Memory loss and aging: What’s “normal?”

Head upstairs for something and come back down without it? Find yourself struggling to remember someone’s last name or phone number? Take a wrong turn going somewhere you’ve been driving to for years? Forget to pay a monthly bill? Forgetfulness may be upsetting, but examples like these are common as we age and nothing to worry about. Yet for many older Americans, forgetting things on an increasingly regular basis may be a sign of oncoming dementia or a form of Alzheimer’s, a degenerative brain disease that affects close to one in four Americans.

Alzheimer’s disease is the sixth-leading cause of death among U.S. adults, and the fifth-leading cause among adults aged 65 to 85. In 2013, an estimated 5 million Americans aged 65 years or older had Alzheimer’s disease. This number may triple by 2050, with the costs of care already projected at over $200 billion per year, and expected to increase to more than $500 billion by 2040.

Alzheimer’s disease causes large numbers of nerve cells in the brain to die. This affects a person’s ability to remember things, think clearly, and use good judgment. It typically involves parts of the brain that control thought, memory, and language. While doctors don’t know what causes the disease, they do know that most of the time it begins after age 60.

Dementia is a general term for a decline in mental ability severe enough to interfere with daily life, and Alzheimer’s disease is the most common. It often starts slowly. In fact, some people don’t know they have it and assume their forgetfulness is just a sign of increasing age. However, over time, their memory problems get more serious. People with Alzheimer’s disease have trouble doing everyday things like driving a car, cooking a meal, or shopping or paying bills. They may get lost easily and find even simple things confusing. Some people become worried, angry or violent.

As the illness progresses, people with Alzheimer’s disease need someone to help take care of their daily needs, including feeding and bathing. Some people with Alzheimer’s live at home with a caregiver. Other people with the disease live in a nursing home or in a facility that specializes in dementia-related illnesses.

Though age is the best-known risk factor for Alzheimer’s disease, researchers believe that genetics may play a role. Changes in the brain can begin years before the first symptoms appear, and scientists are studying whether education, diet, exercise and environment play roles in developing Alzheimer’s disease. They also are finding more evidence that some of the risk factors for heart disease and stroke — such as high blood pressure, high cholesterol, and low levels of the vitamin folate — may also increase the risk of Alzheimer’s disease.

While most changes in the brain that cause dementia are permanent and worsen over time, thinking and memory problems caused by depression, medication side effects, excess use of alcohol, vitamin deficiencies  or thyroid problems may improve when the condition is treated or addressed.

How to recognize signs of early dementia

Alzheimer’s disease is not a normal part of aging. And while memory loss affects all of us as we age, it also is typically one of the first warning signs of cognitive loss.

Different types of dementia are associated with particular types of brain cell damage in specific regions of the brain. For example, in Alzheimer’s disease, high levels of certain proteins inside and outside brain cells make it hard for brain cells to stay healthy and to communicate with each other. The brain region called the hippocampus is the center of learning and memory in the brain, and the brain cells in this region are often the first to be damaged. That’s why memory loss is often one of the earliest symptoms of Alzheimer’s.

According to the National Institute on Aging, in addition to memory problems, someone with Alzheimer’s disease may experience one or more of the following signs:

  • Gets lost
  • Has trouble handling money and paying bills
  • Repeats questions
  • Takes longer to complete normal daily tasks
  • Displays poor judgment
  • Loses things or misplacing them in odd places
  • Displays mood and personality changes.

There is no one test to determine if someone has dementia. Doctors diagnose Alzheimer’s and other types of dementia based on a careful medical history, a physical examination, laboratory tests, and the characteristic changes in thinking, day-to-day function and behavior associated with each type. It’s hard to determine the exact type of dementia because the symptoms and brain changes of different dementias can overlap. In some cases, a doctor may diagnose “dementia” and not specify a type. If this occurs it may be necessary to see a specialist such as a neurologist or gero-psychologist.

Treatment of dementia depends on its cause. In the case of most progressive dementias, including Alzheimer’s disease, there is no cure and no treatment that slows or stops its progression. But there are drug treatments that may temporarily improve symptoms, and it’s important to note that other causes of dementia-like behavior – such as from head injuries, alcohol abuse and depression – can be treated.

Protecting our brains

Evidence also is growing for physical, mental, and social activities as protective factors against Alzheimer’s disease. Our brain is nourished by one of our body’s richest networks of blood vessels. Anything that damages blood vessels anywhere in our body can damage blood vessels in our brain, depriving brain cells of vital food and oxygen. Blood vessel changes in the brain are linked to vascular dementia. They often are present along with changes caused by other types of dementia, including Alzheimer’s disease. These changes may interact to cause faster decline or make impairments more severe.

