Tag Archives: depression

Middle-aged depression connected to Alzheimer’s

A study of almost 1,500 people has discovered a link between feelings of hopelessness in mid-life and Alzheimer’s disease in later life.
Alzheimer Scotland estimates that there are around 90,000 people living with dementia north of the Border, but that figure is expected to double within the next 20 years.
Last night, experts said the new research emphasised the importance of people looking after their emotional wellbeing throughout their lives.
The study assessed a sample of 1,449 Finnish people when they were in mid-life – between 39 and 64 years old – and then re-examined them when they were aged between 65 and 80.
It measured participants’ feelings of hopelessness by asking a series of questions and assessed their cognitive health at the follow-up.
Experts took the health and lifestyle choices of the participants into account and also noted the presence of the gene ApoE4 allele, which is present in around 20 per cent of the population and can increase the risk of developing Alzheimer’s disease.
The study found that those who suffered cognitive impairment at follow-up had experienced higher levels of hopelessness in midlife.
The report into the findings, published this week, reads: “Feelings of hopelessness already in midlife may have long-term implications for cognitive health with a pronounced risk increase for Alzheimer’s disease in persons who in addition carry the ApoE4 allele.
“While most research on emotion and cognitive health has focused on global depression or composite depressive feelings, this study suggests a more differentiated approach to be feasible.
Mental health should be a much greater priority for all of us, irrespective of our age
Greg McCracken, Age Scotland’s early dementia team leader
“The dimension of hopelessness seems like a promising candidate that may have relevance beyond that of global depression – also as a risk factor for Alzheimer’s disease and other dementias.”
Previous studies have linked depression and dementia but failed to find whether one caused the other or vice versa.
However, the latest research found that a significant number of participants suffered depressive thoughts up to 20 years before they developed dementia symptoms.
Last night, Age Scotland’s early stage dementia team leader Greg McCracken said: “These findings would appear to support the importance of looking after your emotional health and wellbeing throughout life. It is well known that people who experience poor mental health often fail to prioritise things like physical activity or a healthy diet, which are also important factors associated with a reduced risk of developing dementia.
“That’s why Age Scotland’s Early Stage Dementia project, funded by the Life Changes Trust, is raising awareness of how looking after oneself – including our mental health – should be a much greater priority for all of us, irrespective of our age.”
The research was carried out by the University of Eastern Finland, Stockholm University and the Karolinska Institute – both in Sweden.
Source The Express

Dementia Carers suffer depression

4 in 10 Dementia Carers suffer depression

according to researchers from University College London.

 

Two-thirds of the people suffering from Dementia are currently living at home with their loved ones, which equates to 670,000 carers in Britain alone, and most of these people will be elderly themselves.

 It has now emerged that 40% (up to 250,000) of those caring for loved ones are clinically depressed themselves.

Helping to support those suffering from Dementia will not only improve their mental health but will also relieve some of the pressures that the carers are currently experiencing.  This will reduce the odds of the relative having to be taken into a nursing home or hospital.

Rebecca Wood, the chief executive of the Alzheimer’s Research UK charity, said:

‘Dementia doesn’t only affect those who are diagnosed with the condition: its effects are felt far and wide, not least for individuals and families who are caring for their loved ones.’

23 Million people in the UK will have a friend or relative who suffers from Dementia in some way. The symptoms are likely to appear in many other cases as well, but are not severe enough to be clinically diagnosed. Many more people will have early signs of dementia but will not take on any care at that stage.  

A number of patients simply refuse to believe that they have any illness, so resist any kind of help. This can have serious effects on the family and carers of dementia patients who struggle to cope with their diagnosis.

However, help and care is available to utilize, but even this doesn’t seem to cut the odds of metal health problems.

Carers are expected to have access to clinical psychologists, but it has emerged that there aren’t enough available for them. Only now has a proper treatment programme been designed.

However, an inexpensive and easy-to-teach course devised at UCL could hold the solution.

Professor Livingston tested 173 carers in an eight-hour course to compare their own progress to that of another 90 who went about their lives as normal. This course covered topics on how to manage their relatives’ behaviour, communicate with doctors regarding their situation and just makes time for themselves.

Carers were introduced to the Strategies for Relatives Programme (START) and asked to work out what part of the programme benefited them and to continue practicing 

them. The carers who continually practiced this course were seven times less likely to be depressed than those who didn’t according to the Alzheimer’s Association International Conference.

Dr Doug Brown, of the Alzheimer’s Society, said:

‘If results like these were found with a new drug, it would be hailed a breakthrough.

