Concussion Leads to Dementia If Neglected

Concussion Leads to Dementia If Neglected

Football faces hundreds of lawsuits from players with dementia caused by concussions. That's because new research shows damage to the brain can persist for decades after a head trauma. Learn why. Find out what to do.

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"Even when you are symptom-free, your brain may still not be back to normal," says Dr. Maryse Lassonde, a neuropsychologist and the scientific director of the Quebec Nature and Technologies Granting Agency.

Lassonde, whose work is supported by the Canada Foundation for Innovation, was a consultant with the Montreal Canadiens hockey team, treating players with concussions for 15 years. She simultaneously undertook research into the effects of concussions on children and young athletes as well as older athletes.

A concussion is traumatic brain injury that changes the way your brain functions. When the skull is jolted or impacted by a hard surface, the brain shifts, slamming against the skull, causing damage and swelling to the brain. If treated correctly, brain will heal. But if not, results can be deadly.

To study the effects of concussions, Lassonde had athletes perform specific visual and auditory tasks and also mapped their brains with the help of EEG and MRI equipment, in addition to testing brain chemistry.

Her research demonstrates that brain waves remain abnormal in young athletes for two years following a concussion, and atrophy occurs in the motor pathways of the brain following a hit.

The results of her work, which have been published in the journals Brain and Cerebral Cortex, have important implications for the regulation of amateur and professional sports, the treatment of players and the importance of preventing violence in hockey and football.

"That tells you that first of all, concussions lead to attention problems, which we can see using sophisticated techniques such as the EEG," says Lassonde. "This may also lead to motor problems in young athletes."

The long-term effects in older former athletes are even more persistent.

By studying older athletes who suffered their last concussion 30 years earlier, and comparing them to healthy peers who had not experienced concussions, Lassonde discovered those who had suffered a head trauma had memory and attention deficits and motor problems similar to the early symptoms of Parkinson's disease. Further testing of these older athletes turned up a thinning of the cortex in the same regions of the brain that Alzheimer's disease usually affects.

"This thinning correlated with memory decline and attention decline," Lassonde says.

In addition to the recovery time required following a concussion, adds that young players who return to their sport too early and suffer a second concussion risk serious brain damage or death.

"If a child or any player has a concussion, they should be kept away from playing or doing any mental exercise until their symptoms abate," Lassonde says. "Concussions should not be taken lightly. We should really also follow former players in clinical settings to make sure they are not ageing prematurely in terms of cognition."

MORE INFORMATION:

About the Canada Foundation for Innovation
The Canada Foundation for Innovation gives researchers the tools they need to think big and innovate. By investing in state-of-the-art facilities and equipment in Canada's universities, colleges, research hospitals and non-profit research institutions, the CFI is helping to attract and retain the world's top talent, to train the next generation of researchers, to support private-sector innovation and to create high-quality jobs that strengthen the economy and improve the quality of life for all Canadians. For more information, visit innovation.ca.

The dementia epidemic: is it really stabilising?

A new study suggests that dementia rates aren't increasing, but if we take a look at the age of those studied, the living conditions of those born pre and post-war plays a huge role. As younger generations become less healthy, it is likely to increase in the future

NAAHEED MUKADAM

 

 

Monday 24 August 2015

The Lancet Neurology published an article last week on dementia prevalence in Western Europe. Surprisingly, in spite of an ageing population, the data suggests that the prevalence of dementia is stabilising rather than continuing to increase.

The paper presented findings from five European studies that measured changes in dementia prevalence over time. 

The headline finding is that in the UK-based study, the prevalence of dementia in those aged 65 or over fell from 8.3% in the 1990s to 6.5% in the same age group 20 years later. 

The authors of the review paper suggest that this fall in dementia prevalence could be due to improvements in general public health and better management of risk factors for dementia.

While this is potentially very encouraging, the results need to be interpreted with some caution. Most of the studies done outside the UK found that rates of dementia had remained stable. 

The only studies that found a reduction in the prevalence of dementia were the UK study and the Spanish study, which looked at people over the age of 65.

