Page numbers in italics indicate illustrations.
Abilify (aripiprazole), 66
accidents and driving, 79–80
accusations: of infidelity, 115–17
of stealing, 92
acetylcholine, 62–63
activities: attendance at, 53–54
to counteract boredom, 111
day care, 55–56
sleep disturbances and, 104
“Three-Strike Rule” for, 54
adult protective services, 130
adversity, facing, 73–75
agencies: adult protective services, 130
bonded, 90
recommendations for, 89–90
aggressive or agitated behavior, 67
aging, dementia as accelerated process of, 33–34
alcohol: consuming after diagnosis, 107–8
health benefits from, 47
sleep disturbances and, 103
alertness, level of, 91
Alzheimer disease: as cause of dementia, 8
characteristics of, 10
criteria for diagnosis of, 8–9
first symptom of, 9
frequency of, by country, 47. See also diagnosis of Alzheimer disease; stages of Alzheimer disease
amyloid deposition, 27
amyloid PET scans, 9, 10, 17, 17–18
amyloid precursor protein (APP), 39, 41–42
amyloid precursor protein (APP) gene, 34, 37–38, 40
amyloid protein, 11
amyloid theory of Alzheimer disease, 39
analgesic medications, 113
animals, 60–61
anticholinesterase medications, 62
anti-dementia medications, 61–64
antidepressant medications, 64–65, 103, 110, 114
antipsychotic medications, 66–68, 92, 99, 106–7
anxiety and sleep disturbances, 104
APP (amyloid precursor protein), 39, 41–42
APP (amyloid precursor protein) gene, 34, 37–38, 40
apps to locate or follow individuals, 97
Aricept (donepezil), 61–64, 65
aripiprazole (Abilify), 66
assessment: of dangerousness of current situation, 129–30
of disrupted sleep, 102–5
of pain, 112–13
of risk for wandering, 98
of triggers for crying, 113–14
attorneys, consulting with, 77
bad news: responses to, 74–75
sharing, 135–36
bathroom schedules, 102
behavioral variant of FTD, 26
benzodiazepines, 106
beta-amyloid protein, 38
biomarkers, 3
blood lipid abnormalities, 45
blood tests, 18
boredom, counteracting, 111
lobes of, 25
scans of, 16–17
brain stem, 123
caffeine and sleep, 103
caregivers: agnosia and, 99–100
depression in, 86
disrupted sleep of persons with dementia and, 103, 106
guilt and frustration in, 87
home help for, 89–90
long-distance support for, 88–89
use of term, ix
catastrophic reactions, 118
causes of dementia: alcohol and drug use and, 29–30
Alzheimer disease, 8
blood tests for, 18
cerebral amyloid angiopathy, 27–28
cortical basal degeneration, 27
Creutzfeldt-Jakob disease, 42
CTE, 28–29
disturbed sleep, 43
environmental, 41
frontotemporal dementia, 10, 25–27, 52
interactions among, 49
Lewy body dementia, 23
normal pressure hydrocephalus, 22
overview of, 8
Parkinson disease dementia, 24
proteins in, 38. See also vascular dementia
cell phones, learning to use, 96–97
cerebral amyloid angiopathy, 27–28
chewing, impaired, 69–70
children, talking with about dementia, 84
chronic subdural hematomas, 22
chronic traumatic encephalopathy (CTE), 28–29
coconut oil, 65–66
cognition: testing, 2–3, 20–21
worsening of, 90–91
cognitive impairment: alcohol and drug use and, 29–30
medications and, 30. See also mild cognitive impairment
cognitive training, 46
communication: about accusations of infidelity, 116
about behavior, 127–28
about diagnosis, 130–31
about feeding tubes, 138–39
about future plans, 83–84, 131–32
tips for improving, 13–14
during visits, 114–15
competence: power of attorney documents and, 77
refusal to take medications and, 95–96. See also incompetence
conversations. See communication
cortical basal ganglionic degeneration, 27, 124
cortical symptoms, 12–15
Creutzfeldt-Jakob disease, 42
cruises, going on, 80–81
crying: sundowning and, 119–20
triggers for, 113–14
CTE (chronic traumatic encephalopathy), 28–29
CT scans, 16
cure, progress toward, 50
daily functioning: decline in, 2, 4–5
feeding skills, 14
toileting, 100–102
dangerousness of current situation, assessment of, 129–30
day care, 55–56
death, 71–72
decision making: about feeding tubes, 70, 137–39
about long-term placement, 56–57
about lying, 132–35
about treatment of terminal illnesses, 137
