Category / Alzheimers Dementia

Take a Break

June 25, 2020

Are you a full-time caregiver for someone with Alzheimer’s or dementia? A little breather may be just what you need.

Alzheimer's disease is life-changing for both those who are diagnosed and those close to them. Having a helping hand when you need it is key to keeping yourself, and your loved one living with dementia, healthy and happy.

When you need a break, consider adult day services.Not only is it good for you, but it’s good for your loved one. Adult Day Services offer people living with Alzheimer's and other dementias the opportunity to be social and to participate in activities in a safe environment.

Adult Day Services may be for you if:

  • You are a full-time caregiver: Adult Day Services can provide a much needed break. While your loved one is at adult day, you'll have time to rest, run errands or finish other tasks.
  • You work during the day: Adult Day Services can help you to balance a job with caregiving duties.
  • You want a safe, caring environment for your loved one:  Adult Day Service is a chance for your loved one to share time with their peers. It provides a chance for them to be social and to participate in engaging activities such as music and exercise programs, as well as fun outings. 

Did you know that Woodside Place of Presbyterian SeniorCare Network offers Adult Day Services at its campuses in Oakmont (412-828-5600) and Manchester Commons (814-838-9191)? We are here to help!

Taking a Familiar Walk: Dementia Amid COVID-19

June 12, 2020

A daughter experiences the neighborhood from her mom's perspective
By Laurie Matlin

My 95-year-old mother has reached the limits of her patience with the daughter in her basement. As one of her nine children currently helping out, I take no personal offense. Even for people without dementia, COVID-19 can complicate a well-planned life.

“I’m going away,” she declares one mid-spring day. “Everyone in this place has something to do but me!” My dad and I have just emerged from his office from where we ordered groceries online. She doesn’t understand this new system, and she believes I have overstepped my role.

Mom finds her wool coat and struggles with its zipper. Dad leans in to see how he can help. They turn to me, and I quickly zip the uncooperative coat.

As a power play among younger people who might wish to exert control, running away can be particularly problematic for people with dementia like my mom. Yet here we are, Dad and I both acting as accomplices as if Mom were a temperamental kindergartner bound to return before dinner.

She reaches for her hat and scarf. “Do you want the red one?” Dad asks helpfully. She ignores him and grabs the gray hat with matching scarf. Strands of frizzy silver curls slip out from under her cap, and she slides red Keds onto her feet. Wearing the same sweat outfit she has donned over the past few days, she suddenly looks more youthful.

“You can’t come with me!” she barks at me. Dad pleads for her to reconsider.

“I’m going away,” she declares one mid-spring day. “Everyone in this place has something to do but me!”

“I’m just going for the mail,” I tell her. Stay non-confrontational, I whisper to Dad.

With Dad on one side and me on the other, she manages a step from the front door, then another step off the stoop. Her eyes narrow, and she begins a steady pace along the front sidewalk.

She pauses at the driveway. “Which way did Sam go?” she says aloud to no one. Sam was my late brother with Down syndrome who regularly walked to a bus stop for his job.

Mom looks left, starts in that direction, then stops.

“There’s neighbors there,” she speaks again to herself, allowing me privileged insight as to how her mind is working.

Following Closely Behind

She glances in the opposite direction and sees a hill. “That’s too high,” she says, and I marvel how one part of her is speaking for another part to hear. She resumes her original direction, but now crosses the street.

“Hi Fran!” Pauline, the neighbor she sought to avoid, waves after watching for a bit. Mom makes no acknowledgement, her feet pattering on the pavement. Ten feet behind her, I serve as her shadow in stealth. I smile at Pauline, shaking my head and pointing to my ears to suggest Mom’s hearing inadequacies.

I follow Mom down the hill and around the bend. Tracking her requires few skills attributed to private eyes; I could have practically stepped on the back of her shoe without being spotted. While systematically on guard, she is less capable of easily turning around.

The neighbor teen on his driveway peers momentarily at this odd-looking lady who is overdressed in temperatures approaching 80 degrees. He smirks, resuming the whump, whump, whump of his basketball before pivoting in an easy layup.

From the other side, the mail truck approaches. The mailman looks at Mom as if he’s unsure how he might be of help. While swift for a person her age, Mom walks gingerly, almost like a child with autism, her big toe angling up, and it is perhaps this rigidity that alerts the viewer that something is slightly off. Mom slows at the tree, grabbing a branch. She seems to wish to wait for the mail truck to pass before resuming her plan.