Those over 65 in 1990 would have been born before the Second World War and those surveyed 20 years later in the UK would have been a post-war cohort. 

The post-war group had access to better education, living conditions and general health than those born before the war – and this could have impacted on their cognitive health and given them protection against dementia. 

So the fall in prevalence could be purely due to a birth cohort effect, the reasons for which are not fully understood.

The authors also point out that the incidence and mortality of cardiovascular disease in most high-income countries has decreased since the 1980s and there has been a general focus on improving health through reducing smoking, drinking and modifying cardiovascular risk factors. Risk factors for heart disease like high blood pressure, diabetes, smoking and physical inactivity are also major risk factors for dementia. 

As the management of chronic medical conditions improves and the population starts to lead a generally more healthy life, the risk of dementia could well decrease.

The problem with this is that although our management of chronic conditions like diabetes and hypertension has improved, these conditions are now becoming more common. If the prevalence of diabetes increases as expected, the prevalence of dementia will show a corresponding jump. We should also remember that age is still one of the biggest risk factors for dementia so as we live longer we can expect to see greater numbers of people with dementia. Hopefully, improving care of people living with chronic conditions means that there may not be the explosion in numbers that was previously predicted - but dementia will remain a serious social and healthcare concern for the foreseeable future.

The causes of dementia are complex and it is important toexplore risk factors that could be modified to give a lower risk of dementia. The results from the Lancet paper are encouraging as they suggest that improving the general health of the population might lead to a corresponding drop in the risk of dementia. But the increasing rates of obesity and diabetes mean that it is quite possible the prevalence of dementia over the next 20 years will actually increase. 

Dementia remains a potentially devastating illness which receives much less funding than research into heart disease and cancer, despite costing the UK economy more in social and healthcare costs. There is still an urgent need to do more for both prevention and cure.

Dr Naaheed Mukadam is a Clinical Training Fellow at the Division of Psychiatry, Faculty of Brain Sciences, UCL

Scientists find first drug that appears to slow Alzheimer's disease

Scientists find first drug that appears to slow Alzheimer's disease

Solanezumab blocks memory loss in patients with mild version of the disease, making it the first medicine ever to slow pace of damage to patients’ brains

Dr Matthew Norton, head of policy at Alzheimer’s Research UK, welcomes a new drug that slows the pace of mental decline

Scientists appear to have broken a decades-long deadlock in the battle against Alzheimer’s disease after announcing trial results for the first drug that appears to slow the pace of mental decline.

The drug, called solanezumab, was shown to stave off memory loss in patients with mild Alzheimer’s over the course of several years. The effects would have been barely discernible to patients or their families, scientists said, and it is no cure. But the wider implications of the results have been hailed as “hugely significant” because it is the first time any medicine has slowed the rate at which the disease damages the brain.

“This is the first evidence of something genuinely modifying the disease process,” said Dr Eric Karran, director of research at Alzheimer’s Research UK. “It’s a breakthrough in my mind. The history of medicine suggests that once you get through that door you can explore further therapeutic opportunities much more aggressively. It makes us less helpless.”

Alzheimer's drug trial shows promising early results

Existing drugs help with the symptoms but ultimately do nothing to slow the disease’s progression.

The drug, developed by the American company Eli Lilly, had previously been tested in a larger group of patients with both mild and moderate dementia and this trial had appeared to end in failure in 2012.

However, when scientists analysed the data more closely, they found that in the 1,300 patients with mild dementia, those who had been placed on the drug showed a roughly 30% slower decline in memory and cognitive tests than those who had taken a placebo during the 18-month trial.

This was a fairly small difference from the perspective of the patients who had not yet suffered the devastating memory loss or profound changes to personality that come later on. But the result hinted that the drug could work as long as it was given early enough.

Questions remained about whether the drug was simply treating the symptoms – improving a patient’s mood or concentration – rather than actually delaying the loss of neurons in the brain, which drives memory loss.

To test this, Eli Lilly switched the half of the 1,300 patients who had been on the placebo on to the drug as well and the entire group was given solanezumab for a further two years.