‘This programme gives us an effective way to support carers and reduce depression and anxiety, which will have the added benefit of improving life for those that they care for.

‘It is great to see research focusing on improving the well-being of dementia carers whilst other scientists search for treatments and a cure.

‘Too often people forget the profound effect dementia has on loved ones caring for someone with dementia and surrounding friends and family.’

Our Care Plans on Dementia sets out a clear explanation of the resident’s issue, and will guide the nurse or carer through the process of preparing a comprehensive, individual person centred Care Plan.

If you would like to try our Care Plans relating to Dementia please click the link – Try Our Care Plans

Our website offers a whole range of other care plans for carers and nurses that could help you. Please visit today – Planning For Care


 Dementia care

 

Depression is not contagious but an upbeat mood is, say scientists

Sad friends will not bring you down but upbeat moods are contagious a new study has shown.

Researchers at the universities of Manchester and Warwick studied 2,000 teenagers to see if their social groups could influence how they felt about life.

They found that having mentally stable, happy friends helped to improve the mood of those who were depressed. But crucially depressed people did not seem to have an impact on the state of mind of those around them.

The research team used statistical methods usually used to monitor the spread of infectious diseases to find out how mood spread through social networks over 12 months.

The results show that being friends with someone who is depressed does not put a person at risk of becoming depressed themselves, but it will be beneficial to a glum mate.

“We know social factors, for example living alone or having experienced abuse in childhood, influences whether someone becomes depressed,” said Dr Thomas House, senior lecturer in applied mathematics from the University of Manchester.

“We also know that social support is important for recovery from depression, for example having people to talk to.

“Our study is slightly different as it looks at the effect of being friends with people on whether you are likely to develop or recover from being depressed.

“This was a big effect that we have seen here. It could be that having a stronger social network is an effective way to treat depression. More work needs to be done but it may that we could significantly reduce the burden of depression through cheap, low-risk social interventions.”

The results suggest that all friendships between teenagers can reduce depression since having depressed friends does not put them at risk, but having healthy friends is protective and curative.

University of Warwick social science expert Professor Frances Griffiths and applied Mathematician Edward Hill collaborated on the study. Edward Hill said: “We’ve ensured that the method we used was not confounded by homophily – that’s the tendency for people to be friends with others like themselves.

“This would have affected our research. For example if many adolescents drink a lot of alcohol and their friends drink a lot too it may be that alcoholic drink cause depression among the young people rather than who they are friends with.”

The research was published in the journal Proceedings of the Royal Society B.

Source The Telegraph

Let GPs offer mindfulness meditation to patients, say experts

An ancient Buddhist approach to meditation rebranded as “mindfulness” should be made available to the millions of Britons who are suffering from stress, depression and anxiety, according to the Mental Health Foundation (MHF).
The call comes as new figures being released by the charity will show that more than one in four (29 per cent) of Britons regularly suffers from stress.
Nearly one in four (24 per cent) of people admit to being anxious on a regular basis, and more than one in seven (17 per cent) are often or always depressed.
The pressures of everyday life, and dealing with problems ranging from debt to work worries and relationship issues, are contributing to significant numbers of people succumbing to mental health problems.
And the scale of the problem illustrated by the snapshot of the country’s stress levels means that a new approach to dealing with mental health is needed, with more emphasis on prevention, says the charity. Stress, anxiety and depression are part of a wider picture of mental illness which costs Britain £100bn a year, according to campaigners.
Jenny Edwards, MHF chief executive, said: “We have just had a general election where for the first time mental health was a key issue addressed in the manifestos of the major parties.
“The public is calling for practical action. It’s now time to hold the incoming government to commit to significant steps.”
She added: “Of course adequate funding of mental health services is vital, but we also need a national prevention strategy, to help prevent mental health problems from developing wherever possible.”
Mindfulness aims to reduce anxiety, stress, and depression, typically by meditation, yoga and breathing exercises aimed at increasing people’s awareness of themselves and their emotions, and so encouraging them to focus on living in the moment rather than dwelling on things that are beyond their power to control.
Mindfulness-based cognitive therapy is recommended by the National Institute for Health and Care Excellence (Nice) for staving off depression, but only a handful of clinical commissioning groups make it available in their area, says the MHF. “We are calling for mindfulness to be available in all areas of the country, so that GPs can recommend it and Nice recommendations can be acted upon,” said Ms Edwards.
Medical experts are backing the calls for a new approach, to mark the start of Mental Health Awareness Week tomorrow.
Dr Liz England, mental health lead at the Royal College of GPs, said: “Often our patients do not want to be reliant on drugs in order to feel better, so alternative, evidence-based therapies for common mental health problems should be encouraged, as long as it is in line with an individual patient’s wishes.”
She added: “Mental health is a clinical priority for the college, and we would champion more research into finding new and effective therapies to treat mental health problems – the emergence of mindfulness therapy, and other treatments, such as talking therapies, is a step in the right direction to giving mental health the same parity of esteem as physical health.”
A spokesperson for the Royal College of Psychiatrists commented: “There is a growing evidence base for a wide range of psychological therapies that can help in the management of stress and mood disorders; including mindfulness-based cognitive therapy.
“The college supports calls for increased access to therapies and preventative interventions that can help build up resilience as well as support recovery.”

