Spring Arbor Living Blog

Mental health and memory are closely tied to physical health. Physical and emotional vitality are important to maintaining mental health. As you or your loved one gets older, and become less able to do some activities, replacing lost activities can help keep a positive attitude and sense of well-being over time.  If you can no longer run, try walking for example. But just as physical health needs upkeep, so does memory and mental health.

Protect or improve your memory and mental sharpness by:

• Challenging your brain daily. Read, learn a new musical instrument or language, do crossword puzzles, or play games of strategy with others. Just like an active body, an active brain continues to develop and thrive, while an inactive brain loses its power over time.
• Help your memory. Write down dates, names, and other important information that you easily forget. Use routine and repetition. For example, keep daily items such as keys and eyeglasses in a specific place. No matter what your age, having too much on your mind can keep you from remembering new information. And as you age, it is normal to take longer to retrieve new information from your memory bank.
• Preventing depression, which is a common yet treatable cause of cognitive decline in older people. In addition to getting regular physical activity and social contact, avoid the depressant effect of alcohol and sedative use, eat healthy meals and snacks, and include meaningful activity in your daily life.
• Not smoking. Cigarette smoking may speed mental decline. This connection was identified in a large study comparing smokers and nonsmokers age 65 and over.

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One day your doctor might give you this prescription to prevent Alzheimer’s: Eat less red meat and sugar; eat more fruits, vegetables, fish and olive oil.

At least that seems to be the finding of a new study that found that eating a diet low in saturated fat and sugary treats can improve your memory and may reduce your risk of developing dementia.

Researchers with the University of Washington and Veterans Affairs Puget Sound medical center decided to see if a change in diet could affect the risk for Alzheimer’s or benefit those already suffering some mild but early symptoms of the disease.

What they found was that a diet rich in fruits, vegetables, grains, fish and olive oil can improve some memory skills in both healthy older adults, as well as those already experiencing cognitive difficulty.

More importantly, eating this kind of diet can help healthy adults reduce their risk of developing dementia, says study researcher Suzanne Craft with the Memory Wellness Program at the VA.

Researchers found that after four weeks on the low-fat diet, subjects had fewer toxic proteins and evidence of inflammation in their spinal fluid, both considered to be bio-markers for Alzheimer’s, Craft said.

“I like to think of this kind of diet as promoting healthy brain aging, as well as reducing the risk of Alzheimer’s,” she said.

The Washington state researchers wrote that they decided to take a “whole-diet” approach, rather than focus on a single dietary component, such as omega-3 fish oil. They also chose to test the subjects’ spinal fluid for bio-markers because of the importance of the central nervous system to brain health.

The 49 subjects, all older than 60, included 20 healthy adults with no signs of memory decline, and 29 who were at high-risk for Alzheimer’s, having already been diagnosed with some cognitive impairment.

They were randomly selected to either follow a four-week low-saturated fat, high-fiber plan similar to a Mediterranean diet, or a four-week high-saturated fat diet that included foods like red meat, butter, french fries and soda.

Both groups ate the same amount of protein and the diets were balanced so subjects did not lose or gain or weight.

However, for those who want to protect their brain health, it seems pretty clear from these preliminary results that eating a healthy diet is a powerful first step.

Original article on AARP

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The link to healthy diets and brain health is well established. The link to diet and Alzheimer's disease is less clearly established, but new information on curcumin (found in turmeric) may prove to be helpful.

The brain is particularly vulnerable to oxidative damage due to its high rate of metabolism and long-lived neurons. Free radicals can cause oxidative damage to important cellular components such as DNA, or the cell membrane. Cells may function poorly or die if there is too much oxidative damage.

Antioxidants defend the cells from free radical damage. Many long term studies have demonstrated that those with higher antioxidants in their diets from fruits, vegetables and certain spices have slower rates of cognitive decline than those who ate less of these foods.

Curcumin has been studied recently because of the low rates of Alzheimer's disease in India. The Indian population consumes large amounts of curcumin through Tumeric and have a relatively low (4 times less) incidence of Alzheimer's disease compared to the U.S. population.

