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As we grow older, we tend to worry about our memory and thinking. We hear so much about Alzheimer’s disease and other dementia, and chances are we have friends and loved ones who have been touched by one of these conditions. Some people even believe that memory loss is inevitable—that they will surely become “senile” in their later years.

This couldn’t be farther from the truth for most of us. Sharpness of memory varies from individual to individual. Genes are a factor—by some accounts, about 30 percent of our memory health is hereditary. But the other two-thirds of memory wellness might well be within our control, say experts. There are steps we can take to maintain a healthy memory.

1. Exercise your mind and memory. Mental stimulation encourages new connections between brain cells. “Use it or lose it” isn’t just a cliché when it comes to memory health. Brain experts tell us to give our brains a workout with challenging activities. Learning something new is especially good. Take up an instrument, learn a foreign language, join a club, volunteer, do a difficult puzzle each day. Passive activities, such as watching TV, don’t offer the same benefits. You can also “exercise” your memory using visualization and concentration. And memory aids—from sticky notes to smartphone reminders—can pick up where our memory leaves off.
2. Exercise your body, too! Aerobic exercise has been found to ward off Alzheimer’s disease, stroke and other memory-damaging conditions. It helps us avoid obesity, which is also bad for brain health. Recent research also shows that muscle-strengthening exercise helps the brain. And relaxation exercises, such as tai chi and yoga, are also showing promise. Talk to your healthcare provider about an exercise program that is right for you.
3. Take care of your all-around health. The more we know about cognitive wellness, the more we realize that brain health can be negatively impacted by heart disease, diabetes, high cholesterol, high blood pressure, kidney disease and a number of other disorders. Follow your healthcare provider’s instructions. And ask for a review of your medications; recent studies implicate certain drugs in raising the risk of dementia.
4. Eat a brain-healthy diet.  We can choose foods that help protect memory. Avoid cholesterol, saturated fats and trans fats. Instead, choose fish, fruits, vegetables, and healthy fats such as olive oil. Take a multivitamin if your healthcare provider recommends it—but don’t take megadoses that could be toxic.
5. Quit smoking and limit alcohol consumption. Many substances found in cigarette smoke damage the brain and impair memory. And while some studies suggest drinking in moderation might actually be beneficial, having more than a drink or two per day can be toxic to the brain.
6. Get enough sleep and seek treatment for sleep disorders. You’ve probably noticed that when you don’t get enough good quality sleep, it is harder to concentrate the next day. And did you know that while we’re sleeping, our brain is busy converting short-term memories into those that are retained? Neurologists also tell us that harmful waste material is cleansed from our brain as we sleep.
7. Lower your stress level and seek help for depression. Stress and depression cause chemical changes in the brain that can be so severe that a person’s family or physician mistakenly suspects Alzheimer’s or other dementia—and in addition, they do raise the risk of Alzheimer’s. Talk with your healthcare provider if you feel stressed or depressed. Counseling, meditation and other relaxation techniques can all help.
8. Protect against head injury. A lot of people who worry about Alzheimer’s disease forget that head injuries are another major cause of memory loss. A head injury can result in catastrophic damage to the brain and memory. Always use your seatbelt, and if you are a cyclist, wear a helmet. And protect against falls—especially at home, where most serious fall injuries take place.
9. Have your hearing checked. Studies suggest that older adults with moderate to severe hearing loss may be at higher risk of developing dementia. This may be due to the stressfulness of social isolation, and also to the “exhaustion of cognitive reserve”—our brains have to work much harder when we can’t hear. Hearing loss is often preventable, and hearing aids and other technologies can help seniors improve their hearing.
10. Have regular dental checkups. Tooth loss and gum disease make it harder to eat a healthy diet, and can be a factor in social isolation. And experts now believe that the bacteria and inflammation caused by gum disease and linked to dementia. Talk to your dentist if arthritis or other problems make it hard to care for your teeth and gums.

If you’re experiencing memory lapses, or if you just find yourself fretting about memory problems, share your concerns with your doctor. Stress can really work a number on our memory—so stressing out about our memory is an ironic cycle we want to avoid! Then you can relax, knowing you’re doing everything you can to keep your memory strong.

