brain | WellnessMaster

Alzheimer’s is a horrible disease that has uniquely devastating effects on the people who have it and their loved ones.

Common symptoms include memory loss; struggling to plan, complete tasks or solve problems; feeling confused; experiencing new problems with speaking and writing; misplacing items; making poor judgment calls; social withdrawal; and more.

While those symptoms are ones we often hear about, they aren’t the only ones. There’s a symptom that many caregivers aren’t aware of and think is a result of “bad” caregiving: agitation.

“It’s critical to first appreciate that agitation is a symptom of brain changes caused by Alzheimer’s disease, not poor caregiving,” said Dr. Richard Stefanacci, the medical director of Inspira LIFE, a senior living program.

“The brain damage from Alzheimer’s makes people prone to agitation regardless of how loving caregivers are,” said Stefanacci, who also specialises in older populations and Alzheimer’s.

According to information the Alliance of Aging Research sent to HuffPost, “agitation” in this sense can present itself in a variety of ways: pacing, trying to leave, angry outbursts, profanity, hitting, mood swings, throwing items and more.

Caregivers may blame themselves, AAR continued, thinking it’s a result of their burnout, introducing a new routine or not being patient enough.

Dr. Nikhil Palekar, the director of the Stony Brook Center of Excellence for Alzheimer’s Disease at Stony Brook Medicine, said there’s a stigma when it comes to this specific symptom.

“Caregivers often feel they might be doing something wrong, which is causing their loved one with Alzheimer’s to react in an uncooperative, hostile or agitated manner, without realizing that agitation in Alzheimer’s is very common, with rates ranging from 56% in early stages to 68% in the moderate-severe stage of the disease,” he said.

How Alzheimer’s can cause agitation symptoms

Like with other Alzheimer’s symptoms, it all comes down to the brain.

“Alzheimer’s disease is the result of brain damage to areas of the brain that control emotions, decision-making and behavioral responses,” Stefanacci said.

“This neurological damage explains why people with Alzheimer’s may react strongly to situations that wouldn’t have bothered them before the disease progressed to this point.”

More specifically, we’re looking at neurotransmitters. “Alzheimer’s disease results in dysregulation and a decrease in three neurotransmitters (chemical messengers) in the brain – serotonin, norepinephrine and dopamine – resulting in symptoms of agitation,” Palekar said. Keeping in mind that those neurotransmitters help with mood, motivation, energy, anxiety and more, this makes sense.

We also have to consider environmental factors. For example, the holiday season – or other high-commotion events – can exacerbate agitation and its causes.

“Large gatherings with unfamiliar faces, disrupted routines, unusual foods and changes to previously familiar environments can cause agitation in someone with Alzheimer’s, especially [in] later stages of the disease,” Stefanacci continued.

“Most critical is to make adjustments and accommodations to reduce the stress, such as maintaining routine and familiarity.”

There is hope for Alzheimer’s agitation

Whether you experience agitation from Alzheimer’s or love someone who does, know that hope is not lost. Below, doctors share tips and other helpful information that can help you manage this symptom together:

Create and maintain routines

Consistent daily schedules with meals, activities and bedtime are key, according to Stefanacci. When you do have to prepare your loved one for a change, he encourages doing it ahead of time if/when you can and trying to maintain other routines.

Avoid arguing when possible

If the person with Alzheimer’s has a harmless belief, Stefanacci recommended not arguing with them about it. Rather, he said to focus on the emotion behind what they’re saying and remember that you can’t reason with an Alzheimer’s-damaged brain.

Use calming approaches

While difficult at times, staying calm and helping the person with Alzheimer’s stay calm is important. Speak in a calm, reassuring voice, play familiar music they enjoy and reduce confusing noise, Stefanacci said.

Know that there are helpful treatments available

It’s easy to feel hopeless when someone has Alzheimer’s, and to think that small interventions won’t make a difference. That’s understandable – and thankfully not true.

“This symptom can be effectively treated with behavioural interventions as well as medication, which is FDA-approved for the treatment of agitation in Alzheimer’s disease,” Palekar said.

To get to that point, he recommended discussing any agitation-like symptoms with the patient’s medical provider.

Similar to the tips above, Palekar listed some specific, non-pharmacological interventions that can decrease agitation, too:

Maintaining a daily routine and structure
Reducing noise and clutter
Gentle touching
Soothing music
Reading
Walking (ideally outside in the sunlight)
Staying busy with distractions, like snacks, objects or fun activities
Avoiding stimulants, such as caffeine, late in the day.

Take care of yourself as a caregiver

Being a caregiver is hard work, to understate it. Stefanacci urges these individuals to seek support from other caregivers, support groups and counselling. He also mentioned giving yourself permission to simplify or skip holiday traditions that are simply too overwhelming.

