of these drugs can interfere with long- and short-term memory, especially when used for extended periods of time.

Alternatives: In patients under the age of 50 years, nonsteroidal anti-inflammatory drugs (NSAIDs) are the frontline therapy for pain. Unfortunately, NSAID therapy is less appropriate for older patients, who have a much higher risk of dangerous gastrointestinal bleeding. Research shows the risk goes up with the dosage and duration of treatment.

Talk with your doctor or other health care provider about whether tramadol (Ultram), a nonnarcotic painkiller, might be a good choice for you. In my practice, I often recommend supplementing each 50 mg dose with a 325 mg tablet of acetaminophen (Tylenol). While there are prescription drugs that combine tramadol and acetaminophen, these products have only 37.5 mg of tramadol, and in my practice I’ve found that patients generally need the larger dose. 

6. Parkinson’s drugs (Dopamine agonists)

Why they are prescribed: These drugs are used to treat Parkinson’s disease, certain pituitary tumors and, increasingly, restless legs syndrome (RLS).

Examples: Apomorphine (Apokyn), pramipexole (Mirapex) and ropinirole (Requip).

How they can cause memory loss: These meds activate signaling pathways for dopamine, a chemical messenger involved in many brain functions, including motivation, the experience of pleasure, fine motor control, learning and memory. As a result, major side effects can include memory loss, confusion, delusions, hallucinations, drowsiness and compulsive behaviors such as overeating and gambling.

Alternatives: If you are being treated for RLS, ask your doctor or pharmacist whether one of your prescription or over-the-counter medications may be the trigger. Potential culprits include many antinausea and antiseizure medications, antipsychotic drugs with tranquilizing effects, some antidepressants, and some cold and allergy medications. In this case, your RLS — and memory problems — could potentially be resolved by simply replacing the offending medication with another drug.

7. Hypertension drugs (Beta-blockers)

Why they are prescribed: Beta-blockers slow the heart rate and lower blood pressure and typically are prescribed for high blood pressure, congestive heart failure and abnormal heart rhythms. They’re also used to treat chest pain (angina), migraines, tremors and, in eyedrop form, certain types of glaucoma.

Examples: Atenolol (Tenormin), carvedilol (Coreg), metoprolol (Lopressor, Toprol), propranolol (Inderal), sotalol (Betapace), timolol (Timoptic) and some other drugs whose chemical names end with “-olol.”

How they can cause memory loss: Beta-blockers are thought to cause memory problems by interfering with (“blocking”) the action of key chemical messengers in the brain, including norepinephrine and epinephrine.

Alternatives: For older people, benzothiazepine calcium channel blockers, another type of blood pressure medication, are often safer and more effective than beta-blockers. If the beta-blocker is being used to treat glaucoma, I recommend talking with your health care professional about potentially using a carbonic anhydrase inhibitor, such as dorzolamide (Trusopt), instead.

8. Sleeping aids (Nonbenzodiazepine sedative-hypnotics)

Why they are prescribed: Sometimes called the “Z” drugs, these medications are used to treat insomnia and other sleep problems. They also are prescribed for mild anxiety.

Examples: Eszopiclone (Lunesta), zaleplon (Sonata) and zolpidem (Ambien).

How they can cause memory loss: Although these are molecularly distinct from benzodiazepines (see No. 1 above), they act on many of the same brain pathways and chemical messengers, producing similar side effects and problems with addiction and withdrawal.

The “Z” drugs also can cause amnesia and sometimes trigger dangerous or strange behaviors, such as cooking a meal or driving a car — with no recollection of the event upon awakening.

Alternatives: There are alternative drug and nondrug treatments for insomnia and anxiety, so talk with your health care professional about options. Melatonin, in doses from 3 to 10 mg before bedtime, for instance, sometimes helps to reestablish healthy sleep patterns.

Before stopping or reducing the dosage of these sleeping aids, be sure to consult your health care professional. Sudden withdrawal can cause serious side effects, so a health professional should always monitor the process. 

