Denmark’s first dementia village

Mike the Psych's Blog

Denmark has opened a village equipped with a music library, restaurants and shops reserved for dementia sufferers.

Svendborg Demensby on the island of Funen is the first of its kind in Denmark and is modelled on similar villages in Italy, Canada and the Netherlands.

The village of 125 homes was developed on the site of an old brewery which had already been used as a care centre for the elderly. The idea is to give residents the feel of living in a small town and is expected to give dementia sufferers a safer environment and a more fulfilling life in comparison with ordinary sheltered housing. It’s a pilot scheme with plans to open similar projects in Aalborg, Odense and Herning.

The Danish Alzheimer’s Association cautiously welcomed the initiative but voiced worries about the villagers being cut off from the outside world. “It concerns us when special dementia villages are being…

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Can dementia patients actually get better?

head_outline_puzzle_1600_wht_10307There has been some excitement about reports that people with early-stage Alzheimer’s have recovered from their memory after being put on a controversial recovery plan.

Scientists say the results are unprecedented. There were only 10 patients, aged late 40s to mid-70s, in the trial and most of the reports are anecdotal but they include a 69 year-old entrepreneur who was able to go back to work and expand his business and a woman who recovered her fluency in two foreign languages.

There is currently no one drug which can reverse the symptoms which include confusion, loss of speech and memory loss (but see post about symptoms other than memory loss).

The California researchers claim that a customised programme of 36 different treatments can restore some patients with Alzheimer’s or cognitive impairment to normality and improve their lives significantly.

The plan is called Metabolic Enhancement for Neural Degeneration or MEND. Basically it requires patients to make major lifestyle changes – exercise and sleep patterns – as well as taking drugs and vitamin supplements.

Brain scans of all 10 patients showed significant increases in grey matter. The improvements lasted as long as the patients stuck to the plan lasting up to four years.

The MEND programme

  • Fast at least 3 hrs before bedtime
  • Low GI & low-calorie cereal
  • At least 30 mins exercise, 4 to 6 days a week
  • Hormone supplements
  • Melatonin to guarantee 8 hours sleep
  • More than a dozen dietary supplements including reveratrol, curcumin & vitamins D3 & K2

British experts are being more cautious one saying the experiment had been carried out sloppily and risked raising unfair expectations among patients.

The head of research at Alzheimer’s Research UK said it was likely that the best way to deal with it was to use multiple strategies but that this study was too small.

The researchers at the University of California now want to expand the trial to larger groups. This will be important to establish the reliability of the plan using a blind controlled method with good diagnostics and follow-up.

See previous post on dementia

Dementia update 2016

elderly_man_holding_a_custom_text_sign_12871The government has announced a pilot programme to screen 40-year olds for dementia. The government wants to make Britain “the best place in the world to live with dementia“.

There are about 850,000 in the UK who suffer from Alzheimer’s disease and other severe neurodegenerative problems (approx 70% have Alzheimer’s and 20% vascular dementia).

Only those over 65 have a mid-life MoT at present. If the pilot is a success it will be extended to all GPs allowing them to suggest ways that people can cope with it better.

Exercising more, controlling weight and blood pressure, and eating better, are a few ways that could help.

Another part of the project is to enlist people in research to allow doctors to better understand and treat the condition.

Dementia can be frightening and the Alzheimer’s Society says  more than 9 out of 10 people think hospitals are frightening places. The health secretary has pledged that people in high dependency units will be seen regular by consultants, up to twice a day if appropriate.

Dementia support groups welcomed the shift in attitude from the government which has made dementia one of its top four priorities. “Many people with dementia face stigma and a health and care system that simply does not work for them resulting in emergency hospital admissions, extended stays and desperate loneliness

Public Health England is looking at lifestyle as a risk factor and asking doctors to look at patients with high blood pressure, irregular heartbeats or early signs of type 2 diabetes (this is part of the mid-life MoT).

A study published by Cardiff University in 2013 had looked at the lifestyles of over 2,000 men aged 45-59 over 35 years.

It found that men who were non-smokers, who took exercise, kept their weight down, drank little and ate well, had a 60% drop in dementia and cognitive decline as well as 70% fewer instances of heart disease, stroke, and diabetes.

The director of research and development at the Alzheimer’s society says “What’s emerging is that what’s good for the heart, in terms of lifestyle, is also good for the head. We don’t yet understand why this is so and we need to do more research on it”

If we could delay the average age on onset of Alzheimer’s by five years we could cut patient numbers (currently 850,000 and predicted to rise to 2 million by 2050) by a third” Dementia is the leading cause of death for women in England and Wales.

Researchers at Yale University think that helping people to have a more optimistic view of old age could delay the onset. They found that people with pessimistic views of old age, thinking that the elderly are irritable, slow to learn and forgetful, are themselves more likely to acquire the disease.

