Tag Archives: Dementia

California deals with dementia among aging inmates

An inmate sits in the yard of a cellblock which mainly houses prisoners with cognitive decline, Alzheimer's, and dementia, at the California Health Care Facility in Stockton, California, U.S., May 24, 2018. REUTERS/Lucy Nicholson

By Sharon Bernstein

STOCKTON, Calif. (Reuters) – California prison inmate Richard Arriola does not remember the digestion problems that drove him to the doctor on a recent morning, or details of the conviction for child molestation that sent him to prison at age 88.

Arriola is one of about 18,400 inmates over the age of 55 in California prisons, according to the California Department of Corrections and Rehabilitation.

It is a swelling population that has led authorities to take the first steps toward creating a dementia unit at the state’s main prison medical facility in the San Joaquin Valley city of Stockton, Reuters has learned.

“We have identified a specific need for a specialized unit for our dementia population and are in the very early phases of concept development,” said Elizabeth Gransee, spokeswoman for California Correctional Health Care Services.

The wing would mark a shift from California’s earlier efforts to treat prisoners with cognitive decline, relying on inmate volunteers and a modest staff to help them rather than a more expensive medical unit.

Reuters visited two California prisons recently to look at the challenges states face, as improved medical care, long sentences from tougher crime laws, and a steady increase of older adults entering prison has contributed to an extraordinary rise of elderly inmates.

In California, seven percent of the state’s 130,000 prisoners were over the age of 60 in 2016, the most recent year for which data is available, compared to just 1 percent 20 years earlier, according to a report by the California Department of Corrections and Rehabilitation.

“We and all of the jails and prisons around the country need to be able to do a better job with individuals who have cognitive impairment,” said Dr. Joseph Bick, chief medical executive at the California Medical Facility in Vacaville.

Throughout the United States, states are grappling with similar challenges as prisoners age. Inmate medical costs amount to about $3 billion per year nationwide, according to a recent report by the state of Georgia, where medical care for inmates over the age of 65 costs $8,500 per year, compared to $950 for those who are younger, the report showed.

Nationwide, 44 percent of inmates over the age of 50 have disabilities, compared to 27 percent of prisoners overall, a 2015 report by the Department of Justice shows. About 20 percent have cognitive disabilities, the report showed.

ROUND-THE-CLOCK CARE

Prisoners with cognitive decline can require round-the-clock care and help with dressing themselves, brushing teeth and going to the restroom. Because prison life – and for many, life on the streets before prison – is so difficult, inmates are considered geriatric after the age of 55 in California and many other states.

Arriola, who is housed with about 2,600 prisoners with chronic conditions at the California Health Care Facility in Stockton, came on a Thursday morning in May for a follow-up visit with a gastroenterologist. But he talked distractedly to the doctor, and said he did not recall having stomach problems.

It is not an uncommon situation at the Stockton facility, where physicians and nurses are trained to work with an increasing number of patients experiencing cognitive decline, said Dr. Anise Adams, the chief medical officer.

About 500 prisoners are being treated for dementia or Parkinson’s Disease in California prisons, including 200 at Stockton, officials said.

“It’s hard for them to explain to the nurses what they want or how they feel,” said inmate Scottie Glenn, 47, who participates in a program in which able-bodied inmates help those who are ill.

On a recent May morning, Glenn, who is serving 25 years to life for murder, was assisting a wheelchair-bound inmate who needed to see a doctor. Sometimes, he writes letters for inmates, or helps them to communicate.

HOSPICE CARE

Older inmates’ needs have led the state to build a large dialysis center, stock hundreds of wheelchairs and offer assistance with hearing and declining vision. Stockton’s medical facility has a physical therapy center, and a palliative care unit is set to open in the next few weeks.

The California Medical Facility in Vacaville set up a hospice decades ago during the AIDS crisis, which now houses more inmates dying of old age diseases, officials said. The state expects to spend about $26,000 per inmate on health care next year.

Once a dementia unit is set up, California would follow New York, which opened one for its much smaller prison population in 2006. New York spends about $2.7 million annually to care for 29 patients in the unit, the state corrections department said.

California officials say it is too soon to know how much the unit they hope to create will cost, but it would not be difficult to re-purpose an existing ward for use by dementia patients.

Such patients wake up in the middle of the night not knowing where they are, requiring trained staff to comfort them. Others behave in ways that normally get an inmate in trouble, such as batting away a doctor’s hand during an injection.

In a normal prison ward, that is considered assault, said Captain Paul Vasquez, whose job includes reviewing behavioral issues at the Stockton facility.

Inmates can be handcuffed, lose privileges and even be sent to the Security Housing Unit, where prisoners are kept in near-isolation, he said.

“We need to learn to respond to them a different way – and not in a regular mainline type of prison,” Vasquez said.

 

(Reporting by Sharon Bernstein; Additional reporting by Jane Ross; Editing by Bill Tarrant and Diane Craft)

Signs of brain disease in 99 percent of former NFL players: study

FILE PHOTO - New England Patriots linebacker Junior Seau celebrates sacking San Diego Chargers quarterback Philip Rivers in first quarter of the NFL's AFC championship football game in Foxborough, Massachusetts, U.S. on January 20, 2008. REUTERS/Brian Snyder/File Photo

By Scott Malone

BOSTON (Reuters) – The brains of 99 percent of former National Football League players showed signs of a disease linked to repeated hits to the head that can lead to aggression and dementia, according to research published in a leading medical journal on Tuesday.

The findings were based on the broadest review yet of the brains of former football players for signs of chronic traumatic encephalopathy. The condition, also known as CTE, is linked to the sort of head-to-head hits that were long a part of the sport, though the NFL and school leagues have been tweaking the game in recent years to limit blows to the head.

