Welcome to the United Church of Sun City
Greetings from your Parish Nurse.
Hello again! Last month, I talked with you about dementia and some of the early stages. This month, I want to talk about a few specific types of dementia, some of the treatments used and some things we can do to keep our brain healthy.
The most common type of dementia is associated with Alzheimer’s Disease. In this disease, our brains develop clumps of protein, and tangles of fibrous masses made of a different protein. We don’t know all the causes, but please understand that only a small percentage are related to genetic changes that can be passed down.
Lewy Body Dementia is the second most common type. It is caused by a specific type of protein deposit in the brain called Lewy Bodies. This type of dementia is often associated with hallucinations, acting out dreams while sleeping, and may also include symptoms of Parkinson’s Disease like rigidity, tremors and slow movements.
Vascular Dementia is a form of the narrowing of and damage to the blood vessels in our brain causing small blockages and small strokes. It is caused by the same factors affecting our heart health—high cholesterol, high blood pressure, diabetes and smoking. This often happens gradually as the narrowing and small strokes occur over time and affect more of our brain’s functions.
Frontotemporal Lobar Degeneration is a type of dementia that affects primarily the frontal and temporal lobes of our brain. Although we don’t know all the causes, this affects the functions that are controlled by these parts of the brain. Symptoms include personality or behavioral changes, decrease in judgement causing odd or inappropriate behavior and perhaps a reduction in social graces.
In order to diagnose dementia, physicians most frequently use a mental status exam—which asks a variety of questions to evaluate the function of the brain. They may draw blood to check for conditions that can mimic dementia such as a thyroid condition or a Vitamin B12 deficiency. They may also use imaging tests like MRIs, or in some cases, they may do blood testing for biomarkers or genetic markers. These are usually used in early onset of dementia and not for those over 65.
There are a number of medications they have been using—but most of them are costly and have significant side effects. They are most effective with early detection as they are unable to cure the underlying cause but work to slow the progress of the disease so symptoms do not progress as quickly.
From my point of view, the most important thing we can do is to change our lifestyle to reduce the risk of dementia. Some of the lifestyle factors that Mayo Clinic points out are:
Staying physically active. Exercise improves blood flow which we know is beneficial to our brain health. The exact amount that’s best for the brain is not known, but the recommendation is for 30 minutes at least 5 times a week. It can be walking, swimming, or biking which are aerobic exercises, but stretching and balance exercises also have benefits.
Eat more plants. Eating more plants, fish and lean poultry, cutting down on saturated fats and added sugars makes small to moderate improvements in our cognition and memory later in life.
The recommendations include:
- 6+ servings a week of green leafy vegetables
- 1+ servings a day of vegetables other than green leafy
- 5+ servings a week of nuts
- 4+ meals a week including beans and lentils
- 3+ servings a day of whole grains
- 2+ servings a week of berries
- 2+ meals including poultry
- 1+ meals a week including fish. Use olive oil for fat.
Improving your sleep is also important as some of the toxins and proteins are actually removed from your brain during good sleep. The recommendation is 7-8 hours of sleep a night, but the quality of sleep is what is important—not just the time you spend in bed. Untreated sleep apnea and insomnia can affect sleep quality.
Be social. Engaging with others triggers the “good” enzymes of serotonin and dopamine which improve mood and protect the brain from dementia, especially Alzheimer’s Disease. Social isolation may make you more likely to have trouble with thinking and memory. It can worsen conditions like high blood pressure and heart disease which are associated with dementia. Social connections seem to boost cognitive reserve, preserving our brain.
Get a hearing test. If we have difficulty hearing, it tends to isolate us even if we are in a social gathering. Our brain also focuses so much energy on just figuring out what people are saying that it increases the cognitive load on our brain at the expense of other cognitive functions.
Manage stress. Chronic stress, the feeling of constantly being overwhelmed by one or more of life’s challenges, can result in a shrinkage of the hippocampus which is where the creation and storage of memories takes place. Stress can cause chronic inflammation and affect cell aging in our brain as well. It also can increase our blood pressure which is also a risk factor in dementia.
So, what can you choose to change? Please don’t try to change everything at once (talk about stressful!!). But please evaluate the risk factors and take action to decrease the risk and prevent some dementia. Some of them we can combine—like walking with a friend!
Again, please let me know if you would like to sit down and talk about your risk factors, or actions you can take for prevention or diagnosis. We have many resources available in the Sun City area.
