Medicaid Florida

Learning How to Communicate with Someone Suffering From Alzheimer's Disease

2011-04-12T15:12:00.000-04:00

As I thought about this I came to a simple conclusion. Instead of trying to change Alzheimer's World, instead of trying to fight Alzheimer's World, not only would I accept Alzheimer's World as a reality, I would go into Alzheimer's World and learn how to communicate effectively...

By Bob DeMarco
Alzheimer's Reading Room

Earlier today, Carole Larkin published an interesting article -- How the Loss of Memory Works in Alzheimer’s Disease, and How Understanding This Could Help You.

The article described in layman's terms how problems with short term memory are directly related to the region of the brain known as the hippocampus; and, how when this brain region stops functioning properly a person losses their ability to store information.

A person suffering from Alzheimer's disease can hear you and even respond to you. What they can't do is remember what the hell you just said. Well, in layman's terms anyway.

I grappled with this problem several years ago as I was constructing my own understanding of how Dotty was thinking (or not thinking) and feeling. I named the parallel universe that Dotty lives in -- Alzheimer's World.

To continue reading go here -- Learning How to Communicate with Someone Suffering From Alzheimer's Disease

Reading, Engaging, and Communicating with an Alzheimer's Patient (Podcast))

2010-09-16T10:23:00.001-04:00

By Bob DeMarco

Take the extra step. Walk the extra yard. Engage. Keep on living. Don’t be afraid to try things. Do things that you have always done together. Don’t let anyone discourage you or get in your way.

Make your own parade and have fun.

Click the button above to listen. If you don't see the podcast button go here. You are welcome to comment, share or embed this podcast.

If you would like to hear my Alzheimer's patient, Dotty, read and interact with me -- go here.

More About the Alzheimer's Reading Room

Alzheimer's Caregivers Advice and Insight (20 articles)
Test Your Memory for Alzheimer's (5 Best Self Assessment Tests)
Alzheimer's Disease Statistics
What is Alzheimer's?
Alzheimer's and Driving
Alzheimer's Caregiving Dealing with Behavior
Dementia and the Eight Types of Dementia

Bob DeMarco is the editor of the Alzheimer's Reading Room and an Alzheimer's caregiver. Bob has written more than 1,690 articles with more than 70,000 links on the Internet. Bob resides in Delray Beach, FL.

Original content Bob DeMarco, the Alzheimer's Reading Room

2-1-1 Get Help

2010-05-24T09:58:00.001-04:00

Every hour of every day, hundreds of people need essential human services - they are looking for training, employment, food pantries, help for an aging parent, addiction prevention programs for their teenage children, affordable housing options, support groups and ways of becoming part of their community. 2-1-1 allows people to give help and to get help.

clipped from 211us.org

Caregiving -- Insight and Advice
Test Your Memory for Alzheimer's (5 Best Self Assessment Tests)
Alzheimer's Disease Statistics

What is Alzheimer's? What are the Eight Types of Dementia?

Seventy Percent of Alzheimer's and Dementia Patients Do Not Receive Treatment Early On

2010-01-28T08:32:00.001-05:00

Decision Resources, one of the world’s leading research and advisory firms focusing on pharmaceutical and healthcare issues, finds that 70.7 percent of newly diagnosed Alzheimer’s disease patients do not receive treatment within a year of being diagnosed.....

By Bob DeMarco

I moved to Delray Beach, Florida more than six years ago to take care of my mother, Dorothy, who now suffers from Alzheimer's disease. I didn't know it at first, but my mother was suffering from mild cognitive impairment (MCI) when I arrived on the scene. MCI is often a precursor to Alzheimer's disease and dementia.

It is my belief that the early detection of the disease in my mother is the reason why we had a good outcome using Aricept, Namenda, and other medications. The introduction of an exercise program, an active social life, and healthy eating are major factors in slowing the progression of the disease. All of these above help control behavior problems that are also associated with Alzheimer's disease.

I wish I had the information in this article at the beginning of our trip down Alzheimer's land -- I didn't.

The Combination of Aricept and Namenda Helps Slow the Rate of Decline in Alzheimer's Patients
__________________________________
In the beginning, I decided to move into my mother's condominium and keep her in her own home. I did this because I concluded after reading some of the literature that moving her into a new environment would be too difficult and disconcerting for her. As a result, I ended up living in an over 55 community with a large fraction of the residence 75 years or older. When it comes to Alzheimer's and dementia I have received an eye opening education.

One by one I have watched friends and acquaintances of my mother fall into dementia. More often than not their children do little or nothing as the disease starts to progress. The children often watch the parent deteriorate until there is no alternative to full time care. I watched as one person had one automobile accident, then a second before their children concluded there was something wrong. I watched another go from mild dementia to full blown Alzheimer's almost overnight because nothing was being done by the family, or the personal care physician.

I suggested to them that they get some memory testing, and/or a neurological or geriatric consult. They didn't listen.

In the future I will start adding this, I hope you don't regret your decision not to move on this. (I'll say this to myself, I hope I am wrong and it doesn't get worse -- much worse -- then you could ever imagine).

It is only after you become a caregiver that you begin to understand the importance of early diagnosis. Believe it or not, as hard as caring for someone with Alzheimer's can be, it is likely to be much worse if you stick your head in the sand.

I doubt that many people understand that not only are they hurting the person suffering from dementia by failing to action -- they are hurting themselves.
__________________________________
I learned, over these years, that most personal care physicians do not understand Alzheimer's or dementia. Many of them "let it slide". Some doctors seem to think there is nothing to do until things get bad. They are lacking in education about dementia and Alzheimer's. Either they don't know of the importance of early intervention, or they don't care.

I know I don't like things the way they are right now, and I know we need education and solutions.

