Exercise in Nature to Build a Better Brain

Research has found that there are benefits imparted by exercising in the natural world or a setting that is rich with the things we find in nature; like plants, fresh air, and wildlife.

While gyms serve a great purpose, and some people love them, I prefer to exercise in nature. The natural world provides a deeper and more dynamic level of stimulation for your brain that you simply cannot find at any gym.

One study conducted by Richard Louv, coined the phrase 'Nature Deficit Disorder'.

At first glance, this might sound a bit contrived. However, Louv asserts that human beings are hardwired by evolution to have a connection to nature. Unfortunately, the modern world and the trend for people living in large urban and suburban places reduces the opportunities for people to spend time in nature.

This sentiment that exposure to the natural world has an impact on us has been echoed by many people throughout the generations. The father of the National Parks system and one of the first naturalists, John Muir, said: “Civilized man chokes his soul.”

Although Muir himself lived a significant amount of his life in Martinez, California just outside of Oakland, the goal in his eyes was not that man needed only urban or natural settings, but that both were of equal value and that people who only embraced urban life were indeed cutting themselves apart from the very therapeutic aspects of a direct relationship with the natural world.

'Green Exercise' involves hiking in nature, or getting involved in other activities in the natural world. For people who live and work deep inside urban areas, this could also extend to things like taking a walk in the park, or along a natural stretch of river, or even getting involved in something like a community garden.

When you’re in nature, there is a lot of multimodal stimulation. You’re smelling the trees, flowers and the other scents in the air. You start to notice things like changes in humidity and the presence of birds and other creatures around you.

When you’re in the gym you’re going to have certain smells but you can usually predict what those smells are. It’s old gym equipment and rubber mats on the floor.

When you’re exercising in nature there is a greater sense of self-awareness, improved mood, increased sense of self-esteem, and even an increase in creativity. People exercising in nature tend to have creative thoughts come to them and find it easier to express those ideas with greater clarity.

The bottom line is that exercising in nature does, in fact, elevate the level of your brain and body functions. It’s a win-win for you and nature, and an important way to help build a better brain. I recommend that everybody get out there and do it!

Contributor: Dr. Michael Trayford is a Board-Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For more information, please visit www.ApexBrainCenters.com/memory.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

Dementia Risk Factors: Alcohol

The health benefits that various foods and diets to improve overall health or lower risk for disease is a newsworthy topic. Some reporters state that eating fiber-rich fruits, vegetables, and whole grains helps us to maintain a healthy weight as well as may lower risk for colon cancer. Others assert the Mediterranean diet, one which encourages replacing red meat for fish and chicken, saturated fats with olive oil, and refined carbohydrates with whole grains, reduces the risk for heart disease, certain cancers, and diabetes.

Many research studies are touting the benefits of red wine on lowering cholesterol blood levels and thereby reducing the risk of heart disease, strokes, cataracts, and colon cancer. Though a controversial area of research, some studies indicate drinking moderate amounts of red wine may slow declines in brain function. 

With respect to consuming wine and other alcoholic beverages - moderation is the keyword. However, most people are unsure of how much is a moderate amount. According to the Dietary Guidelines for Americans, a low to moderate alcohol consumption is no more than one drink a day for women and older adults, and two for men. One drink is usually one 1/2 ounce or 15 grams of alcohol, which equals approximately 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80-proof liquor. (Note 1)  

These dietary guidelines refer to the amount consumed on any single day and not as an average over several days. In other words - do not save your daily allocation for a weekend binge.

Alcohol-related brain damage, (ARBD) conditions that include Wernicke-Korsakoff syndrome  (WKS) and alcoholic Dementia is the result of drinking too much alcohol over several years. (Note 2) Though both types of ARBD exhibit Dementia-like symptoms, neither condition is true-Dementia. (Note 2) The difference between ARBD and a Dementia such as Alzheimer disease is in the ability to treat or stop the progression of symptoms.

Consuming more than the recommended amounts of alcohol does increase the likelihood of developing Alzheimer disease and vascular Dementia later in life. However, researchers have yet to establish the scientifically measurable relationship between alcohol consumption and risk for Dementia. The reasons are many and include research entirely dependent on reported observations and evaluating the variables that, in combination with alcohol consumption, affect the long-term risk for Dementia. 

However, one can state with certainty, the more you drink, the greater the likelihood of developing Dementia later in life. High alcohol consumption also increases the risk for stroke, heart and liver disease, and depression – all of which are well-known Dementia risk factors. 

