SIMEDHealth

Alzheimer's Dementia Resources and Health Tips

Older man plays a musical instrument called the accordion smiling with a statistic about dementia
You probably know someone with Alzheimer’s dementia. More than 5 million Americans live with Alzheimers, and many more people feel the effect as friends and family members of an individual with dementia.
November is Alzheimer’s Awareness Month, and we spoke with Dr. Anthony Ackerman, a practicing neurologist and sleep medicine physician at SIMED Neurology, to get the details on what people with Alzheimer’s can do to slow their memory loss and what resources they can use to get help.

Medications

The best medications to slow down memory loss are Aricept (Donepezil) and Namenda (Memantine). These medications have proven to work effectively in conjunction with each other. It’s important to make the distinction that Alzheimer’s medications don’t resolve the disease or  improve memory, but instead slow the decline.
While TV and magazine advertisements may offer alternative medications, Dr. Ackerman warns they may not have gone through as many well-designed studies and there may not be as much evidence supporting their benefits so users should be careful and discuss these alternatives with their physician.

Alzheimer's Infographic with tips for people with dementiaDiet

Diet is important for the brain, and Dr. Ackerman recommends the Mediterranean diet for almost everyone, but especially people with Alzheimer’s. 
The suggested guidelines for the diet, which was created by a team specifically to combat Alzheimer’s, include:
- Eating a green leafy vegetable and one other vegetable a day
- Snacking most days on nuts
- Eating beans every other day
- Eating poultry at least twice a week
- Eating fish at least once a week
- Drinking a glass of wine a day
- Eating berries at least twice a week
Foods that are unhealthy for the brain include: red meat, butter, stick margarine, cheese, pastries, sweets, and fried or fast food. These foods should be limited.

Exercise

Regular exercise is important for people with Alzheimer’s or people who have the potential to get Alzheimer’s. Exercise and a healthy diet ensure blood pressure and cholesterol are controlled and keep patients healthy. 

Sleep

Sleep is particularly important for cleaning up the debris and amyloid plaque in the brain of Alzheimer’s patients. Inefficient sleep or disruptive sleep can increase plaque buildup and Alzheimer’s symptoms. 
A leading cause for disruptive sleep is sleep apnea, so if you believe you might have sleep problems, getting tested and diagnosed is important. In a study done on people with sleep apnea, those who did not treat the apnea had greater plaque buildup compared to those who were treated. 
SIMED offers sleep testing for people who would like to get tested for sleep apnea, and Dr. Ackerman is one of our board certified sleep medicine specialists.

Keep the Brain Active

Activities like puzzles are good for people with Alzheimer’s. Crossword puzzles, Sudoku and similar activities can help maintain the neurologic pathways our brain uses to problem solve.
Alzheimer’s patients can benefit from playing games and being active with family and friends as well.
Playing musical instruments has also proven to be beneficial to people with memory loss. While Dr. Ackerman does not expect patients to learn a new instrument, patients who already play can benefit from practicing regularly.
Avoid passive activities like watching TV. 

Higher Education

Researchers have found that higher education protects the brain against dementia. People who have advanced degrees are less likely to get Alzheimer’s to the same extent as those without higher education.

Resources

ElderCare of Alachua County is a good resource for people with Alzheimer’s. They offer services that can help people over the age of 60 including a program called Al’z Place that provides care for people with Alzheimer’s disease five days a week.
The Alzheimer’s Association is another great place to look for resources on Alzheimer’s. On their website you can view the signs of Alzheimer’s and other important information about Alzheimer’s. 
Most people who have Alzheimer’s won’t notice the signs. Instead, family members or friends are more likely to recognize the changes. The Alzheimer’s Association is a good supplement to visiting a neurologist and a good resource for friends and families of patients with Alzheimer’s.
Dr. Ackerman also highly recommends the book “The 36 Hour Day” by Nancy Mace and Peter Rabins to care givers of people with dementia. The book includes information about research, different situations that can arise when taking care of people with dementia and plenty of other useful information.
 
If you or someone you know has Alzheimer’s, contact SIMED Neurology in Gainesville at 352-374-2222 or schedule an appointment online
You may also request an appointment online or call the number above to schedule an appointment with Dr. Ackerman. 
To see Dr. Ackerman or one of our sleep medicine specialists, call the SIMED Sleep Center at 352-224-2338.