This might sound harsh, but the number of persons with Alzheimer's is increasing fast; this and only this is going to make the medical community get up to date. There is lots of money to be made.
__________________________________
In the beginning, observing the children's lack of action made me very angry. Over time, I came to understand how difficult this situation can be for children that are busy living their own lives. Like I was, they are unequipped to understand Alzheimer's and dementia when it strikes. As adults we are not well equipped to become the parents of the parent. I never had that course in college. The children of baby boomers are going to get one heck of an education. The smart one's should start now -- get ahead of the curve.
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I now believe the single biggest reason Alzheimer's sufferers fail to get diagnosed early and get treatment is denial on the part of the children and the personal care doctor.

I know when the diagnosis comes, family and friends of the sufferer often can't believe it, and often refuse to believe the diagnosis. I have discussed this with many caregivers and many agree. It happened in our case--with family and friends. They just can't comprhend or accept Alzheimer's disease. This is now understandable to me. Alzheimer's is hard to understand and comprehend when you sit in the front row.
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Alzheimer's and dementia are hard to comprehend. I use the word comprehend with purpose. I recognized the situation with my mother, but it took me more than one full year to deal with the problem effectively. Keep in mind, this was all I was doing day and night--learning and assessing the alternatives. At that time, there wasn't much good information available. Fortunately, this has changed.

I learned on the job. Full time. I am now convinced that if I had not acted in the way I did, when I did, that something horrible would have happened. I base this on the fact that I have seen the horrible that comes with inaction and denial.
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I now have a better understanding of why seventy percent of Alzheimer's patients do not get diagnosed early. Many sufferers don't get diagnosed properly until they need full time care. Until they "can't do it anymore", or until something near devastiting happens. Automobile accident, lost and wandering, or a precipitous drop in health usually serves as a wake up call. But, not always.

If you are related to someone over 75, you really need to start getting educated now. If you know someone approaching 85, I suggest you start reading the books on Alzheimer's now.

Please know and try to understand this---nearly one out of every two persons over the age of 85 suffers from Alzheimer's or dementia.
__________________________________
I bet if I told you that you were going to die if you didn't lose 50 pounds you would do something about it. I bet if I told you were going to live to be 95 years old, you still wouldn't do anything to try and prevent Alzheimer's.

Consider this. When your brain starts dying you will lose the ability to do all these things: brush your teeth, take a shower, put your cloths on, take a poop, and eventually you won't be able to swallow. While this is happening your heart will still be working. You will still be breathing. Brain death is ugly.
__________________________________
My mother is 93 and she is still going. We were lucky we got her treated early on. Nevertheless, all the things I described above are happening.

What to do? I'll let you decide. If you want my opinion just ask.
__________________________________

Decision Resources, one of the world’s leading research and advisory firms focusing on pharmaceutical and healthcare issues, finds that 70.7 percent of newly diagnosed Alzheimer’s disease patients do not receive treatment within a year of being diagnosed.

The reasons for this are due to their denial, preference for no drug therapy, concerns about cost, or the side-effect and safety risks associated with drug treatment.

The report entitled Treatment Algorithms in Alzheimer’s Disease finds that surveyed neurologists primarily attribute their decision not to prescribe treatment for newly diagnosed Alzheimer’s disease patients to patient prerogatives.

Surveyed primary care physicians (PCPs) also cite presence of mild disease as a factor to delay drug treatment.

A Caregiver's Guide to Alzheimer's Disease: 300 Tips for Making Life Easier

Bob DeMarco is the editor of the Alzheimer's Reading Room and an Alzheimer's caregiver. Bob has written more than 1,050 articles with more than 8,000 links on the Internet. Bob resides in Delray Beach, FL.

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Does the Combination of Aricept and Namenda Help Slow the Rate of Decline in Alzheimer's Patients
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Original content Bob DeMarco, the Alzheimer's Reading Room

Caring for Our Parents (Book Review)

2009-07-19T20:55:00.000-04:00

This is a serious book by an accomplished journalist, writer--Howard Gleckman.

'If you are a Boomer, you should buy this book and put it on the coffee table. You will need it in the future to take care of yourself. The notes section of this book, alone, is worth the purchase price. The 22 pages of notes come in the form of a bibliography that you will be referring to over and over in the years ahead.

Caring for Our Parents is chock full of information and example that you, and I, will need as we age'. --Bob DeMarco, the Alzheimer's Reading Room

Caring for Our Parents: Inspiring Stories of Families Seeking New Solutions to America's Most Urgent Health Crisis

To continue reading go here.

Questions About Test Your Memory (TYM) for Alzheimers and Dementia

2009-06-14T18:20:00.001-04:00

On Wednesday, I published an article about a new memory test for Alzheimer's that can be administered in five minutes. The links to the test and scoring sheet are contained in the original article -- Test Your Memory (TYM) for Alzheimer's or Dementia in Five Minutes.

I am receiving emails from readers and I thought I would address two questions.

One reader asked, "I am curious to hear their opinion, about the level of education for the test taker, and its effect on the validity of the test".

The authors did not specifically assess the effect of education during their testing. In the BMJ article they wrote,

This ceiling effect suggests that education and social class would have only mild effects on the TYM score, but we did not formally assess this. The reason for the low scoring controls was often apparent from the score sheet—lack of interest, reading problems, or a sense of humour.

I will try to talk to researchers and get a clearer answer to this question.

Several readers are asking about the scoring system for the test.

The control group scored 47 out of 50 (ages 18-70).
A score equal to, or less than, 42 detects Alzheimer's 93 percent of the time.
Patients with Alzheimer's scored 33 out of 50.
The range of scores for patients with Alzheimer's was 9-50.

The main finding of this research

The new "test your memory" (TYM) test is quick to use, examines 10 cognitive skills, and detects 93% of cases of Alzheimer’s disease.

If you would like to read the highly technical paper which was published in the BMJ follow this link -- Self administered cognitive screening test (TYM) for detection of Alzheimer’s disease: cross sectional study.

Have a question, put it in the comments box.

This is the first draft of this article and it will be updated.

For more Insight into Alzheimer's Disease
Subscribe to The Alzheimer's Reading Room

Bob DeMarco is an Alzheimer's caregiver and editor of the Alzheimer's Reading Room. TheAlzheimer's Reading Room is the number one website on the Internet for insight into Alzheimer's disease. Bob taught at the University of Georgia, was an executive at Bear Stearns, the CEO of IP Group, and is a mentor. He has written more than 600 articles with more than 11,000 links on the Internet. Bob resides in Delray Beach, FL.