Case study

Andrea Shaw, 30, a student nurse from Sheffield.

Andrea shaw, 30, from sheefield first discovered mindfulness in 2010 after a bout of severe depression source: marjorie ellis-thompson

Andrea Shaw, 30, from Sheefield first discovered mindfulness in 2010 after a bout of severe depression

“I first discovered mindfulness in 2010, in the aftermath of an episode of severe depression. I have had mental health problems since I was a teenager, although I experienced a long period of being well at university. 

 
However, after my degree, I was faced with job and money worries, as well as family issues. I couldn’t cope and, as a result, I developed severe anxiety which eventually led to my depression.
Mindfulness is about accepting your present experience, just as it is, whether that’s good, bad or neutral. 
Reduced anxiety may happen, or it may not; learning to accept life’s experiences is the true value of mindfulness. You could be going through some pretty awful emotions but mindfulness will allow you to manage them more effectively.
Mindfulness is not a cure all; I don’t think that’s the point. But I find it extremely useful as a way of living and a way of being. I’m just so glad that I gave it a chance.”
Source The Independent

Mindfulness as effective as pills for treating recurrent depression – study

Mindfulness-based cognitive therapy may be as good as pills at stopping people relapsing after recovering from major bouts of depression, according to a study.

Mindfulness-based cognitive therapy (MBCT) was developed from mindfulness techniques, which encourage individuals to pay more attention to the present moment, combined with cognitive behaviour therapy (CBT), specifically to try to help people who have recurring depression.

It teaches people to recognise that negative thoughts and feelings will return, but that they can disengage from them. Rather than worrying constantly about them, people can become aware of them, understand them and accept them, and avoid being dragged down into a spiral leading back to depression.

Current best practice, endorsed by Nice (the National Institute for Health and Care Excellence) is to encourage people with a history of recurrent depression to remain on antidepressants for at least two years.

However, some are very reluctant to keep taking pills, while others find their depression comes back when they finally stop using the tablets.

The trial, published in The Lancet, a medical journal, involved a group of 424 adults from GP practices in the south-west of England, who were willing to try either the pills or the therapy.

Half were randomly allotted to each. Those assigned to mindfulness had eight group sessions of more than two hours plus daily home practice and the option of four follow-up sessions over a year.

The course involved mindfulness training, group discussion and cognitive behaviour exercises. The patients gradually came off their medication. Those assigned to the other group stayed on the tablets for two years.

The relapse rates in the two groups were similar, with 44% in the mindfulness group and 47% for those on the drugs. In each group there were five adverse events, including two deaths.

The researchers had thought the study might show that therapy was more effective than pills, based on their earlier work. Lead author Willem Kuyken, a professor of clinical psychology at the University of Oxford, said: “That was our hypothesis. It was based on our pilot study in 2008. There was a suggestion that MBCT might do better than medication. The reality is that it was not superior to medication.”

However, they established that mindfulness-based therapy is equally as good as drugs, which could offer a new option for those who do not want to be on medication for years. Co-author Prof Richard Byng, from the Plymouth University Peninsula Schools of Medicine and Dentistry, said: “Currently, maintenance antidepressant medication is the key treatment for preventing relapse, reducing the likelihood of relapse or recurrence by up to two-thirds when taken correctly.

“However, there are many people who, for a number of different reasons, are unable to keep on a course of medication for depression. Moreover, many people do not wish to remain on medication for indefinite periods, or cannot tolerate its side-effects.”

Nigel Reed, from Sidmouth, Devon, who took part in the trial, said: “Mindfulness gives me a set of skills which I use to keep well in the long term. Rather than relying on the continuing use of antidepressants, mindfulness puts me in charge, allowing me to take control of my own future, to spot when I am at risk and to make the changes I need to stay well.”