Curcumin is a member of the ginger family and is the main ingredient of turmeric, a spice used in curry and many Middle Eastern dishes. Curcumin is an antioxidant with nonsteroidal anti-inflammatory properties which prevents the damage caused by free radicals. The more antioxidants in the diet, the more the cells are protected.

The National Institutes of Health and other research organizations have been completing Alzheimer's clinical trials. Recently, curcumin has been in the forefront of much of this research. Curcumin's powerful anti-inflammatory and anti-oxidant properties suppress the buildup of beta-amyloid in brain tissue.

The National Institute of Neurological Disorders and Stroke (NINDS) studied mice and found that curcumin crosses the blood-brain barrier to bind with beta-amyloid peptides. These peptides are dangerous when they build up into plaques.

As Alzheimer's disease develops, neurons go through a process from a healthy state to some loss of molecular efficiency, to a loss of synaptic function, to loss of synapses, and, ultimately, to cell death. When curcumin was fed to aged mice, there was a reduction in amyloid levels and the overall amount of dangerous plaque.

More studies are needed to investigate the safety and tolerability of curcumin in the elderly population. Research is also needed in the areas of using curcumin to prevent Alzheimer's Disease as well as to lessen symptoms.

As clinical trials produce more information about the efficacy of curcumin, guidelines will be established for those at risk and for those affected.

Original article on CDApress.com by Seanne Safail, , Ph.D, RD

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An older person who cares for a spouse with dementia is also at an increased risk of developing problems with attention and memory, according to a new review of studies.

This is because the spousal caregiver likely shared lifestyle risk factors with the person with dementia, and undergoes ongoing stress from caring for the person.

Researchers from the University Of Washington School Of Medicine reviewed more than 100 studies that examined the cognitive health of older adults who cared for a family member with dementia, with the majority of the subjects being spouses. They found that these caregivers have more trouble with attention and memory, also known as cognition, than people who don't have to care for a family member with dementia.

The review of the studies showed that those caregivers had a higher risk of cognitive decline or dementia than people who do not have to care for someone with dementia. This could be due to a number of factors, including depression, loneliness, sleep problems, social isolation, exercise, diet and even obesity.

People who are caring for a spouse with dementia may themselves be at risk for cognitive problems which, in turn, will not only negatively influence their quality of life, but may reduce their ability to provide the necessary care for their spouse.

Most care-recipients prefer to be cared for in their homes, and, by remaining in their homes, health care costs are reduced greatly, therefore, often spouses of end up providing care.

The study was published in the Journal of the American Geriatrics Society.

People with dementia are not the only ones who have health problems – a spouse who cares for them are also at risk for attention and memory problems.

Original article on MSN.com

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In this excerpt from a recent issue of Health After 50, Marilyn Albert, Ph.D., director of the Johns Hopkins Alzheimer’s Disease Research Center, talks about current methods of diagnosing Alzheimer's Dementia.

•   Traditionally, how has Dementia been diagnosed? How accurately can it be diagnosed today?

Research now tells us that Dementia progresses over time and likely begins years or decades before symptoms first appear. But right now, we can only diagnose Dementia late in the game. 

To diagnose Dementia we rule out other potential causes for cognitive decline, such as stroke, tumor or metabolic syndrome (a combination of medical disorders that raises the risk of heart disease, diabetes and stroke that may also increase the risk of dementia).

We then run a battery of cognitive tests and brain scans to rule out other neurological disorders and to determine whether the pattern of symptoms seems consistent with Dementia. If these things match up, we can give a probable diagnosis of Dementia. At major medical centers, a probable Alzheimer's Dementia diagnosis can be 80 to 90 percent accurate.

•   What are biomarkers, and how will they help with earlier, more accurate diagnosis of Dementia?

"Biomarker" is a term that describes a measurable change in a person that will give us information about what is going on in his or her brain tissue. For example, the signature of Alzheimer’s disease includes amyloid plaques [abnormal accumulation of amyloid proteins] and neurofibrillary tangles (deposits of defective tau proteins, a type of protein abundant in the brain).

