Read! Exercise for Your Brain

Most people have an innate desire to learn, and language is the primary tool for learning. Reading is an important mechanism for the delivery of information to the brain to be solidified as acquired knowledge. Reading is critical for your own personal and cultural development because it relates to so many factors in your life. The benefits are broad and significant.

First, the mental stimulation of reading is vital for brain health. It is quite literally exercise for the brain. Synapses fire, neurotransmitters are released, and hormones begin circulating. Reading material that evokes an emotional response actually stimulates the brain to produce hormones specific to the physical expression of those feelings. 

Next, memory is improved by reading. When you read a novel, for it to make sense, you must remember different characters and plot elements. Keeping all of these things in play has your short term memory working hard. This also requires, and so with repetition improves, the focus and concentration you need to follow the action through the course of the story. 

And don’t forget that the escapism offered by novels can also be an excellent stress management tool.

Analytical skills are also engaged through reading. Stimulating novels keep you involved - trying to figure out where the story is going. Technical books, however, require that you reason out how all the different pieces of information come together as a concept, procedure, or system. 

Reading also improves writing ability as vocabulary and variations in sentence structure are introduced or reinforced.  

The bottom line is that reading to learn something new is better for your brain than simply reading for entertainment. Still, even an entertaining novel offers the mental stimulation you wouldn't find passively watching TV or streaming media.

Contributor: Dr. Michael Trayford is a Board-Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For more information, please visit https://apexbraincenters.com/cognitive-decline-asheville-nc/.

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

Art as a Spice to Life

It's so easy for family caregivers to get stuck in the daily routines of their loved one's care. Each new day brings the same as the last– make breakfast, dole-out medication, struggle with their hygiene, and manage challenging behaviors. The sameness can contribute to your emotional and physical exhaustion and strain your capacity to be a warm and loving son, daughter, husband, wife, or friend. Taking the time to be mindful of creative needs can give both of you a refreshing mini-vacation from illness. 

Making and finding art opportunities for your loved one may not be as difficult as it may appear. Watercolors, paper, brushes, and a kitchen table and you are good to go. Share the creative process with your loved one. Making art together also makes memories.

Many community and senior centers offer art classes for people in early and mid-stage dementia. Contact your local Agency on Aging or other organizations that provide local support and counseling services for people who have dementia and their families.

Another easy way to find art programs is by searching the internet using keywords such as "art and dementia". Narrow your search by including the name of your state, city, or town. If you come up empty-handed, just ASK. You have everything to gain when you explain to senior center directors and directors of other organizations the need for art programs customized to meet the needs of people who have dementia.

Other options are the art education programs that many museums and, some galleries, offer. The Museum of Modern Art (MoMA), in New York City, has set the standard for making art accessible to those with Dementia. With the guidance of specially trained museum docents, visitors explore selected museum collections where they can see and, when appropriate, touch wall art and sculpture. Interactive installations may invite viewers to experience sight, touch, and sound. The conversation about art and the environment is another facet of the MoMA program. However, feelings and memory – not art history – are the inspirations for meaningful interactions and conversation

The MoMA website gives a complete description of the MoMA Project. (https://www.moma.org/meetme/modules/index ) Search the internet to locate nearby programs. Type in the name of the state followed by descriptive words such as “museum,” “Alzheimer,” “Dementia,” and “outreach.”

The year after my mother’s death, I decided to volunteer some of my newly-realized free time to the dementia community. I developed a curriculum that I hoped the “artists” would find satisfying and challenging. The outcome was a brief presentation to a local support group was four eager participants and their spouses. The three men and one woman had various types of dementia. Over the year, the artists learned basic design principles, made relief prints, painted self-portraits, and designed and printed T-shirts for themselves and their family members. Donations covered the cost of supplies.

I expected the spouses would take their off-duty time to run errands. But as it turned out, they formed an impromptu support group and spent the class time in a nearby coffee shop. Soon, “just coffee” morphed into family dinners. One of my most precious moments was when one man told me that the art class made him feel that he was becoming something rather than losing what he had once been.

Want to Know More?

