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December 2, 2014

Jonathan Tobin: Defending the Right to a Jewish State

Heather Hale: Compliment your kids without giving them big heads

Megan Shauri: 10 ways you are ruining your own happiness

Carolyn Bigda: 8 Best Dividend Stocks for 2015

Kiplinger's Personal Finance editors: 7 Things You Didn't Know About Paying Off Student Loans

Samantha Olson: The Crucial Mistake 55% Of Parents Are Making At Their Baby's Bedtime

Densie Well, Ph.D., R.D. Open your eyes to yellow vegetables

The Kosher Gourmet by Megan Gordon With its colorful cache of purples and oranges and reds, COLLARD GREEN SLAW is a marvelous mood booster --- not to mention just downright delish
April 18, 2014

Rabbi Yonason Goldson: Clarifying one of the greatest philosophical conundrums in theology

Caroline B. Glick: The disappearance of US will

Megan Wallgren: 10 things I've learned from my teenagers

Lizette Borreli: Green Tea Boosts Brain Power, May Help Treat Dementia

John Ericson: Trying hard to be 'positive' but never succeeding? Blame Your Brain

The Kosher Gourmet by Julie Rothman Almondy, flourless torta del re (Italian king's cake), has royal roots, is simple to make, . . . but devour it because it's simply delicious

April 14, 2014

Rabbi Dr Naftali Brawer: Passover frees us from the tyranny of time

Greg Crosby: Passing Over Religion

Eric Schulzke: First degree: How America really recovered from a murder epidemic

Georgia Lee: When love is not enough: Teaching your kids about the realities of adult relationships

Cameron Huddleston: Freebies for Your Lawn and Garden

Gordon Pape: How you can tell if your financial adviser is setting you up for potential ruin

Dana Dovey: Up to 500,000 people die each year from hepatitis C-related liver disease. New Treatment Has Over 90% Success Rate

Justin Caba: Eating Watermelon Can Help Control High Blood Pressure

The Kosher Gourmet by Joshua E. London and Lou Marmon Don't dare pass over these Pesach picks for Manischewitz!

April 11, 2014

Rabbi Hillel Goldberg: Silence is much more than golden

Caroline B. Glick: Forgetting freedom at Passover

Susan Swann: How to value a child for who he is, not just what he does

Cameron Huddleston: 7 Financial Tasks You Should Tackle Right Now

Sandra Block and Lisa Gerstner: How to Profit From Your Passion

Susan Scutti: A Simple Blood Test Might Soon Diagnose Cancer

Chris Weller: Have A Slow Metabolism? Let Science Speed It Up For You

The Kosher Gourmet by Diane Rossen Worthington Whitefish Terrine: A French take on gefilte fish

April 9, 2014

Jonathan Tobin: Why Did Kerry Lie About Israeli Blame?

Samuel G. Freedman: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Jessica Ivins: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Kim Giles: Asking for help is not weakness

Kathy Kristof and Barbara Hoch Marcus: 7 Great Growth Israeli Stocks

Matthew Mientka: How Beans, Peas, And Chickpeas Cleanse Bad Cholesterol and Lowers Risk of Heart Disease

Sabrina Bachai: 5 At-Home Treatments For Headaches

The Kosher Gourmet by Daniel Neman Have yourself a matzo ball: The secrets bubby never told you and recipes she could have never imagined

April 8, 2014

Lori Nawyn: At Your Wit's End and Back: Finding Peace

Susan B. Garland and Rachel L. Sheedy: Strategies Married Couples Can Use to Boost Benefits

David Muhlbaum: Smart Tax Deductions Non-Itemizers Can Claim

Jill Weisenberger, M.S., R.D.N., C.D.E : Before You Lose Your Mental Edge

Dana Dovey: Coffee Drinkers Rejoice! Your Cup Of Joe Can Prevent Death From Liver Disease

Chris Weller: Electric 'Thinking Cap' Puts Your Brain Power Into High Gear

The Kosher Gourmet by Marlene Parrish A gift of hazelnuts keeps giving --- for a variety of nutty recipes: Entree, side, soup, dessert

April 4, 2014

Rabbi David Gutterman: The Word for Nothing Means Everything

Charles Krauthammer: Kerry's folly, Chapter 3

Amy Peterson: A life of love: How to build lasting relationships with your children

John Ericson: Older Women: Save Your Heart, Prevent Stroke Don't Drink Diet

John Ericson: Why 50 million Americans will still have spring allergies after taking meds

Cameron Huddleston: Best and Worst Buys of April 2014

Stacy Rapacon: Great Mutual Funds for Young Investors

Sarah Boesveld: Teacher keeps promise to mail thousands of former students letters written by their past selves

The Kosher Gourmet by Sharon Thompson Anyone can make a salad, you say. But can they make a great salad? (SECRETS, TESTED TECHNIQUES + 4 RECIPES, INCLUDING DRESSINGS)

April 2, 2014

Paul Greenberg: Death and joy in the spring

Dan Barry: Should South Carolina Jews be forced to maintain this chimney built by Germans serving the Nazis?