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2009-02-06T12:14:00.001-05:00

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TauRx Therapeutics-- New treatment halts progress of Alzheimer's disease

2008-08-09T12:12:00.000-04:00

clipped from alzheimersreadingroom.blogspot.com

The results of the Phase 2 study of TauRx's new treatment strongly suggest that it is possible to halt progression in mild and moderate Alzheimer's. TauRx is continuing to refine its treatment and hopes that restoration may be possible at least at the earlier stages with improved versions of its drug. Tangles are already destroying nerve cells in parts of the brain critical for memory in people in their fifties and upwards. The ultimate goal is to develop a product that is convenient for patients that could be widely used at the very earliest stages of the disease, long before patients experience the first symptoms of Alzheimer's.

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New Alzheimer’s Study Underscores Importance of Sustaining Viable Medicaid System

2008-03-25T12:56:00.000-04:00

New Alzheimer’s Study Underscores Importance of Sustaining Viable Medicaid System

Unraveling Alzheimer's secrets

2008-03-10T13:40:00.000-04:00

clipped from www.telegram.com

Kerley, 52, has spent much of her life in the shadow of an illness that gradually destroys memory, personality and the ability to think, speak and live independently. Her mother, grandmother and a maternal great-aunt all developed Alzheimer's disease. Her mother, 78, is in a nursing home in the advanced stages of dementia, helpless and barely responsive.

Currently, the diagnosis is not made until symptoms develop, and by then it may already be too late to rescue the brain.

A radioactive dye called PIB (for Pittsburgh Compound B) has made it possible to use PET scans to find deposits of amyloid, an Alzheimer's-related protein, in the brains of live human beings.

It may lead to earlier diagnosis, help doctors distinguish Alzheimer's from other forms of dementia

"PIB is being used today to help determine whether drugs that are meant to prevent or remove amyloid from the brain are working, so we can find drugs that prevent the underlying pathology of the disease."

Unraveling Alzheimer's secrets

Scientists searching for ways to detect disease early

By Denise Grady
The New York Times

For a perfectly healthy woman, Dianne Kerley has had quite a few medical tests in recent years: MRI and PET scans of her brain, two spinal taps and hours of memory and thinking tests.

Kerley, 52, has spent much of her life in the shadow of an illness that gradually destroys memory, personality and the ability to think, speak and live independently. Her mother, grandmother and a maternal great-aunt all developed Alzheimer's disease. Her mother, 78, is in a nursing home in the advanced stages of dementia, helpless and barely responsive.

"She's in her own private purgatory," Kerley said.

Kerley is part of an ambitious new scientific effort to find ways to detect Alzheimer's disease at the earliest possible moment. Although the disease may seem like a calamity that strikes suddenly in old age, scientists now think it begins long before the mind fails.

"Alzheimer's disease may be a chronic condition in which changes begin in midlife or even earlier," said Dr. John C. Morris, director of the Alzheimer's Disease Research Center at Washington University in St. Louis, where Kerley volunteers for studies.

Currently, the diagnosis is not made until symptoms develop, and by then it may already be too late to rescue the brain. Drugs now in use temporarily ease symptoms for some, but cannot halt the underlying disease.

Many scientists believe the best hope of progress, maybe the only hope, lies in detecting the disease early and devising treatments to stop it before brain damage becomes extensive. Better still, they would like to intervene even sooner, by identifying risk factors and treating people preventively - the same strategy that has markedly lowered death rates from heart disease, stroke and some cancers.

So far, Alzheimer's has been unyielding. But research now under way may start answering major questions about when the disease begins and how best to fight it.

A radioactive dye called PIB (for Pittsburgh Compound B) has made it possible to use PET scans to find deposits of amyloid, an Alzheimer's-related protein, in the brains of live human beings. It may lead to earlier diagnosis, help doctors distinguish Alzheimer's from other forms of dementia and let them monitor the effects of treatment. Studies with the dye have already found significant deposits in 20 percent to 25 percent of seemingly normal people over 65, suggesting that they may be on the way to Alzheimer's, though only time will tell.

"PIB is about the future of where Alzheimer's disease needs to be," said Dr. William E. Klunk, a co-discoverer of the dye at the Alzheimer's research center at the University of Pittsburgh. "PIB is being used today to help determine whether drugs that are meant to prevent or remove amyloid from the brain are working, so we can find drugs that prevent the underlying pathology of the disease."

Though PIB is experimental now, studies began in November that are intended to lead to government approval for wider use.

Currently, for the most common form of Alzheimer's disease, which occurs after age 65, there is no proven means of early detection, no definitive genetic test. But PIB tests might be ready before new treatments emerge, making it possible to predict who will develop Alzheimer's - without being able to help.

Researchers are also using MRI scans to look for early brain changes, and testing blood and spinal fluid for amyloid and other "biomarkers" to see if they can be used to predict Alzheimer's or find it early.

Studies of families in which multiple members have dementia are helping to sort out the genetic underpinnings of the disease.

Finally, experiments are under way to find out whether drugs and vaccines can remove amyloid from the brain or prevent its buildup, and whether doing so would help patients. The new drugs, unlike the ones currently available, have the potential to stop or slow the progress of the disease. At the very least, the drug studies will be the first real test of the leading theory of Alzheimer's, which blames amyloid for setting off a chain of events that ultimately ruin the brain.

Alzheimer's was first recognized 100 years ago, and in all that time science has been completely unable to change the course of the disease. Desperate families spend more than $1 billion a year on drugs approved for Alzheimer's that generally have only small effects, if any, on symptoms. Patients' agitation and hallucinations often drive relatives and nursing homes to resort to additional powerful drugs approved for other diseases such as schizophrenia, drugs that can deepen the oblivion and cause severe side effects such as diabetes, stroke and movement disorders.

