May 31, 2011

The Rewards of Aging #2 -- Reflections on the Kennedy Center's Revival of Sondheim's "Follies"

A week ago, I saw a sumptuous revival of Follies, the 70's musical about shattered mid-life illusions.  Sondheim described the show as being about "the death of the dream."

The story captures a reunion in a crumbling Broadway theatre. There, actors from Weismann's Follies -- a musical revue that had enjoyed a successful run between the wars -- meet again one last time before the theatre is demolished. It focuses on two couples: Buddy and Sally Durant Plummer and Benjamin and Phyllis Rogers Stone. Sally and Phyllis were showgirls. Both couples are unhappy with their marriages. Buddy, a traveling salesman, is having an affair with a girl on the road; Sally is still in love with Ben, and Ben is so self-absorbed that Phyllis feels emotionally abandoned.

Amidst this dysfunction, several of the former showgirls perform their old numbers.

In the Kennedy Center revival, Sally is played by Bernadette Peters and Buddy by Ron Raines.  Both Peters and Raines are actually 63 years old. But Sally in the script is described as 49 and Buddy, 53.  Having these two leads played by actors in their 60's bothered me a bit since I think most of us by the time we get into our 60's are not consumed by the midlife angst at the center of Follies.  The plot is depressing enough, but it would be even more depressing to think that a couple in their mid-60's was still struggling with these issues.

May 28, 2011

Here's a brain fitness exercise that I keep trying . . . and failing. How about you?

In the  May 27 post below I note the research showing that we can challenge our brains and even build new brain cells by doing simple coordination exercises that basically involve using different movements with different parts of the body.  I also mention that I have great difficulty trying to do these exercises on the healthy aging and balancing DVD that I have (and cite).

So I decided the thing to do was to write down the instructions for just one of these exercises and keep practicing it until I master it. Well, I keep practicing it and I've yet to master it.

Here's the instructions:

  1. While seated, put your feet together in front of you.
  2. Keep your heels grounded and move the front of both feet first to the left and then to the right -- like your feet were a windshield wiper.
  3. Now raise both hands and point the index fingers upward and rotate them in a circle while continuing the windshield-wiping feet.
Sounds simple doesn't it?  Try it.

If you find it easy to do, I don't need to hear back from you.(grin).

May 27, 2011

Warding off dementia: brain exercises that work!

Exercise tops the list of recommendations for dealing with many health issues -- aging, Parkinson's, diabetes, depression, etc.  So it's no surprise that exercise in general and brain exercises in particular are seen as crucial in dealing with the cognitive impairment that comes with age and with the more serious issue of dementia.

Many studies have underscored the benefits of exercise in general.  Last month, we discussed one of the more recent findings: http://bit.ly/ilx0Gh

What I want to focus on here is the "use-it-or-lose-it" exercises that work for the brain.  Despite a century of being told it's impossible, a mounting body of evidence suggests that the brain has more plasticity than previously thought and we can use exercise to create new brain cells!

You've heard the usual recommendations for mental fitness -- crossword puzzles, Sudoku, chess. These fun "mind games" are a good start, but the latest studies show that workouts pushing us beyond our normal patterns are MORE stimulating to the brain.  Here are some proven brain-challenging workouts:

May 26, 2011

A poem from a friend (and traveling companion) today, my 82nd birthday

This poem (with the photo that apparently inspired it, taken last year at an outdoor restaurant in Sirince, Turkey) popped into my inbox yesterday. I secured my pal's OK to share it with you. See the expression on my face in the picture? That's how I look NOW, thanks to this charming BD present from a dear friend.

May 25, 2011

Healthy aging tips from Oprah's pal Dr. Oz. Hmmm, sex, chocolate, coffee.... What's not to like?

A friend sent me a link to this recent appearance by Dr. Oz on the Wendy Williams Show (Wendy bombed out early on this season's Dancing With the Stars). Dr. Oz  also often was a  guest on Oprah's show which, coincidentally, ends today.

Yes, the video is a little hokey and simplistic.  I prefer eating salmon or herring several times a week to taking fish oil or Omega-3 pills. And yes, I need more exercise than just squeezing my butt when sitting in a chair!

Still, it's a fun, helpful clip. Take a look; what do you think?