We can help protect our brains with some of the same strategies that protect our heart – don’t smoke; take steps to keep our blood pressure, cholesterol and blood sugar within recommended limits; and maintain a healthy weight.

Regular physical exercise may help lower the risk of some types of dementia. Evidence suggests exercise may directly benefit brain cells by increasing blood and oxygen flow to the brain. And what we eat may have its greatest impact on brain health through its effect on heart health. The best current evidence suggests that heart-healthy eating patterns, such as the Mediterranean diet, also may help protect the brain. A Mediterranean diet includes relatively little red meat and emphasizes whole grains, fruits and vegetables, fish and shellfish, and nuts, olive oil and other healthy fats.

If you or someone you know has several or even some of the signs of increasing forgetfulness, it does not mean that you or they have Alzheimer’s disease. It is important to consult a health care provider regarding concerns about memory loss, thinking skills, or behavioral changes.


 

Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Beware hernias masquerading as stomach aches

So when the doctor says “drop your drawers, turn your head, and cough,” he or she obviously isn’t listening to your lungs – typically, it’s a simple way of diagnosing the most typical form of abdominal hernia.

Hernias are very common, and occur in different locations. A hernia occurs when an organ pushes through an opening in the muscle or tissue that holds it in place. For example, the intestines may break through a weakened area in the abdominal wall. Hernias are most likely to occur in the abdomen, but they also can appear in the upper thigh, belly button, and groin areas. Most hernias are not immediately life threatening, but they don’t go away on their own and can require surgery to prevent potentially dangerous complications.

Inguinal hernias, the most common abdominal hernia, make up about 70 percent of all hernias, and are more common in men than in women. This is because a man’s testicles descend through the Inguinal canal shortly after birth, and the canal is supposed to close almost completely behind them. Sometimes, the canal does not close properly and leaves a weakened area prone to hernias.

Hernias are caused by a combination of muscle weakness and strain. Common causes of muscle weakness include failure of the abdominal wall to close properly in the womb, which is a congenital defect; age; chronic coughing; or damage from injury or surgery. Sports-related hernias can be caused by repetitive twisting or turning, especially at high speeds.

The most obvious symptom of a hernia is a bulge or lump in the affected area. In the case of an Inguinal hernia, you may notice a lump on either side of your pubic bone where your groin and thigh meet. You’re more likely to feel your hernia through touch when you’re standing up.

Other common symptoms of an inguinal hernia include:

  • Pain or discomfort in the affected area (usually the lower abdomen), especially when bending over, coughing, or lifting
  • Weakness, pressure, or a feeling of heaviness in the abdomen
  • A burning, gurgling, or aching sensation at the site of the bulge

In some cases, hernias have no symptoms. You may not know you have a hernia unless it shows up during a routine physical or a medical exam for an unrelated problem.

Depending on its cause, a hernia can develop quickly or over a long period of time. You can’t always prevent the muscle weakness that allows a hernia to occur. However, you can reduce the amount of strain you place on your body. This may help you avoid a hernia or keep an existing hernia from getting worse. Prevention tips include:

  • Not smoking
  • Seeing your doctor when you’re sick to avoid developing a persistent cough
  • Maintaining a healthy body weight
  • Avoiding straining during bowel movements or urination
  • Lifting objects with your knees and not your back
  • Avoiding lifting weights that are too heavy for you

Other types of hernias

Incisional hernias can occur after you’ve had abdominal surgery. Your intestines may push through the incision scar or the surrounding, weakened tissue.

Hiatal hernias occur when part of your stomach protrudes up through the diaphragm into your chest. This type of hernia is most common in patients over 50 years old. If a child has the condition, it’s typically caused by a congenital (birth) defect. Hiatal hernias almost always cause gastro esophageal reflux, which is when the stomach contents leak backward into the esophagus, causing a burning sensation. Symptoms of a hiatal hernia include acid reflux, which is when stomach acid moves backward into the esophagus causing a burning sensation; chest pain; and difficulty swallowing.

Umbilical hernias can occur in children and babies under six months old. This happens when their intestines bulge through their abdominal wall near their bellybutton. You may notice a bulge in or near your child’s bellybutton, especially when they’re crying. An umbilical hernia is the only kind that often goes away on its own, typically by the time the child is one year old. If the hernia has not gone away by this point, surgery may be used to correct it.