Alzheimer's is the most common cause of dementia (artery disease, Parkinson's and other brain disorders can also lead to dementia). Five million people in the United States have Alzheimer's, most of them over 65. It is the nation's sixth leading cause of death by disease, killing nearly 66,000 people a year and probably contributing to many more deaths. By 2050, according to the Alzheimer's Association, 11 million to 16 million Americans will have the disease.

"Sixteen million is a future we can't countenance," said William H. Thies (pronounced thees), the association's vice president for medical and scientific relations. "It will bankrupt our health care system."

The costs are already enormous, $148 billion a year - more than three times the cost of chronic lung disease, even though Alzheimer's kills only half as many people.

To a great extent, increases in dementia are the price of progress: More and more people are living long enough to get Alzheimer's, some because they survived heart disease, strokes or cancer. It is a cruel tradeoff. The disease is by no means inevitable, but among people 85 and older, about 40 percent develop Alzheimer's and spend their so-called golden years in a thicket of confusion, ultimately becoming incontinent, mute, bedridden or forced to use a wheelchair and completely dependent on others.

"It makes people wonder whether they really want to live that long," Klunk said.

The potential market for prevention and treatment is enormous, and drug companies are eager to exploit it. If a drug could prevent Alzheimer's or just reduce the risk, as statins such as Lipitor do for heart disease, half the population over 55 would probably need to take it, Thies said.

If new drugs do emerge, they will come from studies in patients who already have symptoms, Thies said. But he said the emphasis would quickly shift to treating people at risk, before symptoms set in. Many researchers doubt that even the best preventive drugs will be able to heal the brains of people who are already demented.

Researchers are especially eager to study people like Kerley, because the children of Alzheimer's patients have a higher-than-average risk of dementia themselves, and tracking their brains and minds may open a window onto the earliest stages of the disease.

Alzheimer's Activities: Hundreds of Activities for Men and Women With Alzheimer's Disease and Related Disorders

Assisted living costs for Alzheimer's patient is tax deductible

2008-03-05T15:50:00.000-05:00

clipped from www.usatoday.com

Q: My mother just went into an assisted living facility due to Alzheimer's. It costs over $4500 per month. Are any portion of these expenses tax deductible?

Answer from AICPA member Kenneth J. Strauss: Sorry about your mother but the good news is that the entire $4,500 is fully tax deductible as a medical expense.

The rules can get pretty complicated but it is clear that Alzheimer's disease is a severe cognitive impairment which is the threshold for determining if the taxpayer is entitled to a full medical deduction.

Like all medical deductions the total amount of medical deductions is an itemized deduction. The medical expenses in excess of 7.5% of her adjusted gross income are deductible.

Depending on how high her income is will determine the full tax benefit. This might be a year to take some extra money from her retirement account. If your mother does not have the resources and you or another family member is paying then you should see if your mom can qualify as a dependent.

Assisted living costs for Alzheimer's patient is tax deductible

2008-03-05T14:45:00.000-05:00

clipped from www.usatoday.com

Q: My mother just went into an assisted living facility due to Alzheimer's. It costs over $4500 per month. Are any portion of these expenses tax deductible?

Answer from AICPA member Kenneth J. Strauss: Sorry about your mother but the good news is that the entire $4,500 is fully tax deductible as a medical expense.

The rules can get pretty complicated but it is clear that Alzheimer's disease is a severe cognitive impairment which is the threshold for determining if the taxpayer is entitled to a full medical deduction.

Like all medical deductions the total amount of medical deductions is an itemized deduction. The medical expenses in excess of 7.5% of her adjusted gross income are deductible.

Depending on how high her income is will determine the full tax benefit. This might be a year to take some extra money from her retirement account. If your mother does not have the resources and you or another family member is paying then you should see if your mom can qualify as a dependent.

Evercare Unveils Details Of Nation's First Alzheimer's Disease Special Needs Plan In Phoenix

2007-10-25T15:45:00.001-04:00

I am looking forward to learning more about this program. I will investigate when this program might be coming to South Florida.

clipped from www.medicalnewstoday.com

Evercare, one of the nation's, and Arizona's, largest health care coordination
programs, today unveiled the details of the first-ever Medicare Advantage
Special Needs Plan designed exclusively for people with Alzheimer's disease and
chronic dementia. Residents of Maricopa County, Ariz. will be the first in the
country to have access to this innovative health plan with tailored benefits and
services, including special prescription drug coverage and the Alzheimer's
Association Safe Return® program. Evercare Care Managers will collaborate with
memory disorder specialists from the prestigious Phoenix-based Banner
Alzheimer's Institute, with the goal of enhancing Evercare's innovative model of
care. <BR><BR>The <I>Evercare® Health Plan for People with Alzheimer's Disease
and Related Dementia</I> provides benefits that go beyond traditional Medicare
coverage

Discovery suggests new ways to treat Alzheimer's cause, not just symptoms

2007-10-24T12:56:00.000-04:00

clipped from www.newsroom.ucla.edu

For some time, scientists have blamed Alzheimer's disease on a small molecule called amyloid beta protein (A beta) that leaves large gummy deposits in the brain. Recent studies suggest that these A beta proteins stick together to form floating toxic clumps that kill brain cells. Now, UCLA scientists have identified a tiny loop in A beta as the likely culprit behind the adhesion process.

The UCLA team discovered that gene mutations in A beta increase the loop's flexibility, enabling it to join easily with loops from other A beta proteins and form clumps. The loop also appears in the region of the protein that regulates how — and how much — A beta is made.

Principal investigator David Teplow, professor of neurology at the David Geffen School of Medicine at UCLA, is available for interviews.

The Proceedings of the National Academy of Sciences published the findings in its Oct. 10 online early edition. For a PDF of the study, see www.eurekalert.org/pio/tipsheetdoc.php/237/zpq7481.pdf.

