1. Heart disease
2. Cancer (lung, breast and colorectal)
3. Stroke
4. Chronic Obstructive Pulmonary Disease (associated with lung cancer, emphysema and smoking)
5. Alzheimer's Disease
6. Diabetes
7. Accidents
8. Pneumonia and influenza

Some surprising facts:

Colorectal Cancer - This is often thought of as a "man's disease," but as many women as men (28,000) die from this disease each year.

Stroke - Women make up two thirds of the 163,000 people dying of stroke each year in the U.S. Stroke is the number three killer of women but also a leading source of disability among women.

Diabetes - An estimated 5 million Americans have diabetes and don't know it. Since they do not get treatment they only become aware of their disease when they develop life-threatening complications, including blindness, kidney failure and severe nerve damage.

Falls - One out of every three people over 75 falls each year. Almost eight thousand women die from these falls.

ALZHEIMER'S AND ESTROGEN

As you can see, Alzheimer's Disease ranks fifth among the leading threats to women's health. Almost 42,000 women die from Alzheimer's each year. This is double the number of male deaths.

Why does Alzheimer's Disease affect so many women? Until recently scientists speculated that this was because women live longer than men. Dementia (including Alzheimer's) strikes half of all people over 85. Most of these victims are women because there are many more "eighty-something" women than men.

But now scientists have uncovered a surprising new culprit.

Post-mortem studies by a team from the University of Chicago report that women with Alzheimer's have a lower estrogen level in their brains than women without the disease.  Doctors think that a deficiency of brain estrogen causes the build up of the brain "plaque" that characterizes Alzheimer's.

This study was led by Dr. Rena Li, senior author of the paper and principal scientist/associate professor at Sun Health Research Institute in Sun City, Arizona. Dr. Li and her colleagues conducted the first study of brain estrogen, rather than blood estrogen, in women.

Hormone replacement therapy works on raising the estrogen in the bloodstream. It has not been particularly successful as a defense against Alzheimer's and it carries an unacceptable risk of breast cancer, heart disease and stroke. But this new development allows scientist to focus on raising estrogen in the brain as a means to protect women from Alzheimer's.

Stereotypic movement disorder is characterized by repetitive, but non-functional motor behavior which has lasted at least 4 weeks.

The causes of this disorder, when it occurs in the absence of other conditions, are unknown. The movements appear to increase with stress, frustration, and boredom.

While everyone else seems to be reveling in holiday spirit, it may be just another day for an Alzheimer's patient who has lost cognitive skills. For that person's family, there may seem to be little to celebrate as they care for a person who may not even know who they are. It could feel as if they lost their loved one and ended up with a stranger.

Even when [Mom] was struggling to speak, the word she used the most often was "love."

When people hear the word "Alzheimer's," it seems so final. However, this was not so. It somehow brought out a potential that was never there before.

• Lisa had my parents' apartment redone while my parents were in New Jersey at the seashore. She brightened up the apartment and added several conveniences that make their lives a little easier.
• Tim and Nance had my parents' seashore home redone while my parents were away. The house is very old, and they redid several parts of the house to update it and make it more modern and comfortable.
• My brother Owsley is the "shadow." He watches my parents like a hawk. He lives with them, cooks for them, and cleans up behind them. He has an amazing eye for detail, so he spots things that need doing before they become a problem.
• Tim goes on daily morning walks with Mom. Physical exercise is supposed to help slow her Alzheimer's. Tim has been known to get Mom out of bed to walk with him.
• Lisa picks my Mom up a couple times a week and drives her all around doing errands, shopping for clothes, having her hair done, and taking her out to lunch.
• Lisa and John often walk Mom and Dad home after they eat dinner each evening at their nearby restaurant.
• Nancy, Timmy and their family stop by frequently to visit Mom and Dad and to check on them.
• Lisa helps out at my father's office in Media. She goes through my mom's old clothes to help get her clothes cleaned and to update and simplify her wardrobe.
• Everyone checks on my parents' refrigerator and throws out old foods.
• Everyone checks my parents' answering machine to field calls that my parents have missed.
• Everyone helps drive my parents around, even though they still have their car.
• Everyone asks my parents to their home for visits and meals.

My Dad is a much happier man. He seems less grumbly and out of sorts these days.

OUR NEXT CHALLENGE

Our next challenge is looming on the horizon: Florida. What to do about Mom and Dad when they make their annual pilgrimage to Key Largo. They are snow birds, and the icy roads and the freezing temperatures around Philadelphia are making Mom yearn for the sunny South.

Thanks to Dad's tirade, he and Mom have a real support system at their home base in Media. But if they decide to return to Florida, what kind of support will they have? We can all visit them, but it won't be the same.

Stay tuned.

A team of scientists from Alzheimer’s Disease International estimate 24.3 million people currently suffer from dementia. Cases are rising by 4.6 million a year or one every 7 seconds.

Without prevention, the number will hit 42 million in 20 years and nearly double again by 2040 with the bulk of the increase in India, China, south Asia and the western Pacific.

Surprisingly, the number of people with Alzheimer's Disease will be three to four times higher in developing countries than in developed regions.

The rate of growth of Alzheimer's Disease is also disturbing. Any disease that doubles every 20 years is a potential global disaster. If we follow the projections:

• 24 million people with Alzheimer's in 2005
• 42 million people in 2020
• 81 million people in 2040
• 160 million people in 2060
• 320 million people in 2080
• 640 million people in 2100
• 1 billion-plus people with Alzheimer's in 2120

What is causing this global doubling of Alzheimer's Disease? Part of the reason is that more people are living longer. Alzheimer's disease only affects 3 percent of the population who are under 60, but it hits 30-40% of all people living past the age of 80.

Developing countries have given little attention to Alzheimer's Disease because of people's relatively short life span. Health agencies in the developing world must turn their attention to Alzheimer's soon. By 2020 more than 75% of all people with dementia will be from the developing world. (See manbir-online.)

Weblogs are the place for daily stories, impassioned reactions, mundane details, and miscellanea. They are as varied as their maintainers, and they are creating a generation of involved, impassioned citizens, and articulate, observant human beings.

 

They are a training ground for writers -- and there is fine writing being posted daily on hundreds of sites. They are platforms for intelligent reaction to current events and ubiquitous pundits. They are repositories of Web trivia. They are desktop broadcasting. They are, as one early weblogger put it, pirate radio on the Web.

The Pew Internet and American Life Project estimates one in every five teenagers on the Internet keeps a blog. That translates into nearly 4 million teens talking about interests, writing about feelings and sharing personal information via dozens of popular online journaling Web sites like Xanga.com and MySpace.com.

• It's a diary -- A blog is very personal. It lets you share things you normally wouldn't share with anyone. But somehow it feels safe to share it on a blog.
• It's a filter -- The Internet is vast. Bloggers are passionate about some narrow subject. They know a lot about this subject and they have strong opinions. Bloggers filter the infinite information on the web and compress it to small, manageable chunks, with an edge.
• It's real-time -- A blog is updated daily. You can count on new information every day.
• It's a revolution -- Blogging is simple and free. Everyone can blog. You don't need an agent, an editor or a publishing house. You go online, set up a blog (see below), and start writing whatever comes out of your head. Millions of people around the world start blogs every day.

START YOUR OWN BLOG

If you want to start a social blog, then you can go to MySpace.com or Xanga.com.

To start a general-purpose blog about any topic, go to Blogger.com. It takes three steps to start a new blog on Blogger. If you have something on your mind, you can be sharing it with the world in under ten minutes.

Blogging is a global phenomenon. For a mind-boggling look at look at blogs from around the world, click on the "Random Blogs" and the "Blogs of Note" links on the Blogger.com page. Click on the "Next Blog" link and you can scroll through blogs like channel surfing. Spend a few minutes surfing the blogs and you'll be amazed at this new avenue for self-publishing.

• Four states (Massachusetts, Montana, Minnesota and Hawaii) have no standards. Only six states require sprinklers in all facilities. Fewer than half the states require smoke alarms that alert fire authorities.
• Thousands of smaller, unlicensed facilities never receive visits from fire and building inspectors.
• Four out of every ten state fire marshalls say that their state's safety standards are "poor or weak."

If you or a loved one is moving into a nursing home or assisted-living facility, be sure to check on its fire safety standards. This is a life or death matter that, unfortunately, you can't take for granted.

Every year, Americans lose more than $40 billion to telemarketing fraud. More than one-half of the victims of these crimes are older people. Illegal telemarketers direct anywhere from 56 to 80 percent of their calls at older consumers1. As the number of Americans over age 65 dramatically rises in the next two decades, seniors will become an increasingly inviting target for criminals who steal with telephones.

Studies show that many older people do not make the connection between illegal telemarketing and crime. They may not understand that dishonest telemarketers are not shrewd business people but criminals who are trying to steal their life savings.

Sensors are placed throughout the home: at the refrigerator, in the bathroom and at the front door, among other locations. When someone opens the refrigerator door to get breakfast, for example, the sensor detects the movement and logs it by sending a wireless message to a base station.

 

... It also calls under certain conditions that could indicate a fall or other emergency, such as a person failing to leave a bedroom in the morning or remaining in the bathroom too long.

• Physical ailments such as high blood sugar, diabetes, Parkinson's Disease, heart disease
• Emotional ailments such as anxiety and depression
• Excessive use of alcohol
• Fatigue
• Certain medications including statin drugs
• Drug interactions
• Aging (some memory loss begins normally after the age of 50)
• Non-Alzheimer's Dementia
• Alzheimer's Disease

For a comprehensive look at memory loss go to the Wrong Diagnosis website and look at the article on Forgetfulness.

NON-ALZHEIMER'S DEMENTIA

Alzheimer's Disease is the most common form of dementia. But what is dementia? According to a CNN Health/Library report (from MayClinic.com):

Dementia is a neurological disorder that affects your ability to think, speak, reason, remember and move. While Alzheimer's disease is the most common cause of dementia, many other conditions also cause these symptoms. Some of these disorders get worse with time and cannot be cured. Other types can be treated and reversed.

The three most common forms of dementia are Alzheimer's disease, vascular dementia and Lewy body dementia. Sometimes, a person can have more than one of these problems at the same time.

Vascular dementia occurs when blood arteries feeding the brain become blocked or constricted, often due to high blood pressure or a stroke. A person can suffer from Alzheimer's Disease and from vascular dementia at the same time. Symptoms of vascular dementia include difficulty thinking, speaking, seeing, walking, and loss of bladder control.

Lewy body dementia occurs when round bodies begin growing inside of cells in the midbrain, beneath the cerebral hemispheres. Symptoms of Lewy body dementia mimic symptoms of Alzheimer's Disease and Parkinson's Disease, including confusion, loss of memory and judgment, and a shuffling gait and flexed posture.

Still other forms of dementia include:

• Frontotemporal dementia - Affects the lobes of the brain used for judgment and social behavior. It often occurs between the ages of 40 and 65 and seems to run in families.
• Huntington's Disease - This hereditary disease often occurs between the ages of 30 and 50. Symptoms include jerky limbs, clumsiness and muscle weakness. Dementia develops as the disease progresses.
• Parkinson's Disease - Characterized by tremors, speech impairment and a shuffling gait. Dementia may occur late in the disease.
• Creutzfeldt-Jakob Disease - Extremely rare in the past, but now receiving attention due to the emergence of of mad cow disease caused by human consumption of beef from contaminated cattle.

TREATABLE DEMENTIA

If you become aware of memory loss in yourself or others, it's best to be optimistic. Many mild forms of memory loss can be caused by temporary conditions such as health issues, depression, or drug interactions. The best course of action is to overcome your fear and go see a doctor. It is likely that the doctor will find a cause that you can treat such as:

• Your reaction to a medication
• A metabolic abnormality such as decreased thyroid function
• A nutritional deficiency such as dehydration or a deficiency of Vitamin B-1 or B-6
• Emotional issues such as depression and anxiety
• Infections such as meningitis, syphilis, encephalitis or HIV

All the above are treatable and your memory can be enhanced or restored. But the important thing is to go to the doctor and get a full evaluation so you can do what's needed to recover.

Although nutrition may have little effect on how Alzheimer's disease progresses, it's important for your loved one to eat a variety of foods, particularly fruits and vegetables.

Poor nutrition can result in physical weakness, increasing the likelihood of falls and fractures. It can also reduce the efficiency of the immune system, making it less able to fight off disease and heal wounds. Malnutrition and dehydration may increase confusion and stress, and reduce your loved one's ability to cope.

"I'VE GIVEN UP COOKING."

Mom told me recently, "I have given up cooking. I've cooked for over sixty years. I'm tired of cooking. I've given it up."

At first I took this on face value. But then I thought that perhaps her Alzheimer's Disease was a factor in her giving up cooking. Cooking is a pretty detailed process: there's shopping, bringing dozens of items home, organizing them in your kitchen, reading cookbooks, following recipes, measuring out and mixing different ingredients, cooking and serving different dishes, all at the same time. Cooking is complicated. Maybe it's too complicated for Mom.

I give Mom credit for recognizing this and for devising a classy story to cover her decision to quit cooking.

IT'S JUST LIKE HOME

So if Mom has "given up cooking," how do she and dad eat?

Mom may have given up cooking, but she still makes breakfast. Each morning in her apartment, Mom makes cereal, tea, and coffee for herself and dad. She takes a lot of pride in her breakfasts. It helps her self-esteem to feel in control and serve Dad a meal each day, just as she has done throughout their marriage.

How about lunch and dinner? Mom is fortunate that her husband is the owner of D'Ignazio's Towne House Restaurant, which is only a block away from hers and dad's apartment. She and dad eat breakfast in their apartment, and they eat lunch and dinner at the Towne House.

I was talking with Mom yesterday. She said she loves going to the Towne House. "When I get to our little booth in the bar," she told me, "I feel I'm home." She should. She has been sitting in this same little booth for decades. It really is home.

It also has an added value: lots of mingling with other people. Mom gets lots of social interaction and stimulation -- so valuable for fighting her Alzheimer's -- each day at the restaurant.

She and Dad are in the spotlight the moment they sit down. Having them there regularly is valuable. They are the face of the restaurant --  its stars. The Towne House and my parents have been there together for 50 years.

Both of my parents are real characters. This can make them tough to deal with as parents. But the restaurant's customers love them. Customers show their affection by visiting my mom and dad's booth and chatting with them, teasing them, flirting with them, reminiscing, and swapping stories. It is entertaining just sitting at their booth.

FADING SENSE OF TASTE AND SMELL

It is a blessing that my mom and dad have the restaurant. Whenever I go with Mom to a different restaurant, something bad happens. She is never happy with her meals. The rest of us don't see anything wrong with the food, but it is a rare meal that meets mom's expectations.

According to the CNN Health/Library report:

The senses of taste and smell tend to diminish with age. So even healthy seniors often eat less because food doesn't smell or taste as good as it once did. Alzheimer's disease seems to inhibit eating even further.

This is true of Mom when she dines away from my dad's restaurant. Perhaps the unpredictability of food in other restaurants is what affects Mom. She orders. Her food arrives at the table. Invariably she is surprised by how it looks. She tastes it. It is either too much, or it doesn't have enough seasoning, or it has the wrong texture. There is always something wrong.

Mom gets agitated. She has a small tizzy. Then she shuts down and retreats inside herself.

This pattern repeats itself over and over.

At Dad's restaurant it's different. The servers know Mom and her quirks. They cater to Mom gently, responding quickly to her every whim. The food is always the same. The table is set the same way. The decor is the same. Nothing changes. This familiarity of routine is critical for a person with Alzheimer's. And it keeps Mom happy.

IF YOU DON'T HAVE YOUR OWN RESTAURANT

The CNN article gives lots of tips to help you make your loved one's meals more smooth and successful:

* Look for non-Alzheimer's causes for eating problems, including ill-fitting dentures; health problems such as diabetes, heart disease, or stomach problems; medications (such as pain-killers and antidepressants) that stifle a senior's appetite.

* Call your loved one at mealtimes to remind them and to walk them through a safe, healthy meal preparation.

* Store prepackaged meals in your loved one's refrigerator for easy access and "fast-food" preparation.

* Stock your loved one's cupboard with brightly covered plates and utensils. Studies show that persons with Alzheimer's eat 25 percent more when they have brightly covered dinner utensils.

* Reduce distractions at mealtimes. People with Alzheimer's are easily agitated by change and hubbub. Standardize the mealtime into a regular routine.

* Divide a meal into many little meals. For example, make breakfast into three mini-meals: a juice meal, an eggs meal, and a toast and cereal meal.

* Remind your loved one to chew and swallow carefully. Give them as much time as they need to eat. Don't rush them. (Be familiar with the Heimlich Maneuver and the new, easier guidelines for CPR.)

* Make eating physically easy. Serve meals on a nonskid surface like a wet towel or a place mat with a rubbery mesh. Switch from plates to bowls to make eating easier. Switch from a fork to a large-handled spoon.

* Concentrate on morning meals. Studies show that people with Alzheimer's are more alert and hungry in the morning.

Alzheimer's Disease is one of the most feared illnesses of our time. With baby boomers aging, it threatens large portions of our society -- those who get Alzheimer's and their families, who will most likely take care of them.

The amount of stress that caregivers go through in the course of this disease is absolutely enormous. There is a study that 50% of Alzheimer's caregivers are going through clinical depression

 

... If you can imagine a disease that requires 24 hours of your day, 7 days a week, without vacations, that puts a financial strain on you, that is taking away one of the people you love most from you, that is Alzheimer's.

This is a film that is filled with heroes ... The patients and family members are heroes. The toll on a family member to try to take care of someone with Alzheimer's [is huge.] Most people try to keep their family member with Alzheimer's at home for as long as they possibly can. They put off a decision for nursing-home care until it's absolutely unavoidable. And that unconditional, unwavering love is one of my most moving experiences in making this film.

I'm losing my mind but the essence of a person is their heart. I hope that as I grow older I'll still be able to laugh, and I'll still be able to hug, and I'll still know love.

I think one of the reasons this disease is so terrifying ... is that it robs you of who you are. It takes away the very essence of your humanity: your memories, your place in society, your relationships to other people, your loved ones, your friends, your community. And because it happens slowly and insidiously and over a long period of time, it's even worse for the family to watch as their loved one just disappears before their eyes.

Keep all alcohol in a locked cabinet or out of reach of the person with AD [Alzheimer's Disease]. Drinking alcohol can increase confusion.

Discourage the use of alcohol, which may make the patient feel "better" for a while. After the euphoria wears off, it can trigger feelings of depression.

My mom likes to drink. Back in the 1950s and 1960s, it was the custom to drink a lot. Now Mom drinks one or two rum and cokes each day at lunch. At night she either has wine or a couple of mixed drinks. Her reaction to alcohol fits the descriptions above. She becomes animated for a short while after drinking. Then she sometimes (not always) seems to retreat inside herself. Sometimes after drinking she appears confused; sometimes depressed.

It is better that Mom not drink at all. In fact, my father has tried many times to wean Mom from alcohol. He has tried kidding her, cajoling her, teasing her, and forbidding her to drink.

Nothing works.

(So far he hasn't tried the "locked cabinet" approach.)

The flip side to drinking is that it is something Mom wants to do and that, at least briefly, gives her pleasure. She is 81 years old, she doesn't drink to excess, and what other "perks" does she have to look forward to each day?

Will the alcohol hasten the progress of Alzheimer's in Mom's brain and nervous system? Or does it give a little boost to her quality of life?

Friends and family were still hunting for Hooks when a Smithfield police officer knocked on Betty Hooks' door.

"It's been a heavy burden," Betty Hooks said. "I did the best I could, but you can only do so much."

The deeper you research a topic [like life after death], the harder it becomes to stand on unshifting ground. In my experience, the most staunchly held views are based on ignorance or accepted dogma, not carefully considered accumulations of facts. The more you expose the intricacies and realities of the situation, the less clear-cut things become.

Alzheimer's still has no cure, but some medications can stabilize the symptoms and slow the progression of the disease. This can improve quality of life for both the person with Alzheimer's and his or her caregivers. It may even delay placement in a nursing home.

In an interview that Tom and Joyce did on NPR, Joyce admitted that her quality of life suffered drastically after Tom came down with Alzheimer's. Joyce had been a practicing artist in Alexandria, Virginia, where she and Tom live. She had been forced to leave the studio where she had practiced for many years because she was no longer able to keep up her commitments and obligations to the community of artists. As Tom's personality faded and his needs increased, Joyce slipped into a deep depression. Antidepressant drugs were only partly successful. Joyce is still depressed. Meanwhile Tom's condition, ever so slowly, keeps getting worse.

Have life-extending Alzheimer's drugs helped Joyce DeBaggio?

Even the plans for committing Tom to an institution have been put on hold. The drugs have slowed the progress of the disease to the point that the moment for his switch to an Alzheimer's-care facility has become blurry and unclear. In the interview Tom and Joyce had an exchange about this. Joyce is waiting to hear from Tom that he is ready to leave her, to leave his home. Tom admitted he is ready. Perhaps this what Joyce needed to hear. But she isn't sure.

My wife has a friend who has a Down Syndrome child born without an esophagus. Thanks to medical technology her child has survived for fourteen years. But the cost to her and her single mother has been horrific, including dozens of major surgeries, millions of dollars in medical costs, financial bankruptcy, and years of unrelenting stress, roller-coaster mood swings, and anguish.

Have these medical advances improved the quality of life for these two people?

We have another friend who is 35 years old. Her mother has early-onset Alzheimer's Disease. She has had it for almost ten years. Yet, even now, she is only sixty-four.

This morning my wife Janet and I were discussing our two friends and the terrible caregiving responsibilities they wrestle with every day.

"Look at how much you worry about your mother," Janet said. "But she came down with Alzheimer's when she was in her late 70s and early 80s. Your family and your dad have to look after your mother. But, on the outside, she may have another ten years to live.

"That doesn't even begin to compare with our other two friends. They face being caregivers for decades to come. Medical miracles can prolong people's lives but they also stretch out caregiving into a faraway future. For our poor friends, there is no break, no relief, in sight. Their whole lives have been affected.

"Without the medical advances caregivers might have faced a relatively swift death for their loved one. The loss would have been painful for them. But it would have occurred quickly. They could have moved on with their lives.

"But that's not possible now. Now many caregivers are stuck in a kind of quicksand as they worry over their loved one who never gets better but who doesn't die either.

"Where is the quality of life in this picture?"