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Antidepressants To Treat Dementia: How Can They Help?

“Wow, Celexa?”

“Yeah, who knew?”

I overheard this conversation in the ladies’ room immediately after a session speaker advised treating agitation and aggression in dementia with citalopram. Indeed, there was a bit of a murmur in the audience when Dr. Aleta Borrud made the suggestion during her talk at the Mayo Update in Hospital Medicine 2011 course.

Part of the reason for the reaction may be– as a physician I spoke with noted– that Read more »

*This blog post was originally published at ACP Hospitalist*

Best Online Resources For Alzheimer’s Disease Information

The Alzheimer World Day only took place a few days ago and we received many suggestions about creating a selection focusing on this important topic. Webicina’s new Alzheimer’s Disease and Web 2.0 collection features relevant and quality social media resources from blogs and podcasts to community sites and Twitter users focusing on Alzheimer’s disease.

Here is my top 10 social media selection for Alzheimer’s disease: Read more »

*This blog post was originally published at ScienceRoll*

Caring For People In The Later Stages Of Alzheimer’s Disease

Barbara Moscowitz, coordinator of geriatric social work for the Geriatric Medicine Unit at Harvard-affiliated Massachusetts General Hospital, spoke to me and about a dozen other Harvard Medical School employees yesterday as part of series of seminars on family life and other issues offered by the school’s human resources department.

Moscowitz’s talk was titled “Dementia and Cognitive Decline (Aging Gracefully).” I was there mainly out of professional interest because I’ve written a couple of articles for the Harvard Health Letter recently about Alzheimer’s and dementia, including a piece in the September 2011 issue about mild cognitive impairment and another in July 2011 about new Alzheimer’s guidelines.

But I also wonder about how my own aging brain is faring (not well, it seems, on some days) and I have an older parent (age 81).

So my curiosity wasn’t entirely work related.

A disease of behaviors

Moscowitz covered Read more »

*This blog post was originally published at Harvard Health Blog*

New Alzheimer’s Guidelines Emphasize Early Detection, Frightening Some

WheredIputmyglasses 225x300 New Alzheimers Guidelines: Better Late than Never

For the first time in 30 years, an expert panel has updated guidelines for the diagnosis of Alzheimer’s disease. The long overdue facelift should favorably impact care for millions and accelerate badly needed research on the disease.

The guidelines were produced by representatives from the National Institute on Aging and the Alzheimer’s Association. They portray Alzheimer’s for the first time as a three-stage disease. In addition to ‘Stage 3,’—the full-blown clinical syndrome that had been described in earlier versions of the guidelines—the new guidelines describe an earlier ‘Stage 2,’ of mild cognitive impairment due to Alzheimer’s, and a ‘Stage 1, or preclinical’ phase of the disease. The latter can only be detected with biochemical marker tests and brain scans.The guidelines legitimize years’ worth of observations by the family members of Alzheimer’s patients, who recognize in retrospect that Grandpa had a slowly progressive cognitive disorder long before he was diagnosed. The guidelines also reflect progress on the research front, where it has now been established that the disease begins years before patients become symptomatic.

Alzheimer’s patients and their families, and the teetering US health system that supports them, would have been better served by the publication of these guidelines 2-3 years ago. Read more »

*This blog post was originally published at Pizaazz*

When “Doing Fine” Is Relative

It was 11:00 pm when the pager vibrated, then beeped: it was the ER, Hospital #3.

“This is Dr. Fisher returning your page?”

“Thank you Dr. Fisher, just a moment for Dr. Frigamafratz.”

A brief pause, then:

“Wes, I think we’ll need your services. Old guy, found down at the nursing home, brought in unconscious, pulse 25 – hooked him up to an external pacer, he’s back with us now.”

“I’m on my way.”

When I arrived, there was the usual cacophony of activity in the Emergency Room. Someone screaming in one corner. Intercom sounding. Ambulance en route to our location. Breathing treatments underway in Bay 5. Room 10 headed to the CT scanner. Has room 12 got a bed? By comparison my patient was easy: his disposition in the eyes of the ER staff had been made: he was on the Express Track to the EP lab.

There he was, chest twitching. Big forceful jerking. He was a big guy, uttering something with purpose but impossible to understand. Next to him, his wife, just arriving and removing her coat. “Is he going to be okay?”

My head scrambled for an answer. “He’s okay for now,” I think I replied. Read more »

*This blog post was originally published at Dr. Wes*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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