Lisa Dunbar, Parish Nurse
Dispelling Some of the Information About the COVID-19 Vaccine
As a Parish Nurse, the pandemic of COVID-19 has certainly brought many challenges in focusing on the health of our congregation. Currently, the challenge is to help our congregation members to understand, to make an educated decision, and to receive the vaccination.
I have found that the first hurdle is in educating our congregation. I have been able to put short articles in the church newsletter, and to send an all-church email that gave information about the vaccine. It focused on dispelling some of the misinformation being disseminated on the web. For instance:
Concerns have been expressed about the vaccine being developed so quickly. Is it safe?
Although we don’t have years of research, the companies developing the vaccines tested it on the usual number of people that they have tested before with any new drug or vaccine. The difference in the timing is because much of the governmental bureaucracy that slows down the process after the test is finished was mitigated. The testing itself was still completed in a manner similar to other vaccines. As with any new treatment, vaccine or drug, there are potential side effects, but for the vast majority of recipients, the benefit far outweighs the risk.
I have heard about people reacting to the vaccine and becoming very ill, or even dying. Is this true?
As with anything that we put into our body, we run a risk of being allergic to a substance in the medication or vaccine. At times, this may be a severe reaction called anaphylactic shock. In this case, the allergy may cause the body to swell tissues especially of the neck and trachea that may result in shortness of breath, a racing heart, and at its worse, a cardiac arrest. This is the reason that any recipient of the vaccine is required to remain at the site for 30 minutes after the injection as this is the time period where an anaphylactic reaction would take place. Each site is equipped with medical personnel and supplies to deal with this type of allergic reaction.
This happens very, very rarely. The current numbers are 11 reactions like this in 1 million recipients. These reactions may also occur after an influenza vaccination injection at a slightly lower rate. Although very serious for the 11, the 999,989 other recipients had no serious problems. A recipient of the vaccine may commonly have minor symptoms – a sore arm, muscle or joint pain, a low grade fever – similar to symptoms following other vaccinations. These are from an inflammatory response our body produces after a foreign substance has been introduced and usually only lasts 24-48 hours.
I have heard this vaccine may change my DNA. Is that true?
There is nothing in the vaccine to change our DNA. This vaccine is a new technology. In the past, vaccinations have carried in them a weakened amount of virus, which immediately stimulated our bodies to make antibodies to fight off the infection, The new Covid 19 vaccine has no weakened virus in it. Instead, it carries a message to our RNA to watch for an identifying factor on the virus – in this case a “spike” on the virus body. When our body recognizes that factor, it then begins very rapidly producing antibodies to fight the virus.
So a recipient may in fact “have the virus” for a short time before the antibodies are produced. It fights the virus before serious symptoms develop so one does not become ill. But it does raise the question of whether someone who has been vaccinated may still “spread” the virus even though they may have no symptoms. Studies continue to focus on this question. This is why even after vaccination, we may be required to wear masks in public places where social distancing is not possible.
Are fetal cells used in the production of the vaccine?
Fetal cell lines from fetuses in the 1960s and 1970s continue to be used in much of the early testing of many of our vaccines and other drugs. These tissues are registered and reported as the testing takes place. But no recent fetal tissue has been used in developing the Moderna or Pfizer Vaccinations. Other vaccines, notably the one from Johnson and Johnson, do continue to use more recently harvested fetal tissue in their development. There may be other companies as well.
After educating our congregation, the next step has been to identify those who are most vulnerable and require help in registering for the vaccination.
I began to make phone calls on those over 75, and those with chronic illnesses. Many had family or friends who were working with them to register for an appointment and who were willing to transport them to the appointment.
However, some of our congregants did not have access to a computer or were not able to complete the process on their own. I was able to assist them over the phone, at times registering them as my “family members” (after all, we are a church family!). I also helped to arrange transportation for those needing assistance.
Finally, I have continued to follow up with those registering – reminding them to take their ID and insurance card, walking them through the process at the sites, and informing them of the possibility of minor discomfort after that could be treated with Tylenol. I also continue to remind everyone to continue their social distancing precautions, handwashing, and wearing a mask.
Some in our congregation have chosen to wait to receive the vaccine. Some because of concern of long-term effects of the vaccine, others wish to wait for the vaccines with only 1 injection. I continue to share information with them, and to support them as they continue to follow the social distancing precautions and choose to remain limited in their social activities.