It is at that moment that she turns around and finds me standing at her back. “Hi Mom! What are you doing over here?” I feign happy surprise that our paths should cross at just this moment. The ruse seems to work. “I am heading over there,” Mom points with no rancor in her voice.

I fall in line with her pace and we turn down another street. “The road is closed that way. Maybe we need to go a different way,” I suggest, pointing to the diamond-shaped construction sign. She continues past the sign. We proceed as two toddlers locked in parallel play, aware but not working at all together.

A Walk She Needed

“Where are you going?” I ask after a bit.

“Sam walked this way to catch the bus. It took him downtown,” she explains.

“And then what?” I ask.

“Who knows?” she replies without pausing. She tolerates my presence, perhaps welcoming another mind to support her if things turn rough. I marvel at the workings of her plan, as if following breadcrumbs left by Sam in a different time when buses operated because that’s what buses are supposed to do.

“Why do you want to go downtown?” I ask.

“I want to get to the railroad. Where my father worked,” she explains. She has talked recently about her need to get to her father at the train station, a commuter system that no longer exists in our town. Her father died a half-century ago.

She says she needs to rest and maneuvers herself atop a a tree stump cut at waist level. She watches the birds and feels the breeze, then eventually gets up to walk again.

“You’ve come an awful long way,” I suggest.

“I thank you for walking with me,” she says so softly I lean to hear her words. She still doesn’t look at me, but her voice conveys warmth that surprises me.

No answer.

“I wonder if we might turn around,” I probe gently.

“I’d like to get to the top of the hill,” she starts and then seems to change her mind. She turns around, like Forrest Gump who abruptly ends after running across the country.

“I thank you for walking with me,” she says so softly I lean to hear her words. She still doesn’t look at me, but her voice conveys warmth that surprises me. There is something she needed in this, I realize.

Life Is More Than Just Staying Alive

We continue silently, less fast-paced than on the outward jaunt. She rests at times, but then starts moving again. She reaches the side door to the garage.

“Do you need a hand?” Dad’s face suddenly appears at the doorway, surely watchful for her return.

“No, I can do it myself.” Her voice is resolute but without confrontation. Still, she takes his hand, then ambles up two steps.

When she turns, her eyes suggest a glimpse of a larger world. Her autonomy expanded just a little, other parts loosened from more rigid bounds. In this moment, her opinions still matter and her inner compass is shaken to new life. She looks straight at me.

“Thank you, Laurie,”she says, as if for that moment she can see me as something more than the invader in her land.

Life is more than just staying alive, her presence seems to say. Like unsteady feet on pavement, uncertainties will always arise. “Let life happen to you,” the poet Rilke wrote more than a century ago. “Life is in the right, always.”

The dual punch of dementia and COVID-19 is not easy, not even one little bit. But if we pay attention, maybe there’s still something we can learn.

By Laurie Matlin

Laurie Matlin is on personal leave from her job as a hospital and palliative care chaplain resident while she helps to care for her parents. A former journalist, she has been keeping a video diary of what she calls a sacred time in her family's life.    

Detecting Early Onset Alzheimer’s Disease in Innovative Ways

November 25, 2019

Thanks to new funding, research on biomarkers and blood tests moves forward
By George Lorenzo

The progression and symptoms of early-onset Alzheimer’s Disease, typically identified in patients in their 40s or 50s, can vary dramatically depending on the individual. According to the Alzheimer’s Association, “getting an accurate diagnosis of early-onset Alzheimer’s can be a long and frustrating process. Symptoms may be incorrectly attributed to stress or there may be conflicting diagnoses from different health care professionals.”

The Alzheimer’s Drug Discovery Foundation (ADDF) is working to eliminate such conflicts through its $50 million Diagnostics Accelerator program. It’s aimed at supporting the development of “novel biomarkers” for the early detection of Alzheimer’s and related dementias.

“The health of small blood vessels is an increasingly recognized component of dementia and AD.”

“We want to accelerate the science,” says Dr. Howard Fillit, founding executive director and chief science officer of ADDF. That means providing funding to support innovative research to quicken the process of developing and implementing clinical trials required for regulatory approval of Alzheimer’s diagnostic tools and programs.

