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Not Just Dementia

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I have written in earlier blog postings about dementia: “preventing” Alzheimer’s Disease, Alzheimer’s from the inside outmaternal genetic links to Alzheimer’s, and women’s predisposition to Alzheimer’s.  I would like to share some research that shows dementia to be tied to a number of other chronic conditions we often find among the elderly.  This posting is about monitoring and managing other medical conditions in order to reduce the chances of developing dementia, and it underscores one of the most important parts of geriatric care management specifically or caregiving generally.

Dementia is more common among people with diabetes than among the non-diabetic population.  Diabetes seems to be more related to vascular dementia, but research shows also some risk for Alzheimer’s among diabetics.  One study found that even a 1% rise in long term glucose levels (referred to as A1c) was associated with declines in three different measures of cognitive function.  Researchers have long known that poorly controlled diabetes is associated with renal and cardiac complications.  These same micro-vascular issues associated with diabetes can lead to brain disorders, with some suggesting that Alzheimer’s disease could be considered “type 3 diabetes.”

Another risk factor associated with higher rates of dementia is elevated blood pressure, or hypertension.  And the flip side is true as well with one clinical study documenting that well-controlled hypertension actually reduced the risk of dementia. And blood pressure registering above 140/90 evidently encourage Alzheimer’s or other dementias.

Finally, alcohol use taken to excess can lead to impaired cognitive function for anyone.  For older adults, excessive alcohol consumption has been associated with dementias and also have been found to aggravate existing dementia or Alzheimer’s disease.

A care manager or caregiver should always be alert to any signs of impaired executive function in an older adult as this may mean that the diabetes or hypertension are not well-controlled, or that there may be alcohol abuse.  Be alert to an elder’s:

  • poor organization,
  • loss of attention or train of thought,
  • poor judgment sorting good from bad ideas,
  • faulty short term memory, weak reasoning and even 
  • lack of awareness of their deficits. 

A medical provider can assist in administering a Mini-Mental State Exam to confirm any deficiencies as well as address these other co-morbidities.  Acting early can save an elder from the slippery slope that is dementia. 

Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families throughout metropolitan Chicago.  Please email your questions to Charlotte Bishop.

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