The study also showed that the therapy might work better than pills for those who have some of the most troubled histories and are at the highest risk of relapse. It was found to have protected people with increased risk because of a background of childhood abuse. The paper said: “Perhaps MBCT confers resilience in this group at highest risk because patients learn skills that address some of the underlying mechanisms of relapse or recurrence.”

Kuyken said he expected Nice to look at the study when it convenes shortly to revise its guidelines on recurrent depression.

In a commentary with the study in The Lancet, Prof Roger Mulder, from the University of Otago in New Zealand, said the findings had substantial significance. He suggested that because it is group therapy, which reduces the costs involved, it may be possible to offer MBCT as a choice to GP patients. He said: “We … have a promising new treatment that is reasonably cost-effective and applicable to the large group of patients with recurrent depression.

“Depression remains a disabling condition with high prevalence and a large clinical burden. Despite the increased use of drugs, the long-term outcome of mood disorders has not improved in the modern era. Having an alternative non-medication strategy to reduce relapse is an important means to help patients with depression.”

Source The Guardian

MS drug ‘may already be out there’

Depression and heart-disease drugs are to be tested in a trial to find treatments for Multiple Sclerosis (MS) from existing medicines.

There are currently no treatments in the secondary progressive stage of the debilitating disease.

Doctors hope the necessary drugs are already out there, but have never been tested on MS.

More than 400 people will take part in the trial at University College London and the University of Edinburgh.

Walking, balance, speech, and vision become impaired in the later stages of the disease.

There are treatments in the early phases of MS to prevent the frequency or severity of relapses. But there is nothing once the disease progresses.

Repurpose

The MS-Smart trial will test the safety and effectiveness of three drugs used in other conditions:

  •     Amiloride – licensed to treat heart disease
  •     Fluoxetine – used in depression
  •     Riluzole – for Motor Neurone Disease

They were identified after a review of previously published research into drugs that appear to protect the nerves from damage.

Researchers believe these treatments could slow down the progress of MS and the trial will be the first time they have been tested on such a large number of patients.

Dr Jeremy Chataway, a consultant neurologist and lead researcher on the trial based at UCL, said there was “huge unmet need”.

He told the BBC: “It may be the case that we have already invented the drugs we need to treat MS.

“In the same way that aspirin was developed as a painkiller and is now used to treat stroke patients, we may well have invented the drugs that we need, we just don’t know that they work in different situations than what they were invented for.

“One of the advantages is they are very cheap, and we know a great deal about them as they have been tested on millions of people around the world in their original indication.

“So it’s much more of a running start when we use drugs that we aim to repurpose.”

Prof Siddharthan Chandran, a clinical neurologist at the University of Edinburgh, said: “This is a landmark study that seeks to not only test three potential treatments, but also showcase a new approach to clinical trials for progressive neurological conditions.”

MS-Smart is a phase two trial, making sure the drugs are safe and demonstrate sufficient effectiveness before they are tested in a larger number of people.

If successful, it could lead to new ways of using the existing drugs to modify the way the disease develops.

Sanjay Chadha

It is the first time Sanjay Chadha, 47, has had any real hope for his condition.

He has lived with progressively worsening MS for 25 years, and is now a wheelchair-user with round-the-clock care.

He said: “In recent years, as my MS has progressed into secondary progressive MS, those treatments aren’t available to help stop the accumulation of disability, which just seems to weaken the whole body.

“It’s very dispiriting and – I hate to use the word – depressing that there’s very little that can stop the symptoms and give me some kind of control and some kind of certainty for the future.

“To have even some kind of hope that there is some kind of possibility of something that might help – it’s that word ‘hope’.

“It’s so meaningful for somebody in my situation. Living is hard enough, but to live with no hope is even harder.”

Sourced from the BBC Online

‘Dementia’ victims who are just depressed or low on vitamins: Continuing our series, the patients told it’s Alzheimer’s when their real problems could be easily cured

Being diagnosed with dementia can come as a devastating and life-changing blow. As well as getting the right treatment, the patient’s future plans have to be rethought – and often those of their nearest and dearest, too.

Yet because there is no definitive test for dementia, inevitably mistakes are made. Some people may be told they have dementia when, in fact, they are stressed or depressed, and vice versa.

Checking for these conditions is vital because their diagnosis – and proper treatment – can often reverse symptoms that are much harder to tackle in true dementia.
Some people may be told they have dementia when, in fact, they are stressed or depressed

Some people may be told they have dementia when, in fact, they are stressed or depressed

Today, in the second part of our major Good Health series on dementia, we look in detail at the conditions that often get mistaken for this cruel degenerative brain disease. And when dementia is correctly diagnosed, we show you the best current treatment options.