Developing Biomarkers

The onset of Alzheimer’s, in general, is currently diagnosed through: mental and neuropsychological tests performed by primary care doctors and/or neurologists, along with a review of a patient’s medical history; genetic testing that identifies the APOE e4 gene associated with early-onset Alzheimer’s; a PET scan or invasive spinal tap that may reveal the presence of amyloid plaques and/or tau tangles in the brain and a CT or MRI that can identify vascular dementia.

All of these solutions are relatively expensive (excluding mental testing), time-consuming, challenging to take advantage of, and, in some cases, not administered properly nor proven to yield 100% valid results in diagnosing Alzheimer’s.

“We must now develop inexpensive and noninvasive biomarkers, preferably blood tests, that will help diagnose Alzheimer’s disease and track the effectiveness of treatments,” wrote Fillit in a recent article published in Scientific American.

4 First Round Award Winners

ADDF’s first round of award recipients, announced on May 30, 2019, allocated approximately $3.5 million to two Alzheimer’s diagnosis blood tests and two retinal imaging R & D programs. The four — Saliha Mussaoui, Amoneta Diagnostics, based in France; Kaj Blennow, University of Gothenberg, Sweden; Tom MacGillivray, University of Edinburgh, Scotland and  Peter van Wijngaarden, the Centre for Eye Research in Australia  — were chosen out of 300 applicants from 30 countries.

Creating a Blood Test to Identify Early-Onset Alzheimer’s

Amoneta is an affiliate of Firalis, a life sciences biotechnology company created by Dr. Huseyin Firat. Since 2014, Amoneta has conducted research and development for ultimately creating a valid blood test that can identify mild cognitive impairment (MCI) and early-onset Alzheimer’s.

The test, called MemoryLINC, is based on finding difficult-to-monitor and characterize lncRNAs (long noncoding ribonucleic acids) in blood panels. These lncRNAs regulate gene expression and diverse biological functions. “It is increasingly recognized that lncRNAs is tightly related to the pathogenesis and prevention and cure of AD (Alzheimer’s Disease),” notes a January 2019 study published in Pathology – Research & Practice.

Fillit says Amoneta has data indicating that certain RNAs are elevated in blood samples of people with Alzheimer’s that are relevant to learning and memory and the disease itself.

The MemoryLINC Project has reached its final clinical validation phase comprised of 800 subjects at 13 European clinical sites in France, Switzerland, Belgium and Turkey. Firat says “the MemoryLINC study is the most important clinical study ever done in this domain.”

Tau-related Research

The ADDF funding for Blennow’s project intends to develop brain-specific, tau-related blood tests to identify and monitor neurodegeneration. Tau is a protein contained in nerve cells. It resides in cerebrospinal fluid in the brain and spinal cord and can be gauged through an invasive and highly uncomfortable spinal tap. The aggregation and collapse of tau into tangles that elevate and spread throughout the brain is symptomatic of Alzheimer’s.

“Measuring tau in blood can be very useful,” Fillit explains. “But the problem is that tau is present in the blood in such low quantities as it relates to [Alzheimer’s] that, so far, we haven’t been able to measure it effectively.” Blennow, however, has discovered how to measure brain-specific tau fragments in blood.

Over the next two years, Blennow’s team will evaluate the presence of different levels of tau in blood samples. Many of these samples will be identified from a Swedish BioFINDER cohort at Lund University, which includes 600 cognitively healthy individuals, 500 patients with subjective cognitive dysfunction or mild cognitive impairment, and 100 patients with Alzheimer’s.

“This is an exploratory project aiming to develop a novel analytical method to establish robust blood biomarkers for tau,” Blennow explains.

Looking Behind the Retina

The other two ADDF-funded awardees are conducting research on imaging techniques and processes that can identify the possible unhealthy accumulation of amyloid plaques behind the retina, which is another symptom of Alzheimer’s. The Alzheimer’s Association’s “2019 Alzheimer’s Disease Facts and Figures” report noted that recent research has shown that the accumulation of amyloid in the brain “were significantly increased starting 22 years before symptoms were expected to develop.”

In addition to focusing on amyloid buildup, MacGillivray’s project is looking closely at vascular changes in the small blood vessels in the back of the retina, both of which can be seen with Optical Coherence Tomography (OCT) machines that are commonly utilized by ophthalmologists.