Johnnie Byrd Alzheimer's Center gets the shaft from the State of Florida

2007-08-16T12:50:00.000-04:00

Alzheimer's Reading Room: Johnnie Byrd Alzheimer's Center gets the shaft from the State of Florida

The early signs of Dementia (Alzheimer's)

2007-07-26T12:01:00.000-04:00

Looking back, there is little doubt in my mind that if I had had the proper education or information I would have realized my mother was suffering from dementia sooner. Most people like me tend to ignore the symptoms at first believing they are simply signs of "old age". Anyone who ends up in my shoes knows and understands that a person in the early stages of dementia or Alzheimer’s can function with some normality--even drive a car. It is not until they deteriorate or until some "event" takes place that we wake up to reality.

The article on the next page is one of the best I have read. The basic underlying premise is that behavior changes slowly in the elderly and if they begin to suffer cognitive impairment it will be evidenced in behavioral changes. Sometimes these changes can be quite subtle but if detected could raise a “red flag”.

If my mother had been enrolled in any of these studies I feel certain she would have been diagnosed with dementia sooner. This would have allowed me to get her in an exercise program, get her proper nutrition, and insure that she was taking her medicines as prescribed. I leaned in the last three years how important these three factors are in the quality of her life.

My mother turned 91 years old in June and she suffers from Alzheimer’s disease. I am her CarGiver.

I am an Alzheimer's Caregiver: The early signs of Dementia (Alzheimer's)

Statins that stave off Alzheimer's (Zocor)

2007-07-21T13:39:00.000-04:00

"The strength of this study is that it examines the issue with a huge amount of statistical power and uses existing data to look prospectively at Alzheimer’s and Parkinson’s," said lead author Benjamin Wolozin, MD, PhD, a professor of pharmacology at BUSM.

"The strength of reduction of incidence of dementia with simvastatin is striking,".

Simvastatin
zocor
statins
alzheimer's
caregiving

Researchers from Boston University School of Medicine (BUSM) have found that the statin, simvastatin, reduces the incidence of Alzheimer’s disease and Parkinson’s disease by almost 50 percent. This is the first study to suggest that statins might reduce the incidence of Parkinson’s disease. These findings, will be published in the July online open access journal BioMed Central (BMC) Medicine.

Statins that stave off Alzheimer's

By Nicole Laskowski

Statins May Stave Off Alzheimer’s

What’s up:

If you’re taking a statin to reduce cholesterol, you may also be improving your chances of avoiding certain neurodegenerative diseases. New research from the School of Medicine indicates that simvastatin, a statin sold as Zocor, reduces the incidence of Alzheimer’s disease and Parkinson’s disease by almost 50 percent.

The researchers, led by Benjamin Wolozin, a MED professor of pharmacology, screened the Decision Support System database of the United States Veterans Affairs Medical System, looking for the effects of three statins — simvastatin, lovastatin, and atorvastatin — on the expected incidence of Alzheimer’s disease and Parkinson’s disease. His study of more than 700,000 subjects taking simvastatin showed that the drug reduced the incidence of both Alzheimer’s disease and Parkinson’s disease by almost 50 percent. A study of people taking atorvastatin showed that the drug reduced the incidence of Alzheimer’s disease by almost 10 percent. Lovastatin was not shown to reduce the incidence of either disease.

Wolozin is unsure why simvastatin reduces the incidence of these diseases, but he suspects that because the statin blocks a cholesterol-producing enzyme called HMG-CoA reductase, it may also affect the production of other chemicals. He notes that simvastatin reduces inflammation, and that it increases the production of some growth factors in the brain, which may make neurons more capable of resisting chronic degenerative disease.

What it means to you:

“If you are someone who is at risk for Alzheimer’s or Parkinson’s disease, you should use simvastatin because it could slow the process,” said Wolozin. “Most people currently use atorvastatin, because it is effective at reducing vascular injury related to cardiovascular disease. If your major health risk is cardiovascular disease, you might want to stay with atorvastatin, but if your major health risk is neurodegenerative disease, you might consider switching to simvastatin.”

Word to the wise:

At the moment, researchers recognize a relationship between simvastatin and the onset of Alzheimer’s and Parkinson’s disease. They do not know how this relationship works. Be advised that statins may cause side effects such as headaches, nausea, rash, weakness, and muscle pain.

What’s next: Wolozin hopes to learn to determine how strong the relationship is between statins and degenerative diseases, like Alzheimer’s and Parkinson’s disease. He plans on studying how the drug slows the progression of symptoms by gathering data on when Alzheimer’s and Parkinson’s disease patients, both on and off the drug, meet certain well-known markers of the diseases.

Simvastatin
zocor
statins
alzheimer's
caregiving

alzheimer's disease, BioMed Central (BMC) Medicine, Boston University School of Medicine, caregiving, dementia, HMG-CoA reductase, lovastatin, simvastatin, statin, zocor

Novartis' skin patch for Alzheimer's approved by FDA

2007-07-10T12:46:00.000-04:00

Once-daily skin patch offers novel approach to treating mild to moderate Alzheimer's disease, providing smooth and continuous delivery of drug over 24 hours.

Exelon Patch preferred by caregivers in a study because it helps manage patient care and gives visual reassurance that medication has been administered.

Exelon Patch minimizes gastrointestinal side effects seen with oral form of drug.

Taken directly from the Novartis Press Release

Exelon®Patch, the first and only skin patch for the treatment of Alzheimer's disease, receives first worldwide approval in US

Once-daily skin patch offers novel approach to treating mild to moderate Alzheimer's disease, providing smooth and continuous delivery of drug over 24 hours
Similar efficacy to highest doses of Exelon capsules with significant improvement in memory and ability to perform everyday activities compared to placebo
Exelon Patch preferred by caregivers in a study because it helps manage patient care and gives visual reassurance that medication has been administered
Exelon Patch minimizes gastrointestinal side effects seen with oral form of drug

Basel, July 9, 2007 - Exelon®Patch (rivastigmine transdermal system) has received its first worldwide approval in the United States as an innovative way to deliver an effective medicine for mild to moderate Alzheimer's disease patients through a skin patch instead of an oral capsule.

