How Do You Know If You re Having a Memory Problem? Speakers: John M. Ringman, M.D., Assistant Professor Diane Katz, MA, MPH, Director Education and Community Outreach Core UCLA Alzheimer Disease Center UCLA Department of Neurology www.californiacrc.org 2006 Family Caregiver Alliance 180 Montgomery Street, Suite 1100 San Francisco, CA 94104 Sponsored by California s Caregiver Resource Centers (CRCs) and the Department of Health Services, Alzheimer s Disease Research Centers of California (ARCCs). Funded by the California Department of Mental Health and a Bristol-Myers Squibb Foundation grant to Family Caregiver Alliance.
What is Memory? Memory is the ability to store and retrieve your memory files Multiple kinds of memory exist: 1) Habits and skills (e.g. riding a bike) 2) Knowledge (what color is a banana?) 3) Memory of events a) Recent memory b) Remote memory Memory Process Information is taken in or registered Information is STORED in short-term memory, long-term memory, or is discarded In the final step of the memory process, Information needs to be RETRIEVED 1
Memory Changes with Aging Many older people complain about memory changes. These complaints usually pertain to difficulties in retrieving recent information. Registration can be affected by such things as vision and hearing deficits, pain, emotions (e.g. depression) Retrieval time increases as we age. This is a normal change. Consider the following strategies: Don t panic; try to relax Give yourself extra time Try to find another word to substitute for the one you can t remember (Tip of the tongue phenomenon) Have a sense of humor 2
Some memory changes are serious, others are not How can we tell the difference? Normal vs. Serious Memory Changes Normal memory changes don t get much worse over time Memory changes are considered serious when everyday life activities, such as cooking, shopping, or handling money are affected Serious memory changes get worse over several months to several years 3
Serious Memory Changes Signs of serious memory changes may include: Repeating phrases or stories in the same conversation Becoming lost in places you know well Having trouble learning new things Difficulty making choices or handling money Not being able to keep track of what happens each day Other Memory Changes Mild memory loss is sometimes referred to by physicians as Mild Cognitive Impairment or MCI MCI describes a gradual decline in thinking abilities An individual with MCI experiences memory decline greater than normally expected with aging People with MCI can still manage their daily activities 4
What Causes Serious Memory Changes? The brain has billions of nerve cells called neurons which Communicate with each other Carry out metabolism Repair themselves If neurons cannot do these tasks, memory is severely disrupted. 5
What Is Dementia? Global, progressive deterioration of: Memory Language Thought Behavior Personality/Mood Causes of Dementia Degenerative Dementias Alzheimer s disease (47-66%) Dementia with Lewy bodies (5-20%) Frontotemporal dementia (12-17%) Other Vascular dementia (20-47%) HIV, Creutzfeldt-Jakob, B 12, NPH, neurosyphilis, EtOH, head trauma 10% of Dementia cases may be medically treatable 6
Dementia* Prevalence Increases with Age * Includes Alzheimer s dementia and other types. Adapted from Graves, Kukull, Handbook of Dementing Illnesses, 1994. Dementia is Not a Normal Part of Aging 7
Alzheimer Disease Alzheimer disease is a brain disorder that Occurs gradually Destroys a person s ability to learn, make judgments, communicate and carry out daily activities Alzheimer disease is not a normal part of aging Diagnosis There is no cure so why should I bother being assessed? Doctors can rule out other treatable conditions that may contribute to memory loss Treatments may be started earlier, when they may be more effective Patients and families have more time to plan for the future 8
How A Diagnosis Is Made The diagnosis of Alzheimer disease by an experienced clinical team may be based on: Information from family and friends Physical and neurological exams Lab tests (to rule out other illnesses that cause memory loss) Memory and language testing Brain scans (MRI, CT and PET) Benefits of an Early Diagnosis More timely patient and family education Important choices can be made while patient still competent Drug treatment started early may be more effective Greater possibility of benefiting from treatments being developed Possible participation in clinical trials Many disease-modifying treatments being studied are focused on early stages of the disease 9
How Do I Get A Diagnosis? Alzheimer Research Centers of California (ARCCs) provide diagnostic evaluations For example, at UCLA, Call: (310) 794-6039 Managing Alzheimer s Disease Nonpharmacologic interventions Practical advice and direction Education/support of family/caregivers Activity programs to help ameliorate behavioral symptoms Medication to ameliorate behavioral symptoms Medications to enhance/maintain cognitive function 10
Current Treatment Right now, we do not have a treatment that can cure Alzheimer disease. Medications may help prevent some symptoms from becoming worse for a limited time. Donepezil HCI (ARICEPT TM ) ADAS-cog * 11
