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Early Signs of Dementia in Women

Early Signs of Dementia in Women

“Memory is the treasure house of the mind wherein the monuments thereof are kept and preserved”.  Thomas Fuller

Early signs of dementia in women:

Early: This refers to the beginning stages or the initial phase of something. In the context of “early signs of dementia,” it means recognizing symptoms at an early stage before they become more severe or noticeable.

Signs: Signs are indications or signals that suggest something is happening or present. In this case, “early signs” of dementia are the first noticeable changes or behaviors that may indicate the presence of dementia.

Dementia: Dementia is a general term used to describe a decline in cognitive function (thinking, memory, and reasoning) severe enough to interfere with daily life. It is not a specific disease but rather a set of symptoms associated with various underlying causes.

Introduction

You may have heard that more women than men show early signs of dementia, but let’s set the record straight. Recent studies suggest there’s not enough evidence to support this claim. So, if you’re a woman, don’t fret – your risk of dementia isn’t higher just because of your gender (Beam et al., 2018).

Understanding early signs of dementia in women isn’t easy. Dementia affects everyone differently, no matter their gender, but let’s try to develop our understanding of it!

The Facts:

Let’s start by looking at what recent studies tell us about dementia and its risk factors.

According to Neergaard et al. (2016), there are certain things we can’t change (non-modifiable risk factors), like getting older and genetics that might make us more likely to develop dementia.

There are other things we can change (modifiable risk factors), like how much we exercise, nutrition, chronic stress, sleep, and whether we smoke that play a big role in whether or not we begin experiencing early signs of dementia. Norton et al. (2014) found that things like not exercising enough and smoking could make us more likely to get dementia.

Surprisingly, Neergaard et al. (2016) discovered that being a bit overweight when we’re older might not matter as much as we thought! Being obese doesn’t seem to make much of a difference according to the evidence. So, it’s not just about being thin or fat – it’s more complicated than that!

Sex Differences in Early Symptoms:

Now, let’s talk about the early signs of dementia and whether they’re different for women and men.

In a study by Edahiro et al. (2023), they found that women with early-onset dementia were more likely to have trouble with their memory. Men, on the other hand, were more likely to feel irritable.

Mendez (2012) also discovered that the first signs of dementia might not always be about forgetting things. Sometimes, they can be about having trouble with things like seeing things around us and paying attention.

The most common symptoms of early-onset dementia across gender are as follows:

    1. Loss of memory (Edahiro et al., 2023)
    2. Difficulty in word generation (Edahiro et al., 2023)
    3. Loss of motivation (Edahiro et al., 2023)
    4. Increased mistakes in the workplace or domestically (Edahiro et al., 2023)
    5. Unusual behaviors or attitudes (Edahiro et al., 2023)
    6. Visuo-spatial dysfunction (Mendez, 2012)
    7. Executive dysfunction (Mendez, 2012)
    8. Attention impairment (Mendez, 2012)

What can you do?

Stay physically active: Engage in regular physical activity, such as walking, swimming, or dancing, to promote brain health and reduce the risk of dementia

Manage depression: Seek support and treatment for depression if needed, as depression has been identified as a potential risk factor for dementia

Stay mentally active: Keep your brain stimulated by engaging in activities that challenge your cognitive abilities, such as puzzles, reading, learning new skills, or socializing with others

Monitor and manage other health conditions: Take steps to manage other health conditions that may increase the risk of dementia, such as diabetes, hypertension, and smoking

Be mindful of early signs: Pay attention to any changes in memory, cognition, or behavior, and seek medical advice if you notice any concerning symptoms. Early detection and intervention can be crucial in managing dementia

Bottom Line:

So, what’s the bottom line? Even though some studies say women might show early signs of dementia more than men, it’s not necessarily the case. That said, there are some gender differences like women being more likely to experience memory difficulties in the early stages of dementia than men.  Dementia is a complicated thing, and lots of factors can play a part in whether we get it or not.

I will forever tell everyone I know that there is no harm in seeking functional oversight of your cognition! Find a board-certified medical professional trained in memory, cognition, and neurological-based pathologies to evaluate you. This will allow you to remain in control of your brain health and manage modifiable risk factors.

