by National Institute on Aging

Alzheimer’s disease is complex, and it is therefore unlikely that any one drug or other intervention will ever successfully treat it in all people living with the disease. Still, in recent years, scientists have made tremendous progress in better understanding Alzheimer’s and in developing and testing new treatments, including several medications that are in late-stage clinical trials.

Several prescription drugs are already approved by the U.S. Food and Drug Administration (FDA) to help manage symptoms in people with Alzheimer’s disease. And, on June 7, 2021, FDA provided accelerated approval for the newest medication, aducanumab, which helps to reduce amyloid deposits in the brain and may help slow the progression of Alzheimer’s, although it has not yet been shown to affect clinical symptoms or outcomes, such as progression of cognitive decline or dementia.

Most medicines work best for people in the early or middle stages of Alzheimer’s. However, it is important to understand that none of the medications available at this time will cure Alzheimer’s.

Treatment for mild to moderate Alzheimer’s

Treating the symptoms of Alzheimer’s can provide people with comfort, dignity, and independence for a longer period of time and can encourage and assist their caregivers as well. Galantamine, rivastigmine, and donepezil are cholinesterase inhibitors that are prescribed for mild to moderate Alzheimer’s symptoms. These drugs may help reduce or control some cognitive and behavioral symptoms.

Scientists do not yet fully understand how cholinesterase inhibitors work to treat Alzheimer’s disease, but research indicates that they prevent the breakdown of acetylcholine, a brain chemical believed to be important for memory and thinking. As Alzheimer’s progresses, the brain produces less and less acetylcholine, so these medicines may eventually lose their effect. Because cholinesterase inhibitors work in a similar way, switching from one to another may not produce significantly different results, but a person living with Alzheimer’s may respond better to one drug versus another.

Medications that target the underlying causes of a disease are called disease-modifying drugs or therapies. Aducanumab is the only disease-modifying medication currently approved to treat Alzheimer’s. This medication is a human antibody, or immunotherapy, that targets the protein beta-amyloid and helps to reduce amyloid plaques, which are brain lesions associated with Alzheimer’s. Clinical studies to determine the effectiveness of aducanumab were conducted only in people with early-stage Alzheimer’s or mild cognitive impairment. Researchers are continuing to study whether this medication works to affect a person’s rate of cognitive decline over time.

Before prescribing aducanumab, doctors may require PET scans or an analysis of cerebrospinal fluid to evaluate whether amyloid deposits are present in the brain. This can help doctors make an accurate diagnosis of Alzheimer’s before prescribing the medication. Once a person is on aducanumab, their doctor or specialist may require routine MRIs to monitor for side effects such as brain swelling or bleeding in the brain.

At age 94, Rose Burgess had already lost two military veteran husbands, and was legally blind. Her daughter had just died unexpectedly, and she would soon have no place to live. Police Deputy Chris Dyer was on duty when Rose walked in with nowhere else to go. He knew homelessness was dangerous enough for the young, but it could be a death sentence within weeks for Rose. He also knew just where to turn for help, and immediately sent an e-mail to GCVF, Gold Coast Veterans Foundation… “All Hands On Deck!”

The charity in Camarillo, known for rescuing the most damaged homeless veterans, jumped into action. But they quickly found that virtually all public or private agencies providing housing assistance were prohibited from helping Rose. According to government rules, she was plenty rich enough to fend for herself.

The annual income needed for someone to afford a 1 Bedroom apartment in Oxnard is over $60,000 and Rose’s fixed income was $3300 a month. Even though that‘s twenty grand short of the real-world need, it was above the government ‘low-income” assistance threshold. But Rose had also leased a Subaru so her daughter could take her on errands. She had several storage units, and was paying storage for a vintage mid-century travel trailer. These expenses put her even further away from being able to pay rent.

“We’ve helped thousands of veterans and family members, and rescued 87 from homelessness,” says GCVF’s Director Bob Harris; “but this is the first time we had to rescue a 94-year-old blind widow because 12 social service agencies refused to help her… we never saw that one coming.” He adds; “Of course the system doesn’t want to cause harm to people like Rose, but that income threshold was going to put her out on the street regardless.”

St. Vincent de Paul of Ventura, and individual police officer donations covered an emergency motel room for Rose, keeping her safe until GCVF could find a long-term solution. GCVF began the enormous task of condensing her storage, finding a buyer for the trailer, finding an affordable ‘senior living’ apartment for Rose, and getting her moved in before the motel funding ran out. Case manager Donna Lockwood took Rose to Kirby Subaru in Ventura, who very graciously took the car back without any of the typical ‘early termination’ penalties or fees.

Rose was finally able to have a home. Rescue team leader Rafael Stoneman personally covered several urgent expenses, and United Way of Ventura provided funds for move-in costs; GCVF was then able move her into a senior living apartment with meals. After getting everything into one storage locker, they helped sell the trailer to a man who plans to restore it with his wife into a vacation home. In a rather poignant twist, the man’s father is a Vietnam combat veteran.

