A third donor just stepped up with another year-end matching gift challenge! Abbe Sue Rubin will donate $25,000 to the Alzheimer’s Association if we can raise that same amount online by December 31. I can’t think of a better time to make a donation to the Alzheimer’s Association.

The generosity doesn’t stop there. A second donor just stepped up with another year-end matching gift challenge! Both Tina and Karl Weber have been long-time supporters of the Alzheimer’s Association, and this year marks the THIRD year in a row that they have graciously offered a matching gift challenge.

Abbe’s passion for fighting Alzheimer’s disease led her to the Association’s Western and Central Washington State Chapter where she volunteers and serves as the chapter board’s treasurer. Her gift will support public policy initiatives.

A retired statistician, Abbe wants to change the trajectory of Alzheimer’s alarming numbers:

· Someone in America develops Alzheimer’s every 68 seconds

· More than 5 million Americans are living with Alzheimer’s, and that number is growing rapidly

· One in eight Americans over the age of 65 has the disease

Alzheimer’s is the sixth-leading cause of death in the U.S. and the only cause of death among the top 10 that can’t be prevented, cured or even slowed

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Earlier this week I emailed you about a challenge from Jane Bindl Oi, a generous benefactor and strong advocate for the fight against Alzheimer’s disease, who has offered to give $35,000 to the Alzheimer’s Association if we raise this same amount through an online campaign by the end of the year. We are still $10,000 away from meeting this challenge. We need your help! Please generously today so we can meet this matching gift challenge.

Bringing back hope

“The Alzheimer’s Association changed the end of my dad’s life from a foggy, sedated existence to smiles and the ability to connect with others,” Jane explained. “I support the Association out of gratitude for what the organization did for him and for my family.”

Jane’s generous gift will be used to support public policy initiatives related to Alzheimer’s – but we need YOUR support before December 31 to receive the matching amount.

Remember, without your gift today, we won’t be able to take advantage of the wonderful opportunity Jane is providing through her matching gift challenge. Please give as generously as you can so that we can continue to advance promising research and provide much-needed services.

Thank you,

Angela Geiger
Chief Strategy Officer

P.S. This challenge ends Dec. 31. Don’t miss this opportunity for your gift to have twice the impact and receive a charitable deduction on your 2012 tax return!
Give today.

Respite care can help Alzheimer’s caregivers recharge

http://www.alz.org/care/alzheimers-dementia-caregiver-respite.asp?WT.mc_id=enews2012_12_26

Caregiving brings physical, mental and emotional challenges. Everyone can use a break; respite services also can support and strengthen caregivers’ ability to continue taking care of family members or friends with Alzheimer’s.
Learn about respite care >>

Everyone needs a break. Respite care provides caregivers a temporary rest from caregiving, while the person with Alzheimer’s continues to receive care in a safe environment. Using respite services can support and strengthen your ability to be a caregiver.

• Using respite care
• Types of respite care
• Overcoming concerns

Using respite care

Respite care can help you as a caregiver by providing a new environment or time to relax. It’s a good way for you to take time for yourself.

Respite care can provide:

• A chance to spend time with other friends and family, or to just relax

• Time to take care of errands such as shopping, exercising, getting a haircut or going to the doctor

• Comfort and peace of mind knowing that the person with dementia is spending time with another caring individual

Respite care services can give the person with dementia an opportunity to:

• Interact with others having similar experiences
• Spend time in a safe, supportive environment
• Participate in activities designed to match personal abilities and needs

Read more: http://www.alz.org/care/alzheimers-dementia-caregiver-respite.asp?WT.mc_id=enews2012_12_26#ixzz2GCrpil3m

Plan Ahead: Respite Care for Unexpected Situations

Emergencies, unplanned situations or unexpected trips can create a need for immediate care by an alternative caregiver. Try providers out in a non-emergency situation, so you’re ready if the need arises. Also, talk with people you trust — including family, friends and neighbors — about helping out in an emergency. It’s a good idea to have contact information for the person with dementia’s medical team as well as a list of all current medications (with dosage and frequency taken) easily accessible at all times.

Read more: http://www.alz.org/care/alzheimers-dementia-caregiver-respite.asp?WT.mc_id=enews2012_12_26#ixzz2GCrry69i

Types of respite care

Respite care can be provided at home — by a friend, other family member, volunteer or paid service — or in a care setting, such as adult day care or residential facility.

In-home care services offer a range of options including:

• Companion services to the individual with companionship and supervised activities
• Personal care or home health aide services to provide assistance with bathing, dressing, toileting and exercising
• Homemaker or maid services to help with laundry, shopping and preparing meals
• Skilled care services to help with medication and other medical services

Adult day centers offer a place where the person with Alzheimer’s can be with others in a safe environment. Staff leads planned activities, such as music and art programs. Transportation and meals are often provided.

Residential facilities may offer the option for a stay overnight, for a few days or a few weeks. Overnight care allows caregivers to take an extended break or vacation while the person with dementia stays in a supervised, safe environment. The cost for these services varies and is usually not covered by insurance or Medicare.