Other factors that strain your body and may cause a hernia include being pregnant, which puts pressure on your abdomen, and persistent coughing or sneezing. Other factors include a personal or family history of hernias, being overweight or obese, a chronic cough, chronic constipation, or smoking, which can trigger a chronic cough.

If your hernia is growing larger or causing pain, your doctor may decide that it’s best to operate. Repairing a traditional hernia typically involves sewing or closing the hole in the abdominal wall during surgery. This is most commonly done by patching the hole with surgical mesh, and often can be done through laparoscopic surgery, using a tiny camera and miniaturized surgical tools. Not all hernia surgeries can be conducted this way, however.

If you detect what you believe may be a hernia from straining yourself, exertion or genetics, a quick visit to your physician can help determine the easiest course of action.


 

Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Bug off!

The good news is that with all the rain we’ve had this spring in Connecticut, our reservoirs and water tables are almost back to normal and we’re not likely to experience water shortages this summer. The bad news is that all the rain also is producing a bumper crop of mosquitos, gnats, ticks and other flying and crawling creatures.  The more aggressive species will bug us to distraction, and their bites or stings can cause allergic reactions, discomfort, itchy side effects or illness.

Unless you plan to spend the summer indoors, you’re likely to come in contact with some of these annoying pests. You can improve your odds of not getting bitten by wearing protective clothing, headgear and socks, using insect repellants and citronella products, minimizing use of cologne and perfume when planning outdoor activities, avoiding swampy areas, and moving the party indoors during the height of bite time. You also can spray clothes with repellent containing permethrin, and use a repellant like DEET on your skin.

Of great concern is the possibility of contracting Lyme disease caused by the bacterium Borrelia burgdorferi. It is transmitted to humans through the bite of infected blacklegged ticks, which are common to Connecticut. Typical symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system. Lyme disease is diagnosed based on symptoms, physical findings (such as a rash), and the possibility of exposure to infected ticks. Most cases of Lyme disease can be treated successfully with a few weeks of antibiotics. Steps to prevent Lyme disease include using insect repellent, removing ticks promptly, applying pesticides, and reducing tick habitat. The ticks that transmit Lyme disease can occasionally transmit other tick-borne diseases as well.

Certain types of mosquitos carry diseases such as West Nile Virus (WNV), which has been present in Connecticut since 1999 in mosquitoes, horses, wild birds and people. Most people who are infected with WNV have no symptoms or may experience mild illness such as a fever and headache before fully recovering. In some individuals, particularly persons over 50 years of age, West Nile virus can cause serious illness, including encephalitis (inflammation of the brain) or meningitis (inflammation of the membranes covering the brain and spinal cord). Symptoms range from a slight fever, headache, rash, swollen lymph nodes and nausea to the rapid onset of a severe headache, high fever, stiff neck, disorientation, muscle weakness, and coma. West Nile virus infection can lead to death in three percent to 15 percent of persons with severe forms of the illness.

Health professionals also are keeping a vigilant watch for the Zika virus, which is spread mostly by the bite of an infected Aedes species mosquito, which bite during the day and night.

Zika can be passed from a pregnant woman to her fetus, and infection during pregnancy can cause certain birth defects. There is no vaccine or medicine for Zika, and while local mosquito-borne Zika virus transmission has been reported primarily in tropical climates like Florida, Connecticut experienced a few dozen cases in 2016.

Protecting against ticks and mosquitoes

While it is a good idea to take preventive measures against ticks and mosquitoes year-round, be extra vigilant in warmer months (April through September) when ticks are most active. In summer, when out hiking, biking, camping, and spending time in and around grass and woods, there are several steps you can take to limit bites from ticks, mosquitoes and other disease-bearing insects:

  • Avoid direct contact with ticks and mosquitoes as possible. If you can, avoid wooded and bushy areas with high grass and leaf litter. When hiking, picnicking or walking, try to remain in the center of trails.
  • Use repellents that contain 20 percent or more DEET (N, N-diethyl-m-toluamide) on the exposed skin for protection that lasts up to several hours. Always follow product instructions. Parents should apply this product to their children, avoiding hands, eyes, and mouth.
  • Use products that contain permethrin on clothing. Treat clothing and gear, such as boots, pants, socks and tents. It remains protective through several washings. Pre-treated clothing is available and remains protective for up to 70 washings.
  • If you’re using other repellents, go to the Environmental Protection Agency (EPA) website for safety information.

