lupus cognitive dysfunction talk 2014

H O W T O I M P R OV E YO U R M E M O RY

LUPUS: MEMORY PROBLEMS

Donald Thomas, MD, FACP, FACR

Memory Problems ?

Hard to concentrate?

Fuzzy-headed?

Forgetful?

Memory Problems ?

Hard to concentrate?

Lupus Fog

Fuzzy-headed?

Forgetful?

Cognitive dysfunction

MEMORY PROBLEMS IN LUPUS

• 2010 study: Arthritis and Rheumatology:• Lupus patients = 50% • Rheumatoid arthritis = 61%• Multiple sclerosis = 75%

WHAT I WILL COVER

• Causes of memory problems in lupus• What to do about it:• You Game Plan!

DO I HAVE ALZHEIMER'S DISEASE?

• Alzheimer’s disease = degenerative process• Get’s worse over time• 6th most common cause of death in the USA• “Lupus fog” rarely gets worse• “Lupus fog” does not become Alzheimer’s disease

• Rare less than 60 years old

•ALZHEIMER’S

Poor judgment and decision making regularly

•LUPUS FOG•Make bad decisions occasionally

•ALZHEIMER’S

Poor judgment and decision making

•Can’t manage a budget

•LUPUS FOG• Make bad decisions

occasionally

•Miss monthly payment

•ALZHEIMER’S

• Poor judgment and decision making• Can’t manage a

budget

• Lose track of date/season

•LUPUS FOG

• Make bad decisions occasionally• Miss monthly payment

• Forget the date; remember it later

•ALZHEIMER’S

• Poor judgment and decision making• Can’t manage a budget• Lose track of

date/season

• Difficulty having a conversation

•LUPUS FOG

• Make bad decisions occasionally• Miss monthly payment• Forget the date;

remember it later

• Sometimes forgetting which word to use

•ALZHEIMER’S

• Poor judgment and decision making• Can’t manage a budget• Lose track of date/season• Difficulty having a

conversation

•Misplacing things; unable to retrace steps

•LUPUS FOG

• Occasional bad decisions• Miss monthly payment• Forget the date;

remember it later• Sometimes forgetting

which word to use

• Losing things from time to time

ACTION PLAN!

STEP 1:SEE A NEUROLOGIST?

• If > 60 years old• If early dementia runs in your family• If memory interrupts your life• See a neurologist• With special interest in dementia• Neuropsychologists• Dr. Majid Fotuhi

IRREVERSIBLE CAUSES

• Age• Genetics• Decreased kidney function• Chronic kidney disease

• Stroke• CNS lupus• Concussion• Closed head injury

TREATABLE CAUSES

• Depression • Fibromyalgia• Lack of exercise• High blood pressure, over weight, diabetes,

smoking, high cholesterol• Anxiety disorders• Lack of sleep• Antiphospholipid antibodies• Medications• Excessive alcohol

MEDICINES TO AVOID

• Ambien• Anti-histamines• Benadryl

• Benzodizepines• Valium • Ativan

• Opioid narcotics pain relievers• Tramadol• Hydrocodone• Oxycodone• Fentanyl• Morphine

TREATMENTS THAT DON’T WORK

• Gingko biloba• Multiple vitamins• Omega-3 fatty acid supplements• DHA supplements

• Soy protein supplements

TREATMENTS THAT PROBABLY DON’T HELP

• Antioxidant vitamins• Vitamin E, C, beta-carotene

• Vitamins B6, B12, and folic acid

TREATMENTS THAT PROBABLY HELP

TREATMENTS THAT PROBABLY HELP:OMEGA-3 FATTY ACID FOODS

TREATMENTS THAT PROBABLY HELP: MEDITERRANEAN DIET

TREATMENTS THAT PROBABLY HELP

TREATMENTS THAT PROBABLY HELP:FLAVONOID RICH FOODS

TREATMENTS THAT PROBABLY HELP

ALCOHOL SERVING PER DAY FOR WOMEN

TREATMENTS THAT DO HELP

• Cross-trains brain• Memorize steps• Forces Balance

• Listening• Decreases stress• Improves mood

D

A

N

C

E

7 MINUTE HIIT:HIGH INTENSITY INTERVAL TRAINING

LUPUS EXERCISE STUDY:138 WOMEN WITH SLE

• Non-exercisers• 23% with memory problems

• Over-weight• 23% with memory problems

LUPUS EXERCISE STUDY:138 WOMEN WITH SLE

• Non-exercisers• 23% had memory problems

• Exercisers• 5% had memory problems

• Over-weight• 23% had memory problems

• Normal weight• 6% had memory problems

TREATABLE CAUSES

• Depression • Anxiety disorders• Lack of sleep• Fibromyalgia• Lack of exercise• High blood pressure, over weight, diabetes,

smoking, high cholesterol• Antiphospholipid antibodies• Medications

TREATMENTS THAT DO HELP

Brain games without computerGet out of comfort zoneForce brain to do uncomfortable tasks

MEMORY IMPROVEMENT HABITS

MEMORY IMPROVEMENT HABITS