executive function changes and, 132
by trial and error, 61
delusional beliefs, 67
dementia: as accelerated process of aging, 33–34
characteristics of, 7
with Lewy bodies, 23, 104, 124. See also causes of dementia; and specific types of dementia
denial of diagnosis, 82–83, 128–29
depression: in caregivers, 86
medication for, 64–65
sleep disturbances and, 104
symptoms of, 109
treatment for, 110
dextromethorphan/quinidine (Neudexta), 114
diabetes, 48
diagnosis of Alzheimer disease: accuracy of, 22
confirmation of, at autopsy, 10
criteria for, 8–9
disclosing, 75–77
early, benefits of, 3–4
informing patients about, 128–29
ruling out other causes, 18–19
diet, heart-healthy, 46
disability, dementia as cause of, 75–76
disclosing diagnosis, 75–77
diuretics, 103
donepezil (Aricept), 61–64, 65
Down syndrome, 40
dreams, vivid, as side effect of medications, 103, 105
driven pacing, 98–99
driving, 79–80
durable power of attorney: designating, 77–78
refusal to take medications and, 95
early identification, benefits of, 3–4
early onset Alzheimer disease, 34, 37–38
emergency contacts, 96
emotions: acknowledging, 134
anxiety, 104
catastrophic reactions and, 118
music and, 53. See also depression
employment and disclosure of diagnosis, 75–76
environmental causes, 41
ethics of lying, 132–34
executive function: behavioral variant of FTD and, 26
changes in, and making decisions, 132
definition of, 12
Exelon (rivastigmine), 61–64
experts, disagreement among, ix–x
facts, learning of, 51
falls, risk of, 71
family members, recognition of, 99–100
feeding skills, 14
feeding tubes, 70, 124, 137–39
finances, durable power of attorney for, 78
free recall memory, 1
frontal lobes, 118
frontotemporal dementia (FTD), 10, 25–27, 52
frustration: of caregivers, 87
from language impairments, 93–94
future plans, discussing, 83–84, 130–31
galantamine (Razadyne), 61–64
gender, as risk factor, 48
gene testing kits, 36
genetics as cause of Alzheimer disease, 34–38, 49
ginkgo, 65
glucose PET scans, 16
granulovacuolar degeneration, 26
Haldol (haloperidol), 66
harm reduction, 108
head trauma and CTE, 28–29
health, durable power of attorney for, 78, 137–39
Health App, 97
Health Insurance Portability and Accountability Act (HIPAA), 130
help at home, finding, 89–90
hemorrhagic strokes, 27
hereditary, Alzheimer disease as, 34–38, 49
herpes virus infections, 42
high blood pressure, 45
HIPAA (Health Insurance Portability and Accountability Act), 130
hippocampus, 50
home: finding help for, 89–90
giving up, 131
hospice care, 70–71
hospitals and delirium, 90–91
imidazopyridines, 107
incidence rate, 49
incompetence: determination of, 136
power of attorney documents and, 77–78
refusal to take medications and, 95–96
treatment of terminal illnesses and, 137
incontinence, 100–102
independence, tips for maximizing, 14
infection, links between Alzheimer disease and, 41–42
infidelity, accusations of, 115–17
information: learning new, 51, 96–97
retrieval of, 1
jellyfish protein, 65–66
language impairments, 9, 12–14, 93–94
language variant of FTD, 26
lawyers, consulting with, 77
learning new information, 51, 96–97
Lewy bodies, 10
Lewy body dementia, 23, 104, 124
living in moment, 115
living wills, 78
lobes of brain, 25
locator chips, 97
locked doors in long-term care facilities, 59–60
long-distance support for caregivers, 88–89
long-term care facilities: finding, 58
payment for, 58–59
placement in, 56–57
wandering risk and, 59–60
loss, experience of, 122–23, 133, 135–36
lying: to break cycle of repetition, 111
as ethical issue, 132–34
lymphatic system, 43
mad cow disease, 42
MCI. See mild cognitive impairment
Medicare: hospice benefit of, 70–71
nursing home care and, 58–59
ratings of skilled care facilities by, 58
medications: anti-dementia, 61–64
antidepressant, 64–65, 103, 110, 114
antipsychotic, 66–68, 92, 99, 106–7
cognitive and memory impairment and, 30
for MCI, 65
off-label use of, v
pain, 113
for pseudobulbar affect, 114
refusal to take, 94–96
to remove or prevent tau protein deposition, 40–41