If the drug was just treating the symptoms, the placebo group would be expected to “catch up” over time. However, the results, unveiled on Wednesday at the Alzheimer’s Association International Conference in Washington DC, in the US, showed that the differences between the two groups were still there – a sign that the drug had made a genuine impact on the progression of the disease.

“It deflected the course of the disease in an irrevocable manner,” said Karran, who previously worked for Eli Lilly.

The company is now looking to see whether the drug is more effective when given at an earlier stage – something that might be expected given that it apparently had no effect for patients with more serious dementia. “It’s entirely possible you’ll show an even bigger benefit if people are given solanezumab earlier on,” said Karran.

Scientists said the results also support the idea that sticky plaques in the brain – the most visible hallmark of the disease – are what causes mental decline. The drug is an antibody that works by disassembling the building blocks that make up the plaques, slowly causing them to disintegrate.

Until now, drugs that targeted the plaques have not appeared to have any effect leading some to question whether some other biological process in Alzheimer’s was the real root of the disease.

Dr Doug Brown, head of research at the Alzheimer’s Society, said: “Today’s findings strongly suggest that targeting people in the earliest stages of Alzheimer’s disease with these antibody treatments is the best way to slow or stop Alzheimer’s disease. These drugs are able to reduce the sticky plaques of amyloid that build up in the brain, and now we have seen the first hints that doing this early enough may slow disease progression.”

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The positive trial results follow years of failed clinical research. Between 2002 and 2012, 99.6% of drugs studies aimed at preventing, curing or improving Alzheimer’s symptoms were either halted or discontinued at huge financial cost to drugs companies, many of whom shut down dementia programmes as a result.

Richard Morris, professor of neuroscience at the University of Edinburgh, said the result was likely to be significant – although he added that he was reserving final judgment until he saw the data in more detail. “I am cautiously optimistic, from the perspective of the audience, they should be too,” he said. “This is not a mouse study, it’s a people study. And that matters.”

Even if further trial results are positive, it is likely to be several years before the drug would become available on the NHS. Another phase-three trial is due to report in 2016 and then the drug would need to go through regulatory approval and would need to be shown to be sufficiently beneficial to patients.

About 225,000 people will develop dementia in the UK this year – a rate of one every three minutes.

Alzheimer’s Society research shows that 850,000 people in the UK have a form of dementia, and that in less than 10 years, 1 million people will be living with dementia. This is expected to rise to 2 million by 2051 unless preventative treatments are developed.