References

Beam, C. R., Kaneshiro, C., Jang, J. Y., Reynolds, C. A., Pedersen, N. L., & Gatz, M. (2018). Differences Between Women and Men in Incidence Rates of Dementia and Alzheimer’s Disease. J Alzheimers Dis, 64(4), 1077-1083. doi:10.3233/jad-180141

Edahiro, A., Okamura, T., Arai, T., Ikeuchi, T., Ikeda, M., Utsumi, K., . . . Awata, S. (2023). Initial symptoms of early‐onset dementia in Japan: nationwide survey. Psychogeriatrics, 23(3), 422-433. doi:10.1111/psyg.12949

Fitzpatrick, A. L., Kuller, L. H., Lopez, O. L., Diehr, P., O’Meara, E. S., Longstreth, W. T., Jr., & Luchsinger, J. A. (2009). Midlife and late-life obesity and the risk of dementia: cardiovascular health study. Arch Neurol, 66(3), 336-342. doi:10.1001/archneurol.2008.582

Mendez, M. F. (2012). Early-onset Alzheimer’s disease: nonamnestic subtypes and type 2 AD. Arch Med Res, 43(8), 677-685. doi:10.1016/j.arcmed.2012.11.009

Neergaard, J. S., Dragsbæk, K., Hansen, H. B., Henriksen, K., Christiansen, C., & Karsdal, M. A. (2016). Late-Life Risk Factors for All-Cause Dementia and Differential Dementia Diagnoses in Women: A Prospective Cohort Study. Medicine, 95(11). Retrieved from https://journals.lww.com/md-journal/fulltext/2016/03150/late_life_risk_factors_for_all_cause_dementia_and.64.aspx

Norton, S., Matthews, F. E., Barnes, D. E., Yaffe, K., & Brayne, C. (2014). Potential for primary prevention of Alzheimer’s disease: an analysis of population-based data. Lancet Neurol, 13(8), 788-794. doi:10.1016/s1474-4422(14)70136-x

Wrist Flexion and Extension| Occupational Therapy Intervention

Wrist Flexion and Extension| Occupational Therapy Intervention

Wrist Flexion and Extention:

Forearm Strengthening

Occupational Therapy Intervention : Wrist Flexion and Extension

Documentation and Activity Rationale

The patient engaged in a wrist AROM against resistance provided by a 2lb weighted ball. The exercise sequence elicited wrist flexion and extension in order to increase extrinsic forearm musculature. The patient was instructed to perform each movement slowly, methodically, and with complete control. No pain or discomfort verbalized by the patient, though the patient affirmed muscle fatigue at the end of the sequence. Therapeutic rest given after task.

Grading Strategies

Grading Up: 

  • include radial and ulnar deviation, circumduction, pronation and supination in the AROM sequence

Grading Down: 

  • begin with less weight
  • fewer repetitions

Appropriate Diagnoses / Deficits

  • generalized weakness
  • atrophy s/p hand and/or wrist surgery
  • CVA
  • TBI

An occupational therapy practitioner would work on wrist flexion and extension using various shaped and weighted items, such as bars for cylindrical grasp, balls for spherical grasp, and books for specific grasp types, to achieve several therapeutic goals:

Strengthening Muscles: Different shapes and weights challenge the wrist flexor and extensor muscles, promoting muscle strengthening and endurance. This is crucial for improving overall wrist stability and function.

Enhancing Grip Variety: Practicing with various objects helps to enhance different types of grips such as cylindrical, spherical, and pinch grasps. This diversity in training ensures that patients can perform a wide range of everyday activities.

Improving Dexterity and Coordination: Using objects of different shapes and sizes requires fine motor skills and coordination. This helps to improve hand-eye coordination and dexterity, which are essential for precise movements.

Functional Application: Activities that involve gripping and manipulating different objects are directly related to daily tasks such as opening jars, picking up objects, and using tools. Training with these objects simulates real-life scenarios, making the therapy functional and relevant to the patient’s daily life.

Promoting Motor Control: Varying the resistance and shape of objects helps in refining motor control and proprioception, which are important for smooth and controlled movements of the wrist and hand.

Addressing Specific Deficits: Different objects target specific muscle groups and movement patterns. For example, using cylindrical objects primarily targets wrist flexion and extension, while spherical objects challenge the intrinsic muscles of the hand.

Encouraging Neural Adaptation: Engaging in diverse and challenging tasks promotes neuroplasticity, which is the brain’s ability to reorganize itself by forming new neural connections. This is especially important for patients recovering from neurological injuries.

Here’s an example of how specific objects can be used:

Cylindrical Grasp: Bars or tubes to improve wrist flexion and extension strength.

Spherical Grasp: Balls to enhance overall grip strength and coordination.

Lateral Pinch: Books or flat objects to practice the lateral pinch grasp, improving precision grip used in activities like holding cards or sheets of paper.

In Hand Coin Manipulation  | Occupational Therapy Intervention

In Hand Coin Manipulation | Occupational Therapy Intervention

In-Hand Coin Manipulation

Occupational Therapy Intervention : Fine Motor Coordination using Coin Manipulation

Documentation and Activity Rationale

The patient engaged in a fine motor coin manipulation activity using right hand (left hand to assist prn) to retrieve coin using thumb abduction and/or tip pinch, maintain grip and place into a slightly resistive target. The patient was very challenged by this activity requiring frequent adaptations. Patient was unable to retrieve independently requiring max ax1/and placement of coin in webspace of thumb x10 coins. The activity seeks to elicit fine motor active range of motion, coordination, pinch strength, translation, and skills of prehension.