“The data suggest that there is very likely a relationship between exposure to football and risk of developing the disease,” said Jesse Mez, a Boston University School of Medicine assistant professor of neurology, who was lead author of the study published in the Journal of the American Medical Association.

The researchers studied the brains of 202 former athletes who had played football in the NFL, the Canadian Football League or at the college or high school level and found signs of CTE in the brains of 110 of the former 111 NFL players.

The condition, which currently can be diagnosed only by taking brain tissue from a dead subject, has been diagnosed in former players including Hall of Fame linebacker Junior Seau and Pro Bowl safety Dave Duerson, who both committed suicide.

The researchers noted that the study had limitations including that the subjects’ brains were donated by their families, and that families are more likely to opt into the study if the players had showed symptoms of CTE.

“We do not know what proportion of football players, or any group, for that matter, develop CTE,” said Dr. Munro Cullum, a neuropsychologist with the O’Donnell Brain Institute at the University of Texas Southwestern Medical Center in Dallas.

The NFL, which last year pledged $100 million for neuromedical research, said the study would help the league and players to understand the condition.

“The NFL is committed to supporting scientific research into CTE and advancing progress in the prevention and treatment of head injuries,” said NFL spokesman Brian McCarthy, in an e-mail.

The study found signs of CTE in the brains of 91 percent of the 53 former college players whose brains were studied and 21 percent of the former high school players.

(Reporting by Scott Malone, additional reporting by Lisa Rapaport in New York; Editing by Andrew Hay)

Scientists link higher dementia risk to living near heavy traffic

Cars in traffic

By Kate Kelland

LONDON (Reuters) – People who live near roads laden with heavy traffic face a higher risk of developing dementia than those living further away, possibly because pollutants get into their brains via the blood stream, according to researchers in Canada.

A study in The Lancet medical journal found that people who lived within 50 meters (55 yards) of high-traffic roads had a 7.0 percent higher chance of developing dementia compared to those who lived more than 300 meters away from busy roadways.

“Air pollutants can get into the blood stream and lead to inflammation, which is linked with cardiovascular disease and possibly other conditions such as diabetes. This study suggests air pollutants that can get into the brain via the blood stream can lead to neurological problems,” said Ray Copes, an environmental and occupational health expert at Public Health Ontario (PHO) who conducted the study with colleagues from Canada’s Institute for Clinical Evaluative Sciences.

Dementia is caused by brain diseases, most commonly Alzheimer’s disease, which result in the loss of brain cells and affect memory, thinking, behavior, navigational and spatial abilities and the ability to perform everyday activities.

The World Health Organization estimates the number of people with dementia in 2015 at 47.5 million, and that total is rising rapidly as life expectancy increases and societies age. The incurable condition is a leading cause of disability and dependency, and is starting to overtake heart disease as a cause of death in some developed countries.

Independent experts said the Canadian study had important implications for public health around the world. Tom Dening of the Center for Old Age and Dementia at Britain’s Nottingham University said the findings were “interesting and provocative”.

“It is unlikely that Ontario has the worst air quality in the world, so the risks might be even greater in cities that are habitually wrapped in smog,” he said.

Chen’s team analyzed records of more than 6.5 million Ontario residents aged 20 to 85 and found 243,611 cases of dementia between 2001 and 2012. Then they mapped residents’ proximity to major roadways using postal codes.

The increase in the risk of developing dementia went down to 4.0 percent if people lived 50 to 100 meters from major traffic, and to 2.0 percent if they lived within 101 to 200 meters. At more than 200 meters, the elevated risk faded away.

The team also explored links between living close to major roads and Parkinson’s disease and multiple sclerosis – two other major neurological disorders – but the findings suggested no increased risk of these from living near heavy traffic.

The scientists said their results could be used to help town and city planners take traffic conditions and air pollution into account as urban areas become more densely populated.

(Editing by Raissa Kasolowsky)

Scientists Claim Finding Key In Stopping Alzheimer’s

British scientists say they have found the key to stopping Alzheimer’s disease in the early stages.

The study at Cambridge University could lead to a “statin-like” drug that could be prescribed to stop dementia.

The scientists found a naturally occurring molecule that slows down the formation of plaque in the brain.  The plaques are closely connected to memory loss and other symptoms of Alzheimer’s.

“This is the starting point for finding a drug that stops Alzheimer’s disease in its tracks. It might be used when the first symptoms appear. But another potential approach is that people would take it as a preventative drug,” said the study’s lead author, Dr. Samuel Cohen.

The molecules that slow the plaque are Brichos, a family of proteins that naturally exist in human lungs.  Testing in mice showed the molecules stick to fibrils and stop them from forming more plaques.

“There may well be lots of other molecules like this – we just have not been looking until now because it was not clear what to look for,” Dr. Cohen said.

“People could take them in their 60s to stop these proteins grouping together, well before the symptoms appear, which would reduce the risk of developing the devastating effects of this disease.”

Dementia Epidemic Looming By 2050

Health experts are warning that the world could be facing a dementia epidemic by 2050.

Estimates from the group Alzheimer’s Disease International showed a 17 percent increase in the number of people with dementia in 2010 and warned that by 2050 as much as 70 percent of dementia patients could be in third world nations.

“If we look into the future the numbers of elderly people will rise dramatically. It’s vital that the World Health Organization makes dementia a priority, so the world is ready to face this condition,” ADI Executive Director Marc Wortmann told Reuters.

Leaders from the Group of Eight industrialized countries are due to meet in London next week for a special summit on dementia. The condition is so prominent in Britain that it costs the country 23 billion pounds a year, more than cancer, stroke or heart disease combined.

ADI officials said the number of cases by 2050 could triple from 44 million today to 135 million. They said more funds dedicated to research for a cure are necessary and the research needs to begin immediately.