to remove or reduce A beta42, 39, 40–41
for sleep disorder, 103, 106–7
Mediterranean diet, 47
memory: changes in, with age, 1–2
denial of problems with, 82–83, 128–29
medications and, 30
severe impairment of, 110–11, 115
stages of Alzheimer disease and, 11–12
types of, and learning, 51–52
mental activities, 46
mild cognitive impairment (MCI): anti-dementia medications for, 65
benefits of early recognition of, 3–4
development of dementia and, 20
mood disorders, 21. See also depression
mortality and antipsychotic drugs, 66
motor memory, 51–52
moving, difficulties and stresses of, 131–32
MRI scans, 16
music therapy, 52–53
Neudexta (dextromethorphan/quinidine), 114
neuritic plaques, 10, 11, 38, 39–40
neurofibrillary tangles, 10, 11, 28, 38, 40–41
neuropsychological testing, 2–3, 20–21
normal pressure hydrocephalus, 22, 125
nursing homes. See long-term care facilities
observations, asking caregivers for, 88–89
obstructive sleep apnea, 104
onset of dementia, as declining, 49
opinions, asking caregivers for, 88–89
pacing, 97–99
Parkinson disease dementia, 24, 52, 64
PBA (pseudobulbar affect), 113–14
personality, changes in, 117–19
PET scans, 11, 16–17. See also amyloid PET scans
pet therapy, 60–61
physical activity: benefits of, 54–55
to lower risk, 45
sleep disturbances and, 104
physical decline, 15
placebo response, 62
placement in long-term care facilities, 56–57
power of attorney, 77
praxis, impairment in, 14–15
prevention: activities for, 45–47
of delirium, 91
outlook for, 48–50
primary care doctors, role of, 5
prions, 42
procedural memory, 51–52
progressive supranuclear palsy, 27, 124
pseudobulbar affect (PBA), 113–14
quality of life, 73–75
questions, repeating, 110–11
quetiapine (Seroquel), 66
Razadyne (galantamine), 61–64
recognition memory, 1–2
recognition of people and objects, 99–101, 121
reflux, 124
refusal to take medications, 94–96
REM Sleep Behavior Disorder, 104, 105
repetition of questions and comments, 110–11, 127–28
retrieval of information, 1
risk factors: diabetes, 48
Down syndrome, 40
environmental, 41
gender, 48
interactions between, 35
rivastigmine (Exelon), 61–64
Seroquel (quetiapine), 66
sharing health information, 75–77, 130
side effects: of anticholinesterase drugs, 62
of antipsychotic medications, 66
sitters, paid, 91
sleep, disrupted: assessment of, 102–5
as symptom and cause, 43
tips for, 105–7
social activities, 46
Social Security Disability Insurance, 75–76
speech and language pathologists, 124
speed of performance, 2
spouses: accusing of infidelity, 115–17
recognition of, 121
stages of Alzheimer disease: cortical symptoms, 12–15
memory and executive function impairment, 11–12
overview of, 11
physical decline, 15
stealing, accusations of, 92
strokes: cerebral amyloid angiopathy and, 27–28
vascular dementia and, 22
sundowning, 119–20
support for caregivers: for accusations of infidelity, 117
at home, 89–90
long-distance, 88
suprachiasmatic nucleus, 105
surgery and delirium, 90–91
suspiciousness, 92
Tai Chi, 55
talking: about accusations of infidelity, 116
about behavior, 127–28
about diagnosis, 130–31
about feeding tubes, 138–39
about future plans, 83–84, 131–32
with children about dementia, 84
during visits, 114–15
tasks, learning new, 51–52, 96–97
tauopathy, 27
tau PET scans, 11
tau protein deposition, 26, 28, 38, 40
temper, losing, 87
terminal illnesses, 137
36-Hour Day, The (Mace & Rabins), ix
toileting, 100–102
trial and error, 67
triggers: of catastrophic reactions, 118–19
of crying, 113–14
turmeric, 65–66
unawareness of diagnosis and problems, 82–83, 128–29
vacations, taking, 80–81
variant Creutzfeldt-Jakob disease, 42
vascular dementia, 21–22, 64, 124–25
visits and conversations, 114–15
visual agnosia, 9
visual hallucinations, 23
visual perception, impairment in, 15
vitamin B12, 46
walking ability, 124–25
wandering risk: assessment of, 98
long-term care facilities and, 59–60
technology and, 96–97
weight loss, 69
Weinberg, Jack, “What Do I Say to My Mother When I Have Nothing to Say,” 114–15