However it’s hard to untangle the psychological and medical factors given that early changes can take place 15 years before symptoms show. Recent US research suggests that forgetfulness in your 60s can be a sign of a higher dementia risk

However memory loss is not the only symptom.

Walking slowly could be an early sign of dementia, according to researchers in France who measured people’s walking speed and gait. Speed of walking has also been associated with life expectancy along with other simple tasks.

The researchers acknowledge that people could also be influenced by other illnesses such as cardio-vascular disease or depression which could have an impact on the brain.

Some of the symptoms might seem more obvious – like not recognising yourself in the mirror,  forgetting how to work the microwave, or not knowing what day or year it is.

Even a warped sense of humour could be an early sign of dementia. So if you are laughing inappropriately at tragic events or enjoy slapstick humour they could be early warning signs which show up 9 years before other symptoms.

The leader of this research at UCL said “Personality and behaviour changes should be prompts for further investigation and clinicians need to be more aware of these symptoms as a potential early sign of dementia”.

There is a lot of research into this tragic condition and there is also some good news. The number of men developing the condition has dropped considerably since the 1990s when there were 42 cases per thousand population now down to 27. In older men over 85 the incidence has almost halved from 72 to 38 cases per thousand.

This has been attributed to men living healthier lifestyles than they did 20 years ago. However with obesity and diabetes on the increase among the middle-aged these gains might not be maintained. So its back to “what’s good for your heart is good for your brain”

Do vampires know something we don’t?

mouth_vamp_teeth_1600_clr_17745Injecting/transfusing yourself with the blood of virgins (Kim Jong II and Pope Innocent VIII – well maybe not so innocent as blood donors all died), bathing in it (Countess Bathory – or Ingrid Pitt if you’re a Hammer film fan) or just taking a bloody bite (Dracula and a long line of vampires since) may seem other-worldly but scientists now believe that they may have been onto something.

Scientists in California are testing an Alzheimer’s treatment that involves injecting blood plasma from young people in the hope it will reduce brain ageing.

Saul Vileda’s experiments with mice of different ages showed that when you mix their blood. Giving blood from older mice to younger mice accelerated cognitive decline. 

He then found that when he injected older mice with young blood it changed the brain circuitry in the older mice creating new synaptic connections. Plasticity also returned relating to learning and memory-related genes.

He believes it’s because the proportion of different molecules in blood changes with age and older blood has more factors associated with inflammation.

Since the research was published they have received offers of children’s blood and requests from aged billionaires.

However they have taken an ethical stance and in trials at Stanford  University volunteers  with early stage Alzheimer’s  are being injected with young blood plasma. The experiment is reported in a BBC documentary “How to stay young”.

As Vileda says “We have heard about vampires. Is there some truth in that? Children heal so quickly. Is it the fountain of youth?

Well, vampires are immortal after all.

Dementia – more than just memory loss

head_outline_puzzle_1600_wht_10307Behavioural changes in mid-life put down to relationship problems, the menopause, or a mid-life crisis may in fact be early symptoms of dementia according to Jonathan Rohrer, a specialist in frontotemporal dementia at University College, London.

He says doctors are “stuck on the idea” that memory loss was the key symptom. Not so. Whilst that is associated with Alzheimer’s, personality changes and loss of motivation can be warning signs of other forms of dementia. Unfortunately these take much longer to be diagnosed.

Most common in middle-aged people, frontotemporal dementia affects the frontal lobes of the brain leading to loss of motivation, vision problems, and shedding of inhibitions.

People become more irritable, saying rude things that are socially unacceptable, as one of the symptoms is loss of empathy towards loved ones. People go to the GP and say “my partner’s not right” and the doctor says “it’s just mid-life” or “you’re not getting on any more””.

So what are the warning signs?

  • Loss of inhibition including tactless comments and impulsive behaviour
  • Loss of motivation but not accompanied by sadness
  • Loss of sympathy or empathy such as showing less interest in others
  • Cravings for sweet or fatty foods
  • Slow or hesitant speech including stuttering
  • Repetition of compulsive behaviour
  • Decline in personal hygiene

Dr Rohrer has just announced that he is starting a project to look for the genetic causes of this form of dementia.

Reported in The Times

My last post on dementia

Being bilingual has health benefits

head_gear_500_wht_2011The ability to speak a foreign language may double your chances of recovering from a stroke.

Even if you only learn a new language later in life it might help you develop more neuronal connections and strengthen your “cognitive reserve” that helps you cope with brain damage.

Foreign languages challenge the mind and compelled the brain to form significantly more connections. This means it can reroute neural circuits much more easily if damaged.

At one time it was thought that women recovered from strokes better than men because their brain hemispheres were more generalised than men’s i.e. men seemed to have a more dominant hemisphere. You can se the reasoning behind that idea.

In this latest study over 600 stroke patients in Hyderabad, India had their records analysed. This is an area where the majority of people spek two or more languages.

