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Alzheimer’s Disease – How to Spot the Signs
Alzheimer’s disease is not normal forgetfulness as we age. Instead, it is a specific form of mental decline. And according to the Alzheimer’s Association it accounts for nearly 80 percent all dementia cases. Natasa Dragicevic, MD, PhD., behavioral neurologist and Alzheimer’s disease specialist with Renown Institute for Neurosciences, weighs in on diagnosing it and the importance of early medical action. How to Diagnose Alzheimer’s Disease In general, the signs of Alzheimer’s disease occur slowly, getting worse over time. For example, forgetfulness is a daily search – for shoes, keys and other misplaced items. Not only is memory affected, but also speech patterns and behavior. There is no single test for Alzheimer’s disease. “Specifically, a neurologist should be the one to diagnose Alzheimer’s disease given differences in presentation,” clarifies Dr. Dragicevic. “And ideally a behavioral neurologist (Alzheimer’s sub-specialist) will be managing the treatment,” she adds. Brain Imaging Diagnosing Alzheimer’s disease involves multiple approaches and medical providers. In short, medical history is reviewed along with a physical exam, lab tests and other diagnostic testing. “A medical workup includes a variety of tests. These include MRI and other brain imaging, as well as neurological and psychological testing. Furthermore, a lumbar puncture is performed to look for markers of the disease,” she states. What Causes Alzheimer’s disease? Although no one knows the cause, researchers think many factors play a role. Uncontrollable risk factors include your genetics and having a family member with the disease. However, the controllable risk factors include: reducing the risk of head injury and keeping your heart healthy. It’s important to realize that high blood pressure, high cholesterol, stroke and diabetes play a role in brain health. Blood loss to the brain causes vascular dementia, leading to long-term blood vessel damage. Symptoms of Alzheimer’s disease Generally speaking, the signs of this disease differ in each person. Yet noticeable behaviors include: • Losing the way to familiar places • Forgetting to pay bills • Trouble finding the right words when talking • Repeating questions • General confusion • Social withdrawal Alzheimer’s Disease – Benefits of Early Diagnosis Equally important, spotting Alzheimer’s disease early allows more time to benefit from medications and possible clinical trials. Likewise, nutrition and exercise changes can be made, increasing blood flow to the body, and perhaps delaying symptoms. Early diagnosis also allows for personal health decisions and quality-of-life conversations to take place. According to the Alzheimer’s Association, these benefits include: 1. Medical advantage 2. Emotional and social comfort 3. Time to plan ahead 4. Cost savings A Brain Supporting Lifestyle “At the present time, treatment is limited,” explains Dr. Dragicevic. “Usually Alzheimer’s is a progressive ongoing disease – any management at this time is purely symptomatic.” However, she states the following lifestyle changes can help support brain health: • New hobbies such as painting, pottery, music classes or learning a new language • Crosswords, puzzles and playing games, such as Scrabble • Brain challenging mobile apps, such as Luminosity • 30-45 minutes of mild to moderate physical activity per day, such as walking • Eating a Mediterranean diet (primarily plant based foods)
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Alzheimer's Safety Tips for Caregivers to Know
November is National Alzheimer’s Disease Awareness Month. At Renown Health, we know that Alzheimer's safety for your loved one is a priority, as the symptoms can sometimes lead to unsafe situations. We asked Dr. Jonathan Artz – a neurology physician with Renown Health and an assistant professor of clinical neurology at the University of Nevada, Reno School of Medicine – for tips on keeping loved ones safe and secure. According to the Alzheimer’s Association, Alzheimer’s disease affects safety in various ways, specifically due to body and brain adjustments. These changes can include: Judgment, including forgetfulness Sense of place – getting lost on the way home Behavior – being suspicious or fearful Body difficulty – losing balance Sensing ability – noticeable sensitivity in hearing, seeing or temperature Dr. Artz gives us four major tips to ensure your loved one’s safety as you both navigate this disease together. Watch for Wandering Those experiencing Alzheimer’s disease tend to wander and get lost. Try the following tips to reduce the risk of wandering: Get your loved one an ID bracelet and have them wear it at all