Last Newsletter from Richard Taylor

I received this yesterday, and decided that as Richard was so well admired and loved by thousands of people around the world, that I would share it with you. Richard will be sadly missed by many. I know that many friends are taking part in an online remembrance project, tomorrow, but due to a hospital appointment, I will not be able to take part   To  All: I could never thank all of you enough for all the kind words you have sent to our family about Richard. Many of you have sent the most amazing stories about how you met Richard, projects you worked on, and even how he touched your lives in his own unique way. That was the Richard I grew up knowing. As promised I am sending out the last newsletter Richard started. I am going to send it out exactly as he left it and hope this will still provide everyone some helpful information. So apologies in advance for the lack of editing. In the near future I will have to close down Richard's E-mail account. I know some of you still have a few projects working with Richard which I am doing everything I can to jump in and help see completed. So I ask that any of you who need my direct contact information to please reply and I will be sure to get it to you. The first question I am continually asked is who will take Richard's place in this fight? My personal wish is not for any one person to replace him. I would wish to see hundreds if not thousands that take his place and all STANDUP AND SPEAK OUT! -Jason                          ____________________________  Alzheimer's   From the Inside Out  ____________________________ News and views         from between        the ears of        Richard Taylor,        a person living        with the  symptoms        of dementia.       Hello, again. Still Richard here, still living with more and more symptoms of dementia I can't seem to work around/overcome. It is a sign, certainly of my advanced age, that every time I send one of these newsletters out there is a large deteriorating health section. This issue is no different, but I'll spare you the details and just mention my sometimes out of control heart, my aching lungs caused by fluid accumulation, and more dementia symptoms and stronger symptoms to the point where I just can't seem to find a means of "fixing" them so they don't interrupt the life I want to live. Without knowing it for sure I have been overwhelmed by my cognitive disabilities. Like a blanket carefully laid over my head while I was sleeping, and when I awoke I saw and reacted to a different world around me, and in me. I can't trust my own judgment any more. I can't handle my own calendar, meetings, goings and comings from day to day. I still know what to do, most times. I just forget it, confuse it, and/or screw it up while I am doing it. I have lost more weight and am to the point where my doctor wants me to walk around with a feeding tube hanging out of my side. You walk up and down the aisles of grocery stores and the tube sniffs out things I should be eating, pulverizes them, and sucks them in my side and deposits them somewhere in my small intestine. There isn't much new in this "newsletter" which in and of itself is a reflection on how I see Alzheimer's, especially Alzheimer's research, and the National Alzheimer's Association. Same old same old, same old blinders, same old lack of a plan, same old whine for money, lots more money. They are celebrating the actions of one committee in the house which voted to add 350 million dollars to the 545+ million they are already spending, without a clue as how it needs to be spent, nor why it needs to be spent here or there. Some research supporters are already sounding the threat that until Congress funds research at the 2 BILLION dollar level they aren't going to reach the little bit of heaven they have promised by 2025. A world without Alzheimer's is their goal and I have no doubt that if they find out what causes it, if what causes it has little to nothing to do with the disease process, and more to do with a natural part of growing old like arthritis or, poorer eye sight. We can work on the symptoms of these issue, but we can't "stop the ageing clock." Even with the most expensive treatments, even if they discover a way that everyone can afford the cure without selling their own organs to cover the high cost, you will all have to wait until the current 5+ million souls living with the symptoms pass away, then you can talk realistically about what a world without dementia, probably/maybe may be possible. Until then I shall continue to live my life as best I can, with enablers supporting me more and more. I shall never give up, thrown in the towel, pull the cover over my head and waiting for the next BINGO game to begin. I shall always try every day as hard as I can to be Richard. I shall try every day to find joy, meaning, usefulness, purpose in my life. I invite 5,000,000 kindred spirits to join me in adopting a positive self-image of yourselves, a positive outlook to your lives, and seeking to squeeze out as much out of each day as is possible! Find a purpose, live through your purpose. Truly be all you can be, not what "experts" tell you. Richard -------------------------------------------------------------------- In This Issue The Cure is Not My Top Priority Issues/Topics/Concerns/Ideas/ Opinions/Science/Myths Which Sometimes Keep Me up at Night. Money, Money, Money! Trust us, we will tell you when you have given us enough!...Hello, and so the f... Partly Cloudy, chance of reading something of interest and value to you Did the Devil make them do it, or was it Greed? 