health

Medication Is a Short-Term Solution for Dementia

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | July 26th, 2019

Dear Doctor: I’m 95 and was recently diagnosed with dementia. The doctor recommended a pill, but it’s not a cure. I don’t want to go through that illness for years, as it would be too hard on my daughter. Do you have any other suggestions? I do word search puzzles all the time.

Dear Reader: We were moved by your loving and thoughtful letter, which focused so much more on the welfare of your daughter than on what the diagnosis of dementia means for your own future. Living to 95 is quite an accomplishment, and we are sorry that you and your family must now face this new challenge.

"Dementia" is a general term used to refer to an array of progressive neurodegenerative diseases, of which Alzheimer’s is the most common. It’s true that patients now have access to several dementia medications, which work by bolstering chemical messengers in the brain that play a role in learning, memory, mood and judgment. However, the effects of these medications are often uneven, and, unfortunately, they are always short-lived. In addition, they can result in side effects such as nausea, fatigue, muscle aches, insomnia and headache.

A number of herbal and alternative therapies have been promoted as aids for dementia, but the data regarding their effectiveness is weak. If you do decide to explore alternative therapies, please be sure to let your medical care team know so you stay safe. It’s possible for certain herbs and supplements to interfere or interact with prescription medications.

In our individual practices, we focus on helping patients and their families with supportive care. This includes maintaining a consistent environment for the patient, whether at home or in a skilled nursing facility. Exercising the mind with reading, games and all kinds of puzzles, including the word search puzzles you’re already completing, has been shown to be helpful in delaying the onset of symptoms.

Avoiding social isolation is also crucial. It’s common for the elderly to withdraw from family and social life as they age, and this can become even more pronounced after a dementia diagnosis. We would urge you and your daughter to begin researching the community-based services that are available in your area. This will allow you to develop a support network appropriate for both your current needs and future ones. You will be able to connect with others who are facing a similar diagnosis, and your daughter will find a supportive community. The Alzheimer’s Association offers help with home and personal safety, recreational opportunities and quality of life factors. Educating yourself about dementia and its progress can help both you and your daughter prepare for the future.

It’s also important to make any financial or legal decisions, including documents like power of attorney, before things progress too far. A good starting place for more information on all aspects of dementia is the Alzheimer’s Association. You can find the website at alz.org.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

health

Body's Ability To Synthesize Vitamin D Decreases With Age

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | July 24th, 2019

Hello, dear readers, and welcome to the first column of high summer. You’ve kept our inbox full, so we’ll dive right in.

-- A recent column about vitamin D prompted a reader to ask this follow-up question: “It is my understanding -- via a doctor -- that when you reach 65 to 70, the body’s ability to make vitamin D begins to decrease. Is this true?”

Yes, the doctor you spoke to is correct. As we age, we experience a decrease in the ability to synthesize vitamin D. This, along with less time in the sun, and a drop in dietary intake, can lead to deficiency. Since this vitamin plays a role in both physical and mental well-being, it’s important to monitor vitamin D levels in the elderly. This can be done via a blood test, and if a deficiency is found, it can be addressed through diet and supplements.

-- We’ve fielded a few questions about air fryers, which are the countertop appliance of the moment. They cook using a fan that circulates super-heated air and, with just a tablespoon or so of oil, crisp food in the same (well, similar) way that deep-frying does. A reader from Tulsa, Oklahoma, wondered whether this sounds too good to be true and asks, “Are there any negatives to eating foods that have been cooked in an air fryer?"

The good news for air fryer fans is that foods cooked in this manner can be up to 70% lower in calories than those cooked via traditional deep-frying. The devices may also decrease the presence of potentially dangerous compounds like acrylamide, which are created during the deep-frying process. However, high-heat cooking of any kind has been associated with the formation of other potentially dangerous compounds. And remember, air-fried foods are only as healthy as the ingredients you’re starting with.

-- Our column about an elderly man wanting to get a dog continues to get a lot of thoughtful replies, such as this one from a reader in Fresno, California: “You left out two important things -- assessing the elderly person's physical, mental and financial capabilities, and the major differences in the care needed by different breeds. A mature dog with no major physical or emotional problems and that does not need much grooming or running is a very different commitment than a puppy.”