Contributor: Janet Yagoda Shagam, Ph.D., is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” Available through Amazon.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

 
Notes: 
1. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition, Washington, DC; 2015, http://health.gov/dietaryguidelines/2015/guidelines/
(accessed June 15, 2015).
2. What is Alcohol-related Brain Damage?, https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=98 (accessed June 16, 2016).

Is this Normal Aging?

It can be difficult to separate the normal aging process from the progressive and steep declines typical of Dementia. Examples of genuinely age-related changes are thinning and graying hair, sagging skin, and alterations in vision, hearing, and taste. Other changes, such as heart disease and certain types of memory loss, are not a normal part of aging.

 

The normal aging process may affect memory by changing the way the brain stores and retrieves information. While healthy aging does not affect long-term memory, it may affect short-term memory by making it difficult to remember such things as the name of a new acquaintance or misplacing keys or eyeglasses. Occasional word-recall difficulties, rather than frequent ones, are another indicator of healthy aging.

 

How people evaluate isolated events is one way to distinguish normal memory lapses from those caused by dementia. At one time or another, everybody loses a car in a parking lot. With normal forgetfulness, we chalk up those moments of frustration to the number of look-alike cars or having our thoughts elsewhere. A person who has Dementia is sure someone has moved the car.

Name recall and word-finding are other ways to distinguish memory losses caused by the normal aging process from those resulting from Dementia. A person with occasional age-related memory difficulties might ask for a reminder or wait a moment for the right word to show-up. A person with Dementia frequently has trouble finding and using the right word. To compensate, he or she may use either an awkward substitution or a description in place of the word. For example--a furry animal that purrs to replace the word “cat.” Further, there may be a noticeable decline in his or her capability to maintain a conversation.

 

Clinicians use the term “impoverished “to describe the Dementia-related changes in language complexity and vocabulary.

The ability to use household items is another indicator of Dementia. Most people find it annoying or frustrating when upgrading a home appliance to one that is heavy in technology or with new features. The source of annoyance often stems from changes in vision or the reduction in dexterity that arthritis may cause. However, people who have Dementia no longer know how to use their familiar dishwasher or drier.

When considering whether a set of symptoms indicates dementia or normal aging, one must evaluate whether the symptoms are a nuisance, problematic, or debilitating. This is best accomplished with the help of appropriate medical professionals and input from caregivers and loved ones.

Contributor: Janet Yagoda Shagam, PhD, is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” Available through Amazon. 

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

Brain Healthy Diaphragmatic Breathing

Relaxing diaphragmatic breathing focuses on breathing by engaging the diaphragm. Your diaphragm is basically a series of big round, long broad muscles that sit under your lungs. They’re positioned about halfway between your neck and your pelvis.

When they go down (breathing in) they fill your lungs up with air that feeds oxygen into your bloodstream. The diaphragm muscles then go up (breathing out) and it forces that air out. 
Sometimes people have a tendency to suck in their gut, sit improperly in their chair, or have poor posture, which causes them to breathe more from the chest. Chest breathing should be secondary to stomach breathing.

If you look at the way a baby breathes, they breathe through the stomach. Then they breathe in with the help of the chest and the neck muscles. Those secondary muscles of the chest and the neck should come into play after the diaphragm activity.

There’s a simple exercise to show how much you’re incorporating your diaphragm in your breathing. Start by lying on your back, then put your hands on your stomach and take a nice deep breath. You’ll feel your stomach move up towards the ceiling. Your hands will rise and fall.

The goal is to draw about 75% of your breath from the stomach by expanding the lower lobes of the lungs fully. Then the end of the breath "in" should be through the chest. It’s like filling up a sponge with water and then squeezing it out. We’re filling up the lungs with oxygen and squeezing all of it out into our bloodstream.

When you’re breathing in and out really quickly or breathing more through the chest, you’re not getting as much oxygen into your lungs. You end up utilizing about half your lung capacity, and you’re only getting out about half of the carbon dioxide that needs to be expelled. 

There was a great book written in the 1970s by Dr. Benson, called the Relaxation Response. The book is still widely read today. It talks about diaphragmatic breathing, and what he calls Paced Breathing; where we have to breathe through the stomach in order to get the best oxygen exchange. It’s a great book to look at and still relevant today.

Contributor: Dr. Michael Trayford is a Board-Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For more information: ApexBrainCenters.com/memory.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse or guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

Risk for Dementia: Head Trauma

Traumatic brain injury (TBI) describes situations in which an external force, such as a fall or a blow to blow to the head causes extreme pain that is often accompanied by a short or a long period of unconsciousness. People who experience multiple traumatic brain injuries are at high risk of developing dementia later in life. (Note 1)

However, the key phrase “increase risk for” means that TBIs do not cause dementia but do increase the likelihood of having dementia sometime in the future.

