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Seniors Newsletter
July 7, 2008


In This Issue
• More 90-Plus Women Than Men Prone to Dementia
• Mental Test Spots Alzheimer's Risk
• Extreme Heat a Deadly Risk for Older Adults
 

More 90-Plus Women Than Men Prone to Dementia


WEDNESDAY, July 2 (HealthDay News) -- Not as many men as women make it to their 90s or beyond, but those who do have an advantage over their female counterparts: Researchers found that males aged 90 and older are more likely to avoid dementia than women of similar age.

There's no clear reason for the striking discrepancy, according to the study, which found signs of senility in a full 45 percent of women aged 90 and older from a southern California retirement community. Men weren't immune to mental decline, however, since 28 percent of them also suffered from dementia.

Still, "given the increasing number of people (aged 90 and older) this can become a fairly big public health problem," said study lead author Maria Corrada, an assistant adjunct professor of neurology at the University of California, Irvine. "We need to be prepared for that. Dementia requires a lot of care, and a lot of money needs to be spent on caring for these people."

Dementia -- also known as senility -- refers to the mental confusion that can strike the elderly. Alzheimer's disease, stroke and brain injuries can lead to the condition, although the cause is sometimes unknown.

Researchers know little about how senility affects the so-called "oldest old" -- people 90 and older. There are now an estimated two million American in this age group and that number is projected to grow substantially as the population ages.

In the new study, the researchers examined a survey of 911 men and women over the age of 90 between 2003 and 2006. In the 1980s, all the participants had lived in the Leisure Village retirement community in Orange County, Calif., and took part in another study at that time.

Two-thirds of the participants were women and most were white, upper-middle class and well-educated. In some cases, the researchers interviewed them by phone or in person; in others, researchers talked to someone else, such as a relative or caregiver.

The study findings were published online July 2 in the journal Neurology.

Why the discrepancy between the genders in terms of dementia risk? Although the study didn't look at when the participants started showing signs of senility, it's possible that women may simply live longer with the condition than men, Corrada said. Women, after all, live longer than men in general.

It's also possible that men who manage to reach the age of 90 have "the best protoplasm," said William Thies, vice president for medical and scientific affairs with the Alzheimer's Association. In other words, men have to be in pretty good shape to make it that far.

Corrada and her colleagues also found that women with higher levels of education were less likely to show signs of senility. More education didn't seem to have any effect in men, however.

"Education may mean something different for men and women in this age group," Corrada said.

Other research has linked education to brain health, Corrada added. "People who have more education and more intellectual attainment in their lives are less likely to become demented," she said. "That may be simply because they start out so much better than everyone else (brain-wise) that they can cope better" with aging.

More information

Learn more about dementia from the American Academy of Family Physicians  External Links Disclaimer Logo.


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Mental Test Spots Alzheimer's Risk


TUESDAY, July 1 (HealthDay News) -- A new questionnaire may help in both diagnosing older adults facing dementia and also in identifying individuals who need help with daily living.

The Everyday Cognition instrument consists of 39 questions to be answered by people who know the patient well.

"There have been a number of studies that show that people with mild cognitive impairment who have functional problems in addition to performing poorly on neuropsychological testing are more likely to progress in the near future," said study author Sarah Tomaszewski Farias, an assistant professor of neurology at the University of California, Davis, Medical Center in Sacramento. "One of our hopes is that this instrument will be able to help identify very early on those people at increased risk for developing Alzheimer's disease."

That would help both patients and family members prepare for what lies ahead and identify patients who need to be more closely monitored.

In addition, Farias said, the test would also help identify "people who are having [functional] problems so that we know who needs help and who doesn't."

"What's nice about this is that it is designed to pick up very early memory problems, and it's an entirely caregiver-based survey," said Dr. Scott Turner, incoming director of the Memory Disorders Program at Georgetown University Medical Center, in Washington, D.C. "This is something the caregiver can fill out, while the practitioner is looking at the patient. It could be used for screening, for diagnosis and for drug development, if you want to look for some proof that your drug is having some effect, so it has a lot of potential uses."

"They want something that they could use to ask a family member about the potential patient's everyday functioning to see if that's sensitive to picking up the likelihood of dementia early on," added Dr. Gary J. Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York City.

The findings were published in the July issue of Neuropsychology.

Existing neuropsychological tests tend to be very abstract. For the last 40 years, these tests have looked at two categories: so-called "basic" activities (such as grooming, feeding, dressing), which are affected in later stages of dementia, and "instrumental" activities of daily living (such as managing medication, finances, cooking, driving).

"I was interested in understanding how our neuropsychology tests translated into everyday problems, how our cognitive tests . . . translate into everyday problems that a person is experiencing and that a caregiver is concerned about," Farias explained.

Farias and her colleagues divided everyday functioning into seven cognitive "domains:" memory, language, semantic or factual knowledge, visual and spatial abilities, planning, organization and divided attention.

An original list of 138 items was eventually culled to 39, which was then tested in 576 older adults: 174 of whom were cognitively normal, 126 who had mild cognitive impairment (MCI), and 276 who had been diagnosed with dementia.

"Informants" (people who had known the patient for an average of almost 45 years) provided details on whether the patient could remember shopping items without a list, reading a map, balancing the checkbook, and cooking or working and talking at the same time.

Not only did the instrument confirm established diagnoses, it was also able to distinguish people with MCI from those with full-blown dementia, meaning it was able to pick up on subtle differences in function.

The results also weren't highly influenced by occupation and education levels, as are existing tests.

"This is really the first step in development the instrument," Farias said. "What we're really interested in doing is to track people over time to get a better understanding of the early signs of functional impairment."

More information

Visit the Alzheimer's Association  External Links Disclaimer Logo for more on this condition.


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Extreme Heat a Deadly Risk for Older Adults


TUESDAY, July 1 (HealthDay News) -- As the temperatures rise, older adults become more vulnerable to heat-related health issues because their bodies don't cool down as quickly as younger people.

"Sometimes, older people may not feel hot when the temperature is dangerously high and are also less likely to feel thirsty, which means their bodies have lost too much water," Dr. John B. Murphy, president of The American Geriatrics Society, said in a prepared statement.

Most of the 200 Americans who die of health problems caused by high heat and humidity are age 50 or older. To help seniors stay safe this summer, Murphy suggested:

  • Stay in the air conditioning, whether home or out and about.
  • Fans do not adequately cool down the body during intense heat waves.
  • Avoid extended periods of sun exposure, walking long distances, lifting heavy objects or other strenuous activities.
  • Drink plenty of water and other nonalcoholic, non-caffeinated clear beverages. If one's urine is a light yellow color, enough water is being taken into the body, but if it's darker, the body needs more water.
  • Take cool showers, baths, or sponge baths.
  • Wear lightweight, light-colored, loose-fitting clothing and hats.

Common heat-related health problems to watch for include:

  • Dehydration: Signs include weakness, headache, muscle cramps, dizziness, confusion and passing out.
  • Heat stroke: A body temperature of or above 103 degrees; red, hot and dry skin; a fast pulse; headache, dizziness, nausea or vomiting, confusion and passing out.
  • Heat exhaustion: Heavy sweating or no sweating, muscle cramps, tiredness, weakness, paleness, cold or clammy skin, dizziness, headache, nausea or vomiting and fainting.

More information

The U.S. Centers for Disease Control and Prevention has more about protecting yourself from extreme heat.


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