Mayra Bitsko: Save me! An alien took over my child's personality

Frank Clayton: Get happy: 20 scientifically proven happiness activities

Susan Scutti: It's Genetic! Obesity and the 'Carb Breakdown' Gene

Lecia Bushak: Why Hand Sanitizer May Actually Harm Your Health

Stacy Rapacon: Great Funds You Can Own for $500 or Less

Cameron Huddleston: 7 Ways to Save on Home Decor

The Kosher Gourmet by Steve Petusevsky Exploring ingredients as edible-stuffed containers (TWO RECIPES + TIPS & TECHINQUES)

Jewish World Review /

When Alzheimer's isn't the real problem

By Bonnie Miller Rubin




Many cases are misdiagnosed, studies find. Know the signs


JewishWorldReview.com |

D ETROIT— (MCT) His loved ones dreaded what might be next: a diagnosis of Alzheimer's.

Martin Rosenfeld had called too many times - confused and frustrated - from a parking lot outside his synagogue, after driving there in the middle of the night for services that wouldn't begin for hours.

Once a meticulous pattern-maker in the clothing industry, he now nodded off mid-conversation. Spilled things. Mumbled.

"We'd be getting calls all night long. He'd say, 'What time is it? Can I get up now?'" said his daughter, Shelley Rosenberg, whose husband, Don Rosenberg, chairs the Alzheimer's Association's Greater Michigan Chapter.

Rosenfeld's confusion, which turned out to be caused partly by sleep apnea, reflects what the head of Wayne State University's Institute of Gerontology worries is a growing trend in the number of Americans being wrongfully assumed - even medically misdiagnosed - with Alzheimer's, the most common form of dementia and perhaps the most feared disease of old age.

"It's a real problem. If you're older and you get a label of Alzheimer's - even a hint that you have Alzheimer's - there's no more critical thinking about it. You're written off by a lot of people," said Peter Lichtenberg, head of the institute and a clinical psychologist who has testified in several probate cases in which a person's mental capacity was at issue.

Lichtenberg, in a December paper for the journal Clinical Gerontology, highlighted two case studies: in one, a man's bouts of confusion and agitation in his late 70s were caused by illness and painful cellulitis, not Alzheimer's; in the other, an 87-year-old woman, who seemed suddenly confused, was suffering from depression.



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Lichtenberg's paper builds on research elsewhere that suggests that the difficulty in pinning down Alzheimer's makes misdiagnosis too easy. The research is based mostly on small studies but also on an ongoing, long-term study supported by the National Institute on Aging, which is part of the National Institutes of Health. In cases reviewed so far, about one-third of Alzheimer's diagnoses were incorrect, according to the lead researcher, Lon White.

"The diagnosis was dead wrong one-third of the time, and it was partially wrong a third of the time, and it was right one-third of the time," White said.

The project, called the Honolulu-Asia Aging Study, has been under way since 1991 and focused on the precise brain changes linked to Alzheimer's disease and other types of dementia. Pathologists examined the brains of 852 men born between 1900 and 1919, about 20 percent of whom were diagnosed with Alzheimer's.

In the cases carrying an Alzheimer's diagnosis, two-thirds of the brains exhibited the types of lesions closely linked to Alzheimer's. Half of those featured other problems, as well, such as scarring on the hippocampus, the part of the brain responsible for memory, White said.

That didn't mean that those without the Alzheimer's lesions were otherwise healthy, "but what we're calling Alzheimer's is very often a mixture of different disease processes," White said.

Lichtenberg said his concerns about misdiagnosis in no way lessen the enormity of Alzheimer's impact.

"I don't know how vast a problem it is, but I see it too often," Lichtenberg said.

The Alzheimer's Association estimates that 5.4 million Americans are living with Alzheimer's. Lichtenberg's grandmother had the disease. A picture of her, dancing, sits in his office at Wayne State.

But understanding how often Alzheimer's and other dementia are misdiagnosed is hard to quantify. Sometimes, that's because loved ones have not yet noticed a decline; sometimes, they don't want to face the possibility, Lichtenberg said.

Rosenfeld's most pressing problem was severe sleep apnea that had aggravated the more manageable symptoms of undiagnosed Lewy-body dementia. Lewy-body dementia causes a visual processing disorder, disrupts the ability to organize, plan and focus and can causes sleep problems and hallucinations.