In a recent and extensive review of the research literature, Sharan Shively, MD, Ph.D., and colleagues report that a history of moderate and severe TBIs increases the risk of having late-life dementia 2 - to - 4 times that of people who have never experienced a traumatic brain injury. (Note 2) To come to this conclusion, Shively and colleagues reference earlier studies that compare the presence or absence of later-in-life dementia in people who suffered concussions of sufficient severity to cause loss of consciousness to individuals who report never having experienced that degree of head trauma. (Note 2) People who experience multiple traumatic brain injuries are at high risk of developing dementia later in life. (Note 1)

The syndrome, associated with having multiple traumatic brain injuries was originally described in 1928. Called dementia pugilistica or “punch drunk” was first observed in boxers who suffered repeated knock-outs. (Note 3) It took many more years of casual observation before medical researchers linked a history of repeated sports and military-related head injuries, to the onset of dementia symptoms later in life. The condition, chronic traumatic encephalopathy, (CTE) now receives considerable coverage in the public media.

Signs and symptoms of CTE usually begin eight to 10 years after the traumatic brain injuries and include difficulty in thinking, impulsive behavior, memory loss, substance abuse, as well as suicidal thoughts or behavior. (Note 4) Over time, the changes caused by CTE worsen as well as progress to aggressive behaviors, tremor, and speech and language difficulties. (Note 4) More than one-third of people with CTE eventually show signs of other degenerative brain diseases such as dementia and Parkinson disease. (Note 3)

Undoubtedly, ongoing and future research will improve our understanding of traumatic brain injuries and their relationship to later-in-life dementia. In the meantime, you can reduce the likelihood of receiving a head injury by trip-proofing your home, being observant of hazards such as low tree branches and open kitchen cabinet doors, as well as by wearing a helmet to prevent sports-related injuries.

Even if you have experienced multiple head injuries, you may be able to reduce your overall risk of developing dementia by implementing lifestyle changes that include such things as maintaining a healthy weight, eating a heart-healthy diet, as well as participation in an assortment of physical, social and mental activities.

Notes:
1. Alzheimer’s: Can a head injury increase my risk?”, http://www.mayoclinic.org/alzheimers-disease/expert-answers/faq-20057837 (accessed March 21, 2016)
2. Shively et al, “Dementia Resulting from Traumatic Brain Injury” https://www.researchgate.net/publication/229011632_Dementia_Resulting_From_Traumatic_Brain_Injury_What_Is_the_Pathology (accessed March 22, 2016)
3. What Is Chronic Traumatic Encephalopathy?, http://www.brainline.org/content/2010/12/what-is-chronic-traumatic-encephalopathy.html (accessed April 7, 2016)
4. Chronic Traumatic Encephalopathy, http://www.mayoclinic.org/diseases-conditions/chronic-traumatic-encephalopathy/basics/definition/con-20113581 (accessed April 6, 2016)

Contributor: Janet Yagoda Shagam, Ph.D., is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” Available through Amazon.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse or guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

Limit Social Media Time

For some, social media is a significant part of their occupation. For other people, it can be an obsession that can cause problems in their daily life and career. Social media in your personal life can cause a significant amount of stress. There are so many things happening in the realm of social media and it impacts your brain function! You need to find a healthy balance.

Socialization and interaction with other human beings can have significant benefits for the brain. Social media often creates a false sense of interaction. These sites give you a sense that you’re interacting with other people, but there is often little quality or stimulation to the interaction.

Facebook is a parallel universe that cannot, and should not, replace normal healthy social interaction. It pulls people away from normal healthy interactions and relationships; which are critical to the development and maintenance of the aging brain.

In the last decade or two, we’re starting to see evolutionary shifts in the brain that haven’t occurred in the last several hundred thousand years; many related how our brains pay attention to things and how we respond to stress.

While there is a valuable function for these outlets when it comes to businesses, it’s also a tool for keeping in touch of friends and family that might live far away. When it starts to become a lifestyle that takes the place of healthy interaction, it can be a serious problem on multiple levels.

There was a study that was done where people went 30 days without hitting the Like button on Facebook. The study measured several quality-of-life parameters. Each person reported their quality of life improved through the course of the study, simply by not hitting the like button. Imagine what would happen if you took a break from them for extended periods of time on a regular basis! When you set up these habits, your brain simply starts to work better.

It’s important to look at all of these outlets and how much time you spend on them. It’s a good habit to simply allow yourself to check your social media at specific times, limited to about 30 minutes per day.

