The Age Page

When being a female may be an advantage

                                      

Scientists in the US have reported that mild cognitive impairment, like problems with memory and thinking which is known to be a transition stage before dementia, appears to affect older men more than it does older women.

Dementia is a general term for the loss of memory and thinking skills, when it is severe enough to prevent a person from doing normal everyday things such as taking care of themselves, going shopping, paying bills, washing, preparing meals.

The results came from one of the first studies conducted to determine the prevalence of mild cognitive impairment among participating men and women who had been randomly selected from a community.

A person is described as having cognitive impairment when they show problems with memory and thinking that is beyond what might be expected for their age and level of education. Although mild cognitive impairment appears to increase the risk of developing Alzheimer's Disease later, it is not a foregone conclusion.

Investigators interviewed, examined and administered cognitive tests to just over 2,000 people aged between 70 and 89, in Minnesota. They also interviewed people who knew the participants well, for example wives or husbands, about the participants' everyday cognitive functioning.

The participants were classed into three groups: normal cognitive functioning, mild impairment, or dementia.

The results showed that nearly 17 per cent of the group had mild cognitive impairment and that men were 1.6 times more likely to have mild cognitive impairment than women (regardless of the men's level of education or marital status).

The findings contrast with research that showed more women than men – or an equal proportion – have dementia. This could be due to a delayed progression to dementia in men, or women may develop dementia at a faster rate than men. 

However, scientists caution that the results should be seen in perspective, as the genetic risk factors involved in dementia are much greater in magnitude.

Lifestyle factors are also important, and both men and women can reduce their risk of getting dementia. For example, maintaining an active lifestyle rich in mental, social and physical activity and adopting a "brain-healthy" diet that is low in fat and cholesterol and high in dark vegetables and fruit helps.

 Image: NYTimes.com

 

Product Design for the Oldest Old

My mother, who has vascular dementia, lives in a Care Home. At 90 years of age, she has coped very well but recently she had a fall, fractured her pelvis and hit her head. She hasn't been the same since and can no longer support herself on her legs. She seems even less able to communicate with the few words left in her vocabulary – although her non-verbal communication is still largely intact – and she is spending increasing amounts of time in her bed. We are all concerned about the ever present problem of bed sores, so she is 'got up' for short amounts of time to sit in one of the armchairs in the lounge with her feet up.

When on one of my daily visits last week, the carers were moving her from the lounge back to her bedroom, as she had been up for a few hours. The only way to do this was using a full body hoist. 

Of course, I have seen the hoist being used with other residents and had turned away out of respect for their privacy, so I had never experienced it up-close-and-personal, so to speak. it is not dissimilar to the one in the picture.

For those who haven't seen one in use I will briefly describe it. It consists of two parts – the motorised stand on wheels that moves the hoist up and down and swivels from side to side; and a heavy-duty, nylon woven vertically ribbed sling that supports the person's upper back and head and has wide straps that are connected around each of the person's upper legs. The person being hoisted holds on to bars on either side of the hoist contraption. 

Once they are secured, by clips, in the sling, it is attached to the hoist and the motor moves the sling up to lift them and then lowers them into a different location. I have excluded a picture of the sling because in the main, the marketing images for such devices feature young smiley blonde women looking neat and tidy and fully dressed – and un-phased by the experience. There are a few different designs of hoist, the sling at my mother's home is mostly pale cornflower blue and the hoist is pale turquoise and cream. 

All well and good, you may think.  

Here are a few of my casual observations of it:

1 The fabric that goes around the legs is a strong but stiff, scratchy nylon has no soft lining, so rubbing against the sensitive, delicate bare skin of a very elderly person is deeply unpleasant, especially on the inner thighs.

2 The awkward 'man-handling' required in order to slide the back/head support behind the person, particularly if they are sitting in an armchair makes for a rough, uncomfortable experience for them. 

3 Because of the way my mother's home's hoist is designed, although the back and head of the person is well supported, their lower back and bottom are left drooping down, while their knees are pulled up and apart, with their lower legs hanging down so that the body is in a kind of suspended foetal position. This is a debilitating, as well as undignified position for anyone.

4 To be pulled up by the hoist with the motor whirring in this way was confusing and unnerving for a person with dementia such as my mother, even though the staff are always kindly and do their best to be thoughtful.

5 It looks like a piece of hospital equipment, because really, that's what it is. 

Equipment to help the oldest in society is really disgracefully ugly and hostile and often uncomfortable. Even the innocent and ever-helpful Zimmer frame looks out of place in a person's living accommodation.  When my mother could still walk with one of these, I decorated it for her  in a pathetic effort to make it less 'unsympathetic', with ribbons and little furry RSPB bird toys which could be made to tweet, hanging from the cross bar. What the Zimmer frame design needs, is a complete overhaul.

As standard issue for elderly people, the Zimmer has about as much charm as the old National Health spectacles, which have disappeared thanks to the work of fashion accessory designers. Why shouldn't all equipment required for older people be treated in the same way? If only manufacturers and designers could be persuaded to turn their attention to products used by the oldest old in society, my age group might be able to get ourselves about in the future with ergonomically and visually pleasing, recognised designers' walking frames to go with our Ray-ban, Diesel or Dolce & Gabbana shades.

Some Isabel Allende wisdom

Perhaps old age is a new beginning, maybe we can return to the magic tune of infancy, to that time before linear thought and prejudices when we perceived the universe with the exalted sense of the mad and were free to believe the unbelievable and to explore worlds that later, in the age of reason, vanished. I have very little to lose now, nothing to defend; could this be freedom at last? 

Isabel Allende

(Thanks to www.persephonearbour.com)

Don't know ZIP? That'll be your PKMzeta then.

 

The New York Times reported yesterday that neuroscience researchers in Brooklyn have recently been trying out a new drug called ZIP –  which, when delivered to areas of the brain critical for holding specific types of memory, like emotional associations, spatial knowledge or motor skills, can actually erase memories by blocking the activity of PKMzeta – a substance that the brain apparently needs to retain much of its learned information. Critically, the report says that now it has been recognised, if enhanced, the substance could help ward off dementias and other memory problems.

So far, the research has only been carried out on animals, but with more than 100 million people worldwide predicted to have Alzheimer's disease or other dementias by 2050 as well as the far greater numbers who will struggle with age-related memory decline, the scientists' biggest target is to try to get cells to make more PKMzeta.

Unsurprisingly, many questions remain. For example, it is still not known if PKMzeta can really link a network of neurons for a lifetime, nor how, and they don't yet know how it works with the many other substances in the brain that appear to be important in creating a memory. As the article points out, no one expects there to be one, single memory molecule – the system is just not that simple. Many molecules will be found in different kinds of memories all along the process of learning, storage and retrieval. 

Yet even at these early stages, scientists are upbeat about altering our understanding of human nature. Without doubt, they would be making a massive contribution to the ageing population if they can find some way to reverse the memory-degrading effects of dementia.

Image: Photographersdirect.com