10 THINGS YOU SHOULD KNOW ABOUT LBD ---------------------------------------------------------------------  The Cure is Not My Top Priority  While attending Alzheimer's Disease International in Perth, Australia last April, I was invited by Executive Director Marc Wortmann to attend a meeting to share opinions about what our top priorities should be regarding Alzheimer's. Although my conference schedule did not allow me to attend in person, I passed my comments on to Marc, because I feel very strongly about this, and I knew that my thoughts would likely fall outside the majority opinion. I think it's fair to say that most of the people at the meeting-and many others around the world-would list research into new medications as the top priority for Alzheimer's. Many are pushing for a cure, and I imagine that even most of those who realize how daunting a prospect "cure" truly is would still argue that developing new treatments to slow onset and progression would take the top slot. I beg to differ and will probably ruffle a few feathers in doing so. But keep in mind that in spite of my holistic approach and rejection of many narrow bio-medical precepts, I am viewing this as a physician and scientist (and a bit of a mathematician as well). I told Marc (C.E.O. of Alzheimer's Disease International) that I believe our top priority is to build capacity and capability in our communities, both for our aging population in general, as well as those living with changing cognitive abilities of all kinds. Here's why: The rapidly expanding demographics regarding Alzheimer's prevalence are a microcosm of our global aging boom, because Alzheimer's (along with most other forms of  dementia) is, first and foremost, an age-related condition. The rapidly rising number of people living with the diagnosis is not due to our risk increasing-in fact recent studies show that the lifetime risk of developing Alzheimer's is decreasing with each generation, mainly due to better preventive and cardiovascular health. In other words, your lifetime risk of getting Alzheimer's will be less than that of people born in the decades before you. The rapidly rising number of people with Alzheimer's that we see in the US and most high-income countries is mainly due to all of those aging Baby Boomers, who are creating a huge bubble in the ranks of older adults-10,000 Americans turning 65 daily. And we as a nation are ill equipped to respond in a positive way to this aging boom, let alone the increasing numbers of people living with a diagnosis of dementia. Our solution to date has been to force people to live fairly independently, with very little in the way of age-inclusive community supports; and then when they can no longer manage on their own, we move them to a variety of "senior living" environments, which are booming as quickly as the Boomers! This is a recipe for disaster.There is only one number you need to know to understand this: the Potential Support Ratio (PSR), defined as the number of working adults for every retired adult. In 1950, the global PSR was 12:1-that is, twelve working adults for every retired adult. By 2000, the ratio had fallen to 9:1, and in 2050 it will be 4:1! So we clearly cannot respond to the aging boom with more senior living campuses; who will build, staff, and maintain them?? The only sustainable answer is age-inclusive communities, and it follows that such communities must accommodate all abilities, including changing cognition. There are other benefits to this approach-keeping elders (and people living with dementia) engaged in community will not only reduce excess disability and costs; the community also benefits from the wisdom and experience of older adults (including those living with dementia). At Alzheimer's Australia Western Australia in Perth, a program has been running for several years that connects people in the community who are newly diagnosed with Alzheimer's with volunteer opportunities in their community. So when much of society is saying, "You're dying; get your affairs in order" (a message described by Kate Swaffer as "prescribed disengagement"), the message from AAWA is, "We need your talents; your neighbors need your help. You have a purpose." Compare the outcomes and costs of this approach versus the probable early move to a "senior living campus" or nursing home that disengagement would cause. In the UK, 30,000 bus drivers around London were given education about dementia, to help them to be more understanding and helpful of their riders' needs. Inclusive community initiatives in UK, Australia, and many other countries are far ahead of the US; and as with global warming, the period of time during which we can respond before things get really bad is growing short. Do I support drug research for Alzheimer's? Of course I do. But I feel that meaningful progress in drug treatment will be very slow in coming, and that there will never be a day when people do not forget more than we think is normal; that's the result of nearly doubling our life expectancy over the past century. Even if we waved a magic wand and cured all cases of Alzheimer's tomorrow-the sixth leading cause of death in the US-what would the result be? More older people, whom we are already ill equipped to accommodate. And many of them will eventually develop other age-related conditions, including the myriad other forms of dementia that exist. So, to me, the priority is