Friday, March 24, 2017

Trump & ALZ

If you search Twitter, you will find thousands of tweets by using the search terms "Trump dementia."

I first heard these reports in June of 2016.  

They began multiplying in January as the inauguration of Trump approached.

Many of these tweets cite articles on the question of whether the president has dementia.

One interesting and brief summary is "Linguistic Features Identify Alzheimer's in Narrative Speech" by Charles Moore, who reviews a study headed by Dr. Frank Rudzicz.

“Every caregiver knows that people with dementia have good days and bad days — we can tell this by talking to them, because speech is a rich source of information on the brain’s cognitive function,” says study co-author Dr. Jed Meltzer, a neurorehabilitation scientist with the Rotman Research Institute at Baycrest Health Sciences, a premier international center for the study of brain function. 

I've been noticing quite a few ALZ-like qualities in Trump's speech.  I'm familiar with this speech because of spending so much time with my mother in her last four years.

*  repetition -- Trump repeats statements so often in his speeches.  He repeats words like "very very very."

*  simple vocabulary --  Trump doesn't know how to praise a politician or diplomat or anyone else using complex, precise vocabulary.  All he does is repeat five simple words:  great, huge, terrific, amazing, big.  For those he doesn't like it's loser, sad, stupid, horrible, weak.  

* simple sentences -- Subject, verb, period.  There are very few sentences that begin with "Although, when, whether, if" or other subordinating conjunctions.  

* simple ideas and lack of detail in presenting them.

There are other signs of his dementia beyond speech:

  • his inability to remember what he has said or done earlier.

  • his grandiosity, a part of my mother's Alzheimer's.  During late 2007 and early 2008, she confused me with Hillary Clinton and thought I was running for president.  Then she thought my husband was running.

  • his lack of impulse control--like tweeting that President Obama had wiretapped Trump Tower.  His frontal lobes and temporal lobes are not functioning well.

These kinds of things convince me that Trump has dementia.  He lacks the 

The novelist described Trump as a speaker "wielding a vocabulary of seventy-seven words that is better called Jerkish than English.”

How to diagnose ALZ

Dr. Frank Rudzicz and team

There's now a way to diagnose Alzheimer's Disease with 80% accuracy.

Because science didn't have an accurate way to diagnose ALZ in 2004 through 2008, my mother's dementia wasn't correctly identified until after her death, when an autopsy was done.

Her physical, behavioral, and mental symptoms were tentatively diagnosed as Lewy Body Dementia, but instead of small hard Lewy bodies, her brain held the protein tangles of ALZ.

Developed by Dr. Frank Rudzicz at the University Health Network's Toronto Rehabilitation Institute, the new method was reported in the December 2015 issue of The Journal of Alzheimer's Disease.

"Linguistic Features Identify Alzheimer's Disease in Narrative Speech" is the title of the research report.

Speech samples were taken from 167 Alzheimer's patients and 97 control persons of similar ages and backgrounds.

The aspects of speech analyzed included 
lexical diversity, syntactic complexity, semantic content, and acoustics.

Now a start-up company called WinterLight Labs is working to commercialize the techology and make it available to the public. 

Wednesday, March 15, 2017

Signs of Alzheimer's Disease

People fifty years and older often put themselves down with the comment, "I'm having a senior moment."

I don't like to hear this when the thing misplaced or word forgotten is something that could happen at any age.

Let's know the difference between normal forgetfulness and early signs of Alzheimer's.

Go the the Alzheimer's Association website to learn the important differences.

In brief, they are:

  1. memory loss that disrupts daily life
  2. challenges in solving problems
  3. difficulty completing familiar tasks
  4. confusion with time or place
  5. trouble understanding visual images and spatial relationships
  6. new problems with words in speaking or writing
  7. misplacing things and losing the ability to retrace steps
  8. poor judgment
  9. withdrawal from work or social activities
  10. changes in mood and personality

Sunday, March 12, 2017

Thinking of Evelyn in 2017

My mother and I on Zuma Beach with Pt. Dume behind us

My mother would have turned 98 today.

Fortunately, she did not have to face that birthday.  She succumbed to Alzheimer's Disease at age 89 in 2008.  To live longer in her state of incapacitation would have been hard for her to bear... though she did feel a wistful sense of loss at leaving this earth.  

Her friend Janet Krause did turn 98 this year.  

Her Christmas card showed four generations:

  • herself
  • her daughter Karla,
  • her granddaughter Jenny, and
  • her greatgrandson Seth, age 3.

It's a beautiful photo.  

I appreciate knowing that a dear friend of my mother's is still alive and remembers Evelyn and their days together at Children's Hospital in Denver training to be nurses, graduating in 1941.  Out of the 28 who started in 1938, only 19 completed the program and became Registered Nurses.  Several of them went on to serve as military nurses in World War II.

