Ask the Doctor

Resources for AD caregivers...therapy to help insomnia...memory problems and statins

People with a history of depression have been found, on average, to have a smaller hippocampus (the part of the brain involved in memory) and a thinner right cortex (mood),.

Click image to expand view. People with a history of depression have been found, on average, to have a smaller hippocampus (the part of the brain involved in memory) and a thinner right cortex (mood),.

Q I enjoyed the article on Alzheimer’s caregiving in the November issue. Do you have any suggestions for agencies that provide resources for caregivers?

A A number of agencies provide resources for Alzheimer’s caretakers. These include:

  • Eldercare Locator, a service of the Administration on Aging that provides information on local or state programs, 1-800-677-1116 or www.eldercare.gov.
  • Family Caregiver Alliance, a community-based nonprofit organization, provides information, education and services for caregivers. 1-800-445-8106. Online at www.caregiver.org.
  • Alzheimer’s Dementia and Caregiver Center. Provides information on caregiving and links to local or state respite care programs, among other services. Find it online at www.alz.org/care/overview.asp
  • Alzheimer’s Disease Education and Referral Center (ADEAR). Part of the National Institute on Aging, ADEAR offers information for patients, caregivers, and professionals, and identifies state, regional, and federally funded services available in the community. www.alzheimers.org/adear; 1-800-438-4380.
Q My arthritis pain makes it difficult to sleep at night, but I am wary of the negative brain effects of sleeping pills. Sleep hygiene and melatonin haven’t helped me. Any suggestions?
A You might consider addressing your insomnia with talk therapy, especially a type of therapy called cognitive behavioral therapy (CBT) for insomnia. CBT for insomnia is aimed at changing sleep habits and scheduling factors, as well as misconceptions about sleep and insomnia, that perpetuate sleep difficulties. It also emphasizes changing the way an individual thinks about situations that cause distress in an effort to change feelings and behavior. A July 13, 2015 online report in JAMA Internal Medicine suggests that CBT can significantly improve insomnia in people with physical issues such as chronic pain, and is especially beneficial for individuals with psychiatric disorders. To find a CBT therapist in your area, contact the National Association of Cognitive-Behavioral Therapists at www.nacbt.org.
Q My husband, 66, developed memory problems after beginning treatment last month with the statin Lipitor to lower his cholesterol. Is there anything he can do to preserve his memory and still lower his cholesterol?

A A study of nearly 1 million patients published June 8, 2015 in JAMA Internal Medicine suggests that your husband most likely has little to worry about. The researchers compared memory complaints among patients who were taking statin drugs, patients who were taking other types of cholesterol-lowering drugs, and those who were taking no cholesterol-lowering drugs. They found that patients who were taking either statins or other cholesterol-lowering drugs were more likely to report memory loss in the 30 days after they began drug therapy than those taking no drugs. However, because cholesterol-lowering drugs and statins vary so much in chemical structure, the researchers concluded that it was unlikely that the medications were causing the participants’ memory problems.

Instead, they theorize that the memory complaints are related to “detection bias”—heightened awareness of memory performance that is related to taking a new drug, visiting doctors more often, and paying closer attention to matters of health. Since abundant research suggests that long-term use of statins actually helps improve memory, your husband probably needn’t be concerned about short-term memory problems related to his statin medications. Nevertheless, if he continues to worry about memory loss, he should mention his concerns to his doctor and ask for further assessment.

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