In short, it’s “normal” for someone with Alzheimer’s to show agitation – and that’s on Alzheimer’s, not anything the caregiver has done.

As someone with Alzheimer’s or their loved one, know that you are not alone, and that people are available and want to support you.

Doctor, psychiatrist and author of Change Your Brain Every Day, Dr Daniel Amen, has shared 11 ways that we’re damaging our brain and minds daily — without even realising it.

Amen, who’s the go-to doctor for stars like Bella Hadid, Miley Cyrus and Justin Bieber, opened up with his advice on how to protect our brains on Steven Bartlett’s Diary Of A CEO podcast, where he said that our brains are so important because it’s “the organ of intelligence, character and every single decision that you make.”

In the episode, he shares how, in one of his books, he prescribes the pneumonic ‘BRIGHT MINDS’ as a guide for keeping a healthy brain, with every letter representing a different step.

Here’s what he has to say about all things grey matter…

The first letter in ‘BRIGHT MINDS’ represents blood, he says: “The B is for blood flow. Low blood flow is the number one brain imaging predictor of Alzheimer’s disease. How do you get low blood flow? Caffeine, nicotine, marijuana, alcohol, having a sedentary lifestyle, and being overweight.”

He says that caffeine “constricts blood flow by 30%” and also increases the stress hormone cortisol, which isn’t great for long-term health either.

We can assume, then, to get the blood flowing would be to do the opposite of the things he listed — cutting out our thrice daily coffee habits (gah!!), not smoking, limiting alcohol and getting moving in whatever way makes you feel good.

“R is retirement and ageing. You want to prematurely age your brain? Drop out of school. Do not engage in new learning. When you learn something new, your brain makes a new connection. When you stop learning, or you start doing the same thing over and over again, your brain starts to disconnect itself. Being in a job that does not require new learning is a risk factor for dementia,” Dr Amen explains.

Research shows that older adults can still learn new languages, form new memories and pick up new skills, and it’s beneficial to never stop learning as we age.

The I stands for — you guessed it — inflammation. The wellness world has been coming down like a ton of bricks on all things inflammation in the past few years, and Dr Amen says reducing it can really help protect the ol’ noggin.

“If you want to prematurely age your brain, eat a lot of red meat as if your iron and ferritin levels are high. Because ferritin, which is stored iron tends to age the brain,” he says.

“If you want to increase inflammation, which is a root cause of so many medical and mental health issues, never floss, don’t care about your teeth.”

He says there’s a fascinating link between your dental hygiene and your brain: “It’s absolutely critical for you not to have gum disease, but if you have gingivitis, odds are you’re at increased risk for heart disease and depression and dementia. It’s fascinating.”

Next up: genetics. Something that Dr Amen says a lot of health issues are blamed on when lifestyle changes can switch things upon. He says: “I have obesity and heart disease in my family, but I’m not overweight and I don’t have heart disease. Why? I’m on an obesity and heart disease prevention programme every day of my life. Because genes load the gun, it’s what happens to us and what we choose to do that pulls the trigger.”

H stands for head trauma. While it’s important to look after our brain through what we eat and how we exercise, physically looking after it is vital, too. He sarcastically says, “You want to damage your brain? Play football, play soccer, play rugby, and box.” We can guess then that he would rather we didn’t do all of those things…

He goes on to say that toxins in our personal care products and should be avoided.

According to a piece published in the National Institutes of Health, phthalates, parabens, PFAS, and triclosan, found in popular personal care products, are endocrine disruptors, which mimic or interfere with the body’s hormones and have been linked to problems with the brain, as well as development, and reproduction.

Embrace positivity for a healthy brain, he says: “M is mental health. Negativity increases stress, plus negativity drops activity in your cerebellum.”

“The second I is immunity and infections,” he explained. “Low vitamin D, which occurs in about 60% of the population, is associated virtually with every bad thing, including a smaller brain.

The UK government actually recommends that everyone in the UK should take a 10 microgram vitamin D supplement a day due to how we get absolutely no good weather, ever.

According to Dr Amen neurohormones are incredibly “important”. Some hormonal balances, such as too much cortisol, can actually alter brain function, impairing memory and causing brain fog.

D is for what Dr Amen refers to as ‘diabesity’ — a combination of diabetes and obesity — as research has shown being overweight or obese, especially in midlife, is associated with dementia later in life.

Finally, S is for sleep. Without sleep, we can’t form or maintain the pathways in our brain that let us learn and create new memories, and it’s harder to concentrate and respond quickly during the day, too.

So…. cut out coffee and smoking, get an early night, keep learning, embrace positivity, brush and floss and move your body?

Sounds like a tall order, but if we want to keep our marbles as we get older, maybe not so bad after all!

WellnessMaster

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The Alzheimer’s Symptom You Might Not Expect – Or Worse, Blame Yourself For