The proteins related to the plaques and tangles are present in the spinal fluid of patients with Dementia. They’re also present in those with mild cognitive impairment (MCI) -- slight problems in thinking, learning and remembering that sometimes progress to full-blown dementia.

The proteins serve as biomarkers of the progressive changes taking place in the brain. In clinical research, tau and amyloid have been shown to predict the progression of patients with MCI to Dementia and ultimately Alzheimer's.

In other words, measuring these proteins allows us to say more accurately and at an earlier stage of disease that we are pretty sure this person is going to develop Alzheimer’s dementia. Imaging procedures, such as PET (positron-emission tomography) and MRI (magnetic resonance imaging), also can provide information about the pathology present in the brain. For example, amyloid can now be measured with PET.

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Disease develops years before symptoms show.

New guidelines for diagnosing Alzheimer's disease set forth methods for identifying the disease before it progresses to full-blown dementia, and for the first time include lab and brain-imaging tests that can help identify Alzheimer's as the likely cause of a person's mental decline.

The guidelines, revised for the first time in 27 years, reflect a firm consensus among Alzheimer's researchers that the disease begins to attack the intricate structures of the brain 10 years or more before the disabling mental problems appear. Therefore, to be effective, drug or other therapies will have to begin work early in that process.

So far, though, there are no therapies that alter the course of Alzheimer's disease. And in a media briefing, authors of the new diagnosis guidelines emphasized that while testing for Alzheimer's pathology in the brain may one day be used to identify the disease at much earlier stages, today the tests are primarily a research tool. They are not ready for routine use in doctors' offices.

Delaying disability

Even so, doctors hope the new diagnostic criteria encourage people with worrisome memory problems to seek help. There's a lot patients and their families can do to minimize the impact of Alzheimer's, from structuring the patient's environment to optimizing medical care, activities, exercise and diet.

New tests outlined in the guidelines involve looking at the brain with imaging technologies and examining the fluid obtained by a spinal tap. The imaging studies can reveal so-called plaques made up of a protein called amyloid, a defining feature of Alzheimer's. They also can indicate characteristic patterns of shrinkage or reduced metabolic activity in the brain. The cerebrospinal fluid tests look for levels of amyloid as well as of another protein, tau, which makes up the twisted strands or "tangles" that, like plaques, are signature brain pathology in Alzheimer's.

Weaknesses of the tests

Research studies have demonstrated that all these tests can help identify Alzheimer's as the cause of a patient's dementia, and can help predict which patients with milder symptoms will go on to develop dementia. But the tests aren't conclusive in themselves. They aren't standardized so that a certain result means the same thing in every medical center. And there's no clear cutoff separating normal findings from those indicating a problem.

Original article by: Katharine Greider from AARP Bulletin

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As we get older, many of us will notice changes in our memory. Forgetfulness is a normal part of getting older, however, dementia and Alzheimer's disease is not. How can we tell the difference? We all worry, about ourselves and our parents as we watch them age; and with good reason.

Presently, one in ten people 65 and older has Alzheimer's, about 5 million people. But only half have been diagnosed with the disease. It is estimated that by 2050 as many as 16 million people will have it.
As we become more and more educated about this terrible disease, we often find ourselves wondering when we or someone we love will get it, not if we or someone we love will get it. You may be concerned because you have noticed recurring "senior moments".  As we age, we notice our senior moments more and more.
 
So where does normal forgetfulness end and mild cognitive impairment begin? Some experts think that mild cognitive impairment (MCI) is the early signs of Alzheimer's disease. Unfortunately, there is no definitive test for diagnosing Alzheimer’s, but your personal history and mental status exams are accurate about 90% of the time. Alzheimer's progresses very slowly for most people. The downward slide of thinking, memory, and judgment are gradual, over the span of many years.

If you have concerns about yourself or a loved one, find out all you can about your own, or their, personal history and speak with your doctor. Education about Alzheimer’s Disease is the best way to understand an prepare yourself, if necessary, for this terrible disease.