“We catch the veterans that fall through the cracks” is one of GCVF’s slogans; this time they caught an elderly veteran widow before she was homeless. “We make these miracles happen every day, but we can’t do it alone,” says Harris; “United Way and St. Vincent de Paul, Deputy Chris Dyer and his fellow officers, and the fantastic people at Kirby Subaru all pulled together to rescue Rose. We need the whole community’s support to make this same miracle happen tomorrow.”

Gold Coast Veterans Foundation is the region’s leading nonprofit for veterans, providing everything to reduce and eliminate suffering & homelessness for military veterans and family caregivers. Comprehensive, integrated services are provided free of charge at a walk-in / no-appointment service center. http://www.gcvf.org (805) 482-6550

Editor note: Because Rose is living at a government facility we were not able to get her photo.

VCAAA’s HICAP team tackles Medicare Open Enrollment questions and concerns 

The Ventura County Area Agency on Aging’s Health Insurance Counseling & Advocacy Program (HICAP) is tackling all questions and concerns related to Medicare Open Enrollment by hosting a variety of one-stops throughout Ventura County beginning October 15^th. Services will be offered virtually and in-person on a case-by-case basis through December 7^th. All services are free and open to the public. 

The transition to Medicare can be daunting and understanding plan options and the costs associated with each is often overwhelming. The VCAAA’s HICAP team is made up of highly trained counselors who provide free and unbiased assistance to Medicare recipients. Counseling services vary and are based on individual needs. Other services provided include a full assessment through the VCAAA’s Benefits Enrollment Center to determine eligibility for a variety of other benefits and services. 

Medicare Open Enrollment One-stops are currently by appointment only. Online and telephone options are available. No walk-ins will be accepted. All COVID-19 safety protocols will be in place.

Please visit www.vcaaa.org to complete the HICAP Part D/MA Comparison Form or call (805) 477-7300 ext. 5 for more information or 800-434-0222. For additional information or to make an appointment, e-mail [email protected].

This project was supported, in part by grant number 90SAPG0094-02*, from the U.S. Administration for Community Living (ACL), Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official ACL policy.

A draft of the Ventura County Master Plan for Aging is now available for the public to review and the Ventura County Area Agency on Aging (VCAAA) is seeking feedback from the community. The draft of the Plan can be found at www.vcaaa.org.

Older adults now make up more than 23 percent of Ventura County’s population, with the number projected to increase to 30 percent over the next decade. In 2019, Governor Newsom issued an Executive Order (N-14-19) calling for the creation of a Master Plan for Aging, which is a blueprint for state government, local government, the private sector, and philanthropy to prepare the State for the coming demographic changes.

The County of Ventura convened a panel of stakeholders in October 2019 to start the process of talking about the reality and the challenges of growing older in Ventura County and what is needed to make the county more livable. The State issued their Master Plan for Aging in January 2021, and the County of Ventura has drafted a more localized Plan.

“The County of Ventura is committed to evolving to navigate the unique needs of older adults and people with disabilities in our community,” the Plan states. “While the focus is on aging, there is an equal focus on optimally aging across the lifespan because a Master Plan for Aging is for everyone in the community. Moreover, we also know that older adults and people with disabilities have common issues, though other challenges are unique.”

The Plan continues, “As the Master Plan for Aging was developed, there was also special focus on areas of import to Ventura County. Those focus areas are diversity, equity, and inclusion. The County has always been cognizant of the diversity in our County, racially, ethnically, culturally, and linguistically and has made continual refinements in how we provide services and connections to resources to ensure we operate through a lens of diversity, equity and inclusion.”

In doing so, the VCAAA is seeking feedback from the community and welcomes comments, feedback, and corrections during the month of October 2021.

“Responses from the community are critical to developing a successful Master Plan for Aging,” said Victoria Jump, Director of the VCAAA. “We want to hear directly from our County’s older adults, people living with disabilities, caregivers, and all those navigating services to optimize aging for themselves and for loved ones. We want this Plan to be reflective of the real-life experiences of those we are serving, and we want the community to have an active role in the final product.”

All public comments may be sent to [email protected]. For additional information please visit www.vcaaa.org.

The Ventura County Area Agency on Aging, an agency of the County of Ventura, is the principal agency in Ventura County charged with the responsibility to promote the development and implementation of a comprehensive coordinated system of care that enables older individuals, caregivers, and individuals with disabilities to live in a community-based setting and to advocate for the needs of those 60 years of age and older in the county, providing leadership and promoting citizen involvement in the planning process as well as in the delivery of services.

by National Institute on Aging

Alzheimer’s disease is a brain disorder that slowly destroys memory and thinking skills, and, eventually, the ability to carry out the simplest tasks. In most people with Alzheimer’s, symptoms first appear later in life. Estimates vary, but experts suggest that more than 6 million Americans, most of them age 65 or older, may have dementia caused by Alzheimer’s.

