Dr. Jacqueline DuPont is a gerontologist who completed her graduate work in Gerontology at USC and the Geriatric Education Center at the Keck School of Medicine.
(Paris) — Brain and blood chemistry changes that indicate Alzheimer’s disease can be detected 10 to 20 years before memory loss and other cognitive symptoms develop, according to doctors studying families with inherited forms of the disease.
Studying people genetically destined to develop Alzheimer’s disease at a young age will help researchers understand the changes that occur prior to the development of the “type of Alzheimer’s everyone recognizes — the [non-inherited] form of the disease that typically strikes people in their 60s, 70s, and 80s,” says John C. Morris, MD, of Washington University in St. Louis.
Morris heads the Dominantly Inherited Alzheimer Network (DIAN), which is recruiting about 400 people whose families harbor genetic mutations that virtually guarantee a person will develop Alzheimer’s at the same young age as the parent, usually before age 60.
As part of the NIH-funded program, participants will also be enrolled in clinical trials of potentially disease-modifying drugs that target the underlying processes thought to cause Alzheimer’s disease.
The hope is that such drugs will work early on to delay mental decline and slow the progressive degeneration of brain tissue. Currently available drugs like Aricept, Cognex, Exelon, and Razadyne boost mental functioning in a small percentage of people for a time, but none halts the inevitable progression of the disease.
Because study participants are almost certain to develop Alzheimer’s disease at a young age, fewer of them need to be followed for a shorter amount of time to show a drug works in the early stages of the disease than if high-risk people in the general population are studied, says DIAN member Randall Bateman, MD, also of Washington University in St. Louis.
The cholesterol-lowering statin drugs that have revolutionized the prevention and treatment of heart disease were first tested in people with an inherited form of high cholesterol, Bateman tells WebMD.
September 30, 2009
Jane Glenn Haas
Our Health column
Orange County Register Columnist
People want to grow old in their own homes. The question family members have to ask and answer: Are the elders safe at home?
Web sites offering tips on how to hire a home caregiver ( aarp.org, for example) stress working with bonded and licensed caregivers, with agencies known in the community and so on.
But none of these measures will guarantee an elder’s safety like the ability to keep a watchful eye on them, says Jacqueline DuPont, a gerontologist who operates Irvine Cottages in Orange County and Assured InHome Care in Orange and Los Angeles counties.
For more than a decade,, DuPont has advocated for putting cameras in care rooms.
“Cameras protect everyone, from the elder to the care worker,” she says.
A court case followed the first cameras you installed in Irvine Cottages, with some people charging that they were an invasion of privacy.
Cameras in the bedrooms in assisted-living homes benefit everyone – from the person being cared for to the care worker.
We can monitor for personal abuse and neglect, yes, but, at the same time, the cameras protect caregivers from accusations that are false.
I know you won that court case. But in the cottages, cameras are professionally installed. What about in the home?
There is not a lot of control in home care and that is a concern.
With Alzheimer’s and dementia patients, I feel they should be in a skilled setting, such as Irvine Cottages, where they can be closely monitored.
But in home care, fewer people are watching. That makes cameras more crucial. Spy cameras (a camera hidden in a common household item) work well. Recording devices are helpful. And there should be safety measures in the home – like alert systems attached to the patient’s clothing or bed alarms.
The crux of it is safety. When a person is cared for at home, not a lot of people are constantly there.
Sounds as if you don’t trust caregivers to do their job.
Most families are hiring someone they don’t know that well.
It’s important to be up front about the cameras. Both sides want to be open to the best they can give.
Cameras protect the care workers from delusional behavior, from accusations that are false such as “the caregiver stole from me” or “the caregiver hit me.”
All of our caregivers are bonded, and we only hire caregivers willing to work where there are monitor cameras. About 50 percent say they won’t, so they go someplace else.
If you can hire a caregiver who is open to drug testing, is bonded and covered by worker compensation and agrees to camera monitoring, you are pretty sure you will be getting a great caregiver.
Will your agency, Assured InHome Care, help families set up these cameras?
Of course, we will work with the families on all issues.
What does it cost to have a home-based caregiver?
Costs range from $17 to $25 an hour.
But remember, caregivers are usually not full time.
There are a lot of visiting volunteer associations that help keep elders at home – like Meals on Wheels, for example. And day care outside the home at a licensed facility is another option.
The important consideration is that the elder is well cared for and the family feels secure with that care.
For more information, see asssuredinhomecare.org.