1. “I Remember Better When I Paint.” https://www.youtube.com/watch?feature=player_embedded&v=54AtoQVGfwU (Accessed February 26, 2016)

2. Hayes, J. and S. Povey, The Creative Arts in Dementia Care: Practical Person-Centered Approaches and Ideas. London, England: Jessica Kingsley Publishers, 2010.

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 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

Make the Time, Don’t Find the Time

If you've been a regular reader of the Dementia Society of America blog, you know that better heart health can lead to better brain health. Exercise is just one way to increase heart health, so, how do we make exercise a priority in our daily habits and among our countless distractions?

Most people are just kind of trucking through their day, trying to get through their tasks and to-do lists. That might involve getting their kids from school, work-related tasks, and hopefully having some time to spend time with friends or make a quick appearance at the gym.

One very telling trend is the number of people that buy a gym membership, yet fail to use it. While several different studies are posting similar statistics, it is estimated that 73% of people with a gym membership either fail to use it at all or use it so infrequently that it imparts no long term health benefits.

The usual trend is that there are a lot of people who sign up for a year-long gym membership as part of a New Year’s resolution. They get this membership with the best of intentions, but by the middle of January or early February, the vast majority of them have stopped going to the gym. One of the most common excuses use is that their lifestyle doesn’t allow them the time to work out regularly.

I have found that the key to developing a successful long-term exercise routine is to develop a mindset of making the time, instead of finding the time.

You should approach it with the same mentality you would if you were scheduling an office meeting every Monday, or making sure that you’re picking up your kids from school at the same time every day.

Some talk about how juggling their career and family, along with other responsibilities, can be a huge obstacle. While this does present challenges and imposes demands on our time, there are those with even more on their plate that still make it a point to make the time to exercise.

The bottom line is that you need to make the time to exercise, because if you try to find it; the day will get by you and you’ll end up sitting on your couch worrying about our waistline while your brain and everything else suffers as a result of not exercising the way you should.

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

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

Take into Consideration: Planning for the Long Term

Much of Dementia care boils down to anticipating and planning for challenges you will face.

As a first step, the person or persons responsible for a loved one's care must have the legal rights to do so. Legal permission involves becoming the designated power of attorney (POA), or under certain circumstances, the conservator and guardian.

The amount and type of long term care your loved one needs is one of the first decisions you and your family will make.

Concerning home care, who will be the primary caregiver? What happens if it becomes neither realistic nor safe to shoulder caregiving responsibilities alone? Is the next step hiring a paid caregiver? Is the paid caregiver one that you hire or one contracted through a home care service? What are the criteria that make it necessary to transition your loved-one from home to an assisted living facility?

Some individuals fervently believe they will be his or her loved one’s caregiver throughout the illness. However, as is often the case, circumstances change. Therefore, you must anticipate and plan for modifications in the type and amount of care your loved one may eventually need. 

Research the options before you need them!

Contact your friends to discover if they know of a reliable caregiver or affordable homecare support. Look into non-profit organizations that provide various types of home care services. Visit assisted living facilities, speak with the director, ask about the services included in their monthly fees, view their inspection reports, and tour the facility. Learn the differences between a continuum of care, independent living, assisted living, and memory or dementia care. Become familiar with the steps you must take before you can place your loved one in an assisted living facility.

It may be months or even years before you come to this cross-road. However, doing your homework will minimize the time and stress of needing to take, often on short notice, this big step.

Developing the “what, if then, or buts” of medical care is another feature of a long-term care plan. Will your loved-one receive care from his or her family doctor or a Dementia care specialist? Research palliative and hospice care to be sure that preconceived ideas do not color your views. Learn about the purposes for palliative and hospice care, the best time to initiate them, and how they impact quality-of-life and end-of-life care. These last decisions are prone to family conflict and long-lasting feelings of ill-will.

A long term care plan includes funeral arrangements as well as various estate considerations. It’s not ghoulish to plan for the funeral. Cremation, embalming with or without embalming fluid, and burial location – are a few of many examples of the difficult and emotional decisions families make.

Prepare yourself for the eventual transition from caregiver to the representative of the estate. What are the responsibilities and the steps you must take to close the estate?