MacGillivray says the health of small blood vessels is an increasingly recognized component of dementia and Alzheimer’s. “We think we see differences in how wide or how narrow these blood vessels are, and also the number of blood vessels that fill the tissue space,” he notes.

“We are seeing potentially a dying lack of blood vessels or a less optimum range of blood vessels delivering oxygen and nutrients to vascular tissue, and this is then replicated in the brain,” says MacGillivray. “We have a quick and non-invasive way to see if blood vessels are changing [by utilizing relatively inexpensive OCT imagery scans] and degrading in a detrimental way inside the brain without having to go through expensive techniques such as MRIs and PETS.”

‘A Wealth of Information’

“Imagine a world where people who may have memory problems are referred by their primary care doctor to the ophthalmologist around the corner,” Fillit says. The ophthalmologist uses the OCT machine to see if there is an amyloid plaque buildup in the back of the eye. It could tell you whether a person is “cooking” Alzheimer’s or not, notes Fillit.

These same principles apply to Wijngaarden’s project, but with different mechanisms and equipment. This one also deals with looking behind the retina for amyloid plaques, but utilizes a sophisticated camera technology, called hyperspectral imaging. That technology can capture images behind the retina revealing different colors of light that correlate to early-onset Alzheimer’s based on amyloid plaque buildup.

“We can get a wealth of information about the structure of the back of the eye,” Wijngaarden says.

To support his research and ultimately incorporate it into everyday clinical practice, Wijngaarden has developed a low-cost portable camera for hyperspectral imaging of the retina. It’s being tested for use in routine eye exams where the camera will identify amyloid plaque buildup years before a patient might show signs of cognitive decline.

The Future

“What we want to do with the digital accelerator is advance these technologies, measuring things like function, cognition and a whole variety of other variables,” Fillit says.

How long will it take for such innovative technologies to possibly get government approval through clinical trials and validation and ultimately reach patients at their next doctor visit? Amoneta estimates that its blood test could be launched for use in clinics in the U.S. and Europe by 2021. The three other awardees all agree that it should take three to five years for their technologies to possibly become common practice in clinics.

By George Lorenzo

George Lorenzo is an independent writer and publisher from Ann Arbor, Michigan. He writes about aging at OldAnima.

Get by with a little help from Presbyterian SeniorCare Network

November 20, 2019

Get by with a little help from Presbyterian SeniorCare Network
Alzheimer’s support services are available across our Network

Alzheimer's disease is life-changing for both those who are diagnosed and those close to them. Having a helping hand when you need it is key to keeping yourself, and your loved one living with dementia, healthy and happy. When you need a little help or an ear to listen, support services are available.

Support groups

Often times, caregivers say they are looking for support from people who "really understand because they've been there." An Alzheimer's Support Group offers just that – a place for caregivers, family and friends of persons with dementia to meet and develop a support system.

Support groups offer a place to:

  • Exchange information on caregiving problems and solutions
  • Talk through challenges and ways of coping
  • Share feelings, needs and concerns

Presbyterian SeniorCare Network, in affiliation with the Alzheimer’s Association, holds support group meetings in various locations:

We hope you'll join us! 

6 Early Signs of Alzheimer’s Disease

November 4, 2019

Some believe that severe memory loss is a normal part of aging. This is not true. How can you tell the difference between age-related changes and Alzheimer’s disease? Here are six early signs to watch for—and what may just be age-related changes.

  1. Forgetfulness: Is recently learned information, such as today’s weather forecast, more frequently forgotten? Do you or a loved one forget important dates, locations or ask the same questions repeatedly? Age-Related: Sometimes forgetting dates or appointments but remembering them later.
  2. Problem Solving Challenges: Is following a plan or working with numbers more difficult? Is it often harder to make decisions or concentrate on doing familiar, everyday tasks, like driving to work? Age-Related: Making occasional planning or mathematical errors.
  3. Confusion with Time or Place: Do you or a loved one permanently lose track of the date or even forget where you are or how you got there? Age-Related: Losing track of the day of the week but remembering it soon.
  4. Vision Issues: Has judging distance, reading or recognizing color become an issue? Age-Related: Other visual changes, such as those related to cataracts.
  5. Trouble with Words: Is it harder to carry on conversations or find the right words for common topics when speaking or writing? Age-Related: Occasionally searching for the rights words.
  6. Personality Changes: Have you or a loved one started to avoid social activities or hobbies? Do you sometimes feel confused, suspicious, depressed or fearful? Age-Related: Sometimes avoiding social situations or wanting to do things your own way.