May 23, 2011

On to Richmond! The ups and downs of travel by this soon-to-be 82-year-old

While Picasso is not my favorite artist of his time (Cézanne is), I wanted to see the much-touted Picasso exhibit at the Virginia Fine Arts Museum in Richmond.  From my home in Washington, DC, the drive time to Richmond is typically about two hours, but route 95 these days is notorious for its nerve-racking delays and back-ups. I could have asked a pal to join me... and do the driving. But one of my many peculiarities is that I prefer touring art museums on my own.


So, I checked Amtrak and... WOW. The round-trip fare was only $50! And they had a perfect timetable for me: departing DC at 2pm this past Thursday (arriving in Richmond at 5), and leaving Richmond on Friday at 6pm. Excellent! And several friends urged me to book a room at Richmond's historic Jefferson Hotel. Done!


Well, you know what they say about the best-laid plans... 

May 21, 2011

Aging & Parkinson's Light

We've had lots of talk in the postings and comments recently about the importance of humor in dealing with Parkinson's or other afflictions.  Now let's do something about it! I'd like to feature occasional postings that poke fun at us as we age, or deal with Parkinson's, or whatever.  If you have a favorite, please send it along!

I've mentioned before that Peter Dunlap-Shohl is one of my favorite bloggers. Peter had been cartoonist for the Anchorage Daily News, but now we all get to enjoy his work, his humor, and the high spirits of his blog Off and On: The Alaska Parkinson's Rag at:
http://offandonakpdrag.blogspot.com/.

I can't think of a better way to kick off "Aging and Parkinson's Light" than with this video by Peter:


May 20, 2011

My reflections on last week's discussion of living with Parkinson's

There were interesting and thought-provoking responses to my posting of Phyllis Richman’s piece in the Washington Post about the real challenges of living with Parkinson’s. Some of the responders suggested that humor helped them deal with their own Parkinson’s. In her classy response, Phyllis made it clear that she was not anti-humor, saying: “I absolutely agree that a sense of humor is vital to living with Parkinson's. Carefully cultivated, it doesn't wear off as quickly as levadopa.”
I encourage you to read  the rest of her remarks AND take advantage of her peace offering – her recipe for “DON'T-TELL-THEM-HOW-EASY-IT-IS MOUSSE.”

May 17, 2011

As a senior with Parkinson's tottering on the brink of the Medicare Donut Hole, I'm taking a second look at the Canadian online pharmacy option

In an earlier posting, I cautioned about the use of online Canadian pharmacies because many of them that show up on Google searches are bogus.  The one that usually appears first is reputed to be run by a Russian mafia mob. See: http://parkinsonsand5htp.blogspot.com/2010/12/cautions-on-using-canadian-online.htm

However, I’m now taking a closer look at these pharmacies because my high-priced Azilect for Parkinson’s will soon push me into Medicare’s Donut Hole.

If any of you have found ways of dealing with the high cost of Azilect or other pricey meds, I'd love to hear from you. But here's what I'm considering:

May 16, 2011

100 years old and still a teacher, a joker, an inspiration

I've often said I have no interest in living to 100 since I'd pictured it as nothing but disability and dementia.  But I'm reconsidering after reading this wonderful report on how Up the Down Staircase author Bel Kaufman is doing at age 100. I loved the "I'm tired and thirsty" joke.

http://www.nytimes.com/2011/05/12/nyregion/bel-kaufman-at-100-still-a-teacher-and-a-jokester.html?_r=1%20%20

You go, girl!!!

May 14, 2011

Other reactions to Phyllis Richman’s views on living with Parkinson’s

Phyllis Richman generated lots of good discussion within the PD community with her piece (“Lucky to be afflicted? Hardly”) in the Washington Post. Just look below at the comments people posted on this blog a couple days ago!

I also liked the letter to the editor by Carol Gordon that was published in the Post.  Here’s part of what she said:

May 13, 2011

Beet juice beats all health drinks!


I’d seen a few reports of late about the health benefits of beet juice. Yes, believe it or not, beet juice.

May 8, 2011

What's your reaction to this take on aging with Parkinson's or other afflictions?

The Washington Post's long-time and much admired former food critic and restaurant reviewer, Phyllis Richman, last week published a piece on living with Parkinson's that has already stirred up a lot of reactions.  She takes issue with what she sees as the overly Pollyanna-ish view of Parkinson's by Michael J. Fox in his Lucky Man memoir. Presumably she would react the same to my saying that last year, the first year of my Parkinson's diagnosis, was the best year of my life.

