Sunday, February 14, 2016

Too Few Older Adults Tell Doctors About Memory Loss:

Too Few Older Adults Tell Doctors About Memory Loss: Study

Experts believe it's often a taboo subject due to fears of dementia

By E. J. Mundell
Thursday, January 28, 2016
HealthDay news image
THURSDAY, Jan. 28, 2016 (HealthDay News) -- Do you worry that forgetting names, or where you put your keys, might be a sign of impending dementia? If you're like most older Americans, you don't bring this up with your doctor, a new study shows.
Researchers who looked at federal government data on more than 10,000 people found that in 2011, only 1 in 4 adults aged 45 or older discussed memory problems with a health care professional during a routine checkup.
In fact, the likelihood that a person would admit to a memory problem in a doctor's office visit actually declined with advancing age, says a team led by Mary Adams, of On Target Health Data in West Suffield, Conn.
The findings were published Jan. 28 in the journal Preventing Chronic Disease.
"Routine checkups are a missed opportunity for assessing and discussing memory problems for the majority of older adults," Adams said in a journal news release.
Experts agreed that the stigma around memory loss and dementia may hold people back from discussing these issues with their physicians.
"Because dementia is unfortunately an all too common illness, older adults are quite familiar with its heralding signs and symptoms, which they have painfully observed in a long time neighbor or a family member," said Dr. Gisele Wolf-Klein, director of geriatric education at Northwell Health in New Hyde Park, N.Y.
"This reality leads to denial and avoidance, both on the part of the patient and the physician," she said. "'As long as we don't mention it, maybe it's just normal aging.'"
But mentioning memory troubles is important, because it doesn't necessarily have to herald dementia, Wolf-Klein said. "Memory loss may well not be due to dementia, but another highly treatable condition, such as depression," she noted.
And if it is linked to dementia, recognizing that fact early is crucial, she said.
"Patients can promptly meet with family members and elder law advisers, who can best help them in making individualized decisions for their care, rather than rely on last-minute decisions completed by family members at a time when patients now lack capacity," Wolf-Klein said.
Dr. Bruce Polsky is chair of the department of medicine at Winthrop-University Hospital in Mineola, N.Y. He acknowledged that talking about "memory loss and the possibility of the early development of dementia is a difficult discussion for both the physician and patient, mostly because of the long-term implications."
But early diagnosis of dementia can be important, he said.
"Even mild memory loss associated with early Alzheimer's disease may be improved with some of the medicines now available, although these medications do not stop the progression of the disease," he said. "Lifestyle modifications, such as smoking cessation, may also be of value in some cases."
"Although it is difficult for individuals to assess whether their own subtle memory loss is 'normal' or not, open discussion with their physician and, in some cases, testing may result in answers that could potentially lead to treatment and improved functioning," according to Polsky.
SOURCES: Gisele Wolf-Klein, M.D., director, geriatric education, Northwell Health, New Hyde Park, N.Y.; Bruce Polsky, M.D., chairman, department of medicine, Winthrop-University Hospital, Mineola, N.Y.; Jan. 28, 2016, Preventing Chronic Disease

Bladder Health

About Bladder Health

People rarely talk about bladder health, but everyone is affected by it. Everyone uses their bladder many times each day. But they may not know what to do to keep their bladder healthy.

What is the bladder?

The bladder is a hollow organ, much like a balloon, that stores urine. Pelvic floor muscles help hold urine in the bladder. The bladder is located in the lower abdomen. It is part of the urinary system, which also includes the kidneys, ureters, and urethra.

Why do we make urine?

The urinary system makes and stores urine. The body gets nutrients from what we eat and drink. But the body can’t use all parts of foods and drinks. After your body takes what it needs from foods and drinks, it has to get rid of the leftover wastes. The kidneys help remove these wastes and extra water by filtering them out of the blood to make urine. The urine made in the kidneys travels through the ureters to the bladder. The urine is stored in the bladder until you are ready to urinate. When you urinate, the urine exits the body through the urethra.

Daily Urination

Each day, adults pass about a quart and a half of urine through the bladder and out of the body. A quart and a half of urine would fill four 12 ounce cans of soda. But the exact amount of urine made each day is different for every person. The amount of urine you make changes based on the following factors.
  • How much fluid you take in. This includes fluids from foods as well as drinks.
  • How much fluid you lose by sweating. You may sweat more when the weather is warmer.
  • How much fluid you lose by breathing. You may lose more water when you breathe heavily -- such as during physical activity.
  • The medicines you take. Some medicines can change the amount of urine you make. Ask your health care professional if your medicines can affect the amount of urine you make.

How Aging Affects the Bladder

As you get older, the bladder changes. The elastic bladder tissue may toughen and become less stretchy. A less stretchy bladder cannot hold as much urine as before and might make you go to the bathroom more often. The bladder wall and pelvic floor muscles may weaken. Weak bladder wall muscles may make it hard to empty the bladder fully. Weak pelvic floor muscles may make it hard to hold urine in the bladder, which may cause urine to leak.

Bladder Problems and Everyday Life

Bladder problems are very common, and they can really lower a person’s quality of life (the person’s level of health, comfort, and happiness). In fact, people with bladder problems may have a lower quality of life than people with diabetes, heart disease, or high blood pressure. Bladder problems can disrupt day-to-day life. When people have bladder problems, they may avoid social settings, such as faith meetings, community gatherings, and family get-togethers. Bladder problems can also make it hard to get tasks done at home or at work.

