New Checklist Helps Catch Symptoms Earlier

Researchers presenting at the Alzheimer’s Association International Conference 2016 (AAIC 2016) in July introduced and described a new condition known as mild behavioral impairment (MBI) that may be a forerunner of dementia.

MBI Checklist

They also proposed a new MBI checklist that physicians and research professionals can use to help recognize and measure sharp changes in mood and behavior that may precede the memory and thinking problems of dementia. Eventually, a similar checklist may be used by caregivers and family members to document the nature and extent of symptoms, and measure changes over time.

MBI would be a clinical designation that precedes mild cognitive impairment (MCI), a diagnosis that is used to describe people experiencing some cognitive problems but who can still perform most daily functions. Individuals with MBI would typically be functionally independent and younger than typical dementia patients. For a diagnosis, changes in behavior and mood must be present for at least six months and be a change from the person’s longstanding pattern of behavior.

The checklist contains 34 questions in various categories of behavioral symptoms, including: becoming agitated, aggressive, irritable or temperamental; becoming more easily frustrated or impatient; hoarding objects; saying rude or crude things the person would not have said before; becoming suspicious of intentions or motives of others, often to the point of believing they are in danger or that others are planning to harm them or steal their belongings; becoming apathetic or more impulsive.

Warning Signs

Mood and behavior changes have long been known as early warning signs of some kinds of dementia, and research has shown that Alzheimer’s can, indeed, start as a behavioral issue.

“While memory loss is a hallmark of Alzheimer’s, early symptoms such as anxiety, confusion and disorientation are often more common, troubling and obvious to family members,” according to Maria C. Carillo, PhD, chief science officer, Alzheimer’s Association.

Studies have shown that a person with mild cognitive impairment who also experiences mood or behavior changes develops full-on dementia faster than one who does not have behavior changes and, over time, experiences worse symptoms.

Not everyone who is diagnosed with MBI will develop dementia. But catching behavior changes early can lead to an earlier diagnosis of dementia and/or effective treatment that will allow the person to live a more normal life longer. Some behaviors, like anxiety and depression, can be helped with therapy and medication. There are also clinical trials these patients might qualify for.

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Falls are the leading cause of death from injury among seniors, and the risk increases with age. Fully one third of those over age 65 fall each year, and many suffer severe or even fatal injuries.

Research

Researchers at the Mobility and Brain Function Program at the Institute for Aging Research (Harvard Medical School) are concentrating on understanding what causes older adults to fall, which will hopefully lead to development of preventive measures. They have found a direct correlation between balance and reduction of fall risk in older adults.

In a recent article, Dr. Brad Manor, the program’s director, explains that as we grow older, our ability to efficiently perform multiple tasks at the same time start to slowly deteriorate. Even the simplest of simultaneous activities, such as walking and talking, can disrupt our balance and put us at risk for a serious fall-related injury.

Mobility, the researchers conclude, is both physical and mental. The physical part relies on the ability of your muscles and reflexes to create the movement necessary to help maintain balance. The mental part relies on your ability to pay attention to the world around you, your short-term memory of where your legs and feet are located related to the ground, and your ability to make the correct decision to change your movements when needed, such as when a sidewalk is wet or covered with snow.

Preventative Exercises

In an effort to find ways to prevent falls by seniors, researchers at the Center have started looking at exercises that target both the physical and mental fundamentals in mobility. They found that the purposeful movements and fluid repetitious motions in Tai Chi not only boost muscle function but also stimulate the mental functions that make mobility easier. Yoga and dance also have great mind-body interactions and work well to improve balance in older adults. While walking on a treadmill, riding a bike or strength training are all beneficial exercises, they were found to not have the balance component necessary to most effectively prevent falls.

Often, older adults will fall, become injured and then be less active. This chain of events causes further balance deterioration and greater risk of suffering another fall in the future. Dr. Manor stresses that it’s never too late or too early to start exercises to help improve balance and prevent the debilitating results that can come with a balance-related injury later. He does caution that any balance-based exercise should be done in a group or with a partner for safety reasons, and to check with your doctor before beginning a new exercise.

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Veterans are an important class of our population and as such, it is important to know about the various benefits available to them.  Many of the benefits are based on the type of service by the veteran, the health of the veteran, or a combination of these factors. The next several paragraphs will outline benefits veterans should be aware of, however, it is recommended veterans speak with a legal professional who will be able to tailor their benefits to their unique situation.

Disability Benefits

Disability benefits are available for military veterans who were disabled during their service or as a result of their service. In order to qualify, veterans must have a service-related disability rating of 10 percent or more, according to the Department of Veterans’ Affairs (VA). Veterans must also have been discharged under circumstances other than a dishonorable discharge. Typically, these benefits range from $127 to $3,000 per month and you may be eligible for increased benefits if your disability is “very severe.”

Pension Program

The VA also provides a pension program for veterans. This program is needs-based and in order to qualify a veteran must have a permanent disability that is not connected to their service or a limited income without the ability to work. There are several other requirements veterans must fulfill in order to be eligible for the pension program such as having been discharged from service after at least 90 days of active service with one day being in an eligible wartime period, and be 65 years of age or older. Veterans who are eligible for a basic pension may qualify for a pension at an increased rate if they require the assistance of another individual to perform daily tasks.

As veterans age, health care becomes increasingly important and the government recognizes this and provides certain health care services available only to veterans. The VA is required to provide hospital and outpatient care defined as “necessary” to all eligible veterans. In addition to the necessary benefits, veterans may qualify for drug dependency treatment, blindness rehabilitation, and HIV/AIDS treatment programs, among others. The quality of health care at the VA is consistently ranked high among their peers, and with over 1,200 locations where veterans can go to receive care, it is important that veterans take advantage of these benefits and meet with a legal professional to determine their eligibility.

With the rapid rate at which technology changes and new discoveries are being found, it can be challenging for veterans to return to civilian life and interview for a job without some of their skills being outdated. This is one of the reasons educational and occupational programs are so popular with veterans. The most popular is the GI Bill, which is provided by the VA. There are several different GI Bill programs, each with different eligibility requirements, but they all are designed to assist veterans with the cost of obtaining an education or occupational training. In addition to the GI Bill, veterans also have access to other programs such as the Vocational Rehabilitation and Employment Program, which helps service-connected disabled veterans find jobs suitable for their conditions, and the Education and Career Counseling Program which provides veterans with career counseling services.

The Veterans Administration recognizes that veterans require a wide range of services, especially when transitioning home and as they age. If you or someone you know may be eligible for VA benefits, please do not hesitate to reach out to our office with questions or to learn more.