Treating the elderly in a nursing home setting

DEAR DR. GOTT: Please tell me why doctors prescribe Seroquel to elderly dementia patients when warnings about the drug clearly state that it is not for the elderly who suffer from dementia. One patient on the medication at an assisted living facility almost stopped eating completely and was rushed to the hospital very ill. She was then taken to a nursing home in hospice care and did well but is now back on Seroquel and is clearly losing weight again. It seems the patients on this drug are like zombies and do not have an appetite.

DEAR READER: Seroquel is an anti-psychotic used to treat schizophrenia in those individuals – believe it or not – from the age of 13 and up and for bipolar disorder in those 10 and older. It may also be combined with anti-depressants in adults. [Read more...]

Unknown cause doesn’t mean psychiatric cause

DEAR DR. GOTT: Please address this all-too-common problem among doctors. The doctors treating the woman who wrote some time ago, didn’t know what she had, therefore, they concluded (defensively) that she had nothing wrong with her, therefore, it must be mental. This outrages me! I had a son who died from myalgic encephalomyelitis (ME/CFS), and all those patients hear is “It’s in your head” because at this time there is no definitive marker and no drug approved by the FDA to help them. Not knowing is not the same as nothing is wrong.

I would also suggest that your advice is too accepting of “nothing can be done”. Wow! Something happened to that lady. Most of the people in the US are not able to get to the Mayo or Cleveland Clinics. Your usual advice to get to a teaching hospital is much more “doable”.
[Read more...]

Coconut oil likely won’t help memory loss

DEAR DR. GOTT: I would like to know what you know about pure coconut oil being a good supplement for improving several kinds of dementia. My husband and I are both in our early 80s and don’t have many health problems but recently we have been concerned about memory problems. We saw a webmail and video about a doctor’s husband having Alzheimer’s. She gave him pure coconut oil and he improved over a period of time. Our primary doctors have given us both memory tests and will be checking us regularly in follow-up.

DEAR READER: Coconut oil is a tropical oil made from the nut of the coconut palm tree. One single tablespoon of the oil contains 117 calories – not a big deal – but 13.6 grams of fat, which is. Over the years the product has been touted as a cure-all for hypothyroidism, heart health, Alzheimer’s disease, as an energy boost, weight loss product, and a great deal more. [Read more...]

Mental deterioration followed hospitalization

DEAR DR. GOTT: I have a friend whose wife is a 58-year-old Caucasian. She doesn’t smoke or drink alcoholic beverages. She has two daughters. Both her pregnancies were without problems. She is seldom ill. She walks three miles at a brisk pace three to four times each week and isn’t overweight. She is not a complainer or one who visits doctors without cause. She is very conscientious about eating a healthy diet. Most of their vegetables are grown in their home garden. Her only health issue has been a fairly high blood pressure. Around 155/95. She has been taking blood pressure control medicine for about three years with little effect.

Shortly after New Years she was hospitalized for about 10 weeks after she became sick with vomiting and chronic diarrhea. She was treated at a local hospital and then sent to a larger facility for further testing. [Read more...]

Ativan can affect memory

DEAR DR. GOTT: Your article on Ativan was interesting and informative. From a personal point of view, I would like to tell you that my wife, who suffers from Alzheimer’s disease for some 12 years now, was prescribed Ativan while recovering from a radical mastectomy/chemotherapy/radiation. The prescription continued for six years.

During an evaluation at the University of Michigan, Ann Arbor, MI Gerontology Center, she was advised that Ativan is a destroyer of short-term memory. That fact and the damage done to the entire body by chemo and by estrogen earlier in prior years, coupled with a sedentary lifestyle, all played a part in the development of Alzheimer’s, in my opinion.
[Read more...]

Overview of Lewy body dementia

DEAR DR. GOTT: I have been waiting for a column about Alzheimer’s or a form of dementia like it. My brother has a dementia called Lewy body. I have never heard of this before and hope you can shed some light on this horrible disease. He was highly intelligent, and it always amazed me how much his brain stored because no matter how much I try to remember something, it just doesn’t stay.

It’s really hard to watch someone go from remembering everything to having to write it down so he doesn’t forget, doing unexplainable things and having mood swings. When you look at his face, you can see the blankness. When he tries to say something, he doesn’t know how to get it out. He forgets to swallow. Sometimes he knows me, and other times he forgets my name but remembers that we were connected. He now calls me by my first and middle name when he used to use my first name or call me “Sis.” [Read more...]

Research advances support staying the course

DEAR DR. GOTT: My 73-year-old father seems rather forgetful these days. When I took him to his doctor, he was diagnosed with pre-Alzheimer’s disease. I’ve heard of Alzheimer’s, but what exactly is pre-Alzheimer’s?

DEAR READER: It is estimated that more than 5 million Americans suffer from a form of Alzheimer’s, the leading cause of dementia in the Western world. There are new guidelines available for diagnosing early-stage Alzheimer’s (pre-Alzheimer’s), indicating that a state of mental decline can begin years prior to the occurrence of other, more classic symptoms.
[Read more...]

Drug trial doesn’t help Alzheimer’s patient

DEAR DR. GOTT: My wife was diagnosed with Alzheimer’s dementia about five years ago. The current drugs being prescribed are galantamine, Namenda and citalopram. Other than Alzheimer’s, her overall health is good.

Shortly after being diagnosed, she placed in her age class at the Bloomsday road race. We were both runners. Anyway, her height is 5 feet 5 inches, her weight is 115 pounds, and her blood pressure is normal.
Is there any other possible course of treatment? We have been to specialists and more. We did participate in the failed dimebon trial.
[Read more...]

Sundowner’s linked to Alzheimer’s

DEAR DR. GOTT: Please write something on sundowner’s syndrome. It seems as though this is fairly common. Thank you for all the great information I have read.

DEAR READER: Sundowner’s, or sundowning, is confusion that generally occurs late in the day, although it has been known to occur during early-morning hours as well. The cause appears elusive and is often misunderstood.

The disorder is commonly seen in hospital or nursing-home settings where an older individual may be forced to adjust to a different setting. Or, in some cases, it can manifest following illness or surgery. Sundowner’s may be temporary for some but prolonged in other instances. [Read more...]

Pick’s disease resembles Alzheimer’s

DEAR DR. GOTT: Some years ago, you wrote an article on Pick’s disease that I misplaced. Can you discuss it once again?

DEAR READER: Pick’s is a rare but permanent form of dementia similar to Alzheimer’s disease. It has a tendency to affect only certain areas of the brain and can affect people as young as 20; however, it is more common in people closer to 55 or 60. People with Pick’s have abnormal substances known as Pick bodies and Pick cells inside nerve cells within damaged areas of the brain.

Tissue in the temporal and frontal lobes of the brain shrink over time and result in impaired thought processes, behavioral changes and difficulties with speech. [Read more...]