May 5, 2011

Using the Serenity Prayer To Deal with Dementia

You may be familiar with the Serenity Prayer, which I've found to be a great help over the years:

God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.
It occurred to me that this prayer is a useful way for me to look at my fears of dementia.

May 4, 2011

My interview with Robert Rodgers of "Parkinson's Recovery"

I'm not particularly happy with my ramblings in this interview, and I certainly wasn't happy when I accidentally hung up on Rodgers early in the chat.  (I've got to do something about my phone that has the "off" button positioned so that I hit it with my cheek bone whenever I press the phone too close to my face.)

Fortunately Rodgers is a delightful, easy-going, and knowledgeable interviewer.  For the past five years or more, he's been providing information on the use of natural therapies and other resources to help relieve the symptoms of Parkinson's.

May 3, 2011

What are the odds for my getting dementia?

That sounds like a relatively easy question to research and answer.  Turns out not to be that easy or clear.

Dementia prevalence in the general population

Most studies suggest that 5 to 8 percent of the over-65 population have some form of dementia and the number doubles every five years.

A study billed as the first of a nationally representative population in the U.S. found the prevalence of dementia among those age 71 and older was 13.9% and increased with age, from 5.0% of those aged 71-79 to 37.4% of those aged 90 and older.

A fairly recent study in Italy found the following prevalence of dementia in the specific age groups:

  • 80-84 -- 14.6%
  • 85-89 -- 32,8%
  • 90-94 -- 40.6%
  • 95+    --  55.5%
A Dutch study found that about one-third of the population aged 85 and over had dementia.

Most studies have found the incidence of dementia to be higher among women than men, some finding the rate as much as 30% higher among women. But a caution is noted: Significantly fewer men reach these advanced ages.

And most studies find that almost three-quarters of all dementia is due to Alzheimer's.

Dementia prevalance among people with Parkinson's

The incidence of dementia is much higher among Parkinson's patients than in the general population. My neurologist, Dr. Laxman Bahroo at Georgetown University Hospital, said that 50% of Parkinson's patients experience some cognitive decline after 5 years with PD and 50% have dementia after 8 years.

The Parkinson Foundation's booklet on "Mind, Mood, & Memory" also says that 50% of people with PD end up experiencing some form of cognitive impairment.  The booklet adds:
In the early stages of illness, many people with PD will complain of difficulties with attention and task completion . . . For example, the patient may complain of being easily distracted, losing their train of thought, or getting easily "knocked off track" when performing a task.  In the middle stages of illness, difficulties with decision-making, problem-solving, memory and word-finding may become more apparent.  In the latter stages of illness, a more serious cognitive disturbance can arise with confusion, visual hallucinations, delusions, and agitation.   In general, mental and motor decline tend to occur in parallel as the disease progresses.
One reason for the conflicting data on the prevalence of dementia is that some studies lumps people who have Dementia with Lewy Bodies (DLB) with those with Parkinson's dementia.  Differentiating between the two is not clear cut.  In Parkinson's, dementia usually develops years after the diagnosis of PD.  In DLB, the dementia occurs at the same time, or shortly after, the development of Parkinson's.

Risk Factors for PD Dementia

The following factors make it more likely that someone with Parkinson's will develop dementia:

  • Age 70 or older
  • Score greater than 25 on the Parkinson's Disease rating scale (PDRS) that doctors use to check for PD progression
  • Depression, agitation, disorientation, or psychotic behavior when treated with the PD med levodopa.
  • Exposure to severe psychological stess
  • Cardiovascular disease
  • Low education level
Can we do anything to forestall or delay the onset of dementia?  That will be the subject of a future post.

May 1, 2011

My Week: Birth and Death

The past week was booken-ed by birth and death. The week got off to a happy start with the birth on Monday of my second great-granddaughter Mckenzie Joy Dreisenstok, who weighed in at a healthy 7 pounds, 6 ounces. Mother and baby are doing well, as is Kaylee, Mckenzie's going-on-five sister.

On Saturday, daughter Ann and I flew up to Ithaca for a memorial celebration of the life of my sister-in-law Gail who died in January.  My smart and sensible brother Rodger decided to put off the celebration until after the Ithaca winter had passed.  But much of the conversation at the April 30 celebration still was about the weather  -- the tornadoes that had bounced around the area the day before.

