Puzzles To Remember

PUZZLES TO REMEMBER is a 501(c)3 organization that provides puzzles to nursing homes, veterans facilities, and other facilities that care for Alzheimer's and dementia patients. Puzzles To Remember was founded in 2008 by Max Wallack, who recognized the calming effect of puzzles and many other benefits on people suffering from Alzheimer’s disease. Max graduated from Boston University, Summa Cum Laude, in 2015, and from Harvard Medical School in 2020.

Beginning in 2020, Hailey Richman is the Executive Director of PuzzlesToRemember. Since 2011, Hailey has been distributing puzzles to nursing facilities around the globe. Hailey also spends time doing the puzzles with nursing home residents. She always brightens their days.  Hailey is also the founder of KidCaregivers.com, where she provides advice for children dealing with dementia in their family members. Hailey has begun a program called PuzzleTime which involves volunteer students going to nursing facilities and doing puzzles with their residents. Max serves as a mentor to the KidCaregivers program.

If you have puzzles that you would like to donate, please contact us at Puzzles2Remember@gmail.com and we will find a location near you where you can bring your puzzles. We can also provide you with a donation letter so that you can claim the value of your puzzles as a tax deduction.

To see a short video from WCVB Ch. 5 "BOSTON STRONG" about Max's efforts on behalf of Alzheimer's patients, click here.

To see a short video about Hailey's Puzzle Time Program, click here.

Sunday, January 24, 2010

What is Alzheimer's Disease ?


Alzheimer's disease is a physical illness that causes radical changes in the brain. As healthy brain tissues degenerate persons suffering from Alzheimer's experience a steady decline in memory and the ability to use their brain to perform tasks.

Alzheimer's disease is the most common form of dementia

Both Alzheimer's and dementia affect a person's memory, mood, and behavior.
  • Over time, a person with Alzheimer's disease has trouble remembering, speaking, learning, making judgments, and planning.
  • Persons suffering from Alzheimer's are often moody, restless, and sometimes mean.
  • Alzheimer's disease affects almost all aspects of brain functioning, including personality, and the ability to perform the most basic activities of daily functioning.
Memory difficulties and behavior changes can be early signs of Alzheimer's disease.

Alzheimer's disease is a an irreversible brain disorder with no known cure.

The cause of Alzheimer's disease is not yet known.

Alzheimer's disease is always fatal.
  • Alzheimer's disease is the most common form of dementia, accounting for as much as 70% of all cases of dementia.
  • Age is one of the most important risk factors for Alzheimer's disease. The percentage of persons suffering from Alzheimer's disease doubles every 5 years beyond the age of 65.
  • Women are more likely to develop the disease than men are – in part, because women live longer.
  • People who have a brother, sister, or parent suffering from Alzheimer's disease have a slightly higher chance of developing the disease. Right now about 3 percent have a proven hereditary link (genetics).
  • Heredity plays a much larger role in early-onset (before age 65) Alzheimer's. About 500,000 Americans suffer from early onset Alzheimer's. The number is growing.
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Symptoms Of Alzheimer's Disease
  • Memory loss
  • Changes in mood or behavior
  • Changes in personality
  • Loss of initiative
  • Difficulty performing familiar tasks
  • Problems with language
  • Disorientation to time and place
  • Poor or decreased judgment
  • Problems with abstract thinking
  • Changes in gait or walking
  • Misplacing things
Alzheimer's symptoms are often subtle at first. They start with slight memory loss, subtle changes in behavior, and confusion.

As Alzheimer's progresses memory problems persist and worsen.

People with Alzheimer's often:
  • Repeat themselves
  • Forget conversations
  • Routinely misplace things, often putting them in illogical locations
  • Have problems with abstract thinking
  • Are unable to maintain a schedule or keep appointments
  • Eventually forget the names of family members and everyday objects
One early sign of Alzheimer's is the inability to balance a checkbook or properly manage  finances. Eventually this worsens until a person has trouble recognizing and dealing with numbers.