Grading Strategies

Grading Up: 

  • smaller coins
  • more coins

Grading Down: 

  • larger opening to release into 
  • less coins at one time

Appropriate Diagnoses / Deficits

  • coordination deficits 
  • atrophy s/p hand and/or wrist surgery
  • CVA
  • TBI

In-hand coin manipulation using actual coins in occupational therapy treatments helps to ensure the therapy is task-specific, engaging, and objective. Here’s how:

Task-Specific

  • Functional Relevance: Manipulating coins is a common daily activity, making it highly relevant and practical for patients. This ensures that the skills practiced in therapy can be directly transferred to real-life situations.
  • Fine Motor Skills: Coin manipulation specifically targets fine motor skills, including dexterity, finger strength, and coordination, which are crucial for many everyday tasks such as buttoning clothes, writing, or handling small objects.

Engaging

  • Motivating Activity: Using real coins can be more interesting and engaging for patients compared to abstract exercises. The familiarity and tangible nature of coins can make the activity feel more purposeful and motivating.
  • Variety and Challenge: Coins of different sizes and weights provide varied challenges, keeping the activity interesting and progressively difficult as the patient’s skills improve.

Objective

  • Measurable Progress: Coin manipulation tasks can be easily quantified, allowing therapists to objectively measure progress. For example, the number of coins manipulated within a set time frame or the ability to perform specific coin tricks can be tracked and recorded.
  • Standardized Tasks: Using coins allows for standardized tasks, such as picking up coins from a flat surface, sorting them, or moving them from palm to fingertips. This standardization helps in objectively assessing and comparing patient performance over time.

Specific Therapeutic Benefits

  1. Strengthening Intrinsic Hand Muscles: Manipulating coins strengthens the small muscles in the hand and fingers, crucial for grip and precision tasks.
  2. Enhancing Coordination: The activity requires coordination between fingers, improving fine motor control and hand-eye coordination.
  3. Improving Sensory Feedback: Handling coins provides tactile feedback, enhancing sensory perception and proprioception in the hands.
  4. Promoting Cognitive Skills: Sorting and counting coins can also engage cognitive functions such as attention, sequencing, and problem-solving.

Practical Application

  • Grading the Activity: The complexity of the task can be easily adjusted by changing the size, weight, and number of coins, or by varying the speed and accuracy requirements.
  • Engaging Multiple Systems: Coin manipulation tasks can integrate sensory, motor, and cognitive systems, providing a comprehensive approach to rehabilitation.

In-hand coin manipulation, therefore, offers a practical, engaging, and measurable way to improve fine motor skills and hand function in occupational therapy.

Traumatic Brain Injury Rehabilitation TBI

Traumatic Brain Injury Rehabilitation TBI

Traumatic Brain Injury (TBI) Rehabilitation and Support Services

TBI and Concussion in Teens

Traumatic Brain Injury Treatment Buffalo NY - Blue Fill

TBI and Concussion in Adults

What is a Traumatic Brain Injury (TBI)

A traumatic brain injury (TBI) can occur after a fall,  sport injury, motor vehicle accident, blunt force trauma, accident at work, or any other occurrence causing the brain to be jolted or damaged in some way. The severity of the injury can range from mild to severe, and you may experience symptoms lasting days, weeks, months, or even years. 

Most people will begin the recovery process of a TBI in an inpatient hospitalization setting where you will regain physical, sensory, behavioral, and cognitive function. If you experienced a TBI resulting in concussion, but is not so severe that you require inpatient hospitalization, you should be immediately beginning community-based outpatient occupational therapy. In a more severe case, outpatient occupational therapy will be part of the continuum of care. Making sure you see a therapy team familiar with the symptoms and recovery process of a traumatic brain injury is crucial to maximizing your outcomes. 

Symptoms of

Traumatic Brain Injury (TBI)

Physical Symptoms

  • Headaches and migraines
  • Impaired balance and dizziness
  • Neck and lower back pain
  • Upper body and lower body muscle weakness
  • Loss of coordination
  • Difficulty sleeping and staying asleep

Emotional Symptoms

  • Mood changes
  • Personality changes
  • Increase volatility and short-tempered 
  • Unable to balance emotions 
  • Increased desire to be alone

Cognitive Symptoms

  • Confusion
  • Decreased executive functioning 
  • Short attention span
  • Short term memory deficits
  • Impaired information processing speed
  • Impaired multi-tasking ability
  • Impaired working memory skills
  • Word finding difficulties