Contributor: Dr. Michael Trayford is a Board-Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For more information, please visit www.ApexBrainCenters.com/memory.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse or guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

Risks Associated with Dementia: Weight

Body weight and risk for Dementia are both a confusing and complex topic. One can find reports that state obesity increases the risk for dementia as well as ones that indicate the opposite –that being underweight is the risk factor. And to make things even more confusing, there is evidence that indicates being overweight may protect some people from Dementia.*

It’s needless to say, these unexpected findings are difficult to explain and generate considerable discussion and controversy both in the media and between researchers.

However, what these seemingly conflicting findings show is risk – the factors that influence the likelihood of having Dementia is difficult to assess. A too high body mass index (BMI), uses an equation to calculate a numerical rating of your health based on height and weight, is only one of many known risk factors.

Therefore the big challenge is how to determine the combined effects of having multiple risk factors, such as diabetes, insufficient exercise, and smoking. Does having additional factors make having dementia three times more likely than being overweight alone? Or perhaps the risks compound and put people at 10 times the risk for Dementia?

Is it possible that having a high BMI becomes protective when combined with habits and activities known to reduce risk? As you can see, the number of environmental, behavioral, health-related and genetic influences is huge and the combinations of risk factors are infinite.

Another challenge is separating associative risks from those that cause the outcome. For example, obesity is associated with increased risk for diabetes, but in itself does not cause diabetes. What causes diabetes is the inability of the pancreas to produce sufficient insulin. And, as it turns out, having diabetes is a risk factor associated with having dementia later-in-life.

Therefore, based on what we currently know about BMI and risk for Dementia the best answer is, “it depends.” This means, at this time, the best we can to reduce risk is to make a lifelong commitment to what current clinical research shows are health-promoting habits. 

*The Lancet Diabetes and Endocrinology, http://www.thelancet.com/journals/landia/article/PIIS2213-8587(15)00033-9/abstract), Accessed: September 2016.

Contributor: Janet Yagoda Shagam, Ph.D., is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” Available through Amazon.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse or guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

A Word of Caution About Sleep Aids and Medication

Sleep is a critical aspect of overall brain health. Today there are countless individuals that have trouble with attaining sleep, maintaining sleep, and sometimes a combination of both. As a result, millions are turning to sleep aids. 

Many sleep issues, in some form or another, are related to anxiety.   

It’s easy to understand. A lot of people lay down, intending to go to bed, and they have the wheels turning in their mind as they’re engaged in thinking about their to-do lists, relationships, finances, or their career.  

Some of the more common, albeit older, sleep aids come from a class of medications called benzodiazepines. These medications were originally designed to treat anxiety and panic disorders. Lorazepam (Ativan®), one of the most common, many are now taking for sleep issues.  

These drugs essentially ramp down the mind a little bit, which then allows you to obtain sleep and remain asleep. There are also the more common sleep aid medications that were designed for sleep problems, like Ambien® or Lunesta®.  

Most are aware of these prescription medications due to clever ad campaigns that are meant to create associations in your memory.   

While there is absolutely a time and place for sleep medications, by and large, they are incredibly over-utilized in most cases as they are designed to be short-term solutions and most often become long-term traps that have consequences on brain function.

One of the most overlooked factors is sleep hygiene. 

Factors like weight, sleeping environment, computer time, eating before bed, stress management and so many others have a profound impact on our sleep.

The bottom line is that we need to change our mindset. When we see that we can, in fact, get to sleep on our own after implementing sound sleep hygiene methods, this is an incredibly powerful first step to be able to move into sleep on your own and to take the dependence off of pills or supplements.  

When it comes to sleep issues related to stress management, there are a wide variety of tools available at your disposal. If anxiety or poor stress management is an issue that is related to obtaining quality sleep, a good first step is to try journaling. The simple act of putting words on paper can help get the stressors out of your mind and onto paper. This can eventually help prepare you to take the next step toward more advanced techniques.

Contributor: Dr. Michael Trayford is a Board-Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For more information, please visit www.ApexBrainCenters.com/memory.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse or guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

Dementia is Person-Centered

This may surprise you, but it summarizes the impact Dementia may have on our families: we believe that more than 9 million Americans live with some form of Dementia today. Moreover, although the scientific community is attempting to shed additional light on the numbers, Alzheimer's-type Dementia alone is currently considered to represent more than half of the cases.* Even more shocking, according to the World Health Organization, when all forms of Dementia are combined, they are globally thought to be the 3rd leading cause of death, behind heart disease and stroke in high-income countries.*

Did you know? Dementia is not a disease. It is the umbrella term we apply to those cognitive diseases, e.g., Alzheimer’s, Vascular Dementia, Lewy Body, Frontotemporal and other conditions that can cause Dementia, which is the progressive loss of two or more basic brain functions and the accompanying activities of daily living. Yet, how you outwardly express Dementia is unique to you. People living with Dementia are still whole human beings and can experience joy, sadness, creative expression and much more.