Disorientation is another early sign of Alzheimer's. The inability to drive to and locate familiar places. The inability to find the bathroom in the home of a close friend or relative.

Persons's suffering from Alzheimer's disease often lose their sense of time, days, dates, and years.

They can find themselves lost in familiar surroundings.

Hoarding can be an early sign of Alzheimer's. Continually buying items like toilet paper, tooth paste, shampoo, or salad dressing can be a sign of mild cognitive impairment, Alzheimer's or dementia.

Personality changes can be an early sign of Alzheimer's. Constant worries about money. Accusing others of stealing or people talking about them behind their back are examples.

Behaviors include:
  • Mood swings
  • Distrust in others
  • Increased stubbornness
  • Social withdrawal
  • Depression
  • Anxiety
  • Aggressiveness
are all signs of Alzheimer's disease.


No single factor has been identified as the cause of Alzheimer's disease.

Currently, scientists believe that it may take a combination of genetic, lifestyle and environmental factors to trigger the onset of Alzheimer's disease.

The causes of Alzheimer's disease are not well understood.

The affects of Alzheimer's are well understood, Alzheimer's disease damages and kills the brain.

The ultimate cause of neuron death in Alzheimer's isn't known, evidence suggests that the abnormal processing of beta-amyloid protein may be the culprit.

The internal support structure for brain cells depends on the normal functioning of a protein called tau. In people with Alzheimer's, threads of tau protein undergo alterations that cause them to become twisted. Many researchers believe this may seriously damage neurons, causing them to die.

Risk factors

Alzheimer's usually affects people older than 65, but can affect those younger than 40. Less than 5 percent of people between 65 and 74 have Alzheimer's. For people 85 and older, that number jumps to nearly 50 percent.


Your risk of developing Alzheimer's appears to be slightly higher if a first-degree relative — parent, sister or brother — has the disease. Although the genetic mechanisms of Alzheimer's among families remain largely unexplained, researchers have identified several genetic mutations that greatly increase risk in some families.


Women are more likely than men are to develop the disease, in part because they live longer.


The same factors that put you at risk of heart disease may also increase the likelihood that you'll develop Alzheimer's disease. This includes:
  • High blood pressure
  • High cholesterol
  • Poorly controlled diabetes

Body and brain fitness helps ward off Alzheimer's.  Keeping your body fit isn't your only concern — you've got to exercise your mind as well. Some studies have suggested that remaining mentally active throughout your life, especially in your later years, reduces the risk of Alzheimer's disease.


In advanced Alzheimer's disease, people may lose all ability to care for themselves. This can make them more prone to additional health problems such as:
  • Pneumonia. Difficulty swallowing food and liquids may cause people with Alzheimer's to inhale (aspirate) some of what they eat and drink into their airways and lungs, which can lead to pneumonia.
  • Infections. Urinary incontinence which increases the risk of urinary tract infections. Untreated urinary tract infections can lead to more-serious, life-threatening infections.
  • Injuries from falls. People with Alzheimer's may become disoriented, increasing their risk of falls. Falls can lead to fractures. In addition, falls are a common cause of serious head injuries, such as bleeding in the brain.
Tests and diagnosis

Doctors can diagnose Alzheimer's disease. However, Alzheimer's disease can only be diagnosed with complete accuracy after death via a brain autopsy.

To help distinguish Alzheimer's disease from other causes of memory loss, doctors typically rely on the following types of tests.

Lab tests

Blood tests may be done to help doctors rule out other potential causes of the dementia, such as thyroid disorders or vitamin deficiencies.

Neuropsychological testing

Sometimes doctors undertake a more extensive assessment of thinking and memory skills. This type of testing, which can take several hours to complete, is especially helpful in trying to detect Alzheimer's and other dementias at an early stage.

Brain scans

By looking at images of the brain, doctors may be able to pinpoint any visible abnormalities — such as clots, bleeding or tumors — that may be causing signs and symptoms.