Read more: http://www.alz.org/care/alzheimers-dementia-caregiver-respite.asp?WT.mc_id=enews2012_12_26#ixzz2GCrw0QHv

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Type of caregiver may play a role in clinical trial participation

http://www.medpagetoday.com/Neurology/AlzheimersDisease/36547

People with Alzheimer’s disease with adult children or other non-spouses serving as caregivers may be under-represented in clinical trials, and spousal caregivers may be over-represented, which could impact study results, a new study shows. Among their findings, researchers said that fewer adult child and non-spouse caregivers lived with the person with Alzheimer’s, which suggests increased logistical challenges to participating in research.
Read the article >>
Learn about Alzheimer’s Association TrialMatch^® >>

Alzheimer’s Studies Reveal Spouse Influence

By Crystal Phend, Senior Staff Writer, MedPage Today

Published: December 20, 2012

Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and Dorothy Caputo, MA, BSN, RN, Nurse Planner

Alzheimer’s disease patients with adult child or other nonspouse caregivers appear to be underrepresented in clinical trials, which may influence results, researchers found.

Across six cooperative group trials, 67% of participants had spouses as their study partner compared with 26% enrolled with their adult child and 7% with a different relationship to their caregiver, Joshua D. Grill, PhD, of the Center for Alzheimer’s Disease Research at UCLA, and colleagues reported.

By comparison, national figures suggest the opposite proportions, with 68% of Alzheimer’s caregivers being adult children, children-in-law, or grandchildren.

“We observed several relevant differences that could affect trial conduct, results, and interpretations,” the group wrote online in Neurology.

The secondary analysis included 2,041 patients with mild-to-moderate disease in six Alzheimer’s Disease Cooperative Study trials with similar designs testing two different nonsteroidal anti-inflammatory drugs, B vitamin supplementation, valproate (Depakote), the omega-3 fatty acid docosahexaenoic acid, simvastatin (Zocor), and the Chinese herb huperzine.

Each required a study partner to be enrolled with the patient, typically the primary caregiver. Their relationships to the patient were similar across the trials, ranging from 62% to 68% spouses, 20% to 32% adult children, and 6% to 8% other.

While the study didn’t explain why nonspouse caregivers were underrepresented, it did point to some important factors.

Fewer adult child and “other” study partners lived with the affected patient than did the spouses. They were also less often retired than were spouse study partners (20% and 44%, respectively, versus 71%).

“This difference suggests that patients with Alzheimer’s disease who have adult child caregivers face increased logistical challenges to research participation,” Grill’s group wrote.

Patients enrolled with an adult child were also older than those with either other type of study partner. Adult child or other study partners were more likely to be with male patients.

It’s possible that nonspouse caregivers have more negative attitudes that reduce likelihood of trial participation, the researchers pointed out.

“Another possible reason is that trials typically require patients with mild severity and thus enroll young AD patients who, in turn, may be more likely to have spouses,” they added.

While Hispanic patients were underrepresented overall at just 5% of participants, they disproportionately had adult children as their study partner.

The same was true for African Americans, who represented 6% of all participants.

Patients enrolled with their adult child were twice as likely to be Hispanic and nearly three times as likely to be African American as those with spouse study partners.

“Thus, increasing enrollment of patients with Alzheimer’s disease who have adult child caregivers may facilitate increased minority participation,” the investigators noted.

Strategies to do so may be inclusion criteria such as no, or high, upper age limit and lower Mini-Mental State Examination exclusion criteria.

However, that could create challenges for trials, the group acknowledged.

Dropout rates were higher with with adult child or “other” partners (32% and 34% versus 25%), although only the difference versus “others” was statistically significant.

Patients with an adult child or “other” partner randomized to placebo were doing worse at baseline than those with spouse partners on the Alzheimer’s Disease Assessment Scale-Activities of Daily Living (P=0.04), though not at 18 months and without any significant difference in multivariate models.

No baseline differences emerged by partner type for the Mini-Mental State Examination, Clinical Dementia Rating scale Sum of the Boxes score, or Alzheimer’s Disease Assessment Scale-cognitive subscale.

A limitation was that the analysis included only federally-funded studies, conducted largely by academic trial sites.

“It is unclear how the current results may relate to larger trials, including those supported by industry, which recruit to more diverse site types,” Grill’s group concluded.

The study was supported by the National Institute on Aging, the Sidell-Kagan Foundation and the Marian S. Ware Alzheimer Program.

The Alzheimer’s Disease Cooperative Study is supported by the National Institute on Aging.

Grill reported having served as consultant to Avanir and Phloronol and serving as site investigator for clinical trials sponsored by Elan, Genentech, Janssen Alzheimer Immunotherapy, Bristol-Myers Squibb, Medivation, Pfizer, and the Alzheimer’s Disease Cooperative Study.

Primary source: Neurology
Source reference:
Grill JD, et al “Effect of study partner on the conduct of Alzheimer disease clinical trials” Neurology 2013; DOI: 10.1212/WNL.0b013e31827debfe.