times. You can also enroll your loved one in “Wandering Support.” Install door chimes so you know when exterior doors are open. Ask neighbors to call you if they see your loved one out alone. Go with your loved one when they insist on leaving the house. Don’t argue or yell. Instead, use distraction or gentle hints to get them to return home. Discourage Driving Driving can be unsafe for someone with this disease. With this in mind, ask a doctor whether it’s safe for your loved one to drive. For example, on a case-by-case basis, there are certain situations where doctors are required to report individuals with particular cognitive impairments, wherein a form of a driving assessment will be recommended. Limit access to the car. Keep the keys with you or lock them away. Ask an authority figure, such as an insurance agent or a doctor, to tell them not to drive. Adult-Proof Your Abode A simple living space is a safe living space. This means reducing clutter and removing any issues that may pose a safety concern. You may also want to get advice from an occupational therapist (home safety expert). Keep in mind that some changes may not be needed right away. Focus on major safety concerns first. Try the following tips: Add lighting (or glow-in-the-dark tape) to brighten dark areas, including stairways and halls. Use color contrast or texture indicators for dials, knobs and appliance controls. Remind your loved one not to carry items while walking to avoid a fall. Remove sharp objects from drawers and countertops. Avoid using small throw rugs or doormats, as they are easy to trip on. Move frequently used items so that they are easy to reach. Lock away alcohol and tobacco products, as they are not recommended for dementia patients. Install handrails in the shower, tub and near the toilet. Bathroom falls are especially common. Adjust the setting on your hot water heater so water does not scald. Those with Alzheimer’s can lose their sensitivity to temperature. Move and lock up hazardous chemicals and cleaning supplies, such as bleach and insecticides. Disable and remove guns or any weapons. Supervise any medication taken by your loved one. Promote a Positive & Healthy Lifestyle Continually emphasize the strengths of your loved one by promoting participation in meaningful activities, wellness visits and healthy habits to help them improve their well-being. Here are some ways to keep them physically and mentally active: Maintain regular vision and hearing screenings and make necessary adaptations. Establish a routine for daily activities. Encourage participation in self-care and leisure activities. Work with your loved one’s doctor to establish a healthy diet. Ensure proper hydration. It may help to set reminders for your loved one to drink fluids. Encourage regular exercise. Exercise delivers oxygen to the brain, improving brain health. Promote good sleep habits. Good quality sleep can increase overall brain health and has been associated with improving memory, attention and concentration. Resources and support are available with the Renown Memory Disorders Program. Providers within this program are specifically dedicated to treating several different memory-related disorders. Memory Disorders Resources & Support.
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Dr. Max Coppes to Lead William N. Pennington Institute
Max Coppes, M.D., Ph.D., MBA who has served as Nell J. Redfield Chair of Pediatrics at the University of Nevada School of Medicine (UNR Med) and pediatrician-in-chief at Renown Children’s Hospital for the last six years has announced he is stepping down to lead Renown’s Pennington Cancer Institute on a full-time basis. Dr. Coppes will continue to serve as Professor of Pediatrics and Internal Medicine at UNR Med. “Our goal is to improve the health of Nevadans and reduce the burden of cancer,” said Thomas Graf, CEO of Renown Health. “Having Dr. Coppes as our clinical leader for the William N. Pennington Cancer Institute on a full-time basis reflects Renown and UNR Med’s commitment to increase access to cancer care, foster a deeper partnership with UNR Med on clinical trials, collaborate on cancer research opportunities, and enhance medical education and post-graduate training. We are thrilled to have Dr. Max leading this important effort.” Today’s announcement comes two weeks after the William N. Pennington Foundation announced a $15.5 million gift to the Renown Health Foundation to help establish the William N. Pennington Cancer Institute at Renown. Dr. Coppes, a pediatric oncologist by training, has experience in leading large-scale, nationally recognized academic cancer center teams in both the U.S. and Canada. Dr. Coppes came to Reno in 2014 from the British Columbia Cancer Agency in