Donepezil HCI (ARICEPT TM ) ADAS-cog Placebo Washout Effect * Treatments Currently Available Include: Donepezil(Aricept ) Rivastigmine (Exelon ) Galantamine (Razadyne ) Memantine (Namenda ) 12
Clinical Trials Clinical trials are studies that test new medications in people Doctors use clinical trials to discover new treatments and cures for diseases New treatments are possible only through the participation of patients and family members How Do I Find Out About Clinical Trials? Contact your local Alzheimer s Association Contact your local Alzheimer Disease Research Center For UCLA, contact the Kagan Treatment Development Program at: (310) 794-6191 13
Caregiver and Patient Resources Family Caregiver Alliance www.caregiver.org (800) 445-8106 Alzheimer s Association www.alz.org (800) 660-1993 Alzheimer s Disease Education and Referral (ADEAR) Center www.nia.nih.gov/alzheimers (800) 438-4380 Alzheimer s Disease Research Centers of California (ARCCs) www.dhs.ca.gov/cdic/alzheimers/ 14
Alzheimer s Disease Research Centers of California (ARCCs) Fresno University of California, San Francisco (559) 227-4810 Email: alz@ucsfresno.edu Website: http://fserve.fresno.ucsf.edu/alzheimer/ Irvine University of California, Irvine (949) 824-5847 Website: http://www.alz.uci.edu/ Los Angeles University of Southern California (323) 442-7600 Website: http://www.usc.edu/schools/medicine/departments/psychiatry_behavioralsciences/research/gsc/ Los Angeles/Downey University of Southern California Rancho Los Amigos National Rehabilitation Center (562) 401-8130 Los Angeles/San Fernando Valley University of California, Los Angeles General Information: (310) 206-5238 UCLA Appointments: (310) 794-1195 Centinela Freeman-Marina Center: (323) 563-5915 Olive View/UCLA Center: (818) 895-9541 Website: http://www.npistat.org/adrc/ Martinez University of California, Davis (925) 372-2485 Website: http://alzheimer.ucdavis.edu/ Palo Alto Stanford University/VA Palo Alto Health Care System (650) 858-3915 Website: http://arcc.stanford.edu/ Sacramento University of California, Davis (916) 734-5496 Website: http://alzheimer.ucdavis.edu/ San Diego University of California, San Diego/SOCARE (858) 622-5800 San Francisco University of California, San Francisco (415) 476-6880 Website: http://memory.ucsf.edu/index.html Alzheimer s Disease Program Mail Station 7210 Post Offi ce Box 997413 Sacramento, CA 95899-7413 Phone: (916) 552-8995 2006 Family Caregiver Alliance
Caregiver Resource Centers and the Regions They Serve Bay Area Caregiver Resource Center/ Family Caregiver Alliance Statewide Resources Consultant 180 Montgomery Street, Suite 1100 San Francisco, California 94104 Phone: (415) 434-3388 or (800) 445-8106 Website: www.caregiver.org E-mail: info@caregiver.org Alameda Contra Costa Marin San Francisco San Mateo Santa Clara Counties Coast Caregiver Resource Center 1528 Chapala Street, Suite 302 Santa Barbara, California 93101 Phone: (805) 962-3600 or (800) 443-1236 (regional) Website: www.coastcrc.org E-mail: ccrc@silcom.com San Luis Obispo Santa Barbara Ventura Counties Del Mar Caregiver Resource Center 736 Chestnut Street, Suite F Santa Cruz, California 95060 Phone: (831) 459-6639 Website: www.delmarcaregiver.org E-mail: hpc@hpcn.org Monterey San Benito Santa Cruz Counties Del Oro Caregiver Resource Center 5723A Marconi Avenue Carmichael, California 95608 Phone: (916) 971-0893 or (800) 635-0220 (regional) Website: www.deloro.org E-mail: crc@deloro.org Alpine Amador Calaveras Colusa El Dorado Nevada Placer Sacramento San Joaquin Sierra Sutter Yolo Yuba Counties Inland Caregiver Resource Center 1420 East Cooley Drive, Suite 100 Colton, California 92324 Phone: (909) 514-1404 or (800) 675-6694 (California) Website: www.inlandcaregivers.com E-mail: info@inlandcaregivers.org Inyo Mono Riverside San Bernardino Counties Los Angeles Caregiver Resource Center 3715 McClintock Avenue Los Angeles, California 90089-0191 Phone: (213) 821-7777 or (800) 540-4442 (California) Website: www.losangelescrc.org E-mail: lacrc@usc.edu Los Angeles County Mountain Caregiver Resource Center 2491 Carmichael Drive, Suite 400 Chico, California 95928 Phone: (530) 898-5925 or (800) 822-0109 (regional) Website: www.caregiverresources.org/mcrc_home E-mail: smrossi@csuchico.edu Butte Glenn Lassen Modoc Plumas Shasta Siskiyou Tehama Trinity Counties Orange Caregiver Resource Center 251 East Imperial Highway, Suite 460 Fullerton, California 92835 Phone: (714) 578-8670 or (800) 543-8312 (regional) Website: www.caregiveroc.org E-mail: ocrc@stjoe.org Orange County Redwood Caregiver Resource Center 141 Stony Circle, Suite 200 Santa Rosa, California 95401 Phone: (707) 542-0282 or (800) 834-1636 (regional) Website: www.redwoodcrc.org E-mail: rcrc@redwoodcrc.org Del Norte Humboldt Lake Mendocino Napa Solano Sonoma Counties Southern Caregiver Resource Center 3675 Ruffi n Road, Suite 230 San Diego, California 92123 Phone: (858) 268-4432 or (800) 827-1008 (California) Website: www.scrc.signonsandiego.com E-mail: scrc@caregivercenter.org San Diego Imperial Counties Valley Caregiver Resource Center 3845 North Clark Street, Suite 201 Fresno, California 93726 Phone: (559) 224-9154 or (800) 541-8614 (regional) Website: www.valleycrc.org E-mail: info@valleycrc.org Fresno Kern Kings Madera Mariposa Merced Stanislaus Tulare Tuolumne Counties www.californiacrc.org