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Association releases Medicare Annual Wellness Visit recommendations

http://news.yahoo.com/alzheimers-association-publishes-recommendations-primary-care-physicians-assess-050100426.html

The Alzheimer’s Association has released guidance to help health care providers detect cognitive impairment as part of the Medicare Annual Wellness Visit. Physicians are required to include detection of cognitive impairment as part of the visit, but there had been no comprehensive guidance to them on how to accomplish it.
Read the article >>

CHICAGO, Dec. 20, 2012 /PRNewswire-USNewswire/ — Today, the Alzheimer’s Association releases guidance to help health care providers detect cognitive impairment as part of the Medicare Annual Wellness Visit. While physicians are required to include detection of cognitive impairment as part of the Medicare Annual Wellness Visit, until today there has been no comprehensive guidance to physicians on how to accomplish that.

Detecting possible cognitive impairment is the first step in determining whether or not further evaluation is needed. In developing the recommendations, the Alzheimer’s Association convened a group of experts to survey the current literature and build consensus around an effective, practical and easy process that could be used in the primary care setting. The recommendations will be released by the Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association as an article in press online in advance of the hard copy publication.

“We understand that by assessing and documenting cognitive status on an annual basis during the Annual Wellness Visit, clinicians can more easily monitor gradual cognitive decline in a patient over time,” said Bill Thies, Ph.D., Alzheimer’s Association chief medical scientific officer. “Through this workgroup process, we now have a comprehensive recommendation for a brief, step-by-step process to detect cognitive impairment that includes tools for patients and family members as well as an emphasis on vital patient history, self-reported concerns and clinician observations.”

According to the Alzheimer’s Association’s 2012 Alzheimer’s Disease Facts and Figures report, among the more than 5 million Americans with Alzheimer’s disease, as many as half have not been diagnosed. Without initial detection, these individuals would not be diagnosed which would deprive them of available treatments and services as well as the opportunity to make financial and care plans.

“Widespread use of the steps identified by the Alzheimer’s Association Medicare Detection of Cognitive Impairment Workgroup could make significant inroads in reducing the prevalence of missed or delayed dementia diagnosis by either establishing a baseline for cognitive surveillance or a trigger for further diagnostic evaluation,” Thies added.

Starting with an examination of published systematic evidence review studies, the Workgroup then explored whether or not there was consensus in the literature concerning validated tools and commonly used rule-out assessments most suited for primary care practitioners. In addition to the range of tools identified, the recommendations offer suggested questions to include in the required Health Risk Assessments that patients must provide for the visit. The recommendations include tools that are available in multiple languages and are unaffected by levels of education or different cultural backgrounds.

While the Workgroup emphasizes in its recommendations “no one tool is recognized as the best brief assessment to determine if a full dementia evaluation is needed,” several tools were found most suited for assessing cognitive impairment at no cost to the health care provider during the visit. These include the Mini-Cog™, the Memory Impairment Screen (MIS), and the General Practitioner Assessment of Cognition (GPCOG). Positive attributes of these tests are that they were relatively free of education, race or cultural bias and take five minutes or less to administer – a very favorable aspect given the often limited time primary care physicians have per patient. Recognized tools suited for those close to the patient such as spouses, family members or friends were the AD8, the Short Informant Questionnaire on Cognitive Decline in the Elderly (short IQCODE), and the Informant GPCOG.

Use of a tool allows clinicians to obtain an objective score that indicates either a passed or failed cognitive assessment and can improve detection of impairment that should be further evaluated. One study found that structured tools detected more than 80 percent of patients who during follow-up were diagnosed with mild cognitive impairment or dementia compared to the detection of only 59 percent whose detection relied on physician observation alone.

“As a leader in the Alzheimer’s community, the Alzheimer’s Association believes that part of its role is to fuel the advancement of early detection and diagnosis. The Workgroup recommendations empower and equip physicians with a pathway that allows them to make informed choices about which structured assessment tools work best for them and the patients they serve,” said Thies. “Whether the tools the Workgroup identified are used or other detection instruments, informal observation is not enough.”

“We urge all primary care physicians to use the recommended step-by-step cognitive assessment process to take full advantage of the opportunity the Medicare Annual Wellness Visit provides – earlier detection of dementia, potentially earlier treatments, better healthcare management for patients and more favorable outcomes for affected families,” concluded Thies.

The Alzheimer’s Association looks forward to working with physician organizations and government agencies as it works to disseminate these recommendations.

Full text of the “Alzheimer’s Association Recommendations for Operationalizing the Detection of Cognitive Impairment during the Medicare Annual Wellness Visit in a Primary Care Setting,” can be viewed at www.alz.org/physicians and will also be published in an upcoming issue of Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

Alzheimer’s Association
The Alzheimer’s Association is the world’s leading voluntary health organization in Alzheimer’s care, support and research. Our mission is to eliminate Alzheimer’s disease through the advancement of research; to provide and enhance care and support for all affected; and to reduce the risk of dementia through the promotion of brain health. Our vision is a world without Alzheimer’s. For more information, visit www.alz.org.

SOURCE Alzheimer’s Associationf

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