A breathing machine at night made a dramatic difference, said Shelley Rosenberg: "I'm thrilled. He is what he used to be. I have my father back."

SOME TOO QUICK TO JUDGE

It's a difficult balance for the Alzheimer's Association: trying to raise awareness and boost early intervention efforts for Alzheimer's and other dementias, while also cautioning families and clinicians not to jump to conclusions.

Diagnosing Alzheimer's is tricky and is done, in part, by ruling out other health problems, such as an undetected stroke or brain tumor.

Even well-meaning doctors can be too quick to judge, especially when confronted by worried loved ones listing Mom's memory lapses, said Jennifer Howard, executive director of the Alzheimer's Association - Michigan Great Lakes Chapter.

An expert evaluation by an interdisciplinary team that includes a geriatrician and neurologist is crucial, she said.

"The brain is not just a physical structure. It's this incredible computer. It's constantly computing where resources are needed and redirecting, depending on energy is coming from and what task you need to do," said Rhonna Shatz, director of Behavioral Neurology at Henry Ford Hospital in Detroit.

For that reason, a common urinary tract infection, a sudden change in blood pressure or depression are all stresses on an older brain that, combined with other problems, can quickly short-circuit it, Shatz said.

The result is acute confusion or delirium that, to an untrained eye, may look like Alzheimer's disease.

"Pulling these things apart and the need for a real diagnosis - that's important so people can live the best quality of life as possible for as long as possible," said Howard at the Alzheimer's Association.

OTHER FACTORS MISSED

In the case of Al Edelson, a former Wayne State professor and cancer survivor, the confusion was really the result of a regular cocktail of 18 medications prescribed for a variety of health issues.

In his mid-70s, the once sharp-witted, effervescent professor of instructional technology began to withdraw, family members said. For years, he and his wife traveled frequently, but he began to be more comfortable remaining near his family's Huntington Woods, Mich., home.

In the hours before their 5 a.m. departure for a trip to Britain aboard the Queen Mary 2 several years ago, Edelson was wide awake, anxious.

"He said, 'I think I need to cancel this.' It was 2 a.m. I said, 'I will never forgive you,'" his wife, Joanna Edelson, recalled, chuckling.

But the change had become undeniable: Usually at ease dancing with his wife or leading group conversations, the now-retired professor was awkward and withdrawn on the ship, Edelson said.

Eventually, a doctor gave the diagnosis of Alzheimer's.

"The problem is that when you're older and you have a lot of medical conditions, no doctor speaks to the other doctor, and that's basically what happened," said Edelson, a retired teacher.

After consulting with other doctors, family members scaled back Al Edelson's drugs. They were amazed.

"It was like he came out of a coma," his wife said.

When he died in December, having just turned 80, the cause was pneumonia, Joanna Edelson said: "Dementia did not kill my husband."

IS IT ALZHEIMER'S?
Unlike delirium, which usually comes on fast and sets off alarm bells for loved ones, Alzheimer's disease moves through the brain slowly, seemingly shutting off switches one by one.

Diagnosing it isn't easy. There is no blood test, no telltale brain scan. Even the brain anomalies common in an Alzheimer's patient -- plaques (abnormal clusters of a protein called beta-amyloid) and tangles (twisted strands of a protein called tau) -- are shared by those who have no symptoms at all. That means diagnosing Alzheimer's is about ruling out other problems and relying on changes observed over time.

Among the conditions that might bring on temporary, but dangerous, delirium:

• Urinary tract infections

• Medications

• Stroke or vascular disease

• Fever, illness

• Depression

• Blood pressure changes

• Surgery

• Drug or alcohol use

• Tumors

COMMON TERMS AND WHAT THEY MEAN

Sorting through confusion begins with understanding that some changes may be temporary.

Terms to know:

• Delirium: Temporary but acute mental confusion. Can be life-threatening. Involves a sudden onset of symptoms -- anxiety, disorientation, tremors, hallucinations and incoherence -- and can be caused, especially in elderly people, by illness and infection, changes in blood pressure, reactions to medication or vitamin deficiency.

• Dementia: More permanent medical condition that disrupts brain function. Includes Alzheimer's disease, but also vascular dementia (from a stroke or blood vessel disease in the brain), severe alcoholism, depression, delirium, Huntington's disease and inflammatory diseases such as syphilis, tumors and Parkinson's disease. Symptoms include anxiety, paranoia, personality changes, lack of initiative and difficulty acquiring new skills.

• Alzheimer's: The most common form of dementia. Proceeds in stages over months or years and gradually destroys memory, reason, judgment, language and the ability to carry out simple tasks.


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