SOURCE: Alzheimer's Association

Memory Café: Savoring Special Moments

September 6, 2019

Respect for our elders is a canon we all try to be mindful of, but in today’s society, older adults with Alzheimer’s disease and related dementias often find themselves isolated from mainstream society as they lose their ability to follow “customary” social rules.

This often results in loneliness. Trips outside the home go from fun shopping trips and visits to a favorite restaurant, to only a trip to the doctor to address their disease. The fun seems to disappear and the individual living with the disease, and their caregiver, do not get enough interactions with others who genuinely understand their journey.

The good news is that there are places created specifically for these older adults and their caregivers to connect with other people who are on the same path. Where? At a Memory Café. These Memory Cafés provide important social interaction in an environment that everyone can enjoy.

Coming Together

In 1997, Dutch psychiatrist Bere Miesen introduced the idea of a place where those with Alzheimer’s and related dementias can intermingle and enjoy life in a warm and safe environment. The concept of Memory Cafés spread throughout Europe and were so well received that they eventually made their way to the U.S. In 2008, nationally renowned Alzheimer’s specialist Dr. Jytte Fogh Lokvig opened the first Alzheimer’s Café in Santa Fe, NM.

What is a Memory Café?

Those affected by memory loss and their care partners gather to talk, share and take a much needed break from the disease in an accepting, casual environment. Cafes are made up of a group of like-minded individuals run by compassionate volunteers and/or those who work in the field of dementia care. As of 2013, more than 85 Cafés are helping people enjoy more special moments together throughout the U.S., and that number continues to grow.

Although these Cafes all share the same fundamental goal of providing a fulfilling, enjoyable experience, no two Memory Cafés are exactly alike. That’s because each Café is a grassroots effort organized, operated and maintained by the people who attend them, giving every Cafe its own personality and flavor!

For instance, Memory Cafés offer a variety of fun, stimulating activities, from singing to crafting. Laughter, camaraderie and relaxation are mainstays, all to provide support for both caregivers and those who are cared for.

While each Café is different, they all serve an important role in our society today. Alzheimer’s diagnoses are multiplying annually, according to the Alzheimer’s Association. In the U.S., there are already more than 5.4 million people living with the disease today. While it can severely affect the individual with the diagnosis, memory loss also touches the lives of their caregivers and all of those who love them.

Find out if there is a Memory Café near you!

Presbyterian SeniorCare Network hosts free monthly Memory Cafes in three locations. These Cafes are designed exclusively for individuals with dementia and their caregivers and feature a casual, supportive environment full of conversation and meaningful connections.

Washington area

  • Where: Eat’n Park, 320 Oak Spring Rd, Washington, PA 15301 (reserved room)
  • When: Held on the 3rd Saturday of each month starting May 20
  • Time: 10:00 a.m. – 11:30 a.m.
  • RSVP not required – just pop on in! Coffee and cookies provided.

Oakmont area

  • Where: Somma Pizza, 380 Route 909, Verona, PA 15147 (private area)
  • When: Held on the 2nd Wednesday of each month starting June 14
  • Time: 11:30 a.m. to 1 p.m.
  • RSVP not required – just pop on in! Snacks provided.

Erie area

  • Where: Lincoln Community Center Library, 1255 Manchester Road, Erie, PA 16505
  • When: Held on the 2nd and 4th Tuesday of each month (hosted in collaboration with the Alzheimer's Association)  
  • Time: 10 a.m. to 12 p.m.
  • RSVP not required – just pop on in! Snacks provided

For more information, visit www.SrCare.org/cafe.

This Activities Program Engages and Calms People With Dementia

September 5, 2019

It tailors activities to each individual's abilities and interests
By Melba Newsome

For people with dementia, having nothing to do can contribute to agitation, frustration and a feeling of loss of control and well-being. It is a situation family caregivers often encounter.

Laura Gitlin, distinguished professor and dean of the College of Nursing and Health Professions at Drexel University in Philadelphia, has spent more than three decades developing non-pharmacological behavioral approaches to helping adults with dementia age in place.