Some would say that the number of deaths attributable to Dementia is significantly underreported due to the stigma associated with the various diseases, lack of education, or other coexisting health issues that can often occur at the end of your life. No matter what the numbers are, Dementia is costly in every way possible, both financially and emotionally.

Rich or poor, or somewhere in-between, you can die prematurely just because of Dementia. Alzheimer's disease, along with many other causes of progressive Dementia, cross cultural and socioeconomic divides. Today there are no cures or effective long-term treatments for almost all forms of Dementia.

However, you can get great satisfaction, and increased inner strength and sense of well-being in caring for someone living with Dementia, but it is still not easy. Even professional caregivers who are paid to give a helping hand, and assist those living with Dementia, experience occasional burnout. Person-centered care, and going further if possible to person-directed care, requires that we always treat individuals uniquely, with respect, and with dignity to the end of their lives. These are just a few of the keys to an optimal quality of life and the best possible tomorrows.

*Sources: see www.dementiasociety.org/home

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse or guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

Brain Health Through Mindfulness

More and more people are becoming familiar with the term “mindful” or “mindfulness.” Being mindful is exactly what it sounds like. It’s what you’re consuming your mind with at that time.

When it comes to brain health, being mindful during our daily activities has many positive benefits. On an average day, our brains can be bogged down with to-do lists, family, career, and all the other things that compete for our time and take up space in our mind.

We can add to this the fact that many people spend a lot of time sitting in front of their computer, with multiple browser windows open, and their cell phone right by their side waiting for text messages.

With our brains being consumed with processing too much information, we often don’t take the time to be mindful of the basics of our body. Taking some quiet time to be mindful of our breathing can have a positive impact on the brain that goes beyond simple stress management.

The process itself doesn’t need to take a great deal of time out of each day. It could be as short as two minutes, five, 10, or 20 minutes at the maximum for beginners. A simple breathing exercise is a good place to start.

All you need to do is find a consistent time at some point in your day where you sit in a quiet place away from phones, browsers, kids, pets and all of your usual distractions, and simply listen to your breathing. Try to be mindful of your breathing. Feel the air coming in through your nose – how does it feel? Is it cold? Usually, it’s a little bit cooler coming in and a little bit warmer going out.

Let your breath out through your mouth. Be mindful of your lungs inflating. Where do they inflate? Is it the chest? Is it near the level of the stomach? We should be inflating at the stomach first and then the chest last (diaphragmatic breathing). Ahhh, feel better?

There is significant evidence that being mindful and taking your attention away from the distractions of the day and putting them on body processes like heart rate and breathing can be incredibly powerful. Shutting the brain down for a short amount of time helps it to heal and learn more efficiently. It’s about more than just sitting and listening to your breath. It’s about healing and pushing your brain in a positive direction.

Contributor: Dr. Michael Trayford is a Board-Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse or guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor.

Understanding Memory and Language

In the broadest sense, memory is the ability to retrieve information from specific areas of the brain. Types of memory fall into two categories – long-term memory and short-term memory. The kinds of information associated with long-term memory are the names, places, and dates that compose our personal history. Long-term memory also includes such things as the skills we have learned as well as the acquisition and use of language. 

When Dementia damages our long-term memory banks, we forget such things as our address and birth date, and may no longer remember how to drive the car or to use the washing machine.

When we lose access to our collection of learned information and built-in skills, we require assistance to live safely at home. Short-term memory, or working memory, is the ability to retain small bits of recently learned information, such as phone numbers, login codes, and street addresses.

People who have short-term memory deficits may not remember they have already taken their medication or, just an hour ago, ate lunch.

The ability to recall and use language is one of many ways to assess the progression of Dementia. In addition, specific kinds of language difficulties can help clinicians differentiate Frontotemporal Dementia (FTD) from other types of Dementia such as Alzheimer’s disease.

Language difficulties most often associated with Alzheimer’s disease are difficulty in finding the right words, describing objects rather than calling them by name, repeated use of familiar words, relying on gestures to express ideas, and reverting back to speaking a native language.

Unlike Alzheimer’s disease, people who have FTD often have difficulty in using and understanding spoken and written language. Language problems include repeated mispronunciations, such as “sork” for “fork” and the inability to make appropriate associations between names and objects. If your parent is not able to associate an object with a word, he or she may point to a sandwich and call it a baseball. People who have FTD are not aware of how they have changed.