Source: IlluminAge AgeWise

A recent study published in the Journal of Geriatric Psychology and Neurology found that family caregivers who are suffering from depression experience more distress when they are caring for a loved one with Alzheimer’s disease or other dementia. The study, by researchers from University of Eastern Finland, suggested that caregivers be tested for depression. This is not only important to help these caregivers provide better care for their loved one; it can also protect their own brain health!

Depression is one of the most common conditions affecting older adults. According to the University of Pittsburgh School of Medicine, an estimated 15 percent of people older than 65 are dealing with depression, which affects the whole person: mind, body and emotions. Symptoms include a persistent feeling of sadness, lack of energy, changes in normal eating and sleeping, memory disturbances and impaired concentration, loss of interest in usual activities, and trouble keeping up with normal activities at home and work.

If you compare these symptoms to those of Alzheimer’s disease and related conditions, you will notice some striking similarities. Many of the symptoms of depression are known to mimic dementia, so closely that families and even healthcare providers may at first mistakenly suspect that a patient has Alzheimer’s disease. Ruling out depression is an important first step in diagnosing dementia.

Further complicating things, depression itself may be an early sign of dementia. But if depression is a symptom of Alzheimer’s disease, could it also be a risk factor? For years, researchers have speculated that people with depression are more likely to later develop dementia. What is the connection? How could a history of depression make it more likely that a person will suffer cognitive losses later in life?

The American Academy of Neurology states that depression may nearly double a person’s risk of developing dementia. Researcher Jane Saczynzki, Ph.D., of the University of Massachusetts Medical School says, “While it’s unclear if depression causes dementia, there are a number of ways depression might impact the risk of dementia. Inflammation of the brain tissue that occurs when a person is depressed might impact the risk of dementia. Certain proteins found in the brain that increase with depression may also increase the risk of developing dementia.” Researchers from the University of Edinburgh also looked at brain shrinkage caused by high levels of certain stress hormones.

Research is underway to determine the precise nature of the connection between the two conditions. Says Dr. Monica Breteler of Erasmus Medical Center in the Netherlands, “We don’t know yet whether depression contributes to the development of Alzheimer’s disease, or whether another unknown factor causes both depression and dementia. We need to do more studies to understand the relationship.”

University of California San Francisco researchers also found that seniors with serious, increasing depression symptoms are more likely to develop cognitive decline. Said Prof. Allison Kaup, Ph.D., “Our results raise the possibility that older adults’ cognitive health could be improved with interventions to reduce depressive symptoms, such as psychotherapy or other behavioral interventions, or medications. This is an important topic for future treatment studies to investigate.”

One thing researchers agree upon: Depression makes it much less likely that we will follow a healthy lifestyle that protects our memory health. It saps our will and motivation and our desire to be active. Says Saczynski, “Several lifestyle factors related to long-term depression, such as diet and the amount of exercise and social time a person engages in, could also affect whether they develop dementia.”

Depression Can Be Treated

This is yet another reason to seek professional help if you or a loved one shows signs of depression. Depression can become disabling if not properly treated. All too often, people are resistant to the idea that they might have a true depression, feeling that somehow they will “just snap out of it.” But depression is an illness that results from a chemical imbalance in the brain, and it can respond successfully to treatment.

The first step in reversing depression is to have it diagnosed by a physician or other qualified professional. After a thorough exam, the healthcare provider will first try to identify the cause of the depression, which might stem from:

• Distressing life events such as the death of a spouse, financial worries or illness
• Chronic pain
• Nutritional deficiencies such as lack of vitamin B-12 or folic acid, or poor nutrition in general
• Underlying medical conditions such as low thyroid or other hormone changes, diabetes, heart disease, memory loss or Parkinson’s disease
• Side effects of specific medications, overmedication, or effects of polypharmacy (taking many drugs which might have a negative interaction)

Treatment for depression may include:

Lifestyle changes—Patients are advised to focus on better nutrition, spending more time with others, increasing physical activity, making more time for enjoyable activities, managing other health conditions, and confronting and dealing with negative thoughts.

Counseling—It’s not always possible for a person with depression to work through troubling thoughts on their own. Talking with a mental health professional may help identify the stressors that have led to depression, aid in developing strategies to lessen those stresses, and change negative thoughts as patients learn to take better care of themselves.