The symptoms of dementia can vary widely, depending on which type is involved and which part of the brain is affected.

They include problems with short-term memory, difficulty concentrating and communicating, behaviour or personality changes and depression.

But these symptoms are a common feature of other conditions…

Depression

This is a surprisingly common problem among the elderly. Around 15 per cent of the over-65s suffer from depression; among the over-75s, that rises to 30 per cent. The problem is that elderly people do not tend to complain about their depression to family and friends.

Outwardly they may give the appearance of being content, even though they are not.

At the same time, other depressive symptoms such as irritability may be put down to old age.

Many older people will display the typical symptoms of depression, such as low mood and struggling with concentration. There may be tearfulness, problems sleeping, a loss of interest in hobbies and problems with their memory.

Doctors said I had dementia but it was really stress

Mother of two Ros Davies, 58, a former nurse who lives with husband Peter, 61, in St Austell, Cornwall, was misdiagnosed four years ago.

For six months I’d had mild memory problems. I’d found I was forgetting where I was going when I was driving even though I’ve lived in St Austell nearly all my life.

I was working as a home carer. I could remember clients’ faces and their addresses, but couldn’t work out how to get to them. I found that if I kept driving for a few minutes I would remember. It was like a switch had flicked off and then on again.

At first I put it down to my age – I was menopausal at the time and had a busy job. So I kept quiet about it – I didn’t even tell my husband or my two daughters.

But after six months I went to my GP, who referred me to a neurologist. I was given a memory test and scored well, and had a brain scan. Weeks later, I was called back to be told there was some shrinkage in my brain and I had Alzheimer’s. I started to cry.

When I told Peter he looked as if he had been punched in the stomach. I told my family they should put me in a care home when I deteriorated. I was prescribed Aricept for 18 months and my symptoms stabilised. But I resigned from my job.

But she later tried a new scanner that searches for proteins that are a marker for Alzheimer’s, and discovered she didn’t have it

Eight months ago, I found out, through the charity Alzheimer’s Research UK, about research trials at Imperial College Hospital London. They are using a new scanner that searches for amyloid plaques in the brain, proteins that are a marker for Alzheimer’s.

I had a scan and I was given the news that I didn’t have Alzheimer’s after all.

I did have some brain shrinkage, but the doctor said I may have always had it and it might be normal for me. After two years of life with an Alzheimer’s diagnosis, it was like being reprieved from the death sentence.

I still have memory lapses, but they haven’t got any worse, despite being taken off Aricept.

My doctors have been unable to pinpoint the exact cause of my problems. It’s possible stress and anxiety may have played a role.

Just knowing it’s not Alzheimer’s is like a big weight has been lifted off my family’s shoulders.

imperial.nhs.uk/services/neurology/imperialmemoryunit

INTERVIEW: JO WATERS

However, while in younger people all these might obviously be signs of depression, in older people the default diagnosis may be dementia.

Spotting the difference: There is much cross-over in the symptoms between depression and dementia, but there are key differences.

Elderly people with depression may feel apathetic and lack motivation, but they will not have the cognitive problems suffered by people with dementia.

If someone knows the people around them and the date, time and year, they are probably not suffering from dementia.

Also, while many people with dementia will be depressed, with just depression it’s common to have diurnal variation – they tend to feel more depressed at the start of the day, but their mood improves as the day goes on. Someone with dementia will not normally display this cycle.

A lack of vitamin B12

Vitamin B12, found naturally in meat, eggs and dairy, is vital to the metabolism of monoamines – chemical messengers released by nerve cells in the brain which are thought to play a crucial role in cognition.

B12 deficiency is more common after the age of 60 because, as we age, the stomach produces less of the acid needed to absorb this vitamin from food.

Once levels fall below 500 pg/ml (picograms per millilitre – the normal range is 500 to 1,000), the brain starts to deteriorate, making memory loss more likely.

Being deficient in B12 can also lead to delirium or even a psychotic state.

It is most likely to be found in those with poor diets and older people, and can be reversed with injections of B12. Recovery should follow in up to four weeks.

Spotting the difference: If someone is not just having memory problems, but is tired and feeling weak and unwell, it could be a B12 deficiency. A blood test by your GP can reveal this.