Ticks embedded in your skin can be gross, but painless. The best bet is to keep them at bay. But if they do find you, here are tips for dealing with them easily and effectively:

  • Bathe or shower as soon as possible after coming indoors (preferably within two hours) to wash off and more easily find ticks that are crawling on you.
  • Conduct a full-body tick check using a hand-held or full-length mirror to view all parts of your body upon return from tick-infested areas. Parents should check their children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and especially in their hair.
  • Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats, and day packs. Tumble clothes in a dryer on high heat for an hour to kill remaining ticks.
  • Consult your doctor or a nurse (or internet sources) to determine the best method for removing the tick; it’s important to remove the entire tick, or it can leave parts embedded in your skin.

Should you or a family member develop a bulls-eye-type red rash near the bite site, or exhibit other side effects such as a fever, lethargy or extreme exhaustion, consult your doctor. You may need to be tested for Lyme disease.

If you know you have an allergy to one or more biting insects, you should always carry an epi-pen or other backup medication in case you’re stung or bitten, and seek immediate medical attention. For the rest of us, most bites or stings leave a mark and cause some swelling and irritation. Ice or a cool compress applied directly to the site can bring relief, as can topical salves, ointments or sprays sold over the counter. If the area around the bite continues to expand or becomes blistery and weepy, you have to get checked for a possible infection.

If you’re not aware of allergies but react dramatically, experiencing symptoms such as dizziness, nausea, vomiting, trouble breathing or extensive swelling, it’s important to get to a hospital, urgent care center or physician immediately, or to call for emergency medical assistance as quickly as possible.

Last but not least, there are biting spiders in Connecticut. Most spiders in New England are relatively harmless as long as you’re not allergic to their bite. One of the common venomous spiders in this region is the Brown Recluse. You can identify this spider by the violin-shaped marking on its back. The bite produces a mild stinging, followed by local redness and intense pain within eight hours. A fluid-filled blister forms at the site and then sloughs off to leave a deep, enlarging ulcer. Reactions from a Brown Recluse spider bite vary from a mild fever and rash to nausea and listlessness. On rare occasions death results, more often in children.

If bitten by a spider, try and identify the type of spider that bit you. Clean the site of the spider bite well with soap and water. Apply a cool compress over the spider bite location. If the bite is on an extremity, elevate it. Aspirin or acetaminophen (Tylenol, others) and antihistamines may be used to relieve minor signs and symptoms in adults. Use caution when giving aspirin to children or teenagers. Talk to your doctor if you have concerns.


 

Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Teams that play together work better

For many active, over-extended or retired weekend warriors, it’s hard driving past softball games, volleyball or tennis matches, 5K charity walks or groups of bicyclists spinning down paved bike paths without feeling wistful. It’s already June, the weather is finally warm and our bodies could really use the exercise and mental release. But we’re busy with work and life and can barely make time to get to the gym and see our family and friends, let alone go play.

Yet going to play and exercising are crucial for our mental and physical health.  For millions of American workers, the opportunity to combine physical activity within or related to the workplace environment has long been a staple of progressive cultures. This healthy practice is catching on in small and large organizations nationwide as increased awareness of health and wellness becomes integrated in team environments. Savvy employers recognize athletic activity as a tool for increased productivity, stress reduction, improved morale, team building and a path to overall wellness.

One CBIA Health Connections employer created a health and wellness committee to brainstorm and plan activities. They linked several of their ideas to national health- and wellness-related observances. Another tied their activities to local events, charities, and parks. Many employers bring in guest presenters and instructors, or sponsor classes, health screenings, nutritional education, and internal competitions. It’s all good fun, can be used to support charitable programs, and helps build stronger workplace teams.

Every month in the United States, there are a dozen or more formally designated awareness commemorations. These provide great topics around which you, your wellness champion, management team, or staff employees can develop an action plan for one or more activities.

There’s something for everyone, ranging from high-profile cancer-awareness months for ovarian, prostrate, breast, lung and skin cancers, to fruit and vegetables “matter” month, obesity, eye and hearing care, diabetes, yoga, UV protection, blood pressure, workplace and helmet safety, immunizations, and much more.

This month is National Great Outdoors Month – there are a variety of activities planned at Connecticut State parks, perfect locations for picnics and outings. And even though it’s not even summer yet, it’s never too early to begin planning for the autumn and winter – by building a schedule well in advance, you can encourage more employee involvement in planning and implementing activities that ultimately improve teamwork, enhance morale and productivity and support health and wellness.

Healthier employees are happier employees. They get sick less often, suffer from fewer incidences of chronic diseases, and have reduced absenteeism and sick days. By delegating – and using the many health and wellness tools available online – you can play a major role in promoting, supporting and funding health and wellness activities that feature a huge return on your investment.


 

If you’re not enjoying the benefits of a wellness program at your company, join CBIA Healthy Connections at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!