Using words and phrases such as “this,” “that” and “over there” in the place of specific nouns and descriptions are language deficits typical of many types of dementia.

Memory loss and language difficulties often make communication awkward, difficult, and frustrating. It doesn’t take long before “never mind” replaces your efforts to engage in conversation.

Here are a few tips you can use to improve communication between you and your loved one. As you will read, most are expected norms of polite conversation.

· Give your loved-one the time to formulate a response
· Engage in one-on-one conversation
· Converse in a quiet space with few distractions
· Maintain eye contact
· Avoid criticizing or correcting misinformation
· Listen
· Avoid arguments
· Speak slowly
· Give step-by-step instructions
· Use written notes to prevent the frustration and confusion of remembering details.

Contributor: Janet Yagoda Shagam, PhD, is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” Available through Amazon.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor.

Dementia Can Affect Motor Skills

There is accumulating evidence that Dementia has a long pre-clinical phase that may begin years, or even decades prior to a clinical diagnosis.(1) In addition, there is data indicating the pre-clinical signs of Dementia, in addition to declines in memory and other cognitive skills, also include motor skill difficulties.

It’s difficult to tease out normal age-related changes in coordination and balance from those motor skills that put people at increased risk for Dementia. Measures of pre-clinical impairments include changes in gait and walking speed, loss of muscle mass and strength, as well as reduced manual dexterity and balance.

Once Dementia becomes part of the picture, friends and family members become increasingly aware of the changes in their loved one's memory and organizational skills. They may also notice their loved one has difficulty dressing or walking without assistance. Like the worsening cognition we associate with Dementia, losses in stamina and coordination also reflect more widespread brain damage.

Research shows that physical exercise plays an important role in helping to protect, maintain, and improve the health and well-being of people in either the pre-clinical or the clinical stages of Dementia. As is true for everyone, physical exercises must be safe, interesting, as well as give a sense of accomplishment. However, before embarking on new or increased amounts of physical activity, it is important that you first get approval from your loved one’s doctor.

A physical therapist (PT) is often a good place to start. He or she can devise an exercise plan to improve stamina, flexibility, balance as well as exercises that can prevent falls. You can find information about local physical therapists on the American Physical Therapy webpage. Your loved one's doctor, nurse, or medical social worker are other good sources of information.

Exercise also includes activities such as walking, dancing, gardening, and housework. All are inexpensive, do not require specialized equipment, and come with the satisfaction of having done something useful. As an added benefit all of these, and similar activities are sources of social and cognitive stimulation.

Exercise also includes activities that improve small or fine-muscle motor skills. The ability to button a shirt, open a cereal box, or use eating utensils, helps people who have Dementia maintain their independence for as long as it possible. An occupational therapist (OT) can suggest helpful exercises and adaptive equipment that can make it possible to live at home for as long as is possible. Go to The American Occupational Therapy Association webpage to learn more about occupational therapy and the many ways occupational therapy can help people who have Dementia.

Small muscle exercises include pastimes such as craft projects, scrapbooking, baking, working with clay, painting, and drawing. These simple and inexpensive small muscle activities encourage socialization and maintain or improve cognition. An added benefit and perhaps the most important one is making things to share with others creates mementos of a life together and affirms the whole person. 

Contributor: Janet Yagoda Shagam, PhD, is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” 

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse or guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. 


Reference: (1) Buchman AS and D Bennett. Loss of Motor Function in Pre-clinical Alzheimer's Disease. Access; September 25, 2016.

Dementia Risk Factors: Blood Pressure

Blood pressure and health is a frequent topic of casual conversation between friends. However, many people are not aware of the relationship between blood pressure and risk for having Dementia later in life.

Blood pressure is a measure of the force blood exerts against the inner walls of the blood vessels and arteries as the heart pumps blood throughout the body. The first or higher number, the systolic pressure, determines the pressure in the arteries when the heart muscle contracts. A higher than normal pressure, one that is greater than 120, causes the heart to work harder and increases risk for heart attacks, and strokes.

The second number, the diastolic pressure, determines pressure in the arteries when the heart muscle relaxes between heartbeats. A lower than normal blood pressure is having a systolic pressure below 90 or a diastolic lower than 60. Most doctors consider chronically low blood pressure a problem only if it causes noticeable symptoms such as dizziness, fainting, or rapid and shallow breathing.

Some causes for too-high or too low-blood pressure are cardiovascular and neurological abnormalities present at birth and the side effects of certain medications.

Conditions and behaviors such as blood pressure, chronic kidney disease, heart disease, obesity, smoking and insufficient exercise are all causes for having high blood pressure.