-- We recently wrote about advance directives for dementia, in which an individual describes the medical interventions that he or she doesn’t want as the condition progresses. A reader in Terre Haute, Indiana, adds that it’s important to make sure that these directives are accompanied by the specific legal documents required by the laws of their particular state.

We thank you, as always, for your interest in this column. Just a reminder -- we can’t answer specific questions about medications, make a diagnosis or offer a second opinion. Also, space limitations mean that sometimes answers aren’t as in-depth as some readers would like. We’ve noticed that our readers aren’t shy about adding to, arguing with or correcting our work, and we are always happy to revisit previous topics here in our monthly conversations.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

health

Symptoms Vary When Ticks Transmit Lyme Disease

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | July 22nd, 2019

Dear Doctor: We moved from the city to rural Massachusetts, and suddenly Lyme disease is a real threat. I’ve read about it forever, but now that we’re here, I realize I don’t know much about the disease. How do you know if you’ve got it? And how do we protect ourselves and our kids?

Dear Reader: Lyme disease is one of a range of illnesses that can occur when an individual is bitten by a tick. In the case of Lyme disease, the tick has been infected by a bacterium known as Borrelia burgdorferi. In the eastern half of the United States, the bacterium is carried by the blacklegged tick, also known as the deer tick. On the Pacific coast, the disease is spread by the western blacklegged tick.

In order to transmit the disease, the tick must have been attached to its host for at least 24 hours. But because these ticks are quite small -- they range in size from a poppy seed to a sesame seed, depending on the stage of their life cycle -- they can be easy to miss. About 30,000 cases of Lyme disease get reported to the Centers for Disease Control and Prevention each year, but epidemiologists estimate that the true number is closer to 300,000.

One of the challenges of Lyme disease is that the symptoms, which vary depending on the stage of infection, are similar to indicators of other common conditions. In its early stages, Lyme disease can cause fever, swollen lymph nodes, chills and body aches, which are also symptoms of upper respiratory viral infections. Another early symptom can be a localized skin rash, which sometimes clears at the center as the edges expand, forming a distinctive target shape. However, this rash has been found to be a symptom in only about 70% of Lyme cases. To add to the uncertainty, the rash doesn’t always follow the target-shaped pattern. Stiffness and joint swelling, which can arise days or months after the tick bite, mimic arthritis.

Additional symptoms that can arise days or months after an infection include pain in the joints and tendons, heart arrhythmias, dizziness, nerve pain, shortness of breath, loss of muscle tone on one side of the face and even changes to memory and cognition. Anyone with these symptoms who has been bitten by a tick, or who lives in tick country, should seek medical attention. Diagnosis includes a history of potential tick exposure, and it may include lab tests to detect antibodies to the bacterium. Treatment of early-stage Lyme disease with antibiotics such as doxycycline, amoxicillin or cefuroxime is usually quite effective.

Ticks are found in wooded and brushy areas, lawns and gardens, and on outdoor pets. Protect yourself with light-colored clothing, which makes ticks easier to see. Clothes and gear can be treated with the insecticide permethrin. Tuck pants into socks and remember protection for your head. Always perform whole-body tick checks after outdoor activities. If bitten, remove the tick with fine-tipped tweezers, grasping as close to skin as possible. Clean area thoroughly, and see if your physician wants you to save the tick. If so, wrap it in tape. And remember -- a tick bite doesn’t automatically equal Lyme disease.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Next up: More trusted advice from...

  • How Do I Find People Willing To Date Me When I Have Bipolar Disorder?
  • How Do I Find New Friends (After Losing All My Old Ones)?
  • How Do I Stop Feeling Unworthy of Love?
  • Will Trusts Have To Disclose Ownership Information?
  • A Vacation That Lasts a Lifetime
  • The Growth of 401(k)s
  • Make the Most of a Hopeful Season With Festive Home Looks
  • Designing a Holiday Tabletop for a Season Like No Other
  • Light It Up: New Designs Brighten Home Decor
UExpressLifeParentingHomePetsHealthAstrologyOdditiesA-Z
AboutContactSubmissionsTerms of ServicePrivacy Policy
©2023 Andrews McMeel Universal