“It’s important to assess not just what the person can’t do, but also what they can do.”

Gitlin’s most recent approach, the Tailored Activity Program (TAP), has been shown to help manage critical behavioral symptoms in people with dementia while reducing the caregiver’s burden.

Assessing Abilities and Interests

TAP is an individualized, family-centric program that provides people with dementia activities tailored to their abilities and interests. TAP also includes training for both formal and informal caregivers on how to use activities as part of daily care routines.

“Engagement is an enduring need throughout the disease process, but there hasn’t been a protocol for using an activity-based approach before,” says Gitlin. “TAP is very oriented and focused on how we can improve engagement and meaningful activities at any stage of dementia.”

In randomized clinical trials, TAP improved quality of life for people with dementia by reducing behavioral symptoms, improving their engagement in activities, and providing caregivers with an effective tool. TAP can help with behavior issues, such as agitation, aggressiveness, irritability, restlessness and apathy.

Activities for Different Disease Stages

As dementia patients decline in mental abilities, they often experience challenges in cognitive function that increase negative reactions to their environment.

Many times, family caregivers overestimate or underestimate the capability of their loved ones with dementia. When this happens, they may prescribe activities or communicate in a way that falls below or above their loved ones’ abilities, which can lead to frustration and upset for both parties.

“It’s important to assess not just what the person can’t do but also what they can do, as well as their interests, and set up the environment to support that person,” Gitlin says.

TAP identifies patient interests and evaluates their abilities to perform activities tailored specifically for them. This provides a way for them to positively re-engage with their environment.

The program is delivered or supervised by occupational therapists and can be integrated into home care, or used as part of other caregiver support programs in care settings. The program involves three phases:

  • Identify the capabilities, physical functioning and previous and current interests of the person with dementia
  • Develop “activity prescriptions” for the person’s capabilities, an activity schedule and specifications for setting up and effectively engaging the person in the activity
  • Train caregivers to use these prescribed activities

The activities could be physical — such as balloon toss, chair aerobics or a walk with a companion — crafts or games, but they should be of interest to the person.

“We have a protocol to help determine what could be most meaningful to that person and how to set that up,” explains Gitlin. “We use the same approach regardless of the type of dementia for those who have challenges with executive function when interacting with their physical and social environment.”

Success Stories Using TAP

Gitlin gave an example of how TAP worked well for one woman with dementia who lives in a memory care facility. Because the woman was frequently agitated, it led to some disruption at the facility.

Through a TAP assessment of the woman, the caregivers discovered that she had worked in a laundry business before she developed dementia. Using that knowledge, the caregivers provide the woman with a basket of clean clothes or towels to fold when she becomes agitated. The prescribed activity calms her, puts her at ease and she seems happy.

Karyl Chase is the director of the Senior Companion Program funded by the Corporation of National Community Service in Ogden, Utah. Her agency first employed a version of the TAP program as a way to help their volunteer companions feel more comfortable visiting people with dementia. Once they were trained in the TAP practice, volunteers became more open to taking clients with dementia.

For example, before the training, one of the volunteers spent most of her visits with a dementia patient watching television, during which the patient would often doze off.

After an occupational therapist assessed the patients interests and abilities, the volunteer and patient began playing a dice game together. While this particular activity is not connected to anything the patient did in the past, it shows the value of engagement.

“The client lit up and became more engaged, especially when she won,” explains Chase. “The volunteer noticed how much more enjoyable the visits were for both of them. The client is more alert and active during the visit and their time together goes by fast.”

As the disease progresses, people living with dementia will require different kinds of support. Therefore, they should be reevaluated at each juncture to make sure they’re meaningfully engaged and that the activity fits their current mental status.

Dissemination of the Program

TAP continues to undergo trials in the U.S. and several other countries, including Australia, Brazil, Scotland and Chile. Some countries are further along than others in implementing it for dementia care for their particular health care systems.

Widespread dissemination of TAP throughout the U.S. remains a work in progress. While TAP merits further evaluation to establish efficacy with larger, more diverse populations, it shows a lot of promise as a nonpharmacological approach to manage behavioral symptoms, Gitlin says.

“Our mantra is that we can make life better for the person living with the disease and the family member caring for them,” she says.