Common Bladder Problems

Common bladder problems include the following.
  • Lower urinary tract symptoms (LUTS) -- a group of symptoms such as trouble urinating, loss of bladder control, leaking of urine, and frequent need to urinate. LUTS are caused by problems with the bladder, urethra, or pelvic floor muscles.
  • Bladder infection (cystitis) -- the most common type of urinary tract infection (UTI).  A bladder infection means that bacteria (or germs) have entered the bladder and are causing symptoms, such as having strong and sudden urges to urinate or having to urinate frequently.
  • Bladder cancer: cancer in the lining of the bladder.
    Learn more about bladder cancer from the National Cancer Institute.

Bladder Problems and the Prostate in Men

Bladder problems occur more often in women, but they are also quite common in men. The reasons for the problems can be different in men and women. Men have a prostate gland that surrounds the opening of the bladder. While most tissues get smaller with aging, the prostate gets bigger.
When it gets too big, it can restrict the flow of urine through the urethra. This can make it hard to start urinating, cause the urine stream to be slow, and prevent men from completely emptying the bladder.

About Alzheimer's Disease: Other Dementias

About Alzheimer's Disease: Other Dementias

Asian coupleWhat is dementia?

Dementia is the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities to such an extent that it interferes with a person’s daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living.
Many conditions and diseases cause dementia. The most common cause of dementia in older people is Alzheimer’s disease. Other causes include different kinds of brain changes that lead to vascular dementia, Lewy body dementia, and frontotemporal disorders.
In addition, some people have mixed dementia—a combination of two or more disorders, at least one of which is dementia. A number of combinations are possible. For example, some people have Alzheimer’s disease and vascular dementia at the same time.
Other causes of dementia include Huntington’s disease, Creutzfeldt-Jakob disease, head injury, and HIV. In addition, some conditions that cause dementia, such as normal pressure hydrocephalus, thyroid problems, and vitamin B deficiency, can be reversed with appropriate treatment. For an overview of all types of dementia, see the booklet The Dementias: Hope Through Research. For more information about these conditions, visit the National Institute of Neurological Disorders and Stroke.

Vascular dementia

Vascular dementia, considered the second most common form of dementia after Alzheimer’s disease, results from injuries to the vessels supplying blood to the brain, often after a stroke or series of strokes. Vascular dementia and vascular cognitive impairment arise as a result of risk factors that similarly increase the risk for cerebrovascular disease (stroke), including atrial fibrillation, hypertension, diabetes, and high cholesterol. The symptoms of vascular dementia can be similar to those of Alzheimer’s, and both conditions can occur at the same time. Symptoms of vascular dementia can begin suddenly and worsen or improve during one’s lifetime.
Some types of vascular dementia include:
Research has shown that Alzheimer's and vascular disease-associated cognitive impairment are closely intertwined. For example, a large proportion of people diagnosed with Alzheimer's also have brain damage caused by vascular disease. In addition, several studies have found that many of the major risk factors for vascular disease may also be risk factors for Alzheimer's.
The overlap between these two types of dementia may be important because medications and lifestyle changes known to help prevent vascular disease, such as controlling high blood pressure, lowering cholesterol, and engaging in physical activity, may also help prevent Alzheimer's disease.

See also:

Lewy body dementia

Lewy body dementia (LBD) is another common brain disorder in older people. LBD is caused by abnormal deposits of a protein called alpha-synuclein in the brain. These deposits, called Lewy bodies, can lead to problems with thinking, movement, behavior, and mood. For example, symptoms may include changes in alertness and attention, hallucinations, tremor, muscle stiffness, sleep problems, and memory loss.
The two types of LBD are:
  • Dementia with Lewy bodies, in which cognitive symptoms appear within a year of movement problems
  • Parkinson’s disease dementia, in which cognitive problems develop more than a year after the onset of movement problems
Lewy body dementia can be hard to diagnose because Parkinson's disease and Alzheimer's disease cause similar symptoms. Scientists think that LBD might be related to these diseases, or that they sometimes happen together.

See also:

For health care professionals:

Frontotemporal disorders

Frontotemporal disorders are a form of dementia caused by a family of brain diseases known as frontotemporal lobar degeneration (FTLD). These disorders are the result of damage to neurons (nerve cells) in parts of the brain called the frontal and temporal lobes. As neurons die in the frontal and temporal regions, these lobes atrophy, or shrink. Gradually, this damage causes difficulties in thinking and behaviors controlled by these parts of the brain. Many possible symptoms can result. They include strange behaviors, emotional problems, trouble communicating, or difficulty with walking and other basic movements.
Frontotemporal disorders can be grouped into three types, defined by the earliest symptoms physicians identify when they examine patients. The following conditions are frontotemporal disorders:

See also:

Mixed dementia

Autopsy studies looking at the brains of people who had dementia suggest that a majority of those age 80 and older probably had “mixed dementia,” caused by processes related to both Alzheimer’s disease and vascular disease. In fact, some studies indicate that mixed vascular-degenerative dementia is the most common cause of dementia in the elderly. In a person with mixed dementia, it may not be clear exactly how many of a person’s symptoms are due to Alzheimer’s or another type of dementia. In one study, about 40 percent of people who were thought to have Alzheimer’s were found after autopsy to also have some form of cerebrovascular disease. Several studies have found that many of the major risk factors for vascular disease also may be risk factors for Alzheimer’s disease.
Researchers are still working to understand how underlying disease processes in mixed dementia influence each other. It is not clear, for example, if symptoms are likely to be worse when a person has brain changes reflecting multiple types of dementia. Nor do we know if a person with multiple dementias can benefit from treating one type, for example, when a person with Alzheimer’s disease controls high blood pressure and other vascular disease risk factors.

Other conditions that cause dementia

Thursday, January 28, 2016

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