Vancouver, where he served as president with responsibility for six regional cancer centers and two cancer research centers. He was an attending physician at BC Children's Hospital and a professor of Medicine and Pediatrics at the University of British Columbia. During his career, Coppes served as senior vice president at Children's National Medical Center in Washington, D.C. and held positions at several prestigious facilities in the U.S. and Canada including The Hospital for Sick Children (SickKids) in Toronto, Georgetown University, The National Cancer Institute, and the Cleveland Clinic. Since 2016, Dr. Coppes has served in the joint leadership role as the Nell J. Redfield Chair of Pediatrics at UNR Med and pediatrician-in-chief at Renown Children's Hospital, a position made possible through generous philanthropic support from the Nell J. Redfield Foundation along with investments by Renown Health and the School of Medicine. In 2016, the Pennington Foundation recognized the need for enhanced care and expertise for pediatrics and donated $7.5 million to Renown Children’s Hospital to establish the William N. Pennington Fund for Advanced Pediatric Care. “As the Nell J. Redfield Chair of Pediatrics at the University of Nevada, Reno School of Medicine and pediatrician-in-chief at Renown Children's Hospital, Dr. Coppes blazed the trail for the integration of academic and clinical missions at UNR Med and Renown. He demonstrated visionary leadership and undoubtedly will bring the same energy and vision as the clinical leader for the William N. Pennington Cancer Institute,” said Melissa Piasecki, Acting Dean of UNR Med and Chief Academic Officer for Renown Health. “Dr. Max Coppes is an extraordinary leader. In the last six years he has done much to elevate the standard of pediatric care available in our community,” said Sy Johnson, President and Chief of Staff of Renown. “Thanks to Dr. Coppes’ leadership, the generosity of the Pennington gift and other donors, 100,000 area children now have access to pediatric specialists and contemporary healthcare services at the region’s only children’s hospital. Now, less than 3% of all pediatric patients and their families need to leave the area for specialty care. That is an incredible accomplishment.” Significant achievements made under Dr. Coppes leadership include: Advancing Renown Children’s Hospital, the only dedicated children’s hospital in northern Nevada, offering programs and services for families from a 100,000 square mile area, from Sacramento, CA to Salt Lake City, Utah. Renown Children’s provides the area’s only Children’s Emergency Room, Pediatric ICU (PICU), children’s imaging center and the largest neonatal ICU (NICU), a level III intensive care unit. Under his leadership, the following service lines were established; adolescent medicine, pediatric hematology/oncology, pediatric nephrology, pediatric infectious diseases, pediatric ophthalmology, pediatric orthopedic surgery, pediatric cleft and craniofacial surgery, pediatric urology, pediatric dentistry, and pediatric emergency medicine. Hiring and supporting a team of over 40 pediatric physician specialists. These clinicians provide 30,000 patient visits annually, offering an exceptional level of care to help families. As a testimony to the community’s confidence in the care provided, market share for pediatric services at Renown Health is now close to 90%. Renown’s membership in the Children’s Oncology Group (COG), which gives local pediatric cancer patients access to the world’s largest organization devoted exclusively to childhood cancer and most leading-edge treatments. Application to establish a 3-year accredited (by the Accreditation Council for Graduate Medical Education (ACGME) pediatric residency program in Reno. If approved in September 2022, Renown Health and UNR Med will start training four new pediatricians each year starting in July 2023. Successful application to the Nevada Governor's Office of Science, Innovation & Technology to receive financial support to fund a new Graduate Medical Education program. Renown Children’s Hospital was awarded $ 870,433 for the new pediatric residency program. New construction of an expanded Neonatal Intensive Care Unit (NICU) with increased capacity to 49 bassinets, an expanded Pediatric Intensive Care Unit (PICU) with increased capacity to 16 private patient and family rooms, and a new Renown Children's Hospital in-patient floor with increased capacity for 38 private patient and family rooms for a total capacity of 58 pediatric beds on Level 4 of Renown Regional Medical Center. In 2021, Dr. Coppes was named the Healthcare Hero Community Partner by Northern Nevada Business Magazine.
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