Vitamin D and the Elderly

In the last year there has been a lot of research published on vitamin D and the effects of Vitamin D deficiency. Why isn't every senior in America on Vitamin D?

By Angil Tarach RN GCM

I am not saying every single senior in America has a Vitamin D deficiency, but I would venture to guess the numbers of senior who are is staggering.

Many seniors spend day after day indoors without any direct sunlight. It would be a rare older adult who consumes enough Vitamin D in their diet to have a sufficient intake. So why aren’t physicians testing every older adult in America for a Vitamin D deficiency?

Without a big technical explanation of what Vitamin D does in and for the human body I will simplify it as much as possible to help you understand the need of having a sufficient amount on a daily basis.

Vitamin D works in unison with Calcium to keep bones and muscles healthy and strong, preventing osteoporosis. Calcium is not absorbed and distributed appropriately without Vitamin D. On its own Vitamin D doesn’t do very much. There are specific functions within the body that only work correctly by Vitamin D.

Without strong and healthy muscles and bones the elderly are at risk for falls, fractures, and even death. Visiting Angels and Temple University developed a Fall Prevention Program which provides fall statistics.

Falls are the second leading cause of death in the US, with 75% of those falls occurring in the older population. There is evidence that supplemental Vitamin D in nursing home residents reduces the risk of falls and subsequent injuries.

The hormone Calcitonin, which is released from the thyroid gland, can cause cartilage to degrade if Vitamin D didn’t inhibit that process. So in essence this very important vitamin can help by assisting processes or preventing processes.

Parathyroid hormone can cause problems with how the nerves regulate the muscles, immune function, and inflammation which is a major cause of pain in the elderly. Vitamin D also inhibits this hormone, which decreases the problems that can be caused by the parathyroid.

Many people do not realize the heart is a muscle. Vitamin D plays an important role in heart health, and there is increasing research recognizing Vitamin D deficiency and its association to heart disease.

Chronic inflammation can cause many diseases which may include rheumatoid arthritis, kidney and prostate disorders, autoimmune diseases, as well as disorders affecting the skin, pelvis, bowels, respiratory, and vascular systems. Vitamin D deficiency also plays a part in Type I Diabetes.

I wonder how many diseases could be prevented by sufficient Vitamin D? How much pain in our elderly could be helped by adequate Vitamin D?

There is still much to learn and understand when it comes to the human body and disease. I always say, we don’t know what we don’t know. What will the future discoveries tell us? What is the depth of Vitamin D importance in the processes of the human body?

I believe the current information and knowledge about Vitamin D are enough to prove that a deficiency has an effect on wellness. I encourage you to ask your physician, and advocate for your loved one to get tested for Vitamin D deficiency. I don’t recommend beginning a Vitamin D supplement without knowing your lab results or speaking with your physician. It is possible to overdose on Vitamin D, but what if a simple daily supplement of Vitamin D can help you or your loved one’s quality of life? It’s worth pursuing.

Angil Tarach(RN GCM) has over 30 years of experience, and is a nationally known expert in senior care and advocacy. Angil is also the owner of Visiting Angels in Ann Arbor, Michigan.

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Simple Tests to Detect Alzheimer's and Dementia the Old Fashioned Way

In my little world here in Delray Beach, Florida I have learned a harsh lesson -- it is very difficult to diagnose mild cognitive impairment, dementia, and probable Alzheimer's. Here are some simple tests for Alzheimer's and dementia that could be helpful......

Bob DeMarco
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Editor


I knew something was wrong with my mother. I knew it. When I would mention some of my concerns to family and friends they would usually conclude -- she is getting old. When it first started to really bother me my mother was 86 years old.

Her friends that saw her everyday would tell me she is doing great. Her doctor of six years didn't see a problem.

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I did know her behavior was undergoing subtle changes. She talked about money incessantly, she complained about being bored incessantly. She started scrapping her feet on the ground. She said things that lead me to believe she was feeling insecure, maybe fear -- these were very different than what I heard her saying in the past.

After my mother was diagnosed with dementia her friends refused to believe both the diagnosis and me. When she would talk to family and friends that lived far away they would usually say --she sounds great.