clear. Developing an inclusive society is Job One. You can read this argument in much more detail, along with a detailed vision for the "Inclusive Society," in Chapter 11 of my latest book, Dementia Beyond Disease. Tell me your thoughts about this! Al Power Hello, as usual Dr. Power's message should be characterized as Dr. Powerful. Organizations, large organizations are trying to confront the inevitability of a world population which has never been older, never been as vulnerable to the symptoms of dementia by throwing money at a bunch of willing researchers to cure away the problem. It hasn't worked, it isn't working, it won't work (but that's another story). What we already have to work with are our communities. While readiness varies greatly between governmental entities, citizen support services, and an aging and aged psycho social infrastructure, these services can be, should be our first respondents to this crisis. Our communities aren't just the best vehicles to work with, to strengthen, to fine tune, they are our only tools to realistically deal with the inevitability of this growing segment of everyone's population.   While we worry about pot holes, more police officers, occasional terrorist's terror the aging of the world continues. When will human needs trump all and become the priority of now and of the future? When will our leaders think, plan, and act for a better tomorrow starting today? Slow down, if not temporarily stop this baseless and useless rush to fund cure research. If you want to collect money for a real issues of dementia then support psycho-social research. Leadership isn't lacking, there simply isn't ANY forward thinking leadership. A cure is not a solution, it is a twenty plus year hope of many. It is an easy "fix." A fix which simply does not exist, and will never exist to wipe away dementia and return us all to the golden years when people didn't live long enough to confront the symptoms of dementia, they just died earlier. It is time for us each and all to stand up and speak out about an issues which is unresolved, out of control, and impossible to reach. Forward together, towards true, inclusive, and well funded community efforts to adjust and support the aging of their citizens.    Richard  --------------------------------------------------------------------- Issues/Topics/Concerns/Ideas/ Opinions/Science/Myths Which Sometimes Keep Me up at Night. Stigmas                                               Language Giving "Care"                                        Psychotropic Drugs Problem Behaviors                                Nursing Homes Memory Communities                            Alzheimer's Disease Lewy Body Dementia                             Vascular Dementia U.S.A. National Plan                              Fighting Alzheimer's Curing Alzheimer's "A world without Alzheimer's Disease"        Death                                                  Imaging/bio-markers/Amyloid/Tau Purpose                                               Culture Change Staff Ratio to Residents                         Diagnosing Dementia FTLD (Frontal Temporal Lobe Dementia) Atypical Alzheimer's Disease The Gold Standard for diagnosing Alzheimer's Disease     Brain Science                                       Memory/Forgetting Professionals                                        Physicians Bingo and other re-creative activities     ________________ Therapy Drugs                                                  Alzheimer's and Dementia The use of anti psychotic drugs to control problem behaviors    Diagnosis                                             Carer Stress Progression/Stages                               Learned Helplessness The Self Fulfilling Prophecy                    Dementia Friendly Cities Environment as a form of Treatment      Cures Correlations                                         Delirium/hospitals/dementia "Hope"                                                Lying/Therapeutic Fibs Disease Modifying Treatments              "Let's cross those bridges when we come to them!"  The cause of Dementia/Alzheimer's      Music Therapy Suffering                                            Testing Current Research (Nibbling in the dark) Richard  -------------------------------------------------------------------- Money, Money, Money! Trust us, we will tell you when you have given us enough! Hello, and so the folks who claim to be taking care of our brains are demanding of congress to "show them the money." I hope congress doesn't ask them to show some results, show them a time line, show some limiting of the scope of research because they now actually know where they are going. Until then I suppose each of these bodies can continue to blame the other for why they aren't making more progress. In the meantime - the people  whose brains need the most support from each of the organizations are left to fend for themselves. Shame on you all for arm wrestling each other for more  money, power  and results, and have  so little to show for it thus far, and so little to offer in the way of science and a rational plan for the future, other than of course more money, faster please.    