National Sleep Awareness Week Reminds Us How Sleep is Important to Our Overall Health

National Sleep Awareness Week Reminds Us How Sleep is Important to Our Overall Health

Ask yourself the following questions:

  • Are you tired during the day, dozing off during a meeting, church or movie, while reading or watching TV, or when driving? 
  • Have you been told that you snore or have stopped breathing in your sleep?
  • Do you wake gasping or choking during sleep?
  • Do you have trouble staying asleep?
  • Do you wake up unrefreshed as opposed to wakening wide-eyed and bushy-tailed? 
  • Do you wake with a dry mouth, throat irritation or morning headache? 
  • Are you increasingly irritable, forgetful, depressed or anxious?
  • Have you been diagnosed with a hypertension, diabetes, thyroid disease, fibromyalgia, cardiac rhythm problem/atrial fibrillation, congestive heart failure, heart attack, stroke or early dementia?

If you answered yes to any of these questions, you may have obstructive sleep apnea.

What is sleep apnea?

Sleep apnea is a condition where your airway is blocked or partially blocked, causing interruptions in sleep, decreased oxygen to the heart and brain, and may contribute to the development of amyloid plaques in the brain. Amyloid plaques have been found in brains of individuals with Alzheimer-type dementia as well as other neurodegenerative disorders.  Left untreated, obstructive sleep apnea may lead to poor quality of life, contribute to diseases and even have dire consequences for your health, including hastening death. 

Individuals with chronic pain are often are treated with opiates (e.g., tramadol, hydrocodone, oxycodone or morphine); individuals with anxiety are often treated with benzodiazepines (e.g., alprazolam or clonazepam). These medications decrease the breathing drive and may lead to central sleep apnea.

Some individuals may have a combination of obstructive and central sleep apnea, called complex sleep apnea.  Other individuals, especially those who have heart failure, may have cycles of slowing down followed by speeding up in their breathing, which is known as periodic breathing.

How is sleep apnea diagnosed?

Sleep apnea is diagnosed with an overnight sleep study.  These can be done at home or in a sleep center. A center study is preferred because the monitoring can differentiate between the different types of sleep disorders.

A center sleep study consists of:

  • Electodes that are placed around the head to determine stages of sleep and around your eyes, nose and mouth (not to worry, no needles!) to measure breathing, mouth movements, and dream status
  • EKG (heart) monitor placed on your chest to monitor for abnormal heart rhythms,
  • Pulse oximetry to check for drops your oxygen levels,
  • Elastic bands around the chest and abdomen to determine when you are breathing, and finally
  • Electodes on the legs to monitor for leg movements

All of these connected wires which are bunched into a single connector that may be easily disconnected should you need to use the bathroom during the night.  Home studies are an option, but due to the fewer things being monitored are unable to tell the difference between obstructive, central or complex sleep apnea.  Home studies are also unable to identify other sleep disorders, such as periodic limb movements of sleep, nighttime teeth grinding (bruxism) or parasomnias (sleep talking, sleep walking, confusional arousals or REM sleep behavior disorder).

How is sleep apnea treated?

Fortunately, sleep apnea can be easily treated.  The most effective and most preferred method of treatment is positive airway pressure (CPAP or bilevel PAP) therapy.  This therapy consists of a mask that comfortably fits around the individual’s nose and/or mouth, providing the minimum air pressure necessary to keep the airway open, allowing air to reach the lungs and ultimately provide oxygen to the heart and brain.  For those who do not tolerate positive airway pressure therapy, there are alternatives, such has oral appliances that keeps the tongue and jaw forward; or surgical procedures, such implants to support the palate, uvulopalatopharygoplasty (UPPP) or electrical stimulators to keep the tongue from falling back and blocking the back of the throat. 

How can you get evaluated?

If you think that you, your spouse, family member or friend may have sleep apnea, talk to your primary care physician, who can refer you to SIMED Sleep Center for a formal sleep evaluation.  If your insurance does not require a referral and you would like to set up an appointment, you can call SIMED Sleep Center directly at (352) 224-2388 to set up your sleep evaluation.