9. Incontinence drugs (Anticholinergics)

Why they are prescribed: These medications are used to relieve symptoms of overactive bladder and reduce episodes of urge incontinence, an urge to urinate so sudden and strong that you often can’t get to a bathroom in time.

Examples: Darifenacin (Enablex), oxybutynin (Ditropan XL, Gelnique, Oxytrol), solifenacin (Vesicare), tolterodine (Detrol) and trospium (Sanctura). Another oxybutynin product, Oxytrol for Women, is sold over the counter.

How they can cause memory loss: These drugs block the action of acetylcholine, a chemical messenger that mediates all sorts of functions in the body. In the bladder, anticholinergics prevent involuntary contractions of the muscles that control urine flow. In the brain, they inhibit activity in the memory and learning centers. The risk of memory loss is heightened when the drugs are taken for more than a short time or used with other anticholinergic drugs.

A 2006 study of oxybutynin ER, for example, found its effect on memory to be comparable to about 10 years of cognitive aging. (“In other words,” as the study’s lead author put it, “we transformed these people from functioning like 67-year-olds to 77-year-olds.”)

Older people are particularly vulnerable to the other adverse effects of anticholinergic drugs, including constipation (which, in turn, can cause urinary incontinence), blurred vision, dizziness, anxiety, depression and hallucinations.

Alternatives: As a first step, it’s important to make sure that you have been properly diagnosed. Check with your doctor or other health professional to see if your urinary incontinence symptoms might stem from another condition (such as a bladder infection or another form of incontinence) or a medication (such as a blood pressure drug, diuretic or muscle relaxant).

Once these are ruled out, I’d recommend trying some simple lifestyle changes, such as cutting back on caffeinated and alcoholic beverages, drinking less before bedtime, and doing Kegel exercises to strengthen the pelvic muscles that help control urination.

If these approaches don’t work out, consider trying adult diapers, pads or panty liners, which can be purchased just about anywhere. They can be worn comfortably (and invisibly) under everyday clothing and virtually eliminate the risk of embarrassing accidents. In my experience, many patients are reluctant to try this approach, but once over the initial hurdle, come to prefer it for security and peace of mind.

Correction: An earlier version of this article mistakenly implied that mirabegron (Myrbetriq), which the FDA approved last year for the treatment of overactive bladder, is an anticholinergic drug; in fact, it is in a new class of medications called beta-3 adrenergic agonists and is not expected  to cause memory loss seen with anticholinergic medications. There currently are no data describing the effect of Myrbetriq on cognition.

10. Antihistamines (First-generation)

Why they are prescribed: These medications are used to relieve or prevent allergy symptoms or those of the common cold. Some antihistamines are also used to prevent motion sickness, nausea, vomiting and dizziness, and to treat anxiety or insomnia.

Examples: Brompheniramine (Dimetane), carbinoxamine (Clistin), chlorpheniramine (Chlor-Trimeton), clemastine (Tavist), diphenhydramine (Benadryl) and hydroxyzine (Vistaril).

How they can cause memory loss: These medications (prescription and over-the-counter) inhibit the action of acetylcholine, a chemical messenger that mediates a wide range of functions in the body. In the brain, they inhibit activity in the memory and learning centers, which can lead to memory loss.

Alternatives: Newer-generation antihistamines such as loratadine (Claritin) and cetirizine (Zyrtec) are better tolerated by older patients and do not present the same risks to memory and cognition.

Ask the Pharmacist is written by Armon B. Neel Jr., PharmD, CGP, in collaboration with journalist Bill Hogan. They are coauthors of Are Your Prescriptions Killing You? (Atria Books).