Gail and Rodger are examples of the strong social support network that develops when people remain part of the same community from childhood to older age.  They had an exceptionally strong marriage based on their shared good humor, love of life, and down-to-earth ways. A big gap is left in Rodger's life with the passing of his wife of 49 years of close companionship.  But his many friends and supporters are helping him through this.

I mentioned this birth/death bookend to the week at my Parkinson's Support Group meeting on Friday and one of our erudite members referenced the poem "Ecce Puer" that James Joyce composed after his grand-father died at about the same time as a son was born.  It's a lovely poem:


Poem: "Ecce Puer" by James Joyce

Of the dark past
A child is born;
With joy and grief
My heart is torn.

Calm in his cradle
The living lies.
May love and mercy
Unclose his eyes!

Young life is breathed
On the glass;
The world that was not
Comes to pass.

A child is sleeping:
An old man gone.
O, father forsaken,
Forgive your son!

What is Dementia? How is it defined?

As I said in an earlier post, dementia is my No. 1 fear.  To alleviate  my fears, I first need to understand what dementia is.
 
Dementia is a general term used to indicate that a person has developed difficulties with reasoning, judgment, and memory. People who have dementia usually have some memory loss and difficulty with at least one other area, such as:
  • Speaking or writing coherently (or understanding what is said or written)
  • Recognizing familiar surroundings
  • Planning and carrying out multi-step tasks
In order to be considered dementia these changes must be severe enough to interfere with a person's independence and daily activities.

A similar, but more elaborate definition is provided in the Diagnostic and Statistical Manual (DSM) of Mental Disorders published by the American Psychiatric Association -- Evidence from the history and mental status examination that indicates major impairment in learning and memory as well as at least one of the following:
  • Impairment in handling complex tasks
  • Impairment in reasoning ability
  • Impaired spatial ability and orientation
  • Impaired language
  • The cognitive symptoms must significantly interfere with the individual's work performance, usual social activities, or relationships with other people
  • This must represent a significant decline from a previous level of functioning
  • The disturbances are of insidious onset and are progressive, based on evidence from the history or serial mental-status examinations
  • The disturbances are not occuring exclusively during the course of delirium
  • The disturbances are not better accounted for by a major psychiatric diagnosis
  • The disturbances are not better accounted for by a systemic disease or another brain disease
For someone like me whose dementia fears stem mostly from my memory lapses, these definitions are somewhat reassuring because they say a decline in memory must be combined with another attribute before it can be labelled dementia.

Patients with dementia may have difficulty with one or more of the following:
  • Learning and retaining new information (e.g., trouble remembering events)
  • Handling complex tasks (e.g., balancing a checkbook)
  • Reasoning (e.g., unable to cope with unexpected events)
  • Spatial ability and orientation (e.g., getting lost in familiar places)
  • Language (e.g., word finding)
  • Behavior
Doctors often date the onset of dementia by identifying when the individual stopped driving or managing finances.

Also reassuring for me is that self-reported memory loss does not typically correlate with subsequent development of dementia.  Concerns reported by family members and others are much more likely to be linked to a finding of dementia.

An oft-cited description of Alzheimer's (which applies to dementia as well) is:
  • If you can't remember where you put your car keys, it's not Alzheimer's.
  • If you can't remember what the keys are used for, it's Alzheimer's.
This is the first in a series of postings I plan to make about dementia. If you have any questions about dementia, let me know by posting a comment and I'll see if I can find an answer.


I'm scheduled for an interview on Parkinsons Recovery Radio at 6 EDT, Wednesday

Parkinsons Recovery was founded by Robert Rodgers in 2005 to explore how natural remedies and therapies can be used to relieve the symptoms of Parkinson's. Robert conducts a blogtalkradio program on Parkinson's Recovery that airs every week. He has invited me to chat with him this Wednesday, May 4 at 6pm EDT. I'm looking forward to it, and I'd love to hear your comments! If you can't tune in on Wednesday, you can go to Robert's site to hear our conversation.


See  http://www.blogtalkradio.com/parkinsons-recovery 


Also check out Robert Rodgers' website for Parkinsons Recovery at http://www.parkinsonsrecovery.com/
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