The hormone melatonin (treating dementia).

The hormone melatonin, released by the pineal gland and considered important in regulating sleeping behaviour, has been cited as a beneficial supplement for patients with sleep disturbances.

Sleep disorders and disruptive nocturnal behaviour associated with dementia present a significant clinical problem. A characteristic pattern of sleep disturbance referred to as 'sundowning' has been described. This shows itself in increased arousal and activity, usually in the late afternoon, evening or night and is a cause of increased stress for carers.

There is considerable theoretical evidence to support the use of melatonin as a treatment for sleep disturbance associated with dementia. Melatonin is a hormone implicated in the control of the sleep-wake cycle. It is stimulated during darkness and suppressed by light. While the effects of melatonin have been extensively studied in animals, there is growing evidence that melatonin is also involved in the regulation and control of sleep and waking patterns in humans. Dementia appears to disturb these patterns.

One small but well conducted study evaluated the effect of bright light therapy in combination with melatonin or a placebo on restless behaviour. Bright light therapy was found to help restless behaviour, but the addition of melatonin negated the effect. Further research in the use of bright light therapy is necessary. A review found evidence to support the use of light therapy from four small studies, but again with calls for replication of the findings.

Testing for alzheimer's.

1. Periods of memory loss which they often describe as absence. It's the loss of recall that they're describing, unfamiliar with what it really means;

2. Loss of cognitive ability for a period of time, usually fairly short, but recurring. One woman described her experience of getting into her car and looking down at the gas and brake pedals, suddenly aware that she had no idea what to do.

She consciously made herself relax, with slow breathing, and gradually the knowledge returned. She had this same experience in other situations and had had an MRI arranged by her doctor who had suspected she might have brain tumor. Which she didn't. Extensive testing had shown nothing to account for these difficulties.
3. In a more fearful person, these episodes cause tremendous terror reactions which may manifest outwardly as inexplicable attacks of rage or the sudden manifestation of heavy drinking issues;

4. Emotional outbreaks of an unexpected kind of may begin to occur, sudden weeping, loss of emotional control, wild accusations of a kind that might sound paranoid but are actually extreme fear reactions;

5. Stories of neighbors stealing, people breaking in, intruders, may mark this priod of time also;

6. Odd stories that don't make sense -- losing the car, driving off and finding it hard to get home.

Few people are both willing and able to share their sense of disquiet with family members, but some do. One woman, who had been dealing with an increasing sense of incapacity to carry on as before, said to hr husband one day, "I don't know what's going on but there's something very wrong with me. I just can't do these things any more. You're going to have to."

After medical investigation, she was diagnosed as having a dementia of the Alzheimer's type. And her husband did indeed begin to take over the tasks that had once been hers.

Their situation was unusual in that she was very open and honest. Even though everyone knows about Alzheimer's now, people are still seldom that honest with each other. Denial is still the most usual thing that happens.

I suppose that people still feel like little children -- that if they say nothing, then nothing will be the real answer. Our societal issues is that we've made dementias of the Alzheimer's type so fearful and awful that no-one wants to be around it, not even people who have it.

Maybe we start to think about how we need to change all that and have it be just one more illness that we could learn how to deal with.