Alzheimer’s disease is currently ranked as the sixth leading cause of death in the United States, but recent estimates indicate the disorder may rank third, just behind heart disease and cancer, as a cause of death for older people.

Alzheimer’s is the most common cause of dementia among older adults. Dementia is the loss of cognitive functioning — thinking, remembering, and reasoning — and behavioral abilities to such an extent that it interferes with a person’s daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for help with basic activities of daily living.

The causes of dementia can vary, depending on the types of brain changes that may be taking place. Other dementias include Lewy body dementia, frontotemporal disorders, and vascular dementia. It is common for people to have mixed dementia — a combination of two or more types of dementia. For example, some people have both Alzheimer’s disease and vascular dementia.

Alzheimer’s disease is named after Dr. Alois Alzheimer. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary, or tau, tangles).

These plaques and tangles in the brain are still considered some of the main features of Alzheimer’s disease. Another feature is the loss of connections between neurons in the brain. Neurons transmit messages between different parts of the brain, and from the brain to muscles and organs in the body.

How is Alzheimer’s disease diagnosed? Doctors use several methods and tools to help determine whether a person who is having memory problems has Alzheimer’s disease.

To diagnose Alzheimer’s, doctors may:

Ask the person and a family member or friend questions about overall health, use of prescription and over-the-counter medicines, diet, past medical problems, ability to carry out daily activities, and changes in behavior and personality.

Conduct tests of memory, problem solving, attention, counting, and language.

Carry out standard medical tests, such as blood and urine tests, to identify other possible causes of the problem.

Perform brain scans, such as computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET), to support an Alzheimer’s diagnosis or to rule out other possible causes for symptoms.

These tests may be repeated to give doctors information about how the person’s memory and other cognitive functions are changing over time.

by National Institute on Aging

As you get older, your doctor may recommend more vaccinations, also known as shots or immunizations, to help prevent certain illnesses.

Talk with your doctor about which of the following vaccines you need. Make sure to protect yourself as much as possible by keeping your vaccinations up to date.

Coronavirus (COVID-19) is a respiratory disease that causes symptoms such as fever, cough, and shortness of breath. It can lead to serious illness and death. Studies show that COVID-19 vaccines are effective at keeping people from getting COVID-19. Getting a COVID-19 vaccine will also help keep you from getting seriously ill even if you do get COVID-19.

Flu, short for influenza, is a virus that can cause fever, chills, sore throat, stuffy nose, headache, and muscle aches. Flu is very serious when it gets in your lungs. Older adults are at a higher risk for developing serious complications from the flu, such as pneumonia.

The flu is easy to pass from person to person. The virus also changes over time, which means you can get it again. To ensure flu vaccines remain effective, the vaccine is updated every year.

Everyone age 6 months and older should get an annual flu vaccine, but the protection from a flu vaccine can lessen with time, especially in older adults. Still, you are less likely to become seriously ill or hospitalized because of the flu if you get the vaccine. A flu vaccine is especially important if you have a chronic health condition such as heart disease or diabetes.

There are flu vaccines designed specifically for people age 65 and older. Medicare will pay for the vaccine, and so will private health insurance plans. You can get a flu vaccine at your doctor’s office or local health department, as well as at some grocery and drug stores. The vaccine ingredients are the same wherever you receive it.

Pneumococcal disease is a serious infection that spreads from person to person by air. It often causes pneumonia in the lungs and it can affect other parts of the body.

Shingles vaccine for older adults. Shingles is caused by the same virus as chickenpox. If you had chickenpox, the virus is still in your body. The virus could become active again and cause shingles.

Shingles affects the nerves. Common symptoms include burning, shooting pain, tingling, and/or itching, as well as a rash with fluid-filled blisters. Even when the rash disappears, the pain can remain. This is called post-herpetic neuralgia, or PHN.

The shingles vaccine is safe and it may keep you from getting shingles and PHN. Healthy adults age 50 and older should get vaccinated with the shingles vaccine, which is given in two doses. (Zostavax, an earlier shingles vaccine, is no longer available in the United States.)

You can get the shingles vaccine at your doctor’s office and at some pharmacies. Medicare Part D and private health insurance plans may cover some or all of the cost. Check with Medicare or your health plan to find out if it is covered.

What are some side effects of getting a vaccine? Common side effects for all these vaccines are mild and may include pain, swelling, or redness where the vaccine was given. Before getting any vaccine, talk with your doctor about your health history, including past illnesses and treatments, as well as any allergies.

It’s a good idea to keep your own vaccination record, listing the types and dates of your shots, along with any side effects or problems.