Risk factors associated with having low blood pressure include advanced age, medications such as the alpha blockers used to treat high blood pressure, as well as having diseases such as diabetes, Parkinson disease, severe infections, and certain heart conditions.

High blood pressure, independent of its cause, increases risk of having Dementia. However, the good news is there are ways to decrease risk for Alzheimer disease and vascular dementia - the two most common types of Dementia. Some of these include reducing stress, eating a heart-healthy diet, getting regular exercise, and to stop smoking. It’s also important to follow your doctor’s instructions and take your blood pressure medication as prescribed.

Changing lifelong habits is often easier said than done. It’s difficult to reduce stress and to find the time to exercise when juggling the responsibilities of a tightly scheduled day. When eating out, or socializing with family, friends, and coworkers, it is a challenge to manage large portions and to choose foods that are low in saturated fats, salt, and added sugar.

Support groups as well as your friends and family can be your best allies in helping you to achieve a healthier lifestyle. However, be sure to tell your friends and family the reason for making these lifestyle changes is to reduce your risk for dementia. Maybe, just maybe, your explanation will be the motivation they need to make similar healthful changes. 

Contributor: Janet Yagoda Shagam, PhD, is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.”

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

Making Sense! Spotlight On Hearing

Making Sense! Spotlight On Hearing

Hearing connects us to the world, helping us communicate, work, socialize and be alert to potential danger. Hearing impairment, likely affecting over 30% of seniors, touches all aspects of daily living. It contributes to depression, loneliness, poor job performance, and in the long run, may lead to Dementia. It is thought by some, that untreated hearing loss could be responsible for 9% of Dementia worldwide. The good news is that healthy lifestyle choices that include correction of hearing loss, might possibly delay or prevent one-third of Dementia cases.  

Here is a guide to understanding hearing loss and what to do about it:

What causes hearing loss? 

• Age
• Genetics (family history)
• Chronic illness (type-2 diabetes, hypertension, cardiovascular, autoimmune and infectious diseases)
• Medication (diuretics, antibiotics, chemotherapy, others)
• Environment (noise, pollution, industrial chemicals)
• Head trauma
• Smoking
• And more ...

We can’t change our genetics, but we can take steps to affect the other factors. 

What are the types of hearing loss? Peripheral hearing loss occurs in the ear, while central loss involves parts of the brain that process auditory signals. Hearing loss is often a mix of both types.

How does hearing loss cause Dementia? It increases social isolation, reduces stimulation to the brain, and/or it may arise from the same brain changes that cause dementia. 

What does testing involve?  

To be thorough, take three tests:

• Ear testing: wear headphones while identifying short sounds played at different volumes and pitches.
• Central auditory processing (CAP) evaluation: checks speech reception and word recognition using the Staggered Spondaic Word Test (SSW) and the Synthetic Sentence Identification with Ipsilateral Competing Message test (SSI-ICM).
• Cognition: The Montreal Cognitive Assessment (MOCA), available online, for free, in multiple languages and dialects, is one page and takes ten minutes. MOCA detects mild cognitive impairment and early dementia.

What treatment is available? 

• Hearing aids make sounds louder and easier to pick up. 
• Middle or inner (cochlear) ear implants boost signals that go to the brain. 

Treatment slows mental decline and improves cognitive test scores, so sooner is better. 

What lifestyle strategies support hearing? : 

• Moderate alcohol consumption
• Bone-strengthening exercise
• Antioxidant (Mediterranean, DASH) diets
• Stop smoking

Correcting hearing loss improves life enjoyment, daily function, and brain health. Take action today to help counter this modifiable risk for Dementia.

Contributing Blogger: Jennie Ann Freiman, MD, author of The SEEDS Plan.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse or guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor.

References:
  www.ncbi.nlm.nih.gov/pubmed/29964378    
  www.ncbi.nlm.nih.gov/pubmed/29735277
  www.ncbi.nlm.nih.gov/pubmed/29212633
  www.thelancet.com/commissions/dementia2017?code=lancet-site
  www.ncbi.nlm.nih.gov/pubmed/29937713
  www.ncbi.nlm.nih.gov/pubmed/30011159
  www.ncbi.nlm.nih.gov/pubmed/29430246
  www.ncbi.nlm.nih.gov/pubmed/28894825
  www.ncbi.nlm.nih.gov/pubmed/27806352
  www.ncbi.nlm.nih.gov/pubmed/29937713

Have Fun, But be Mindful of Summer's Dangers

Who doesn’t love summer? For many of us it means trips to the beach, longer daylight hours, more socializing with family and friends, picnics, outdoor activities and more. But the lazy, hazy days that summer brings – specifically in sizzling temperatures – also can pose some serious health risks to seniors. Here are some tips to allow for a safe summer season.