This new therapy is the first and only transdermal treatment for this degenerative condition affecting millions of people in the US. Exelon Patch offers effective treatment based on placebo-controlled clinical trial results showing significant benefits to patients in terms of their memory and ability to perform everyday tasks as well as helping their overall functioning.

Exelon Patch maintains steady drug levels in the bloodstream, improving tolerability and allowing a higher proportion of patients to receive therapeutic doses of medication, with potential improvements in efficacy. It is applied to the back, chest or upper arm, and provides smooth and continuous delivery of medication through the skin over 24 hours.

Gastrointestinal side effects are commonly seen with this class of drugs called cholinesterase inhibitors. The target dose of Exelon Patch greatly reduces these side effects, with three times fewer reports of nausea and vomiting than with the capsule form of the drug.

"Exelon Patch represents a significant advance in the treatment of this debilitating disease," said George Grossberg, MD, at St. Louis University in St. Louis, Missouri. "The unique delivery system helps both the patient and the caregiver by providing a much easier way to manage their therapy. The patch provides a visual reassurance for the caregiver that the patient is receiving their medication and helps the patient stay engaged in the activities of daily living."

Exelon Patch is expected to be available in US pharmacies soon. The medication was submitted for review in the European Union in late 2006.

The patch was designed with compliance in mind, and was preferred to capsules by more than 70% of caregivers as a method of drug delivery according to clinical study data, because it helped them follow the treatment schedule, interfered less with their daily life and was easier to use overall than the oral medication.

The approval of Exelon Patch is based on results from the international IDEAL (Investigation of Transdermal Exelon in ALzheimer's disease) clinical trial, involving nearly 1,200 patients with mild to moderate Alzheimer's disease. Exelon Patch showed similar efficacy to the highest doses of Exelon capsules1 and the target dose (9.5 mg/24 hours) was well tolerated by patients.

"Innovation isn't just about developing new compounds, but also about meeting therapeutic needs by taking existing knowledge and applying it in new ways," said James Shannon, MD, Global Head of Development at Novartis Pharma AG. "Exelon Patch addresses an important medical need by delivering a proven drug in an entirely new form that meets the needs of patients and their caregivers."

Alzheimer's disease is a progressive, degenerative disease that alters the brain, causing impaired memory, thinking and behavior. Approximately 18 million people worldwide have Alzheimer's disease. In the US, more than five million people suffer from Alzheimer's disease and almost 10 million people provide care for someone living with dementia, most of which is related to Alzheimer's disease. By 2030, the number of people in the US who are age 65 and over with Alzheimer's disease is estimated to reach 7.7 million, more than 50% more than current levels.

The FDA also approved the use of Exelon Patch in treating patients with mild to moderate Parkinson's disease dementia. Parkinson's disease is a chronic and progressive neurological condition that affects approximately 1.5 million people in the US. Parkinson's disease dementia is a distinct and common disorder, one characterized by impairments in executive function, memory retrieval, and attention, in patients with an established diagnosis of Parkinson's disease. Two of five people with Parkinson's disease are estimated to have Parkinson's disease dementia.

Disclaimer
The foregoing press release contains forward-looking statements that can be identified by forward-looking terminology, such as "expected to be", or implied statements regarding potential future revenues from the Exelon Patch. Such statements involve known and unknown risks, uncertainties and other factors that may cause the actual results to be materially different from any future results, performance, or achievements expressed or implied by such statements. There can be no guarantee that Exelon Patch will reach any particular sales levels. In particular, management's expectation regarding the commercial success of Exelon Patch could be affected by among other things, uncertainties relating to product development, regulatory actions or delays or government regulation generally, the ability to obtain or maintain patent or other proprietary intellectual property protection and competition in general, as well as factors discussed in the Form 20F filed with the Securities and Exchange Commission. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those described herein anticipated, believed, estimated or expected. Novartis is providing the information in this press release as of this date and does not undertake any obligation to update any forward-looking statements contained in this press release as a result of new information, future events or otherwise.

About Novartis
Novartis AG (NYSE: NVS) is a world leader in offering medicines to protect health, cure disease and improve well-being. Our goal is to discover, develop and successfully market innovative products to treat patients, ease suffering and enhance the quality of life. We are strengthening our medicine-based portfolio, which is focused on strategic growth platforms in innovation-driven pharmaceuticals, high-quality and low-cost generics, human vaccines and leading self-medication OTC brands. Novartis is the only company with leadership positions in these areas. In 2006, the Group's businesses achieved net sales of USD 37.0 billion and net income of USD 7.2 billion. Approximately USD 5.4 billion was invested in R&D. Headquartered in Basel, Switzerland, Novartis Group companies employ approximately 100,000 associates and operate in over 140 countries around the world. For more information, please visit http://www.novartis.com.

# # #

Novartis Media Relations

Corinne Hoff
Novartis Global Media Relations
+41 61 324 9577 (direct)
+41 79 248 5717 (mobile)
corinne.hoff@novartis.com Christine Cascio
Novartis Pharma Communications
+1 862 778 8026 (direct)
+1 917 449 9982 (mobile)
christine.cascio@novartis.com

The Emotional Survival Guide for Caregivers: Looking After Yourself and Your Family While Helping an Aging Parent

alzheimer's disease, caregiver, Exelon Patch, family caregiver, novartis, skin patch, worldwide approval

Mental Activity Helps to Lower Risk of Alzheimer’s Disease

2007-07-03T11:44:00.000-04:00

Taken directly from the Rush Memory and Aging Project news release.

How often older adults read a newspaper, play chess, or engage in other mentally stimulating activities is related to the risk of developing Alzheimer’s disease, according to a study by researchers at Rush University Medical Center.

Taken directly from the Rush Memory and Aging Project news release.

Frequent Brain Stimulation in Old Age Reduces Risk of Alzheimer’s Disease

(CHICAGO) – How often older adults read a newspaper, play chess, or engage in other mentally stimulating activities is related to the risk of developing Alzheimer’s disease, according to a study by researchers at Rush University Medical Center published June 27 in the online edition of Neurology®, the medical journal of the American Academy of Neurology.