By Melba Newsome

Melba Newsome is an award-winning freelance writer with feature credits in many prominent publications including the New York Times, Bloomberg Businessweek, Oprah, Playboy, Reader's Digest, Time, Good Housekeeping and Wired. Melba also is a frequent contributor to such online sites as NBCNews and Healthline.

Can the Mediterranean Diet Delay or Prevent Dementia?

July 9, 2019

In this 'Ask the Expert' column, a dietitian explains the possibilities
By The American Federation for Aging Research (AFAR)

Before earning her doctorate in public health nutrition from Queen’s University Belfast in 2012 and embarking on a research career there, registered dietitian Claire McEvoy spent a decade working in clinical nutrition for the National Health Service in Northern Ireland.

That experience, “supporting people to make appropriate and evidence-based dietary choices has completely influenced the type of research I do,” she says. McEvoy studies how different types of dietary habits in people affect their health and “healthspan,” which means the number of years of good health humans can enjoy toward the end of life.

“The Mediterranean diet may have a beneficial impact on cognitive health because it improves our vascular health.”

As a 2015 recipient of the American Federation for Aging Research’s Paul B. Beeson Emerging Leaders Career Development Award in Aging, McEvoy has focused her fellowship research on the Mediterranean diet and other healthy dietary habits.

She says she wants “to increase our knowledge on how diet contributes to cognitive health during aging, and to understand how best we can support dietary behavior change at different life stages to improve health and well-being. Ultimately, my goal is to identify effective dietary strategies to prevent and treat cognitive disorders during aging.”

McEvoy and other AFAR-supported researchers are driving discoveries that move us closer to extending healthspan.

In addition to regular columns by AFAR’s Scientific Director Steven N. Austad, AFAR is excited to share insights from the field of aging research through this “Ask the Expert” interview (previous interviews have addressed age-related dementia research, cancer research and the effects of younger blood on aging).

AFAR recently talked with McEvoy about the link between nutrition and cognitive decline, and the implications of her research for Alzheimer’s disease and other dementias, and healthy aging.

AFAR: What should people know about the link between diet and brain health, especially as it relates to the Mediterranean diet and healthy aging?

Claire McEvoy: It’s generally believed that what’s good for the heart is good for the brain, and that is why most research into diet and brain health to date has focused on the traditional Mediterranean diet.

It’s proven to be effective for reducing both primary and secondary cardiovascular disease and has also shown clinically significant benefits for several cardiovascular disease risk factors, such as cholesterol profiles, high blood pressure, fasting glucose level and inflammatory biomarkers, which are also risk factors for cognitive decline.

The traditional Mediterranean diet is plant-based, rich in fruit and vegetables, whole grains, legumes and moderate in fish and nuts. It also includes alcohol that tends to be consumed with meals. This diet is generally low in processed foods, sugary foods and red meat.

Observational evidence, while inconsistent, tends to support the Mediterranean diet for brain health as well as cardiovascular health.

However, the effects of this diet’s changes on cognitive function have been tested in few intervention studies. Preliminary results have shown improvement in cognitive function for people who are at high risk of developing cardiovascular disease.

Some research has focused on single nutrients, like vitamin E, or B vitamins. Very often, however, the evidence is mixed, likely because of differences in the types of populations studied and the diverse nature of vitamin supplements tested.

Some people with nutrient deficiencies may experience cognitive benefit from vitamin supplements. However, most people in the general population will derive greater health benefits from improving the quality of their regular diet rather than relying on vitamin supplements.

In two recent studies, you looked at how different types of dietary habits, including the Mediterranean diet, affect cognitive function in older adults and people in midlife. What are the most important takeaways so far?

We investigated the Mediterranean diet in the well-known Health and Retirement Study and the Coronary Artery Risk Development In Young Adults (CARDIA) study and found that greater adherence to the this way of eating was associated with better cognitive health in both older and younger adults.

In the most recent study conducted with Dr. Kristine Yaffe and other CARDIA investigators, the most important take-home message is that maintaining healthy dietary practices that align with the Mediterranean diet during young adulthood can help to preserve cognitive function even at midlife.

That is an important point. Because diet is likely to provide subtle, but cumulative, protective effects on brain health throughout a person’s lifetime that help to reduce the risk of, or at least slow down, cognitive decline as we get older, and potentially help to delay dementia in late life.

What are some of the key points research is revealing about the science behind the health benefits of the Mediterranean diet?

