May 23rd, 2009 by Jon LaPook, M.D. in Better Health Network
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The answer is “yes.” An estimated 5.3 million Americans suffer from Alzheimer’s Disease, the majority – 5.1 million – over the age of sixty five. Research suggests that less than 35 percent of people with Alzheimer’s or other dementias are properly diagnosed. Early diagnosis is crucial for many reasons, including:
1) There are medications available today that can reduce symptoms in many people – at least temporarily – and improve the daily lives of patients. There are also trials of new drugs that researchers hope will slow or stop the underlying processes that cause Alzheimer’s in the first place.
2) Knowing what’s going on can lessen anxiety and allow for planning – not only for patients but for their families, friends, and caregivers.
3) Although Alzheimer’s causes 60-80 percent of dementia in patients over 65, there are other causes that need to be considered, especially potentially reversible ones due to medications, alcohol, low thyroid, low B12, depression, and infections. Dementia can also be caused by tumors, increased pressure, blood clots and other abnormalities within the head itself that can be detected by a CT or MRI of the brain. And patients with “vascular dementia” due to problems such as multiple small strokes (that may not have caused any other symptoms) can be treated with measures that include medications and lifestyle adjustments to lower their cardiovascular risk.
The Alzheimer’s Association is a terrific resource for information about Alzheimer’s and other forms of dementia. Its website includes ten warning signs for Alzheimer’s Disease.
May 21st, 2009 by Jon LaPook, M.D. in Better Health Network, Video
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There are few conditions more frightening to my patients – and to me – than dementia. It’s easily the most common fear voiced in my office. One woman recently said, “I couldn’t think of her name and I’ve known her for years; I think I may have Alzheimer’s.” Another patient, a physician, half-jokingly asked, “How do I know if I’m losing it or have just misplaced it?” Behind his nervous attempt at humor was a deadly serious concern.
The most common form of dementia in the elderly is Alzheimer’s disease. According to the Alzheimer’s Association, it affects as many as 5.3 million Americans. Especially cruel is the twilight phase when patients can still understand what they are losing, when they can see the receding silhouette of their memories but cannot reclaim what they’ve lost. This was brought home to me very poignantly last year when I interviewed 65 year old Carol and her husband Mike about Carol’s Alzheimer’s. At one point, Carol could not remember how long she’d been married even though I had just reminded her two minutes earlier. At another point, Mike – a retired cop – broke down talking about his wife’s illness. All the words in the world cannot adequately describe the anguish conveyed by the looks on their faces, the tone of their voices.
Often forgotten in the tragedy of dementia are the caretakers, frequently family members whose lives are torpedoed by the devastating illness. In this week’s CBS Doc Dot Com, I speak with Gloria Signorini, an 80 year old woman with dementia and with her daughter, Joanne, who has put her life on hold to take care of her mother. Mrs. Signorini’s physician, Dr. Gayatri Devi, an expert in dementia at NYU Langone Medical Center, provides perspective about Alzheimer’s and other forms of dementia.
** Editor’s Note: Please click on this link to watch the video (I’m having technical difficulties embedding it here)**
Watch CBS Videos Online
November 9th, 2008 by Dr. Val Jones in Medblogger Shout Outs, Opinion
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As many of you know, I’ve been pretty upset about the “never events” policy put forward by CMS. That’s because they took a theoretically reasonable punitive rule (Medicare will not pay hospitals for patient care related to gross medical errors, aka “never events,” like wrong-side surgery) and made it far too general (never events include delirium, falls, and any infection – even a cold). It is absolutely impossible to prevent these sorts of things 100% of the time. So how should “never events” be defined?
The Happy Hospitalist nails it:
Can the never event happen at home? If the answer is yes, it cannot be a never event. It is a natural event. Even the criminal events that nobody can foresee are considered never events. Tell me how a hospital can prevent a random crazy family member or hospital guest from going berserk and assaulting an employee or patient. It’s impossible to predict or prevent.
October 28th, 2008 by Dr. Val Jones in Medblogger Shout Outs, News
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A fascinating story from Reuters (h/t Dr. Wes):
Bernt Aune’s transplanted cornea has been in use for a record 123 years — since before the Eiffel Tower was built.
“This is the oldest eye in Norway — I don’t know if it’s the oldest in the world,” Aune, an 80-year-old Norwegian and former ambulance driver, told Reuters by telephone on Thursday. “But my vision’s not great any longer.”
He had a cornea transplanted into his right eye in 1958 from the body of an elderly man who was born in June 1885. The operation was carried out at Namsos Hospital, mid-Norway.
“I wouldn’t be surprised if this is the oldest living organ in the world,” eye doctor Hasan Hasanain at Namsos hospital told the Norwegian daily Verdens Gang.
In the 1950s, doctors expected it to work for just five years, Hasanain said. Such cornea operations date back to the early 20th century and were among the first successful transplants.