Janet wrote me a lovely note, citing challenges as well as blessings:

"Some of the challenges include poor eyesight and issues with memory.  Some days can be more challenging than others.  Overall, though, my health is pretty good for a 9-year-old.

My many blessings include being a resident at Countryside Living Retirement and having so many wonderful friends.  My daughter retired in July, so she has been able to visit more often along with her husband Deen, granddaughter Jenny, and great-grandson Seth (3).  I am planning to go to Denver for Christmas so I will be able to visit most of my family at that time.  Other blessings include two very dear friends who come from out of town regularly to visit and help, Linda Ripley and Barb Schommer.

May God's blessings fill your heart this Christmas!

I do think of you, Anne--I am getting too old.  JK"  

The last line is hand-written.

What a blessing to have one's mental faculties at age 98.  

My mother inspires me to do all I can to slow or avoid my own development of Alzheimer's Disease.

The things I do include:

  • Trying to keep my weight down to about 150 pounds.

  • Trying to walk 10,000 steps per day as monitored by my Fitbit.

  • Taking occasional hikes.  I used to jog twice a week, but I have let that lapse.

  • Avoiding sugar except when it comes in natural forms with milk or whole fruit (not juice).

  • Learning Hebrew to keep my mind sharp.  (I'm not patient enough to do crossword puzzles.)

  • Getting 7-8 hours of sleep most nights.  I need to raise that to 8-9.

Saturday, February 11, 2017

Air Pollution and Dementia

We think of air pollution as a problem that impairs our lungs and our breathing, but there's new evidence that it may also affect our brains and even cause dementia.

See this article "Is there a Connection between Dementia and Dirty Air?" by Casey Kelly-Barton on

One specific culprit may be the magnetite particles found in dirty air.

Increased levels of magnetite have been found in the brains of persons with Alzheimer's disease.

I have a friend who died in 2012 from lung cancer--specifically, non small-cell lung cancer.  Her name was Katherine McTaggart.

She never smoked, so the change in her lung cells had to come from some other irritant, such as the polluted air in West Los Angeles, where we both live.  The 10 freeway starts at the beach and passes a few blocks from her house and from mine as it stretches east toward Texas and finally Florida.

Thus I am sure that the pollution surrounding my community is having effects on me and my friends.

Read the article above to find ways you can deal with particles in the air.  These methods include:

  • Avoid the outdoors and exercise on high-pollution days.
  • Wear a mask if you do need to go out on these days.
  • Use HVAC filters to remove irritants inside your home.

The Happy Side of Dementia

My mother with the chihuahua, Irie, in 2007
Dementia can be caused by several types of events, not just by Alzheimer's Disease.

Lewy Body Disease and Parkinson's are also associated with dementia.

Stroke is another frequent cause of impaired function of the brain, including the frontal temporal lobe, which is part of dementia.

Thank you to NPR this morning for the interview with Christine Hyung-Oak Lee, who had a stroke at age 33.

Her book is called Tell Me Everything You Don't Remember.

In the interview, Christine mentions "Depression is part of recovery from stroke," Christine says in the interview.  "It's grieving for the loss of one's former self."

On the other hand, in the initial stage when she had only 15 minutes of short-term memory, she reported being happy and at peace.

"It's actually quite pleasant," she said.  

That rang true for me.  When my mother was living on the Memory Care floor of an assisted living, I noticed her general calm and contentedness and that of most of the other residents.

She didn't remember that her brother had died a year before, nor that her mother had died twenty years earlier.  She had few expectations or worries.

She was more relaxed and happy than she had been during most of her former life, when she was married to my father, an alcoholic, and was working outside the home while raising four kids.

Of course, irritability is also part of ALZ to varying degrees and at different times of the day.  Waiting for meals or for help is difficult.  

My mother wanted to be at my house, not in a facility, and when I would leave after a two-hour visit, she didn't understand why she couldn't go with me. 

Another positive note: I was encouraged to hear that Christine regained much of her brain function with time.

Sunday, May 15, 2016

Voice from the Past -- Still Present

My mother's dear friend Janet Krause sent me a letter.  It's such a joy to hear from her!

She will turn 98 in September.  That reminds me that my mother might still be with us, were it not for the Alzheimer's.  Janet's friends and family will gather to celebrate.  

She writes, "I have trouble remembering names--faces I know."

As I wrote to her:

"You represent my mother Evelyn and so many others.  Because of you they are still with us in some sense.  The times you all lived through together--the Depression and World War II and the 1950s--are more vivid in our memory because they are still in your memory."

Janet and Evelyn were nursing students together at Children's Hospital in Denver in the late 1930s. After the bombing of Pearl Harbor, Evelyn became a Navy nurse and Janet became an Army nurse.

Janet had surgery for breast cancer two years ago--and beat it!  Yay!

She spent a few months with her daughter in Colorado over the winter holidays but then returned to her apartment in an independent living facility in Mitchell, South Dakota.

"I have a collection of 82 hats hanging in my bedroom--all of which I have worn over the years," she writes.  She and her husband LeRoy both liked antiques.