Richard --------------------------------------------------------------------- Partly Cloudy  Chance of reading something  of interest and value to you What's new in my "Cloud"? I find it easier to send my writings and presentations to my cloud site than it is for me to post them to my home page (although I attempt to do both). Float up to the cloud and look around. There are lots of links, articles, opinions floating around up there, and new ones appear every week. Please go to: Richard's Cloud Directory Richard ------------------------------------------------------------------- If you would like to read more of writings and/or  follow my postings more closely please;  friend me on facebook (richardtaylorphd),  visit my home page (www.richardtaylorphd.com),  and/or write me directly (richardtaylorphd@gmail.com). You may sign up for this newsletter on my home page (upper right hand corner of home page). Most all of my writings and presentations are posted on my cloud site which is accessible on my home page.Use this area to provide your contacts information about your organization. Sincerely,   Richard Taylor, Ph.D. Alzheimer's from the Inside Out Alzheimer's from the Inside Out Book  20 Questions, 100 Answers, 6 Perspectives DVD  Live Outside The Stigma DVD ---------------------------------------------------------------------- Did the Devil make them do it?  Or was it Greed? Hello, shame, shame on the makers of Namenda. And where is the moral force of the world's Alzheimer's Associations over this grab for profits at the expense of serving human beings?    Actavis' Stance On Namenda Is Harming Pharma's Image  Richard -------------------------------------------------------------------- 10 THINGS YOU SHOULD KNOW ABOUT LBD Lewy body dementias (LBD) affect an estimated 1.4 million individuals and  their families in the United States.  At the Lewy Body Dementia Association (LBDA), we understand that though  many families are affected by this  disease, few individuals and medical professionals are aware of the  symptoms, diagnostic criteria, or  even that LBD exists. There are  important facts about Lewy body  dementias that you should know  if you, a loved one, or a patient  you are treating may have LBD.    1. Lewy body dementias (LBD)  are the second most common  form of degenerative dementia. The only other form of degenerative dementia that is more common than  LBD is Alzheimer's disease (AD).  LBD is an umbrella term for dementia associated with the presence of Lewy bodies (abnormal deposits of a protein called alpha-synuclein) in the brain. 2.LBD can have three common presentations:   *Some individuals will start out  with a movement disorder leading  to the diagnosis of Parkinson's  disease and later develop dementia.  This is diagnosed as Parkinson's  disease dementia. *Another group of individuals will  start out with a cognitive/memory  disorder that may be mistaken for  AD, but over time two or more  distinctive features become apparent leading to the diagnosis of 'dementia  with Lewy bodies' (DLB). *Lastly, a small group will first  present with neuropsychiatric  symptoms, which can include hallucinations, behavioral problems,  and difficulty with complex mental activities, also leading to an initial  diagnosis of DLB.   Regardless of the initial symptom,  over time all three presentations of  LBD will develop very similar  cognitive, physical, sleep and  behavioral features. The most common symptoms of  LBD include: *Impaired thinking such as  l oss  of executive function (planning, processing  information), memory, or the ability to understand visual information.  *Fluctuations in cognition,  attention or alertness; *Problems with movement including tremors, stiffness, slowness and difficulty walking *Visual hallucinations (seeing things that are not present) *Sleep disorders, such as acting out one's dream while asleep *Behavioral and mood  symptoms, including  depression, apathy, anxiety, agitation, delusions or paranoia *Changes in automatic body functions, such as blood pressure control,  temperature regulation,  and bladder and bowel  function. 2. The symptoms of LBD are treatable: All medications prescribed for LBD are approved for a course of treatment for symptoms related to other  diseases such as Alzheimer's  disease and Parkinson's disease with dementia and offer  symptomatic benefits for cognitive movement and behavioral symptoms. 3. Early as accurate diagnosis of LBD is essential: Early and accurate diagnosis is important because LBD patients may react to certain  medications differently than AD or PD patients. A variety of drugs, including anticholingergics and some antiparkinsonian medications, can worsen LBD symptoms. 4.Traditional anti-psychotic  medications may be contraindicated  for individuals living with LBD: Many traditional anti-psychotic medications (for example, haloperidol, thioridazine) are  sometimes prescribed for  individuals with Alzheimer's  disease and other forms of dementia to control behavioral symptoms. However, LBD affects an  individuals brain differently than  other dementia's. As a result, these medications can cause a severe worsening of movement and a  potentially fatal condition known as neuroleptic malignant syndrome (NMS). NMS causes severe fever,  muscle rigidity and breakdown that  can lead to kidney failure. 5. Early recognition, diagnosis and  treatment of LBD can improve the  patients' quality of life: LBD may affect individual's cognitive abilities, motor functions, and/o ability to complete activities of daily living. Treatment should always be  monitored by a physician and may  include: prescriptive and other therapies, exercise, diet, sleep habits, changes in behavior and daily routines. 