A long term care plan helps families navigate the challenges that dementia care present. Be sure to frequently review, update, and revise your loved one’s long term care plan.

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

Further Your Understanding: Dementia and Mood

Some people say Dementia turned their once loving and upbeat loved-one into an angry tyrant. Others may describe the changes in behavior and mood as “the same person, only more so.” Usually, “more so” is not good. Rarely does one hear that Dementia turned a difficult person into a pleasant one.

The behaviors associated with early-stage Dementia can be the most difficult. Your loved-one is fighting the imposed changes the diagnosis has brought to his or her life. And you, the family caregiver, do not have the experience to both calm your loved-one and cope with the disquiet this new relationship brings into your life.

As Dementia progresses from early to late-stage, moods, and behaviors worsen. In addition to increasing memory loss, depression, belligerence, apathy, physical aggression, wandering, repetitive questioning enters the picture.

It is useless to try to convince your loved one that what they truly believe is not what it seems. You will never win the argument.

“Distraction and redirection” is one helpful strategy to diffuse the situation. Rather than trying to prove his or her hat was misplaced and not stolen, make a comment about the nice weather and suggest going for a walk. Another way to address your loved one’s concern is to listen and tell him or her you will look into the matter. This simple tactic tells your loved-one you are there; you care, and you will make things right.

“Therapeutic deception” is another approach to managing difficult behaviors. Telling your loved one, “you will make things right,” isn’t a lie. It’s a kindness that gives him or her, and you as well, a few moments of peace. You will find a therapeutic deception is an approach you can apply to various difficult circumstances.

Dementia behaviors may also include some weird and scary things. More specifically, your loved one may experience hallucinations. How you respond to these unsettling behaviors has the potential of turning uncomfortable moments into situations that may necessitate assistance from your local police department or a trip to the emergency room.

Managing the difficult behaviors associated with hallucinations involve a different set of challenges. Telling your loved one, there isn’t any blood on the walls or bugs crawling up his or her back is fruitless. Hallucinations are sensory tricks. Your loved-one sees, hears, or feels something without the stimulus of light, sound, or touch. To prevent a difficult situation from escalating into one you cannot manage, you might say something like, “I cannot see what you see, but I am sure it is very scary.”

You might remind your loved one that you are there and that you will make sure they are safe. Sometimes a hug or a gentle touch will have a calming effect. Other times, when hallucinations cause overwhelming fear, the only thing you can do is take your parent to the emergency room.

Medication to reduce mood and behavioral difficulties is a controversial issue. Some people believe the drugs used to manage behavior are “chemical straight-jackets” meant only to make things easier for the caregiver. Other caregivers subscribe to the philosophy that providing meaningful activities for the person with Dementia, establishing a structured routine, and creating an enriching and pleasant environment can reduce the need for behavior modifying medications. In either case, one has to consider quality-of-life. Medication can reduce pain and suffering. If depression becomes overwhelming, belligerence creates a dangerous environment for the caregiver, or when hallucinations cause unrelenting terror, medication is both the humane and one that supports a better quality-of-life.

All of this is easier said than done, but do try to remember it is the disease that is speaking and not the person you once knew.

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

Make a Not-to-Do List for Better Brain Health

A lot of people have a To-Do list loaded with tasks, errands, and projects that they intend to take care of either during the course of that day or at some reasonable time in the future. Most of the people who have lists like this tend to get a few things done, then transfer whatever was leftover to the new list they write up the following day, week, or month. 

Typically, these lists end up getting so filled with uncompleted tasks that they become daunting. It can even get to the point where your bloated To-Do list is a source of stress. If something isn’t getting done it may be due to procrastination, or it’s simply something that just wasn’t important. Leaving trivial items on your To-Do list bogs down your brain capacity and starts causing you to feel things like worry and fear, which are the two most damaging emotions for the brain.

I encourage my clients to keep a Not-To-Do list. This type of list can actually have several different uses. First and foremost, it’s a sort of garbage can where you can dump meaningless tasks that probably shouldn’t have been on your To-Do list in the first place. 

