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Practical Tips for Daily Life

Activities of daily living are divided into two major categories. The first, often called instrumental activities, includes more complex types of activities such as paying bills, shopping, managing medications, working and driving. The second category is activities related to personal care and include eating, bathing, dressing, getting in or out of bed or a chair and using the toilet. In the beginning of the disease, the patient will have trouble completing the instrumental, complex activities. As the disease progresses, the person will have difficulty managing the more basic functions and will need help from caregivers.

Topics

Alleviating Symptoms

Living with the symptoms of neurodegenerative disease can be frustrating, difficult and even scary. The first step is to recognize that these behaviors are part of the changes in the brain. The person has little or no control over them and isn't behaving this way on purpose. Often times, behavioral and environmental changes can help prevent or stop these behaviors. For some symptoms, medication may be helpful.

Aggression

Aggressive behavior may become more common in some forms of dementia due to the brain’s inability to control impulsive actions.

Tips for preventing aggression

  1. Ensure the person does not have pain and see the person's regular doctor for any illness. A change in behavioral symptoms may be triggered by even minor illnesses such as a cold or by pain such as arthritis.
  2. When talking to the person, do not use sarcasm or abstract thinking. Instead, be concrete.
  3. Reduce external distractions when talking, e.g., TV, radio, busy places.

Overview

Dementia can be caused by a number of different conditions; it is a symptom of neurodegenerative diseases like Alzheimer's, frontotemporal dementia or corticobasal degeneration. The term "dementia" describes a progressive, degenerative decline in cognitive function that gradually destroys memory and the ability to learn, reason, make judgments, communicate and carry out daily activities. While it often includes memory loss, memory loss by itself does not mean that a person has dementia. Dementia affects 17–25 million people worldwide.

Dementia is not a specific disease; it is a collection of symptoms that can be caused by a number of disorders, including neurodegenerative disease. The term "dementia" describes a progressive decline in memory or other cognitive functions that interferes in the ability to perform your usual daily activities (driving, shopping, balancing a checkbook, working, communicating, etc.). The deterioration is more than might be expected from normal aging and is due to damage or disease.

Keith Vossel, MD

Assistant Professor of Neurology

Dr. Keith Vossel received his MSc degree in biomedical engineering and medical degree at the University of Tennessee, Memphis. He completed medical internship at Brigham and Women's Hospital and neurology residency at Massachusetts General and Brigham and Women's Hospitals, Harvard Medical School, where he served his final year as chief resident. Dr. Vossel completed behavioral neurology fellowship with Dr. Bruce Miller at the University of California, San Francisco (UCSF) and postdoctoral training in neurodegenerative disease with Dr. Lennart Mucke at the Gladstone Institute of Neurological Disease.

In addition to caring for patients, Dr. Vossel is working at the Gladstone Institute of Neurological Disease, where he investigates mechanisms and novel treatment approaches for neural network dysfunction in Alzheimer's disease, with focus on the tau protein and axonal transport. Dr. Vossel is leading a clinical trial at UCSF to investigate seizures and epileptic activity in neurodegenerative disease. He is a recipient of the Paul Beeson Career Development Award in Aging Research, through the National Institute on Aging and American Federation for Aging Research, and the John Douglas French Alzheimer's Foundation Distinguished Research Scholar Award.

William Seeley, MD

Associate Professor of Neurology

Dr. Seeley attended medical school at the University of California at San Francisco (UCSF), where he first encountered patients with frontotemporal dementia (FTD) in 1999, during a research elective with Dr. Bruce Miller. He then completed a neurology residency at Harvard Medical School, training at the Massachusetts General and Brigham & Women's Hospitals. Returning to UCSF for a behavioral neurology fellowship, with Dr. Miller, Dr. Seeley developed expertise in the differential diagnosis and treatment of patients with neurodegenerative disease. He is currently an Associate Professor of Neurology at the UCSF Memory and Aging Center, where he participates in patient evaluation and management.

Dr. Seeley’s research in his Selective Vulnerability Research Laboratory concerns regional vulnerability in dementia, that is, why particular dementias target specific neuronal populations. Dr. Seeley addresses this question through behavioral, functional imaging and neuropathology studies. The goal of his research is to determine what makes brain tissues susceptible or resistant to degeneration, with an eye toward ultimately translating these findings into novel treatment approaches.

Howard Rosen, MD

Associate Professor of Neurology

Dr. Rosen is a behavioral neurologist. He received his medical degree from Boston University School of Medicine, trained in internal medicine at the Albert Einstein College of Medicine in New York, and subsequently completed a neurology residency at UCSF. After residency, Dr. Rosen pursued fellowship training in brain imaging at the Washington University School of Medicine, and then returned to UCSF to join the team at the Memory and Aging Center (MAC) in 1999.

Dr. Rosen’s primary research interest is in the effects that atypical neurodegenerative diseases, in particular frontotemporal dementia, have on the brain, especially the emotional systems. His current projects use psychophysiology and imaging to examine how these diseases affect self-awareness, and to determine how imaging and other biological markers can be used to track and to anticipate how these disease affect the brain over time. He is also director of education and outreach for the education core in UCSF’s Alzheimer’s Disease Research Center.

As part of the MAC and the UCSF Department of Neurology, he participates in the training of medical students, residents and fellows, and participates in the evaluation of new patients in the MAC clinic as well as the continued management of care for some of these individuals in the continuity clinic.

Photo by Elisabeth Fall

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