For the study, more than 700 people in Chicago with an average age of 80 underwent yearly cognitive testing for up to five years. Participants were part of the Rush Memory and Aging Project, a longitudinal study of more than 1,200 older people. Of the participants, 90 developed Alzheimer’s disease. Researchers also performed a brain autopsy on the 102 participants who died.

The study found that a cognitively active person in old age was 2.6 times less likely to develop dementia and Alzheimer’s disease than a cognitively inactive person in old age. This association remained after controlling for past cognitive activity, lifetime socioeconomic status, and current social and physical activity.

Researchers say the findings may be used to help prevent Alzheimer’s disease.

“Alzheimer’s disease is among the most feared consequences of old age,” said study author Robert S. Wilson, PhD, a neuropsychologist at the Rush Alzheimer’s Disease Center. “The enormous public health problems posed by the disease are expected to increase during the coming decades as the proportion of old people in the United States increases. This underscores the urgent need for strategies to prevent the disease or delay its onset.”

Wilson says the study also found frequent cognitive activity during old age such as visiting a library or attending a play, was associated with reduced risk of mild cognitive impairment, a transitional stage between normal aging and dementia, and less rapid decline in cognitive function.

The study was supported by grants from the National Institute on Aging and the Illinois Department of Public Health.

The Rush Alzheimer's Disease Center is one of 29 NIA-supported Alzheimer's Disease Centers across the U.S. which conduct basic science, clinical, and social and behavioral research on dementia and AD. General information on aging and aging research can be viewed at the NIA's home website, www.nia.nih.gov. For more information on the Rush Alzheimer’s Disease Center, visit www.rush.edu.

"ACTIONALZ.ORG", alzheimer's disease, blog, brain, stimulation, caregiver, care giving, chess, mental-health, National Institute on Aging, neurology, prevent, Rush University Medical Center

The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease, Other Dementias, and Memory Loss in Later Life

2007-05-09T19:00:00.000-04:00

This best-selling book is the "bible" for families caring for people with Alzheimer disease...

Read the full text review at The Alzheimer's Reading Room

Klein wants to block Medicaid reimbursement changes

2007-03-16T18:59:00.000-04:00

The proposed changes that Klein wants to block would “financially devastate” Florida hospitals resulting in a $4.6 billion cut in Medicaid payments over a five-year period, he said.

The Centers for Medicare and Medicaid Services (CMS) recently proposed capping payments to hospitals by limiting payments to public and publicly supported providers and narrowing funding sources available to finance Medicaid expenditures.

Source Boca News

Published Friday, March 16, 2007
by By John Johnston

U.S. Rep. Ron Klein (D-22) has introduced legislation that would block proposed changes to the Medicaid reimbursement system.

The proposed changes that Klein wants to block would “financially devastate” Florida hospitals resulting in a $4.6 billion cut in Medicaid payments over a five-year period, he said.

District 22 hospitals alone would stand to lose $14.8 million alone, said Klein. U.S. Rep. Ileana Ros-Lehtinen (D-18) joined him in introducing the bill.

The Klein and Ros-Lehtinen's bill would place a two-year moratorium on the proposed rule. The bill is a companion to bill S.787 that Senator Mel Martinez (FL) introduced earlier this month.

"This rule could effectively reverse successful efforts by Governor Jeb Bush and other state leaders in Florida to offset the cost of indigent health care," said Klein. "It is disappointing that this administration is putting an even greater burden on our hospitals that must treat everyone who comes into the emergency room. Our bill would suspend this proposed change to the Medicaid reimbursement process. It is simply unfair to punish our local hospitals that are barely able to make ends meet as it is, because of the federal government's reckless spending habits."

The Centers for Medicare and Medicaid Services (CMS) recently proposed capping payments to hospitals by limiting payments to public and publicly supported providers and narrowing funding sources available to finance Medicaid expenditures. The new rule would uniquely impact Florida because it would effectively eliminate the Florida's Low Income Pool (LIP) program, which CMS recently approved as an innovative federal waiver.

Klein said his two-year moratorium on the ruling would provide ample time to examine the impact that the proposed CMS ruling would have on Florida and other states, “especially those states with Medicaid and State Children's Health Insurance Programs (SCHIP).”

John Johnston can be reached at 561-549-0833, or at jjohnston@bocanews.com

Caring for the CareGivers

2007-02-23T18:08:00.000-05:00

“I don’t think I know how to handle the situation with dementia,” she said about her husband’s disease, diagnosed 10 years ago. “I lose my temper a lot and I get exasperated. I know I’m not handling things well, not for him and not for myself.”

Read the article in its entirety Caring for the CareGivers

Huperzine A in Alzheimer's Disease-The Clinical Trial

2007-02-04T17:29:00.000-05:00

"The Huperzine A in Alzheimer's Disease clinical trial is currently open and recruiting patients. This is a Phase II clinical trial."

Read about the study including requirements and available locations at The Alzheimer's Reading Room: Huperzine A in Alzheimer's Disease-The Clinical Trial.

The Alzheimer’s Reading Room

2007-01-11T23:06:00.000-05:00

Everything Alzheimer's Disease. This weblog is for Alzheimer's CareGivers, those touched by Alzheimer's, and those interested in learning more about Alzheimer's disease. The content on this weblog is wide ranging and includes: research, definitions, education, important articles, clinical trials, and content from other CareGiver Weblogs.

To visit the weblog follow this line The Alzheimer’s Reading Room

Decoding Alzheimer's: After a century, promising treatments at last—and whispers of a cure

2007-01-05T22:24:00.000-05:00

This is a fascinating article that discusses treatments for Alzheimer’s disease that are on the near term horizon.

"After a century, promising treatments at last—and whispers of a cure"

Read this article in its entirety at The Alzheimer’s Reading Room

Cutting Medicaid drug payments?

2006-12-28T23:59:00.000-05:00

The Bush Administration is proposing “sweeping reductions in payments to pharmacies” to save money for Medicaid, the health program for more than 50 million low-income (and poor) people. God help them, the pharmacies and beneficiaries . . .