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Alzheimer's disease is the most common form of dementia. Unfortunately, it is presently incurable. With every stage issues crop up, and it is very challenging to care for someone with this disease as their condition deteriorates. However, there are some activities to keep Alzheimer patients engaged and to assist them in coping with this disorder. Those who suffer from Alzheimer’s need care, motivation, support, encouragement and patience. The following activities will help.

• Puzzles and crosswords that are simple and easy will stimulate their brains and help slow down degeneration. These cognitive activities will help in reducing memory loss.
• Crafts and activities with little complication like maintaining a photo album, sorting photographs, making collages, or writing small notes to relatives can be engaging for these patients. It is important that the task is well described, sequenced and easy to handle.
• Reading a story aloud to them that has pictures will enable them to comprehend and answer relevant questions. This will also strengthen the bond between the caregiver and the patient. Alzheimer’s patients have a better chance of remembering information about the caregiver through activities they did together.
• Household work should be encouraged. Alzheimer's sufferers should perform their daily chores. This will create lesser dependency and will assist them in remembering things better.
• Gardening and keeping busy weeding, planting, and watering will enable them have a better approach to cope.

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Alzheimer's disease symptoms result from physical changes in the brain. What causes these changes is still somewhat of a mystery, however researchers have a leading theory of how the Alzheimer's disease progresses.
 
In a healthy brain, certain chemical processes ensure the proper functioning of neurons. One is the processing of amyloid precursor protein (APP) that is attached to the outer membrane of nerve cells. Certain enzymes cut off a section of the protein; while another enzyme snips a second portion and releases APP from the cell’s membrane.

These APP fragments are then broken down and removed from the brain. Another process, which we won’t get into here, carries nutrients through the nerve cells to keep them functioning normally.
 
When the processes that keep a healthy brain functioning go awry, a different enzyme, cuts shorter APP fragments from the nerve cell membrane. These smaller pieces are more resistant to breakdown and tend to clump together in toxic clusters and eventually they collect into plaques that interfere with nerve cell functioning. Within neurons, the transport of nutrients is crippled and nerve cells are destroyed. Loose threads join together to form knotted strands inside neurons. These cause further neuron destruction.

In the early stages of Alzheimer’s, plaques and tangles form in brain areas responsible for learning, thinking, and planning -- in particular, the hippocampus. This is why forgetfulness, disorientation, and verbal repetition are often among the earliest signs of Alzheimer’s. As nerve cell destruction spreads more brain areas are affected, especially the cerebral cortex, responsible for language, reasoning, and judgment. Speaking skills become impaired and emotional outbursts grow more frequent.

When large areas of nerve cells die off in the advanced Alzheimer’s stage, brain sections atrophy and the whole brain shrinks to as much as three quarters of its original size. People with Alzheimer’s lose most of their ability to communicate, walk, and care for themselves.  

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In the field of elder care, music has been explored as a way to encourage social interaction, encourage self-expression, and enhance the overall well-being of assisted living residents who fight illnesses such as Alzheimer's, dementia, memory loss, and other cognitive impairments. So through music, Spring Arbor has found that residents with these health conditions are able to live more fully. They are not defined by their conditions or their need for medicines and skilled medical care. They become engaged members of a supportive community that encourages emotional growth, sharing, and self-worth. This can be vitally important to seniors who experience a number of difficult life events such as retirement, the death of a loved one or spouse, and the need for help with common tasks.

So far, experts know of no other single activity that stimulates the entire brain. In addition to this, music increases dopamine levels, and dopamine can cause a corresponding positive sense of well-being. So what does it mean to say that music promotes well-being? Well-being is characterized by a sense of affiliation. Seniors feel connected and have an increased sense of belonging. Music also brings about a feeling of self-competence and independence in seniors. They enjoy life day-to-day and gain a greater sense of fulfillment.

Many research studies indicate that musical activities have several positive benefits. Patients are reported to have better moods, be more sociable, eat better, and react more calmly to stress. Experts say it’s the “cognitive workout” for the brain that brings on these positive traits. Feel free to contact us to learn more about assisted living and how life at Spring Arbor can be relaxing fulfillment.

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