She did sound great. She could still drive, go to the store, and play bingo. What they didn't see was how her behavior would often turn erratic. I invited all of them to come live in the front row for a few days -- they passed.

____________________________
The time came when I decided to come and spend some extended time with my mother and try to find out what was happening. At the time, you could put everything I knew about Alzheimer's and dementia in a thimble.

It took a few months before I finally started to understand the problem. It took four doctors to get to the bottom of the problem. None of the people that were seeing my mother on a daily basis saw a problem.

People in an early stage of dementia are very good at disguising the problem. They can laugh and change the conversation when you ask them questions about memory, or the ability to go here and go there. For me, it was the changes in behavior, the meanness, and the inability to walk more than a block that tipped me off.

____________________________
If a person suffering from dementia gets lost or starts having problems driving, you will never hear about it. The last thing an elderly person wants to do is lose their independence. One of the biggest symbols of independence is the drivers license. Trying to get that drivers license is like trying to get a steak out of the mouth of a bull dog.

____________________________
After I had been hear a couple of years, I learned some interesting things about my mothers behavior.

She drove her car over a concrete abutment, through a hedge and hit a tree. She then drove the car around some trees, over a sidewalk, over the lawn, and put the care in her condominium parking space. She didn't tell me, my brother, or my sister.

When I first learned about this her friends were laughing telling the story. They were impressed by the fact that she actually got the car back into her space. They did not see it as an indication that maybe she shouldn't be driving -- or worse.

Her friends, still friends, also forgot to mention that they stopped inviting my mother to their lunch time outings to restaurants because she constantly complained about money. When I asked them years later, when I first learned about this, if she had always done this -- they said no. In other words, her behavior had clearly changed but it had no impact on their view of her health.

____________________________
If you live far away from your parent and they are over 80, there is a good chance you could end up in the same situation I found myself in six years ago.

Here are few things you can try to spot mild cognitive impairment, Alzheimer's or dementia at an early stage.

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Bob DeMarco is the editor of the Alzheimer's Reading Room and an Alzheimer's caregiver. The Alzheimer's Reading Room is the number one website on the Internet for news, advice, and insight into Alzheimer's disease. Bob has written more than 800 articles with more than 18,000 links on the Internet. Bob resides in Delray Beach, FL.

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Questions About Test Your Memory for Alzheimers and Dementia (TYM)

On Wednesday, I published an article about a new memory test for Alzheimer's that can be administered in five minutes. The links to the test and scoring sheet are contained in the original article -- Test Your Memory (TYM) for Alzheimer's or Dementia in Five Minutes.

I am receiving emails from readers and I thought I would address two questions.

One reader asked, "I am curious to hear their opinion, about the level of education for the test taker, and its effect on the validity of the test".

The authors did not specifically assess the effect of education during their testing. In the BMJ article they wrote,

This ceiling effect suggests that education and social class would have only mild effects on the TYM score, but we did not formally assess this. The reason for the low scoring controls was often apparent from the score sheet—lack of interest, reading problems, or a sense of humour.

I will try to talk to researchers and get a clearer answer to this question.

Several readers are asking about the scoring system for the test.

• The control group scored 47 out of 50 (ages 18-70).
• A score equal to, or less than, 42 detects Alzheimer's 93 percent of the time.
• Patients with Alzheimer's scored 33 out of 50.
• The range of scores for patients with Alzheimer's was 9-50.

The main finding of this research

The new "test your memory" (TYM) test is quick to use, examines 10 cognitive skills, and detects 93% of cases of Alzheimer’s disease.

If you would like to read the highly technical paper which was published in the BMJ follow this link -- Self administered cognitive screening test (TYM) for detection of Alzheimer’s disease: cross sectional study.

Have a question, put it in the comments box.

This is the first draft of this article and it will be updated.

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Bob DeMarco is an Alzheimer's caregiver and editor of the Alzheimer's Reading Room. TheAlzheimer's Reading Room is the number one website on the Internet for insight into Alzheimer's disease. Bob taught at the University of Georgia, was an executive at Bear Stearns, the CEO of IP Group, and is a mentor. He has written more than 600 articles with more than 11,000 links on the Internet. Bob resides in Delray Beach, FL.

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