6. Individuals and families living with LBD should not have to face this disease alone: LBD affects every aspect of person - their mood, the way they think, and  the way they move. LBD patients and families will need considerable resources and assistance from  healthcare professionals and  agencies. The combination of cognitive, motor and behavioral symptoms creates a highly challenging set of demands for  continuing care. LBDA was formed to help families address many of  these challenges. 7. Physician education is urgently  needed: An increasing number of general practitioners, neurologists,  an other medical professionals are beginning to learn to recognize and differentiate the symptoms of LBD - the most misdiagnosed dementia - from other diseases. However, more education on the  diagnosis and treatment of LBD is essential. ----------------------------------------------         10, 9, 8, 7, 6, 5, 4, 3, 2, 1, 10,  9, 8, 7, 6, etc, etc. We will never be closer than 10 years  to a cure for Alzheimer's disease. Or  to say it in a positive manner we will  always be only ten years away from a  cure for Alzheimer 's disease.  Or to say in in a fund raising commercial/letter/appeal "We are  closer today than ever before to the  cure for Alzheimer's Disease." Each year as we discover more and  more about how the brain seems to  be acting; each year as technology  allows us to see more and more of  how the brain is actually working;  each year as we make up new  theories of what all this means we proudly/loudly announce we are  coming closer and closer to actual  artificial intelligence, brains that  think like humans, and a cure for Alzheimer's Disease. "Why?" you may be asking yourself? Because the more we believe we  know about it, the more we know  we don't know about it. Over the  course of the last ten years it has  been loudly predicted/trumpeted  that "a light at the end of the cure  tunnel" had been seen by many researchers. Major breakthroughs  are announced monthly by some  cure cheerleader or another. One  year it was said: "The bridge from  having no idea how to cure it to the  actual cure was two thirds complete."  And finally this year is was confidently shouted: "It is no longer a question  of if, but when we will cure Alzheimer's Disease. We know how to do it, we  only need more money faster to  beat this thing ten years from now."  And so again the ground has been  laid for another moving of the target  date, this time because Congress  didn't throw enough money after  this search of blind alleys. Researchers, who for years drew  their subjects from a pool of almost exclusively folks in their 70s and 80s  and who were exhibiting most all the symptoms of most all of the forms of dementia, are now drawing subjects  from folks who have been diagnosed  as have mild cognitive impairments.  Some subject pools are labeled as  "pre-clinical," "non symptomatic."  The Amyloid and Tau researchers  have raced up and down the  continuum of symptoms in search  of just the right mix of severity and  variety of symptoms to feel  comfortable they were truly  working with folks living with  Alzheimer's disease. Presently  they have settled on a tiny minority  of folks living with the symptoms of dementia and whose genetic  make-up includes a combination  of several of a dozen different genes. Meanwhile back at the ranch,  inhabited by folks living with the  symptoms of dementia and who  have been told by someone(s) in  a white coat(s) they have Alzheimer's disease, these folks are each year  faced with living with/coping with/understanding more and  more cognitively disruptive thinking/remembering/organizing/ and so on and so on. Walks, runs,  football games/shooting events/and so on and so on are organized each  year to raise enough more money to  make sure the 10 year goal line is still reachable. The only problem is  everyone January first someone  keeps erasing the goal line, and  redrawing it another year away  while announcing a desperate need  for season ticket holders to renew  their pledges and reminding all the  cost of the game keeps increasing  each year. The fact is we don't know what causes Alzheimer's disease. We don't know  it's exact symptomology or progression.  We don't know what we don't know,  and what we thought we knew last  year and led us to the 10 year  prediction now turns out that we  don't know what we didn't know,  and now we know it will take us  another year to learn what we don't  know. On the other hand, we have  known the same label, Alzheimer's  Disease, for many, many years. So  many years in fact we seem to have forgotten it is only a label, not a  proven actual consensus based  scientifically accepted term. It  simply is not a fact of life which  most brain scientists accept. The  symptoms attributed to it are real,  but that in and of itself doesn't  make the label a fact. The symptoms  are shared by many forms of  dementia that we do know exist.  We have theories, facts, scientific consensus that each year still fit  with the original meaning of the  labels of this or that form of dementia. Seldom, if ever do the folks working  on and with these other forms of  dementia take it upon themselves to declare just what year they will cure  this or that form of dementia. And, ironically they know more about their  form of dementia than do those who speak/think/live within the walls of  the Alzheimer 's disease research/promotion community.  Amazing, simply amazing, isn't it?   Richard Quick Links Dementia Alliance International Alzheimer's Disease International  Alzheimer's Weekly  Richard's Web Page  I Can - I Will

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