Hydrate, Hydrate, Hydrate!

Keep your water bottle near you (and filled) at all times. Seniors are more susceptible to dehydration. As we age, our body naturally loses water, so that by the time we reach 80 years of age, we have 15 percent less water than that of a 20-year-old. Aside from that, our kidneys function less efficiently, and we tend to lose our sensation of thirst. Dehydration can manifest itself as dry mouth, troubled speech, lack of sweat, or confusion.

To counteract that, seniors should drink at least a half-ounce of water for each pound they weigh. So, a person weighing 160 pounds should drink 80 oz., or 10 8-oz. glasses of water, to stay hydrated. If spending time outside, seniors should up that quantity.

Sunburn Woes

Older skin is more susceptible to the effects of sun exposure. It’s thinner and has a reduced healing factor when it comes to sunburn. Also, certain medications that seniors take can make them more vulnerable to unsafe sun exposure.

To guard against sunburn, apply sunscreen heavily and often, using a product with an SPF of at least 15. If you must spend time in the sun during the hottest part of the day (10 a.m. to 4 p.m.), reapply more often.

Preventing Heat Exhaustion and Heat Stroke

As we age, our internal temperature regulation system doesn’t work as good as it did during our days of youth. As a result, heat exhaustion – when our core temperature reaches 100 degrees – can come about quickly and unexpectedly. Symptoms may include nausea, dizziness, a rapid pulse and muscle cramps. If left untreated, that condition could quickly escalate to heat stroke, a life-threatening condition.

Seniors are particularly vulnerable to these heat-related conditions. To prevent them from occurring, drink plenty of water and wear loose-fitting, breathable clothing – cotton and linen are great options – when going outside.

Making the right choices when it comes to your health will allow you to enjoy all the best that summer offers.

Source: Visiting Angels, a national agency, providing families with in-home elder care services.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse or guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor.

Stay Sharp for Safe Driving

The fitness of your mind and body must work together in order to drive safely. Follow these tips from AARP to keep yourself sharp, healthy, and ready for the road.

Your eyesight is key to all aspects of driving, but you may not realize how complex vision actually is. Good vision, both near and far, is needed to identify road hazards, road signs, and view your dashboard.

Visual acuity is how clearly or accurately you can see. There are many conditions that affect visual acuity, especially as we age. Here are a few conditions to keep watch for:

• Colorblindness and cataracts may cause problems when identifying traffic signals or brake lights of other cars while driving.
• Decreased contrast sensitivity is the visual ability to see objects that are not outlined clearly or do not stand out from their background. Examples are difficulty seeing pedestrians and road signs, especially in poorly lit roads or in fog.
• Decreased useful field of view refers to the amount of visual information that can be processed in a brief glance using both eyes. The ability to process information slows with age, particularly for situations in which the environment is very complex, e.g., a busy roadway.
• Decreased depth perception and peripheral vision is the ability to judge the distance of objects in relation to ourselves and the ability to see outside our immediate field of view.  Both tend to decrease with age and are essential in everyday driving situations, such as judging the distance and speed of approaching cars when merging or seeing a car approaching you from either side.

With that in mind, it is incredibly important to get regular eye exams to maintain good eye health.

Over time, we can lose the ability to quickly assess and react appropriately to the demands of driving. From something as simple as fatigue to minor memory loss to something as complex as Dementia, our brain health, and overall mental well-being are crucial to the task of driving.

Your ability to carry out the following processes should be gauged in assessing your driving fitness:

• Attention and reaction time
• Concentration (paying attention to changes in your driving environment)
• Ability to process information quickly and accurately
• Problem-solving skills (how to get help if you have a flat tire)
• Memory (how to get to the doctor’s office)

Stimulate your brain by trying new activities. Try testing your memory and problem-solving skills; it can be something as simple as taking a new route to a familiar location. A study by the National Institute of Health recently found that people who had cognitive training for memory, reasoning or speed of processing had 50 percent fewer car accidents than those in the control group.

Driving is a demanding activity that requires your full attention to many things at the same time. Eliminate distractions inside the vehicle and minimize activities that require you to take your eyes off the road or take both hands off the wheel, especially in heavy traffic. Some suggestions:

• Put your cell phone on silent and tuck it away so you are not tempted to answer a text or phone call while driving.
• Pre-set your radio with your favorite radio stations. That way you won’t have to look away from the road to change the station.
• Don’t eat, drink, or smoke while driving.

These important tips will keep you sharp and ready to drive. Driving is demanding, so take measures to ensure good vision, brain health, and reduce distractions while on the road.

Source: AARP

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse or guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor.