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Alzheimer’s Disease – How to Spot the Signs
Alzheimer’s disease is not normal forgetfulness as we age. Instead, it is a specific form of mental decline. And according to the Alzheimer’s Association it accounts for nearly 80 percent all dementia cases. Natasa Dragicevic, MD, PhD., behavioral neurologist and Alzheimer’s disease specialist with Renown Institute for Neurosciences, weighs in on diagnosing it and the importance of early medical action. How to Diagnose Alzheimer’s Disease In general, the signs of Alzheimer’s disease occur slowly, getting worse over time. For example, forgetfulness is a daily search – for shoes, keys and other misplaced items. Not only is memory affected, but also speech patterns and behavior. There is no single test for Alzheimer’s disease. “Specifically, a neurologist should be the one to diagnose Alzheimer’s disease given differences in presentation,” clarifies Dr. Dragicevic. “And ideally a behavioral neurologist (Alzheimer’s sub-specialist) will be managing the treatment,” she adds. Brain Imaging Diagnosing Alzheimer’s disease involves multiple approaches and medical providers. In short, medical history is reviewed along with a physical exam, lab tests and other diagnostic testing. “A medical workup includes a variety of tests. These include MRI and other brain imaging, as well as neurological and psychological testing. Furthermore, a lumbar puncture is performed to look for markers of the disease,” she states. What Causes Alzheimer’s disease? Although no one knows the cause, researchers think many factors play a role. Uncontrollable risk factors include your genetics and having a family member with the disease. However, the controllable risk factors include: reducing the risk of head injury and keeping your heart healthy. It’s important to realize that high blood pressure, high cholesterol, stroke and diabetes play a role in brain health. Blood loss to the brain causes vascular dementia, leading to long-term blood vessel damage. Symptoms of Alzheimer’s disease Generally speaking, the signs of this disease differ in each person. Yet noticeable behaviors include: • Losing the way to familiar places • Forgetting to pay bills • Trouble finding the right words when talking • Repeating questions • General confusion • Social withdrawal Alzheimer’s Disease – Benefits of Early Diagnosis Equally important, spotting Alzheimer’s disease early allows more time to benefit from medications and possible clinical trials. Likewise, nutrition and exercise changes can be made, increasing blood flow to the body, and perhaps delaying symptoms. Early diagnosis also allows for personal health decisions and quality-of-life conversations to take place. According to the Alzheimer’s Association, these benefits include: 1. Medical advantage 2. Emotional and social comfort 3. Time to plan ahead 4. Cost savings A Brain Supporting Lifestyle “At the present time, treatment is limited,” explains Dr. Dragicevic. “Usually Alzheimer’s is a progressive ongoing disease – any management at this time is purely symptomatic.” However, she states the following lifestyle changes can help support brain health: • New hobbies such as painting, pottery, music classes or learning a new language • Crosswords, puzzles and playing games, such as Scrabble • Brain challenging mobile apps, such as Luminosity • 30-45 minutes of mild to moderate physical activity per day, such as walking • Eating a Mediterranean diet (primarily plant based foods)
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Head Injuries, Sprains and Broken Bones
Participating in sports and physical activities is enjoyable and beneficial for our health. However, the risk of injuries comes with the fun and excitement of sports. Sports-related injuries, including sprains, traumatic brain injuries and broken bones, are more common than we realize and can land you in the emergency room. Dr. Scott Shepherd, Emergency Medicine Physician, provides a wealth of information. Traumatic Brain Injuries: The Invisible Threat Traumatic brain injuries come in many forms. From “mild” brain injuries, concussions, to major brain injuries and bleeds. Sometimes it is very difficult to tell the difference between a major injury and a minor injury because many of the symptoms are the same. Concussions Concussions are a type of “mild” traumatic brain injury resulting from a blow to the head or a violent shaking of the body that causes a transient alteration in mental function. They are particularly prevalent in contact sports such as football, soccer and boxing. A concussion can affect memory, judgment, reflexes, speech, balance and muscle coordination. Typically, concussions are not life threatening and usually short lived. However, multiple concussions can lead to permanent disabilities. So, remember there is nothing “mild” about injuring your brain. Contusions The more serious brain injuries from brain contusions (actual bleeding in the brain material) and bleeding that presses on the brain are life threatening. These injuries are caused by the same blow to the head as a concussion and the symptoms are the same from memory deficits, loss of coordination to coma. Because of this, anyone who has a blow to the head and is not acting normal should be evaluated by a medical professional. Anyone suspected of having a severe head injury should seek immediate medical attention and follow a strict protocol for rest and a gradual return to play. It is important to note a person may not lose consciousness if they suffer a concussion; however, major consequences can occur if not properly managed. If you suspect you have an emergency that needs immediate medical attention, please call 911 or visit an emergency room near you. While it is impossible to prevent traumatic brain injuries altogether, the severity of the injury can be mitigated through proper helmet usage and knowing your skill level when participating in high-risk activities. The guidelines for picking a helmet for summer activities such as mountain biking, dirt biking and riding off highway vehicles are similar to those of picking a helmet for winter sports. Learn more about choosing the right helmet. Any blow to your head, neck or upper body can result in a major head injury Signs to watch for include the following: Headache Dizziness Blurred vision Difficulty with thinking, attention or memory Sensitivity to noise or light Ringing in the ears Changes in hearing Double vision Changes in behavior Balance issues Nausea/vomiting Sprains: The Annoying Twist One of the most common sports injuries is a sprain, which occurs when ligaments that connect bones are stretched or torn. Sprains typically occur in joints, such as the ankle, knee or wrist, and are often caused by sudden twists or impacts. Symptoms may include: Pain Swelling Bruising Limited range of motion Rest, ice, compression and elevation (RICE) are the initial recommended treatment, followed by physical therapy to regain strength and mobility.
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As 70,000+ People Congregate for Burning Man, 100 Miles Northeast of Reno, Renown Health’s Emergency Teams and Hospitals Prepare to Serve
Burning Man is an annual event inspired by the values reflected in the Ten Principles and united in the pursuit of a more creative and connected existence in the world. As over 70,000 congregate this week, between Aug. 27 to Sept. 4, in the high altitudes of the hot and windy Black Rock Desert, Renown Health’s emergency and clinical care teams are ready to care for Burners who may find themselves ill and in need of additional urgent, emergent care or hospitalization. This year, people from across the world are expected to make the journey in RVs and cars brimming with tents, food, water, artwork, and costumes, temporarily turning Black Rock into the state’s third largest city. “The Burning Man Project has done an excellent job preparing participants to have a safe, healthy, and wonderful time building Black Rock City and living on the playa for nine days to nurture the distinctive culture emerging from that experience. However, bringing over 70,000 people together in a high altitude, desert environment with limited access to water, food, and sanitary conditions- always presents a challenge,” says Brian Erling, MD, MBA, president and CEO of Renown Health and an experienced emergency medicine physician. “Having excellent care on the playa and plans in place back here in Reno helps to mitigate that risk and ensure the health and safety of all participants.” “We welcome every Burner to northern Nevada,” says Bret Frey, MD, the board-certified emergency medicine physician who heads up the largest Emergency Department at Renown Regional Medical Center; which has the highest-level trauma center for 100,000 miles, located in Reno, NV. Dr. Frey has 23 years of experience in the medical field, and 23 years of experience treating people who have experienced Burning Man. “Burning Man is a fascinating event, and most people have a great time. However, if things go wrong, they are fortunate to have the BlackRock City Emergency Services Department, 24/7, to help. Back here in Reno, we serve as their ‘back up,’ providing care as needed, for the ill and injured and supporting clinical teams when they’re feeling overwhelmed.” Renown Health is home to three 24/7 Emergency Rooms that provide the highest level of emergency and trauma care in the region: Renown Regional Medical Center is the only Level II Trauma Center between Sacramento and Salt Lake City. Located near downtown Reno, this Emergency Room has several helipads and ambulance banks for patients requiring emergency and trauma care. Renown Children’s Hospital at Renown Regional Medical Center is home to the only Pediatric Emergency Room in the region designed just for kids. This location is staffed by pediatric specialists and provides child-sized equipment and family-friendly areas. Renown South Meadows Medical Center includes South Reno’s first 24/7 Emergency Room. Located just off I580, this location is designed to treat patients who need immediate attention for emergencies. These locations are designed to assess and care for emergency situations, including: Heart attack symptoms Stroke symptoms Broken bones Shortness of breath Seizures Severe bleeding Head injuries Chest pains Severe pain Venomous stings and bite All of Renown’s emergency rooms are staffed by Northern Nevada Emergency Physicians, including pediatric specialists and physicians who have completed fellowship training in specialty areas such as sports medicine, ultrasound and emergency medical services. A few interesting medical conditions (Playa Foot and Playa Lung), are associated with Burning Man. The Black Rock Desert in northwestern Nevada is part of the lakebed of the ancient Lake Lahontan, a deep lake that existed 15,000 years ago. Lake Lahontan left fine sediments on the lake bottom to form the extremely flat surface. Playa dust is made of both larger and smaller particulate matter. The Playa dust is in the air, on the ground, and on everything in Black Rock City. People combat the dust with masks, bandannas, and colorful respirators to keep the chalky dust out of their mouths and nostrils, but the effort is often futile. Playa Foot is a malady unique to the Black Rock Desert caused by the alkali dust that makes up the desert. It is, in essence, a chemical burn. The best prevention is keeping feet covered as much as possible, applying a moisturizing skin lotion before bed and wearing socks and closed shoes each day on the playa. “Playa Lung, where the particulate is breathed into the lungs, may cause coughing, throat pain and loss of voice in the short-term,” says William Graham, MD, a specialist in Pulmonary Medicine and Critical Care Medicine at Renown Health. “The dust can cause health issues for smokers, children and elderly and people with pre-existing conditions like asthma and COPD. The best prevention is to get a mask that’s comfortable with n99 filters, wear the mask as much as possible and change the filters often. Be sure to drink lots of water and take protection from windstorms. A doctor visit is recommended if any effects of breathing in dust persist beyond a week or two.” Dr. Derek Beenfeldt is the Chief Medical Officer for Renown’s not-for-profit insurance arm HometownHealth, and has been a frequent participant in the Burning Man experience over the years. In the interest of wanting every person to have a wonderful experience while here- especially since over half of the participants live outside the U.S. health care system, he reminds people of the number of free and low-cost on-site health care and testing resources provided on the playa at Black Rock City. “It is important for Burning Man participants to know that without US health care insurance coverage, the costs can be significant for transportation off the playa for a medical evacuation, hospital emergency department care or hospitalization. Even for people who have insurance, in the past, some have faced some significant out-of-pocket expenses for the flight or transportation to Reno-area hospitals or emergency departments.” He shares the following information; On Site Medical Response A community of EMTs, paramedics, nurses, medical students, and physicians are on site at Black Rock City in RVs to provide emergency response and urgent care to participants as needed. Local Hospital Response Since 2011, the Burning Man organization, has contracted with Humboldt General Hospital in Winnemucca, Nev., to staff and equip Rampart Urgent Care, a field hospital that offers X-rays, ultrasounds, a hand-held head scanner, lab tests and a pharmacy. The single-room wooden structure is easily seen- it is painted pink and yellow. The hospital’s 40 beds are located in adjoining tents. At Rampart, when possible, patients are treated on site. EMTs, medics and nurses are empowered to practice medicine to the fullest ability their licensing and credentialing allow. Patients are not charged for Rampart Urgent Care services, which is covered as part of their ticket fee. The Nevada State Health Division, Bureau of Health Protection Services is also on the playa. You will know them by the Nevada State Health Division logo on their shirts. All Renown’s physicians remind people that if they are experiencing symptoms of a heart attack or stroke, they should go to the closest emergency room (ER) to get needed medical care. Delaying care for a medical emergency, such as a heart attack or stroke, can be life threatening or lead to serious complications. About Renown Health Renown Health is the region’s largest, locally governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe, and northeast California. With a diverse workforce of more than 7,000 employees, Renown has fostered a longstanding culture of excellence, determination, and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the region’s largest, locally owned not-for-profit insurance company, Hometown Health. For more information, visit renown.org.
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Alzheimer's Safety Tips for Caregivers to Know
November is National Alzheimer’s Disease Awareness Month. At Renown Health, we know that Alzheimer's safety for your loved one is a priority, as the symptoms can sometimes lead to unsafe situations. We asked Dr. Jonathan Artz – a neurology physician with Renown Health and an assistant professor of clinical neurology at the University of Nevada, Reno School of Medicine – for tips on keeping loved ones safe and secure. According to the Alzheimer’s Association, Alzheimer’s disease affects safety in various ways, specifically due to body and brain adjustments. These changes can include: Judgment, including forgetfulness Sense of place – getting lost on the way home Behavior – being suspicious or fearful Body difficulty – losing balance Sensing ability – noticeable sensitivity in hearing, seeing or temperature Dr. Artz gives us four major tips to ensure your loved one’s safety as you both navigate this disease together. Watch for Wandering Those experiencing Alzheimer’s disease tend to wander and get lost. Try the following tips to reduce the risk of wandering: Get your loved one an ID bracelet and have them wear it at all times. You can also enroll your loved one in “Wandering Support.” Install door chimes so you know when exterior doors are open. Ask neighbors to call you if they see your loved one out alone. Go with your loved one when they insist on leaving the house. Don’t argue or yell. Instead, use distraction or gentle hints to get them to return home. Discourage Driving Driving can be unsafe for someone with this disease. With this in mind, ask a doctor whether it’s safe for your loved one to drive. For example, on a case-by-case basis, there are certain situations where doctors are required to report individuals with particular cognitive impairments, wherein a form of a driving assessment will be recommended. Limit access to the car. Keep the keys with you or lock them away. Ask an authority figure, such as an insurance agent or a doctor, to tell them not to drive. Adult-Proof Your Abode A simple living space is a safe living space. This means reducing clutter and removing any issues that may pose a safety concern. You may also want to get advice from an occupational therapist (home safety expert). Keep in mind that some changes may not be needed right away. Focus on major safety concerns first. Try the following tips: Add lighting (or glow-in-the-dark tape) to brighten dark areas, including stairways and halls. Use color contrast or texture indicators for dials, knobs and appliance controls. Remind your loved one not to carry items while walking to avoid a fall. Remove sharp objects from drawers and countertops. Avoid using small throw rugs or doormats, as they are easy to trip on. Move frequently used items so that they are easy to reach. Lock away alcohol and tobacco products, as they are not recommended for dementia patients. Install handrails in the shower, tub and near the toilet. Bathroom falls are especially common. Adjust the setting on your hot water heater so water does not scald. Those with Alzheimer’s can lose their sensitivity to temperature. Move and lock up hazardous chemicals and cleaning supplies, such as bleach and insecticides. Disable and remove guns or any weapons. Supervise any medication taken by your loved one. Promote a Positive & Healthy Lifestyle Continually emphasize the strengths of your loved one by promoting participation in meaningful activities, wellness visits and healthy habits to help them improve their well-being. Here are some ways to keep them physically and mentally active: Maintain regular vision and hearing screenings and make necessary adaptations. Establish a routine for daily activities. Encourage participation in self-care and leisure activities. Work with your loved one’s doctor to establish a healthy diet. Ensure proper hydration. It may help to set reminders for your loved one to drink fluids. Encourage regular exercise. Exercise delivers oxygen to the brain, improving brain health. Promote good sleep habits. Good quality sleep can increase overall brain health and has been associated with improving memory, attention and concentration. Resources and support are available with the Renown Memory Disorders Program. Providers within this program are specifically dedicated to treating several different memory-related disorders. Memory Disorders Resources & Support.
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