Sensory Symptoms

  • Tremors in hands, legs, or feet
  • Neuropathy, paresthesia, numbness, or tingling in hands and feet
  • Depth perception difficulties
  • Visual perceptual deficits 
  • Sensitivity to light and sound
  • Ringing in your ears (tinnitus) 
  • Taste changes or lack of appetite

For more information, check out the Brain Injury Association

Meaningful Activities (Occupations) affected by a Traumatic Brain Injury (TBI) 

ADLs 

  • Bed mobility 
  • Cleanliness and thoroughness while toileting
  • Showering and maintaining safety 
  • Dressing 
  • Mobility (standing tolerance, walking, getting up and down without dizziness)

IADLs

Other Occupations (meaningful activities)

  • Maintaining volunteer roles 
  • Participating in hobbies or extra-curricular activities
  • Going to church 
  • Exercising 

Why is outpatient occupational therapy imperative for Traumatic Brain Injury 

What are some problems an occupational therapy can help solve? 

References

Altman, I. M., Swick, S., Parrot, D., & Malec, J. F. (2010). Effectiveness of community-based rehabilitation after traumatic brain injury for 489 program completers compared with those precipitously discharged. Archives of Physical Medicine and Rehabilitation, 91, 1697–1704.

Kim, H., & Colantonio, A. (2010). Effectiveness of rehabilitation in enhancing community integration after acute traumatic brain injury: a systematic review. American Journal of Occupational Therapy, 64, 709–719. https://dx.doi.org/10.5014/ajot.2010.09188

Traumatic brain injury. (2019, March 29). Retrieved March 13, 2020, from https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557

Traumatic brain injury. (2019, March 29). Retrieved March 13, 2020, from https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557

Lewy Body Dementia and Rehabilitation

Lewy Body Dementia and Rehabilitation

Lewy Body Dementia is a condition that looks different for each person, but the way the disease works in the brain, known as pathogenesis, follows the same general pattern. Some specialized physical, occupational, and speech therapists are trained in understanding how the disease spreads through the brain and how it impacts different functions over time. These changes are specific to Lewy Body Dementia, making your journey with LBD different from someone with Alzheimer’s, frontotemporal dementia, or Parkinson’s.

If you’ve been diagnosed with LBD, it’s important to start building your long-term management team. While you won’t need therapy or medical appointments all the time, you will benefit from having periods of therapy when changes in your body or function start to appear. Having someone to contact when these changes happen ensures you can get the right support at the right time. Early diagnosis and intervention are key to maintaining as much independence and function as possible throughout the course of the disease.

What is Lewy Body Dementia?

Lewy Body Dementia (LBD) is the second most prevalent progressive neurodegenerative diagnosis causing dementia. It is second to Alzheimer’s disease (AD), but differs in many ways. It is signified by lewy body proteins that appear in various parts of your brain affecting thinking, functional activities, judgement, executive function, functions of the autonomic nervous system, and mobility.

The Lewy Body Association  has more information regarding the difference between Alzheimer’s Disease (AD) and Lewy Body Disease (LBD).

What do I do if I’ve been diagnosed with Lewy Body Dementia (LBD)?

After receiving an LBD diagnosis, it is important to establish a long-term therapy team including occupational therapy, speech therapy, and physical therapy familiar with the progression of this diagnosis. By establishing a small therapy team that will be able to remain with you throughout the stages of Lewy Body Dementia, you will be able to maximize your physical function, maintain your performance in functional activities, and ensure you remain in control of your symptoms instead of the other way around.

Symptoms of Lewy Body Dementia

  • Runny Nose
  • Visual hallucinations (detailed)
  • Delusions 
  • Agitation and frustration
  • Difficulty multi-tasking or remaining on task 
  • Information processing difficulties 
  • Stooped posture (similar to Parkinson’s disease)
  • Overall movements and mobility slowing down
  • Balance and coordination decline 
  • Walking turns into a ‘shuffle’ 
  • Voice becomes more quiet 

For more symptoms of Lewy Body Dementia, head to Alzheimer’s Association

What are my options after receiving an LBD diagnosis?

Although there are neurocognitive enhancement medications, one of the most important things you can do for yourself is to seek out a team of therapists as early as possible. With the right early intervention strategies you can improve your symptoms and/or control the speed at which you experience decline.

What type of intervention is used by a neuro-centered rehabilitation team?

How can outpatient occupational therapy help after a dementia diagnosis?

  • Once given a dementia diagnosis, we can ‘stage’ your dementia progression through specific screens and assessments so that you always feel in control of your circumstances.
  • Make recommendations for adaptive equipment, durable medical equipment, and mobility aids throughout each stage
  • Provide a hybrid approach to rehabilitation and maintenance grounded in neurocentric principles offering you an inclusive rehab program.