Download - 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