Questions & Answers

Neurostin^TM is a non-prescription supplement that is being advertised as being effective in preventing or even reversing memory loss. Although the drug has not itself been tested in any formal clinical trials, its main ingredients (phosphatidylserine, folic acid, vitamins B6 and B12, vinpocetine, L-alpha glycerylphosphorylcholine (alpha-GPC)) have each independently been demonstrated clinically to improve some measure of brain functioning, such as mild improvements in word recall, attention tasks, or other standard cognitive tests.

The various clinical tests also report that the individual ingredients were each well tolerated individually (i.e., they had few negative side effects). In conclusion, there is nothing in the medical or scientific literature to say that the drug Neurostin^TM would not work as claimed; however, there is also nothing in the literature to say that Neurostin^TM will necessarily produce the level of improvement touted by its manufacturer. If you decide to take Neurostin^TM, please first check with your primary care physician before starting it or any other new supplement. Also, please understand that Neurostin^TM may influence only symptoms of the disease and does not impact the underlying causes.

A review of the medical and scientific literature indicates that there is no known association between receiving laser eye therapy and the development of Alzheimer's disease, dementia, or any other neurodegenerative disorder.

Alzheimer's disease can kill a person if it attacks the parts of the brain responsible for controlling breathing and the heart. Whether or not the morphine had any role in his death is impossible for me to say. At the very least, the morphine would have relieved him of any pain he may have had. So please do not feel guilty. You were there for your friend when he needed you, when it really mattered. There was likely nothing else that could have been done for him. Even if emergency care had been summoned, there is no guarantee that they could have done anything to revive him.

Most hospices have grief counselors who can help guide you through your pain. Please speak to one of these professionals, or else contact a clergy, therapist, doctor, grief support group, or other counselor whom you feel comfortable discussing this subject with. I know that it must be difficult for you, but just remember that all of your dear friend's suffering is now over and he is finally at peace. We should all be so fortunate as to have a good friend holding our hand when our time in life expires.

In many cases, constipation is to blame in cases where dementia patient have been found handling their own feces. Your grandmother may also have hemorrhoids, which can make having bowel movements uncomfortable. Thus, she may not be playing with her feces so much as just trying to help it along, such as by manually assisting in a bowel movement. So first make sure your grandmother is getting enough fiber in her diet so she has normal and regular bowel movements. You might try giving her fiber supplements or even the occasional stool softener. Medicated hemorrhoid wipes or ointments can also help, as can flushable wet wipes which are gentler and more thorough than dry toilet paper.

By now I'm sure you've tried talking to your grandmother to remind her that this behavior is not only inappropriate but highly unsanitary, however, I'm also fairly sure that this approach has been unsuccessful. Reasoning with her is unlikely to make her stop. In this case, your grandmother is simply confused and has forgotten that it is unacceptable behavior to play with feces. It may thus be necessary to monitor her when she uses the bathroom—to make sure she practices good toileting habits.

Some Alzheimer's patients simply become confused in the toilet and forget what they are supposed to do. So give her a refresher course on how to wipe (always front to back!), flush, and wash her hands with soap and warm water. Sometimes posting simple instructions on a bathroom wall can help (easy-to-follow diagrams usually work better than words). Make sure they are posted at her eye level in areas appropriate for the activity (e.g., hand-washing diagram near the sink, wiping diagram near the toilet, etc.)

If she is playing with her feces outside of the bathroom area, then you can also try deterring this behavior by dressing her in special clothing that does not allow her easy access to her bottom. For example, a one-piece jumpsuit that closes from behind can help to discourage this new, and hopefully short-lived, behavior.

Most of all, try to stay calm and patient. Yelling or arguing with your grandmother will only serve to agitate and confuse her. So be positive and encourage her to practice good hygiene by wiping, flushing, and always washing her hands. If her hands are dirty from feces, for example, and she scratches herself (or a caregiver), an infection could easily result. To that end, make sure you keep her fingernails neatly trimmed and filed and encourage her to use instant hand sanitizer (preferably with a moisturizer so that it does not dry out her skin).

Patients in the later stages of Alzheimer's disease are easily confused, so moving such a patient to an assisted living facility can be challenging but it is not impossible. Since every patient/caregiver situation is unique, sometimes it makes better sense to wait until the late stages of the disease to place a loved one in assisted care, and sometimes it simply is more practical to do it earlier on in the disease.

There is also your mother's health and well-being to take into consideration. Even if a caregiver comes to your parents' current home each day, there still may be times when your mother will be solely responsible for your father's care. She may be physically unable to assist him if, for example, he needs help being lifted out of bed or lowered to use the toilet.

Your father may be anxious or confused by his new surroundings initially, but with time he can be aided in accepting them as his new "home." It definitely helps that your mother will be there with him, as this should make the transition easier. Try to have him visit the new home and community as many times as possible before the move, and speak enthusiastically about how nice the new place will be. Immediately following the move, try to get him back on his regular schedule as soon as possible. The more things that are "familiar" to him in the new environment, the sooner he will come to accept it as home. You can also ask the director of the facility for help in objectively assessing when might be the best time to move him, and also about any suggestions they may have to make the transition more seamless.

Please contact your husband's primary care physician and speak to him or her openly about your concerns. The doctor will probably want to see your husband for an exam, so go ahead and schedule an appointment as soon as possible. You can tell your husband that his doctor's office requires him to come in for a check-up before they will renew one or more of his existing prescriptions. Before your appointment, call the doctor's office and remind them of the reason for your visit. The doctor should be able to determine the underlying cause of your husband's forgetfulness. There are many medical and psychological conditions other than Alzheimer's disease that can cause memory problems. For example, certain drug interactions, thyroid problems, stress or depression, vitamin deficiencies, tumors, small strokes or lung problems can all cause mild dementia-like symptoms—any or all of which of these other problems your husband's doctor will need to rule out before he or she can make a definitive diagnosis of Alzheimer's disease.

It is known that exposure to lead-based paint can lead to developmental deficits and stunted growth in children. However, now research also shows that lead exposure early in life may also influence Alzheimer's disease-related protein accumulation in the brain. Researchers at the University of Rhode Island found that aged (23 years old) monkeys that were exposed to low levels of lead (Pb) as infants had higher levels of Alzheimer’s disease-related genes, elevated amyloid-beta levels, and greater Alzheimer’s disease-like pathology in their frontal cortex. The researchers thus suggest that exposure to environmental insults during critical brain developmental periods may influence the expression of disease-related genes and gene products (e.g., amyloid-beta protein) later in life.

Bear in mind, however, that this study was performed in monkeys. Although at present there are no studies in humans conclusively linking lead exposure to the development of Alzheimer's disease, based on the studies in monkeys it is not so great a leap to theorize that exposure to lead early in like may increase a person’s risk of developing Alzheimer’s disease. So, is it possible that the environment your mother lived in contributed to her getting dementia? Certainly it is possible, but further research would clearly need to be performed in order to confirm this hypothesis.

There is one case study in which a man who had been diagnosed with Lyme disease later developed Alzheimer's disease. When his brain was autopsied, DNA for Borrelia burgdorferi, the Lyme disease spirochete, was found within Alzheimer's disease amyloid plaques. However, keep in mind that these results are from only one study performed in one person.

Other studies with a larger number of subjects have not found such a connection. For example, one study found no evidence of Borrelia antibodies (antibodies are an indicator that the body has been exposed to a foreign pathogen, which in this case would be the Lyme disease pathogen) in patients with Alzheimer's disease. Clearly, further research needs to be performed in order to determine if spirochetes can in any way influence the development of Alzheimer's disease.