Janet served as an Army nurse during World War II.  

See an article about her amazing experiences in The Daily Republic of Mitchell, SD, August 29, 2006.  Bombs fell around her as she and others waded ashore in France to provide medical care during the Battle of the Bulge.

My mother would have turned 97 on March 12. Her cousin Walter's wife Aline Pera turned 100 last August. My mother-in-law will turn 94 in September.

May we treasure these living memorials of a time fast fading.  

See also:

Saturday, April 30, 2016

Danger Zone

My mother-in-law, age 93, is happy to be back in her own home after a hospitalization of a couple of weeks followed by nearly six weeks in a rehab place.

But the transition from hospital to rehab or skilled nursing is a danger-filled time, and the transfer to home care is likewise worrisome.  See this article in the Washington Post by Jordan Rau:

Medication errors can occur.  There's no longer a heart monitor or nurses nearby in case of emergency.

Usually the care-giving is transferred from a team to one person doing round-the-clock care and trying to sleep when the patient sleeps.  A tremendous responsibility rests on that one person's shoulders.

It's better if home care can be provided by several aides, each working an 8- or 10-hour shift, with days off each week.  But these things are expensive.  If the person has long-term care health insurance, it can take weeks to activate that policy to fund or partially fund the care.

"Old age is no place for sissies," said Bette Davis (1908-1989).

But my friend Brenda Holguin doesn't like to hear people complain about getting old.  

"Not everyone has that privilege," she notes.

Saturday, April 02, 2016

Gracious Aging

Living into the 90s and experiencing ups and downs as health declines and fails is quite a trial.

I'd like to report, however, that I have one friend who is negotiating these ups and downs with relative good cheer.  

She's 99% ready to leave this earth but also very patient with the day-to-day indignities.  I'm amazed that she is not angry or sad.

Most younger people look at the problems of extreme old age and hope their lives will end earlier.

Perhaps because I spent four years accompanying my mother on this journey, I myself view being in a nursing home with equanimity.  It's a peaceful life surrounded by others without the kinds of worries and pressures that plague earlier years.  

What seems unendurable today--such as wearing Depends--can become just another event later.

When I was in my twenties, in the 1970s, I was close to my grandmother and observed her dealing with cataract surgery.  It seemed awful to me to have a surgeon cutting into one's eyes.

Today my perspective has changed.  I'm 67 and starting to feel the effects of growing old.

I didn't feel old when I got my Medicare card, or when I started collecting Social Security or began noticing increasing wrinkles and gray hair.   

Yesterday, however, when I sat in my ophthalmologist's office and scheduled a cataract surgery, it happened.  I'm where my grandmother was, and now I know I am old.

End-of-Life Choices

Should someone who has Alzheimer's--especially the early-onset kind--have the right to end his or her life before it gets to the point of being placed in a Memory Care floor with assistance for daily life tasks such as bathing and dressing or even eating?

The prospect of wearing Depends and needing personal assistance is humiliating.

How can we respond when a friend or loved one expresses a wish to die before this point?  

No one wants a long period of wasting away.  On the other hand, no one wants to die in a car accident or plane crash.  Ordinarily we don't get a lot of choice in how or when our life ends.

Nevertheless, I want to affirm someone who expresses the wish to avoid long-term care, possibly when unable to recognize friends and family.  It's important to share our feelings with friends and family and to cry out to God.

In a post on December 6, 2014, I rather flippantly said "Why bother to make such wishes?  The bottom line is that we don't get to choose when to clock out... unless we oppose both law and custom."

I'd like to say now that I respect the decision to end life through physician-assisted suicide in a case of terminal illness, even Alzheimer's.

There needs to be a way to express this wish on paper, legally, before one gets to the point where one's decisions are impaired by dementia and one is seen as not competent to make this choice.

On the other hand, treatments to halt and even reverse impairment with Alzheimer's are already being tested.  See the February 11, 2016, issue of Time Magazine with this cover story by Alice Park:

I have a friend who has said he would shoot himself first if he were on the verge of being put on an Alzheimer's care.  Is it a blessing that he has since had two strokes and one ablation surgery for atrial fibrillation?  Despite having one parent who died of Alzheimer's, it looks as if he is not headed for a Memory Care floor--unless by stroke.  

Hi Anne.

Your Dec 6, 2014 post ends by saying:

As for Ekekiel Emanuel's essay about preferring to die at 75 yrs. rather than waste away later, why bother to make such wishes?   
The bottom line is that we don't get to choose when to clock out... unless we oppose both law and custom. 
As a Biblical Feminists do we not both oppose law (in the past) and custom (always)???

So why do you say "why bother" re:  Ekekiel's preference to die at 75 and let custom and law prevail in his case?

This is too personal for me.  It is entirely possible that I will not know you at 75. Or maybe I will have the good fortune re: my cognitive impairment and it will level off at some point before it gets too bad.