This turns the list into an exercise in prioritizing. It forces you to sit down and think about what you really need to get done, what you should do, and what really isn’t all that important. Then you can sharpen your focus and execute the important tasks in your life with fervor. 

The other aspect of a Not-To-Do list is to serve as a reminder of bad habits you want to avoid. It might be eating too much sugar, having one too many drinks, or keeping up with your efforts to quit smoking. Writing down bad habits that you know you shouldn’t do can be an empowering way to break negative cycles in your life. 

It can also be a tool to help you identify sources of stress in your life. You might include things on the list like ‘I’m not going to get angry in traffic today’, or ‘I’m not going to let my annoying co-worker get to me’. 

When you think about all of these things and how they can all add up, a Not-To-Do list can be a very powerful stress management tool!

Many successful people, like Tim Ferris, are advocating Not-To-Do lists. It allows them to be much more proactive and productive than the actual To-Do-list. At the same time, it also invokes creativity and innovation, because you’re no longer bogging down your brain with things that are seemingly not that important.

Sit down and brainstorm about what is not serving you well on your list and in your life. Then compile a Not-To-Do list. You might find that it will become more important than your To-Do list.  This is a really powerful tip to ramp up your brain for peak performance.

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

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

Risk and Dementia – Genetics

For some types of diseases that cause Dementia to occur, there is a genetic association for having the disease by the time an individual is 60-years of age or older. It’s a subtle distinction, but people who have the altered gene inherit the risk and not the disease itself. In fact, Dementia is not a disease, rather, it is the expression of the cognitive challenges that come about because of the changes in brain tissue, caused by a particular disease.

This post mainly focuses on Alzheimer-caused Dementia but there are many other causes, e.g., Lewy body, Vascular, Frontotemporal, et al.

On the bright side, knowing that you have an inherited risk factor gives you the opportunity to do those things known to reduce risk - maintain a healthy weight, refrain from smoking, engage in socially and intellectually satisfying activities, exercise, and eat a heart-healthy diet.

For the most part, the at-risk genes change how the body processes cholesterol and other blood lipids. Therefore, it’s not surprising to find that having high cholesterol blood-levels is another risk factor associated with having Dementia later-in-life.

Early-onset familial Alzheimer disease (eFAD) is inherited Dementia that affects people as young as 30 years of age. (1) Unlike traits that are observable shortly after birth, such as eye color, symptoms of eFAD do not appear until the individual is 30-years of age or somewhat older. By that time, it is likely he or she has one or more children and may have unknowingly passed the early-onset gene to them.

Fortunately, there are DNA tests that can identify the presence of the increased-risk genes as well as those that cause eFAD. 

Making the decision to undergo testing is difficult. Will knowing make you feel anxious, relieved, or empowered? Will other family members also want testing? How might this information affect family planning for you or your adult children? Will having a positive test for a specific cause of Dementia risk factors or early-onset disease influence your employer, your career, or make it more difficult to receive health insurance? (2)

Often, people find talking with a genetic counselor can make the decision to test--or not--easier. The genetic counselor, by explaining the technical and emotional issues associated with genetic testing, can help you make a personally comfortable decision. Afterward, the genetic counselor can explain the test results to you and guide discussion about any further steps you may want to take. (2)

You can find more information about genetics and genetic counseling on the following webpages: National Association of Genetic Counselors (https://www.nsgc.org/page/find-a-genetic-counselor)and the American Board of Genetic Counselors (https://www.abgc.net/about-genetic-counseling/find-a-certified-counselor.aspx/). Both of these sites may help you find a genetic counselor located near your home.

Notes:
1. What is Early Onset Familial Alzheimer Disease? http://www.alzforum.org/early-onset-familial-ad/overview/what-early-onset-familial-alzheimer-disease-efad (accessed April 26, 2016)
2. Genetic Testing and Counseling for Early Onset Familial Alzheimer Disease, http://www.alzforum.org/early-onset-familial-ad/diagnosisgenetics/genetic-testing-and-counseling-early-onset-familial (accessed, April 26, 2016)

Want to Know Even More?
Alzheimer Disease Genetics Fact Sheet, https://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-genetics-fact-sheet#genetics
(accessed, April 26, 2016)

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 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

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.