On February 7^th at 5:30 P.M. The Arts Council of Southwestern Indiana, 

will be presenting Wicker vs. Graham Poetry Bout. This event will be held

at The Bower-Suhrheinrich Foundation Gallery, located at 318 Main Street

in downtown Evansville. It will feature a cocktail hour from 5:30 to 6:30 P.M.

followed by a poetry showdown from University of Southern Indiana Professors,

Marcus Wicker and Matthew Graham. The event is free and open to the public.

Marcus Wicker is the author of Maybe the Saddest Thing (Harper

Perennial), selected by D.A. Powell for the National Poetry Series.

He holds an MFA in creative writing from Indiana University. Wicker’s

awards include a 2011 Ruth Lilly Fellowship, as well as fellowships from

Cave Canem, and The Fine Arts Work Center. Marcus is an assistant

professor of English at the University of Southern Indiana and poetry

editor of Southern Indiana Review.

Matthew Graham is the author of three books of poetry, World

Without End, New World Architecture, and 1946, and is the recipient

of a number of awards and fellowships from The Academy of American

Poets, the Indiana Arts Commission, and the Vermont Studio Center. He

teaches creative writing at the University of Southern Indiana.

USI alumna Dr. Jennifer Titzer is the 2013 winner of the American Association of Colleges of Nursing (AACN) Excellence in Advancing Nursing Practice Award for an outstanding capstone from a student in a Doctor of Nursing Practice (DNP) program.

Titzer graduated with the DNP from USI in 2013.  In her capstone project, titled Nurse Manager Succession Planning: Strengthening Health Systems for the Future, Titzer developed and implemented a model for strategic succession planning for the chief nursing officer in a large hospital system.

Titzer was nominated for the award by Dr. Maria Shirey, her faculty mentor and a former USI associate professor of nursing.

Dr. Sheila Hauck of St. Mary’s Medical Center helped Titzer implement the program at St. Mary’s. Hauck was a member of USI’s first graduating class in the master’s-level nursing program, when she completed a post-master’s certificate in the family nurse practitioner track. In 2011, she was among the first graduates of USI’s DNP program.

Read more about the project on the AACN website.

Titzer also was recently accepted as a participant in the Nurse Faculty Leadership Academy (NFLA) developed by Sigma Theta Tau International honor society of nursing in partnership with the Elsevier Foundation. The objective of the NFLA is to enhance the personal leadership development of new nurse faculty in order to promote faculty retention and cultivate high performing, supportive work environments.

By

Roy M. Arnold MD

As the population ages, the number of persons living with dementia is increasing. This column will discuss the most common causes of dementia, how they are manifested and how they may be delayed or prevented. First, what is dementia? Dementia is the acquired and persistent manifestation of brain function affecting recent memory, decision-making, and expressive speech sufficient to impair daily functioning. It may initially express itself as misplacing things, forgetting conversations or repeating questions. Speech may be impaired by not being able to find the right words for an action or object. Decision-making impairment may be manifested by forgetting to pay bills or disorganization.

The most common cause of dementia is Alzheimer’s disease which is characterized by accumulation of amyloid plaques and a tangling of nerve fibers in the brain. It accounts for 60-80% of all dementia and is the fifth most common cause of death in the US. The second most common cause of dementia is Vascular Dementia which accounts for 10-20% of cases. It is caused by recurrent tiny vascular occlusions throughout the brain causing mini-strokes. When the damage becomes widespread, dementia can result. The remaining 10-20% of cases are caused by a variety of conditions such as Lewy body disease, frontotemporal dementia, alcoholism, Creutzfeldt-Jacob disease and normal pressure hydrocephalus. Rarely infections or nutritional deficiencies may cause dementia. Fewer than 2% of cases of dementia are due to a correctable cause such as infection, normal pressure hydrocephalus, nutritional deficiency or depression.

Dementia is rare prior to age 50, occurs in about 2% of those aged 60-69, but increases to 20-25% in those aged 80-89. The sex distribution is equal in males and females, however in absolute numbers more women are afflicted because women tend to live longer.

Dementia is usually diagnosed by clinical examination and by history. Special testing such as neuropsychologic testing or brain imaging is often performed. Unfortunately, treatment for Alzheimer’s disease and other forms of dementia is limited. Only 2 categories of drugs have been studied in treating Alzheimer’s dementia. First are cholinesterase inhibitors such as Aricept, Exelon and Razadyne. Multiple studies have shown that these drugs can delay the progression of mild cognitive impairment 12-24 months. In the long run however they do not have an effect on overall cognitive decline, disability or death. The second class is NMDA inhibitors of which only one, Namenda is approved in the US. This drug works through a different neural pathway and can improve short term memory function, and decision-making temporarily. It’s effects are not long-lasting and are similar to the cholinesterase inhibitors. Neither of these categories of drugs have been thoroughly studied in other types of dementia, although they are commonly used off-label for those disorders. Several studies have shown promising results using anti-oxidants such as Vitamin E and beta-carotene. More studies need to be done before any firm conclusions can be drawn about the efficacy or lack thereof.

How can persons lessen their chances of developing dementia? First and foremost, the healthier one is entering the seventh decade of life (60+) the less likely one is to develop dementia. Physical conditioning through exercise has a protective effect against dementia that lasts as long as the physical conditioning continues. Being at or near Ideal Body Weight also has a protective effect.

Intellectual activities and cognitive training can stimulate brain function and delay the onset or progression of dementia. Reading educational books, magazines or online publications, brain games, learning a new skill like another language, a new pastime like knitting, cooking or gardening can improve cognitive function later in life.

Social activities like volunteer work, civic or social clubs, or even political activities can lessen cognitive decline.

Healthy diet is important in maintaining overall health, as well as building cognitive functioning. A diet rich in fruits and vegetables, high in protein and with limited amounts of animal fat and alcohol can delay the progression from normal intellectual functioning to cognitive impairment. This effect may be related to the higher antioxidant content of such a diet.

In summary, get fit, stay fit, eat healthy, interact socially, and stimulate your intellect. Even if mild cognitive impairment already exists, these steps have been shown to substantially delay progression. Those of you with loved ones who are experiencing early signs of cognitive impairment, should encourage them to engage in some of these activities after consulting with their healthcare providers.

The Alzheimer’s Association (www.alz.org) has a wealth of information on their website and a local chapter. They can be found on the web at www.alz.org/kyin