Underactive thyroid

With this condition – also known as hypothyroidism – the thyroid gland in the neck doesn’t pump out enough of the hormone thyroxine. This can be the result of the immune system attacking the thyroid gland, for example, or as a side-effect of medication such as amiodarone, used to treat heart rhythm disorders.

Thyroxine plays a crucial role in metabolism and many of the normal functions of the body. If not enough is produced it can lead to a slowing of some of the one’s normal processes. Crucially, there may be a mental and cognitive dulling. That is why this condition can get confused for dementia in the elderly.

Spotting the difference: Those with an underactive thyroid will have other symptoms, such as weight gain, coarse skin and dry hair. They may lose the outer third of their eyebrows and suffer constipation – not just a dulling of their normal mental function.

Deafness

If someone is struggling to hear, it can appear as if they are not following what is being said to them. As a result, deafness can be misdiagnosed as dementia.

Spotting the difference: Any sensory isolation can lead to confusion, but someone with hearing problems may seem especially withdrawn or confused in a large, noisy groups, and may seem more connected when they are in quiet environments.

They will also not have any short-term memory issues.

Delirium

Delirium is often confused with dementia – it can leave the patient unsure of where they are or what’s happening to them. They may also appear excessively drowsy. It is not a stand-alone condition, but comes about as a result of other illnesses, such as urinary or respiratory infections, liver or kidney failure, low blood sugar and cardiovascular problems, such as mini strokes, and after anaesthesia.

It is common and occurs in 15 to 20 per cent of all those admitted to hospital.

It’s not just illness that can cause it – so, too, can medication such as sedatives, drugs for Parkinson’s and anticonvulsants given for epilepsy. Swapping to a different form of the drug may help.

Spotting the difference: Delirium makes people overly sleepy or drowsy when they should be wide awake and they may come and go out of consciousness.

Those with dementia, on the other hand, normally retain full consciousness until the later stages of the condition.

Also dementia is a progressive illness that gets slowly worse while delirium tends to come on quickly – possibly within hours or overnight – and so this behaviour may seem out of the blue.

Parkinson’s disease

This neurological condition is caused by not having enough of the brain chemical dopamine.

Its role is, among other things, to regulate movement and emotional responses. A lack of it results in slowed movements and a tremor as well as an expressionless face. Depression is common and this, together with the lack of expressionless, may make people think the person has dementia.

Spotting the difference: This is hard as they can co-exist. Most Parkinson’s sufferers, however, won’t have cognitive issues – if they do start to have problems with their memory, they should go to their GP.

Sight problems

People who have lost or are losing their sight – even those with cataracts – are prone to Charles Bonnet syndrome.

This means they may see things that aren’t there, such as faces, flashes or colours, which can make them or others believe they are developing dementia.

The condition is thought to occur because, with a lack of visual messages coming to it, the brain fills this gap with stored images instead.

It is surprisingly common and is thought to affect half of the 400,000 people in this country with age-related macular degeneration, which occurs when cells die in the part of the retina that controls central vision.

Spotting the difference: Hallucinations alone are rarely a sign of dementia. Do seek medical help as even though there is no cure for Charles Bonnet syndrome it can be reassuring for someone with sight loss to know they are not developing dementia, too.

Dr Souter is a retired GP and fellow of the Royal College of General Practitioners.

The drugs that can help you cope

Once dementia is diagnosed, what can be done practically to help you and slow the progression of your disease? Here we look at some of the drug treatments:

Cognitive enhancers
: These are mainly for people with Alzheimer’s. Most commonly used are acetylcholinesterase inhibitors (ACEIs). In Alzheimer’s, there is a loss of nerve cells and a reduced amount of acetylcholine, the chemical messenger that plays a part in memory and cognitive function.

The drugs block the enzyme that breaks down this chemical, so more is available to keep passing messages between brain cells.

They include Aricept, Reminyl and Exelon and are normally given during the mild to moderate stages of Alzheimer’s.

They won’t work for all patients and the effects tend to last only six months to a year.

For those who cannot tolerate these ACEIS, there are also NMDA receptor antagonists that block the effects of glutamate, a brain chemical that can cause damage to nerve cells in the brain.

An example is the drug memantine, used for those with moderate or late-stage Alzheimer’s. Again, it slows down the rate of damage temporarily.

Aspirin: With vascular dementia, which occurs when the blood supply to the brain is blocked, the emphasis is on preventing blood clots. Daily aspirin at a dose of 75 mg to 150 mg makes the blood less sticky, as can other drugs such as clopidogrel.

Anticoagulants, such as warfarin, can thin the blood and prevent strokes; and antihypertensives can reduce high blood pressure.