41% of the patients who were bilingual had kept their memory functions unimpaired compared with only 20% who spoke only one language.

Being multi-lingual made no difference when it came to recovering loss of speech however. There was no difference no matter how many languages were spoken.

The study also showed that what you see on a MRI scan and what you get in real life can be different. Two people with the same level of atrophy in their brain because of loss of neurone due to dementia can function quite differently mentally.

People who are very active, do physical exercise, but also do a lot of mental activity tend to perform better, so if your mind and body are active you’re able to cope better with potential damage that diseases can bring” Said Dr Bak who led the study.

150,000 Brits suffer a stroke every year so these findings are important. Scientists already knew that people who are more mentally active throughout their lives are better at dealing with a range of neurological conditions including Alzheimer’s.

There are studies from Belgium and Nigeria which show that bilingual people tend to have dementia diagnosed as much as five year’s later than people who do not speak any foreign languages. The same effect was also found in American nuns but I’m not sure why. (No jokes about speaking in tongues please).

Dr Bak also found that it’s never too late to learn a language. In his unpublished research he found that started to learn a new language as late as 78 had an even bigger protective effect than learning the language at a younger age.

Story in the Times; research published in Stroke journal

I posted on the value of learning a foreign language in relation to dementia four years ago. Click here to read it.

Protect your memory

head_outline_puzzle_1600_wht_10307Apparently we are experiencing an epidemic of premature memory loss. Scientists are now saying our memory begins to fade at 45 years of age rather than at 60 as was previously believed.

Unfortunately failing mid-life memory – the occasional slips which are referred to as Mild Cognitive Impairment (MCI) – could also be an early symptom of senile dementia. This brain disease is now striking people 10 years earlier than it did 20 years ago and is regularly being diagnosed in people in their 40s.

Half of those diagnosed with MCI go on to develop senile dementia. But half don’t so what makes the difference?

There seems to be no simple explanations. Some experts have blamed environmental pollution including exhaust fumes and pesticides. Others have blamed an over-reliance on technology, junk food and our lifestyles generally.

More people are referring themselves to doctors about memory problems. The vast majority suffer from what psychologists have called “security protection overload”. They feel overwhelmed by the numbers, codes and operating systems they need to know to function in a hi-tech environment.

Who hasn’t experienced ‘PIN amnesia’? It happened to me today as I used a credit card I don’t use very often. All my cards have different PINs which I remember pretty much all the time. The stress of getting it wrong and worrying about three strikes and out is enough to interfere with memory recall anyway.

People are using their memory less as they store information on their smartphones. And we’ve seen what happens when people over-rely on sat-navs and end up in a river. The brain is like  a muscle. Use it or lose it!

We have to keep active and our brains active by doing new and different things. Keeping the blood flowing to our brains and making new connections through imagination and planning.

For those of us with middle-aged brains the upside is that we are generally calmer, less neurotic, better in social situations, wiser, and more contented. The Seattle Longitudinal Study, which has tracked the mental abilities of thousands of adults over the past 50 years, has found that middle-aged adults perform better on 4 out of 6 cognitive tests than they did as young adults.

And while middle-aged people can perform tests as well as young people in conditions of silence they are more distracted than them in noisy environments. This might also explain the “doorway amnesia” where we move from one room to another and forget why we are there. The movement breaks our concentration as we are distracted by new stimuli in the new room.

Forgetting is a healthy brain function. You don’t want your brain cluttered up by irrelevant information about previous events when you need to remember something today. People who can’t forget – it’s called hypermythesia – get confused.

Healthy brains allow us to recall information when we need it. The problem is that we don’t always retrieve it efficiently. Our library of information becomes less efficiently managed as we get older.

This post is based on an article in the Times Body and Soul segment which also suggests the following ways to protect your memory.

Walk for 30 minutes a day, three times a week. Regular exercise provides the brain with oxygen and nutrients.

Eat vegetables and nuts. We know mediterranean diets are good for us . Now nutritionists at Rush University Chicago have developed the MIND diet, a specially formulated brain-protecting diet.

Give up transfats. Found in burgers, biscuits and cakes. Designed to increase the shelf-life of food but not people.

Eat less sugar. Studies have shown that high blood glucose can damage brain function. Not to mention sugar ruins your teeth and makes you fat!

Lose weight. It’s not PC to use the F word but obesity is a killer and costs the country a fortune. Overweight people’s memory declines over 20% faster than people of normal weight.

Avoid cigarettes and beer. Middle-aged men drinking two-and-a-half pints of beer a day speed up their memory loss by 6 years. Smoking has also been linked to a faster decline in memory.

Drink strong coffee. Twice a day. It helps middle-aged people do short-term memory tests but appears to have no effect on young people. Caffeine also strengthens brain connections. So there you skinny decaff latte drinkers. Not good for you!

PS Brain training games don’t help. You might get better at the games but that’s all according the the Alzheimer’s society. Same goes for crosswords and Sudoku.