SOURCE: http://www.aarp.org/health/brain-health/info-05-2013/drugs-that-may-cause-memory-loss.html#quest1

December 17, 2015
by Samantha Jeckewicz
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How Stress Can Tip Us Over the Edge

Arcadia-Image - 409For stress to get to the point where we become ill at least two factors are important. First, it isn’t just the length of time you’re under stress it’s also the extent to which you become over-aroused. By arousal I’m referring to physical and mental alertness. Secondly, it’s our perception of stress that makes people different. There are certainly circumstances that could be regarded as universally stressful, but in our day-to-day lives you’ll have noticed clear differences in the way some people perceive issues as stressful and others don’t.

In 1908 the psychologists Robert Yerkes and John Dodson suggested that our performance levels increase in line with our physical or mental arousal. However, if arousal becomes too high our performance decreases. The model is usually represented as a bell-shaped curve and has stood the test of time very well.

 Let’s translate the curve to our everyday experiences by starting at point ‘A’ on the diagram. You’re asleep at this point, so your level of arousal and your performance is as low as it’s likely to get. As you wake up and stumble around looking for your first coffee your level of arousal is still pretty low. Your brain is barely engaged and being asked to do anything complex at this point is likely to lead to under performance. As you warm up to the day your levels of arousal and performance begin to peak. This is point ‘B’ on the diagram. Perhaps you’ve grabbed a newspaper and have taken the train to work? By the time you arrive you’re ready for what the day has to throw at you.

So far so good, but then the pressure points take hold. To the people around you seem as competent and capable as ever. Your efficiency and calm might crack a little and nobody can see the rate at which you’re paddling trying to stay afloat. We can all do this of course but keep it up for too long and things start to happen. You become more tired, more prone to making mistakes, more irritable, anxious and worried. Day after day this keeps happening and at some point you’re a pressure cooker without a release valve, something has to give.

Your stress reaction might take different forms. You may find yourself with increased physical symptoms like a knot that seems to have taken up residence in your stomach or abdomen. Your muscles may become tense. You get headaches when you never used to, or more often than before. You seem to catch every cough and sneeze available. For others the symptoms can seem to come from nowhere. You have a panic attack, you erupt in a temper, or maybe find yourself tearful for no apparent reason. You’ve either reached point ‘X’ on the diagram or you’re well on the way to. Once upon a time people would have said you’re on your way to a nervous breakdown. It’s a term we don’t use anymore but you get the gist. If you live your life in the X zone it’s only a matter of time until your body and mind gives up. At this point you could become clinically depressed and completely unable to function.

SOURCE: http://www.healthcentral.com/anxiety/c/674/178615/stress-tip-edge/?ic=6043&sp_rid=MTAzNjczNDcwNzQxS0&sp_mid=8359656

December 15, 2015
by Samantha Jeckewicz
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Researchers Say They Find Genes Linked to Alzheimer’s Timing

Researchers say they have discovered a network of nine genes that may play a role in the development of Alzheimer’s disease.

Some of the genes seem to delay disease onset by up to 17 years, while others hasten its progress. This discovery may one day help lead to new treatments for the disease that affects up to 35 million people worldwide, the scientists said.

“If you can work out how to decelerate the disease, then you can have a profound impact,” lead researcher Mauricio Arcos-Burgos, an associate professor and medical geneticist from the School of Medical Research at the Australian National University, said in a university news release.

“I think it will be more successful to delay the onset of the disease than to prevent it completely. Even if we delay the onset by on average one year, that will mean 9 million fewer people have the disease in 2050,” he added.

For the study, published Dec. 1 in the journal Molecular Psychiatry, the researchers conducted a genetic study of 5,000 members of a family in Colombia with high rates of hereditary Alzheimer’s. The scientists concluded that the family’s predisposition to the disease is due to a gene mutation in one ancestor who came to the region about 500 years ago.

The U.S. National Institutes of Health has committed $170 million for research to develop new treatments for Alzheimer’s, and those treatments will be tested in this family, the study authors said.

– Robert Preidt

SOURCE: http://www.medicinenet.com/script/main/art.asp?articlekey=192283&ecd=mnl_sen_121015