In our dietary analyses, we’ve found that individual foods on their own tend to have weaker associations with health outcomes compared with overall dietary habits. Therefore, while single foods and nutrients may be important, the combination of foods and nutrients within a person’s diet can act together to have greater biological effects.

In addition, we’re beginning to understand more about the mechanisms of how a healthy diet, such as the Mediterranean diet, affect brain health. These insights come from a range of studies in both animals and humans. The Mediterranean diet may have a beneficial impact on cognitive health because it improves our vascular health.

The Mediterranean diet and other high-quality diets also have antioxidant and anti-inflammatory effects that could protect against cognitive decline and dementia.

Your current research would seem to have larger implications regarding nutrition and healthy aging. Where do you think this might lead?

I am very much a public health researcher, so I want to help inform dietary recommendations that will benefit brain health throughout a person’s life to prevent or delay Alzheimer’s disease and dementia. The Mediterranean diet is clearly an important dietary pattern for overall healthy aging. But it should be emphasized that we don’t yet know the optimal combination of foods and nutrients for brain health.

One of the most interesting aspects of diet is that it has the potential to influence the development of several diseases, including obesity, diabetes, cardiovascular disease and some types of cancer.

Addressing poor-quality diets and diet-related disease in our population should be a major policy focus for healthy aging. While it is important to generate robust evidence of ‘what works,’ a key challenge going forward will be to find effective ways to promote and support healthy dietary habits in people for disease prevention and healthy aging.

By The American Federation for Aging Research (AFAR)

The American Federation for Aging Research is a national nonprofit organization whose mission is to support and advance healthy aging through biomedical research.@

5 Ways to Keep Your Brain Healthy

June 25, 2019

While there is no way of stopping someone from getting Alzheimer’s disease, there are many ways to keep your brain healthy to slow down cognitive decline!

  1. Get Active: Engage in regular exercise that elevates your heart rate and increases blood flow to the brain and body. Exercise helps to lower your blood pressure, reduces mental stress and helps to lower blood sugar, which can all help your brain!

  2. Eat Healthy: Eat a balanced diet that is lower in fat and higher in fruits and vegetables. People that eat a Mediterranean style diet that emphasizes fruits, vegetables, fish, nuts and plant sources of proteins are less likely to develop cognitive impairment and dementia.

  3. Get Enough Sleep: Not getting enough sleep due to conditions such as insomnia or sleep apnea may result in problems with memory and thinking.

  4. Challenge Your Mind with Puzzles and Games: Challenge and activate your mind. Building furniture, doing art, completing puzzles and playing strategic games challenge your mind and have long-term benefits for your brain.

  5. Pay Attention to Your Mental Health and Manage Your Emotions: Some studies show a link between histories of depression with an increase in cognitive decline. Seek medical treatment if you have any mental health concerns. Also, try to manage stress.

You can find all of these facts and tips on health.harvard.edu and alz.org.

Four Ways to Honor Alzheimer’s and Brain Awareness Month

June 19, 2019

Did you know that June is Alzheimer’s and Brain Awareness Month?

Here are 4 ways you can raise awareness for Alzheimer’s disease in the month of June.

  1. Wear Purple
    1. Purple is recognized as the official color of the Alzheimer’s movement.
    2. You can get some of your co-workers together and decorate the office in purple or gather group of your friends and wear purple to raise awareness and support people living with Alzheimer’s disease.
  2. Participate in “The Longest Day”
    1. What is “The Longest Day”? On June 21, which is summer solstice, people are encouraged to partake in an activity of their choice, whether it is painting or running a 5k and raise awareness of Alzheimer’s disease and support the Alzheimer’s Association.
  3. Start a Conversation
    1. Help to raise awareness for Alzheimer’s disease and the Alzheimer’s association by having a conversation with your friends, family and co-workers.
    2. Share with your friends and followers on social media about why you are going purple this month and make sure to use the hashtag, #endalz.
    3. The more people informed about Alzheimer’s disease, the better!
  4. Get Educated
    1. Reading about Alzheimer’s disease and learning new information will help you not only understand the disease, but it will be easier for you to communicate with others about it!
    2. There are many great resources available about Alzheimer’s disease and there is never too much information to be learned.

These facts were modeled off of “Alzheimer’s and Brain Awareness Month: How to Get Involved” on www.alzheimers.net.

 
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