Magnetic resonance imaging (MRI). An MRI machine uses radio waves and a strong magnetic field to produce detailed images of your brain. The entire procedure can take an hour or more. MRIs are painless, but some people feel claustrophobic in the machine.

Positron emission tomography (PET) can reveal areas of the brain that may be less active and the density of amyloid plaques.

Computerized tomography (CT). For a CT scan, you lie on a narrow table that slides into a small chamber. X-rays pass through your body from various angles, and a computer uses this information to create cross-sectional images, or slices, of your brain. The test is painless and takes about 20 minutes.

Treatments and drugs

Currently, there is no cure for Alzheimer's disease.

Only two types of medications have been proved to slow the cognitive decline associated with Alzheimer's.

Cholinesterase inhibitors

This group of medications — which includes donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne) — works by improving the levels of neurotransmitters in the brain.

Unfortunately, cholinesterase inhibitors don't work for everyone. Only about out half the people who take these drugs show improvement. Some people are forced to stop taking these medications due to side effects, which include diarrhea, nausea and vomiting.

Memantine (Namenda)

The first drug approved to treat moderate to severe stages of Alzheimer's, memantine (Namenda) protects brain cells from damage caused by the chemical messenger glutamate.

Namenda is often used in combination with a cholinesterase inhibitor. Memantine's most common side effect is dizziness, although it also appears to increase agitation and delusional behavior in some people.

Lifestyle and home remedies

A healthy lifestyle may help prevent or postpone the development of Alzheimer's disease. Because Alzheimer's is most common in people over the age of 80, delaying the onset of the disease could increase the probability that people will die of other causes before Alzheimer's has a chance to develop.

Eat your veggies

Maintaining a healthy weight and eating a healthy diet appears to reduce the risk of developing Alzheimer's disease.

Eating a Mediterranean diet is often suggested:
  • Lots of fruits and vegetables
  • Fish or poultry, instead of red meat
  • Whole-grain breads and cereals
  • Alternate sources of proteins, such as beans, nuts and seeds
  • More olive oil and less saturated fat
Exercise your body
Higher levels of physical activity have been associated with a lower incidence of Alzheimer's disease.

Exercise your brain

Maintaining mental fitness may delay onset of dementia. Some research shows that lifelong mental exercise and learning may promote the growth of additional synapses, the connections between neurons, and delay the onset of dementia.


Right now, there's no proven way to prevent the onset of Alzheimer's disease.

You may be able to reduce your risk of Alzheimer's disease by reducing your risk of heart disease. Many of the same factors that increase your risk of heart disease can also increase your risk of dementia. The main players appear to be blood pressure, cholesterol and blood glucose levels.

Keeping active — physically, mentally and socially — also seems to reduce the risk of Alzheimer's disease.

Early onset Alzheimer's disease

The term early onset refers to Alzheimer's that occurs in a person under age 65. Early onset individuals may be employed or have children still living at home. People who have early onset dementia may be in any stage of dementia – early, middle or late. Experts estimate that some 500,000 people in their 30s, 40s and 50s have Alzheimer's disease or a related dementia.

More About the Alzheimer's Reading Room

Bob DeMarco is the editor of the Alzheimer's Reading Room and an Alzheimer's caregiver. Bob has written more than 1,050 articles with more than 8,000 links on the Internet. Bob resides in Delray Beach, FL.

The Alzheimer's Action Plan: The Experts' Guide to the Best Diagnosis and Treatment for Memory Problems

Original content Bob DeMarco, Alzheimer's Reading Room

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PUZZLES TO REMEMBER was founded in 2008 by Max Wallack, in memory of his great-grandmother, Gertrude Finkelstein, who died of Alzheimer's disease in 2007.
Puzzles To Remember is registered in Massachusetts as a public charity. Contributions are welcome, and are tax deductible under sec. 501(c.)3 of the Internal Revenue Code.

For more information, write to us at Puzzles2Remember@gmail.com