Antipsychotics: Once known as ‘major tranquillisers’, these are given to those with dementia who are severely agitated.

They are prescribed far less than they used to be. It is preferred to identify and treat the cause of the agitation – such as pain – or to use distraction techniques.

There are two versions: the older type, such as chlorpromazine, trifluoperazine and sulpride, which alter the action of brain chemicals, mainly dopamine, that helps with our emotional responses.

The newer types, such as amisulpride, olanzapine, risperidone and zotepine, also work on dopamine, yet have a gentler mode of action.

Antidepressants: While there is no cure for dementia, specific problems such as depression and sleep difficulties can be treated. Antidepressants can help improve mood – and can be given at a lower dose than those used for younger people.

Source Mail Online

Women bosses ‘more depressed’ than male counterparts

Women are more likely than men to display symptoms of depression when in a position of authority at work, according to US scientists.
In men, authority, such as the ability to hire and fire people, decreases depressive symptoms, the study said.
The study, published in the Journal of Health and Social Behaviour, looked at 2,800 middle-aged men and women.
One expert said the study showed the need for more women in authority and more varied female role models.
Scientists at the University of Texas at Austin interviewed 1,300 male and 1,500 female graduates from Wisconsin high schools over the phone in 1993 and 2004, when they were aged about 54 and 64.

Flexibility for men


Researchers asked participants about job authority and about the number of days in the past week they felt depressive symptoms, such as feeling sad and thinking one’s life is a failure.
When the job included hiring, firing and influencing pay, women were predicted to have a 9% increased rate of depressive symptoms than women without authority.
Meanwhile, men had a 10% decreased rate of depressive symptoms.
The study said it controlled for other factors that could cause depression, such as hours worked per week, whether people had flexible hours and how often workers were checked by a supervisor.
Scientists also said men were more likely to decide when to start and finish work than women and were less frequently monitored by their advisers.
Lead researcher Tetyana Pudrovska said: “These women have more education, higher incomes, more prestigious occupations, and higher levels of job satisfaction and autonomy than women without job authority.
Office bullying by men to women at work
When women adopted masculine behaviours as leaders they were criticised for being unfeminine, said one scientist
“Yet they have worse mental health than lower status women.”

Natural female leadership

Ms Pudrovska said female bosses had to deal with interpersonal tension, negative social interactions and stereotypes, prejudice, social isolation, as well as resistance from subordinates, colleagues and superiors.
Dr Ruth Sealy at City University in London said women were often “trapped” by the gendered notion of a good leader.
When women adopted traditionally masculine behaviours as leaders they were criticised for being unfeminine, yet colleagues would not believe the women were good leaders if they saw only their feminine characteristics, she added.
Dr Sealy said: “Because we assume men’s ‘natural’ competence as leaders, women often have had to work much harder to get to those positions, only to find that even when they get there, their ‘right’ to that status is continuously questioned.”
She said female leadership needed to be made as natural as male leadership.
Dr Gijsbert Stoet at the University of Glasgow said the study was strong from a psychological and social science perspective.
He said: “The scientists have used the data from a large longitudinal study and it is very valuable to answer these sorts of questions.”
Companies should question what they can do to help their workers manage stress, such as providing a staff counsellor, he said.
Source BBC News

Music therapy ‘can cut depression’

Music therapy is a practical intervention which involves children writing songs or composing music to express their feelings
Music therapy can significantly reduce depression in children, it has been claimed.
The social skills and self esteem of young people suffering emotional, behavioural and developmental problems was dramatically improved when their medical treatment was enhanced by music therapy, according to new research.
It is hoped the study, by Queen’s University Belfast (QUB), will help pave the way for the treatment becoming more mainstream.
Ciara Reilly, chief executive of the Music Therapy Trust which provides the service in Northern Ireland said: “The findings are dramatic and underscore the need for music therapy to be made available as a mainstream treatment option.
“For a long time we have relied on anecdotal evidence and small-scale research findings about how well music therapy works. Now we have robust clinical evidence to show its beneficial effects.”
It is estimated that about 20% of Northern Ireland’s youth population present with a mental health problem before their 18th birthday.
Music therapy is a practical intervention which involves children writing songs or composing music to express their feelings. Guitars and keyboards were the often the most popular choice of instruments for participants.
Karen Diamond, also from the Music Therapy Trust said: “It is a non-verbal intervention. The children do not have to say anything. Instead the therapist may ask the child to play a tune to describe their week or how they feel. And, f or a seven or eight-year-old with a mental health problem words can be difficult at the best of times.”
 