Cutting Medicaid drug payments?
By Jerry Mazza
Online Journal Associate Editor

Source Online Journal

The Bush Administration is proposing “sweeping reductions in payments to pharmacies” to save money for Medicaid, the health program for more than 50 million low-income (and poor) people. God help them, the pharmacies and beneficiaries . . .

The goal seems like all sunshine and good things to make sure Medicaid gets drug discounts like those provided to larger customers in the private sector, companies like Caremark Rx and Medco Health Solutions, who manage drug benefits for people whose health insurance comes through employers.

The states that share costs of Medicaid with the federal government come up with the final decisions on what pharmacies are paid, of course, according to federal limits. The proposed new rule would offer states new data in their calculations, redefining the “average manufacturer price” for brand name and generic drugs.

Consumers wouldn’t be affected directly by the proposed revamping. But federal bright lights said they hope consumers would ask for lower drug prices after checking the price list to be posted on a Web site. Shouldn’t that be the government’s job? If I’m poor and/or sick, I’m supposed to be checking my drug’s prices? Then what, get in my wheelchair and go picket Pfizer or the generic producer?

One of the bright lights, S. Lawrence Kocot, senior adviser to the administrator at the Centers for Medicare and Medicaid Services, said the new rule would carry out provisions of no less than the Deficit Reduction Act, signed by President Bush on Feb. 8, 2006. Well, I’ll be . . . Is that the out-of-control annual Bush deficit of between $400 and $500 billion, or the beyond-belief National debt, weighing in at close to $9 trillion?

The law, along with the proposed new rules, would limit payments to state Medicaid agencies for the cumulative costs of prescription drugs when a generic substitute is available. Fair enough. The officials claim the rule would save $8.4 billion over five years, a 5.6 percent reduction in total projected Medicaid spending on prescription drugs in that period. If the new rule is adopted, the administration claims the government would save $4.9 billion and the states some $3.5 billion. I look forward to reading those numbers.

Now, we’ll get into the fine print

The Department of Health and Human Services estimates that more than 90 percent of the savings would come from the pharmacies. Huh? The rest, 10 percent of savings, would come from Big Pharma. And the administration admitted to the fact that the new rule could cut revenues for many of the nation’s 18,000 small retail pharmacies.

In fact, they said they had no way to measure the impact precisely. But they did know the revenue reductions could (would) fall particularly hard on those pharmacies in low-income areas, containing high concentrations of Medicaid beneficiaries. Nice. So kick the neighborhood stores serving the underserved till they fold and there’s even less service.

The bright lights said pharmacies could “mitigate the effects” of lost revenue by buying lower-cost drugs, that is if pharmacies can find other generic drug companies ready, willing and able to lower their prices below the new federal limits. Does that sound real or reasonable? Well you, the public, will have 60 days to comment on this idiocy. And the idiots will weigh your comments and then pronounce “a final rule with the force of law.” Wow, and faster than a speeding bullet.

Meanwhile, Bruce Roberts, executive vice president of the trade group the National Community Pharmacists Association, commented, “The proposed rule would have the perverse effect of discouraging the use of generic drugs . . . The new limits on Medicaid reimbursement will be way below what drugstores typically pay for those drugs.” In other words, these mom and pop or smaller drugstores will have to eat the difference. But not Big Pharma. Or the chain stores.

Under a 1990 law, drug producers must give discounts to states that buy their drugs for poor people who receive Medicaid benefits. The discounts come in the form of rebates -- paid by companies every time their pills go to a Medicaid beneficiary.

For generic drugs, the rebate is 11 percent of the average price paid to the manufacturer. That is the average manufacturer price. For brand-name drugs, the basic rebate is at least 15.1 percent of the average price. And it could be more because Medicaid is supposed to be able to access the “best price” paid by any other buyer.

The curve ball is that each drug company calculates how much it owes Medicaid back for each of its drugs. And to whom are they accountable as to the validity of their calculations?

Well, the Government Accountability Office (GAO), an investigative arm of Congress, said that manufacturers calculated prices and rebates in quite different ways. Duh, why? Because they have not gotten “clear guidance” from the federal government. Well, why not? They are the ones trying to cut expenditures. Yet the GAO also said federal Medicaid officials rarely check the accuracy of these calculations. Of course, someone is probably pulling them out of a hat.

Medicaid has consistently bargained for lower prices

Also, the truth is that Medicaid has more consistently been able to deliver better prices on drugs than Medicare, even with its Plan D (fill in the blank for what D stands for). But then Medicare was not able to bargain with drug manufacturers. That’s a no-no. They might damage Big Pharma’s bottom line.

Medicaid could and did bargain with manufacturers, and got better deals for the poor, including veterans. So let’s kick them in the head and create even more obstacles and paperwork for them. And make it almost more tempting to get a bigger discount with the more expensive name-brand drugs.

By the way, the facts of this story come from the New York Times, some of whose writers live in my West Side building. They are more genteel folks than my Brooklyn street kid self. They won’t come right out and tell you this is baloney, messing with Medicaid and the 50 million people it serves, and messing specifically with the pharmacists who are on the frontlines in those communities serving the people everyday.

It’s still another way to slash and burn part of the only public retirement and healthcare system we have ever had in this country -- thanks first to FDR for Social Security, thanks second and third to JFK and LBJ for conceiving of and bringing to reality Medicare then Medicaid, which spun out of Social Security thinking.

And for 70 years, the life of Social Security, the Repuglicans have hated every dollar workers and employers paid into Social Security do benefits could be dispensed to America’s seniors, as they hated every dollar for services and drugs the 42-year old government-funded Medicare and Medicaid programs dispensed for America’s disabled and poor. A pox on the GOP, sick beast that it is.

Jerry Mazza is a freelance writer living in New York. Reach him at gvmaz@verizon.net.

2006-11-27T12:39:00.000-05:00

The CareGiver: Americans Fear Alzheimer’s More Than Heart Disease, Diabetes or Stroke