The study was the largest of its kind anywhere in the UK.
Researchers monitored 251 young people aged between eight and 16 between March 2011 and May of this year.
Participants were divided into two groups with 128 being given the usual care options, while 123 were assigned additional music therapy.
All of the young people were being treated for emotional, developmental or behavioural problems.
The study, which was funded by the Big Lottery fund, found that those who received music therapy had improved communicative and interactive skills, compared to those who only received usual care options.
Early findings suggest that the benefits sustained as a result of music therapy are long term.
Dr Valerie Holmes from the Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences and co-researcher, added: “This is the largest study ever to be carried out looking at music therapy’s ability to help this very vulnerable group.
“What we found was that while music therapy improves communication and interaction skills for all children there is significant evidence that it benefits those aged 13 and older.
“At the minute, music therapy is not a mainstream clinical option. This study gives us evidence and we hope that the results will help ensure that music therapy may become a mainstream option for children and young people with mental health difficulties.”
Professor Sam Porter of the School of Nursing and Midwifery at QUB, who led the study, said the results were “hugely significant” in terms of determining treatments.
The research findings will be presented at a conference in Riddel Hall at Queen’s University Belfast today.
Source The Belfast Telegraph

Antidepressants can affect the brain in just three HOURS – not weeks, as previously thought

A single dose of antidepressant medication is enough to produce dramatic changes in the brain within three hours, a study has found.
Volunteers had their brains scanned after taking the widely-prescribed drug escitalopram, marketed in the UK as Cipralex and Lexapro in the U.S. 
The drug is a serotonin re-uptake inhibitor (SSRI) and aims to boost the level of this ‘feel-good’ chemical in the brain.
SSRIs are believed to change brain connectivity in important ways, but the effects had generally been thought to take place over a period of weeks, not hours. 
Study leader Dr Julia Sacher, from the Max Planck Institute for Human Cognitive and Brain Sciences in Germany said: ‘We were not expecting the SSRI to have such a prominent effect on such a short time scale or for the resulting signal to encompass the entire brain.’
The scans, which measured blood flow, showed that the drug reduced connectivity in most parts of the brain. 
 
But there was an increase in connectivity within two specific brain regions, the cerebellum and thalamus.
Although SSRIs are among the most widely studied and prescribed antidepressants, it is still not entirely clear how they work.  
Serotonin is a neurotransmitter – a messenger chemical that carries signals between nerve cells in the brain). It is thought to have a good influence on mood, emotion and sleep.
After carrying a message, serotonin is usually reabsorbed by the nerve cells (known as ‘reuptake’). 
SSRIs work by blocking (‘inhibiting’) reuptake, meaning more serotonin is available to pass further messages between nearby nerve cells.
Dr Sacher said: ‘What we are seeing in medication-free individuals who had never taken antidepressants before may be an early marker of brain reorganisation.’
She added the new findings represent an essential first step toward clinical studies in patients suffering from depression.
The next step is to compare the brains of those in recovery and those of patients who fail to respond after weeks of SSRI treatment.
Dr Sacher said: ‘Understanding the differences between the brains of individuals who respond to SSRIs and those who don’t could help to better predict who will benefit from this kind of antidepressant versus some other form of therapy.
‘We hope our work will help to guide better treatment decisions and tailor individualised therapy for patients suffering from depression.’ 
The research is published in the journal Current Biology. 
WIDELY-USED ANTIDEPRESANT COULD WARD OFF ALZHIEMER’S
A widely-used antidepressant could help slow the onset of Alzheimer’s disease.
Scientists say citalopram can significantly reduce the formation of plaques in the brain, which could go some way to warding off the disease.
The U.S. academics admit it is too early to recommend the drug to Alzheimer’s patients, but dementia charities last night welcomed the ‘promising’ findings as providing ‘vital new clues’ about the disease.
Plaque deposits are closely associated with declining memory and other symptoms of Alzheimer’s, so anything that can stop their build-up in the brain is likely to help ward off the condition.
The research, published in the journal Science Translational Medicine, found that a single dose of the antidepressant citalopram lowered production of the plaque protein amyloid beta by 37 per cent.
The experiment was conducted in healthy adults aged 18 to 50, but the scientists, from the universities of Washington and Pennsylvania, hope the findings can be replicated in elderly patients.
The drug, marketed in the UK as Cipramil, also had a dramatic effect on elderly mice, halting the growth of existing plaques and reducing the formation of new deposits by 78 per cent. 
 
 
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