Medication—Antidepressant medications work by helping the brain make its normal chemicals again. These medications can help with sleep, improve energy and reduce anxiety and negative thoughts. There are several classes of these drugs; it is important to work closely with the healthcare provider during the process of finding the best medication for each patient. This may take several months.

Many older adults avoid seeking help for depression. They may have a generational attitude of self-sufficiency and keeping one’s problems to oneself. Seniors should be encouraged to understand that treating depression is no different than treating any other illness. Professional help can let them get their lives back on track. And now we know it may very well also protect their brains!

Better treatment of depression and understanding of the connection between depression and dementia is not only important for senior patients; it is vital for our nation’s healthcare system as well. According to University of Pittsburgh School of Medicine professor Meryl Butters, Ph.D., “An understanding of how late-life depression increases the risk of dementia could lead to better prediction and prevention mechanisms. Early diagnosis and prevention of depression could have a major dual public health impact as they could also potentially prevent or delay cognitive decline and dementia in older adults.”

Source: IlluminAge Communication Partners. Copyright 2016 IlluminAge.

An expert says a decline in financial management skills might be an early sign of Alzheimer’s disease, and family may need to step in.

What’s the most challenging topic to discuss with older loved ones? Family caregivers often name end-of-life wishes, driving safety and incontinence as tough-to-talk-about subjects—but according to many experts, money management is right at the top of the list. Most older adults view taking care of their financial affairs as a private matter, and pride themselves on doing a good job of it. Yet, according to the Consumer Financial Protection Bureau, seniors may have cognitive challenges that make it hard to keep track of money matters and could make them vulnerable to scam artists and financial elder abuse.

Daniel Marson, Ph.D., J.D., of the University of Alabama at Birmingham (UAB) has studied this topic for a number of years. In a 2009 study, Marson, who is a professor of neurology and director of the Alzheimer’s Disease Center at UAB, noted that poor money management might even be an important early sign of Alzheimer’s disease.

Marson and his team studied a group of people who had mild cognitive impairment, and found that some of them remained able to manage their financial affairs, while others became less able to balance their checkbook, pay their bills or understand their bank statement. This latter group, the researchers found, were far more likely to be later diagnosed with Alzheimer’s. According to Marson, “Impairments in financial skills and judgment are often the first functional changes demonstrated by patients with incipient dementia.”

What signs should families be alert for? In 2014, Marson presented at a symposium called “Financial Planning in the Shadow of Dementia,” put on by the Massachusetts Institute of Technology AgeLab and Transamerica.

He listed the following warning signs:

• Memory lapses, such as forgetting to pay bills or taxes, or paying bills twice.
• Poor organization of financial information flow, where a previously neat desk is now in disarray and disorganized. An individual might be confused about when an activity transpired, and mail might not be opened in a timely manner.
• Math mistakes in everyday life, such as figuring out a tip, balancing a checkbook or needing help with the steps of a calculation.
• An erosion in the ability to comprehend basic financial concepts.
• Impaired financial judgment, particularly a new interest in get-rich-quick schemes. A classic sign is that the person would not have considered the scheme five years ago and is now listening and interested.
• An unrealistic anxiety about personal finances.

It’s important to note that some of us are more money-savvy than others, so what families should be looking for is a change in their loved one’s abilities.

When it’s time to step in, Marson suggests caregivers can:

• Oversee their loved one’s checking transactions.
• Contact their loved one’s bank to detect irregularities such as bills being paid twice.
• Become cosigners on a checking account so that joint signature is required for checks above a certain amount.
• Help their loved one with online banking and bill payment.

If a family is worried about their loved one’s financial safety, it’s time for a conversation. You might need to call in an expert—your loved one’s physician, an elder law attorney, an aging life care professional (geriatric care manager) or a financial advisor. These are sensitive conversations indeed, but very important to help loved ones with cognitive impairment preserve self-esteem while avoiding financial damage and exploitation.

Source: IlluminAge AgeWise, reporting on studies from University of Alabama Birmingham.

A 16-year-old high school student (we’ll call her Anne) recently stood in front of a packed ballroom to speak at an Alzheimer’s fundraiser. She was there to talk about the effect Alzheimer’s had had on her life. When she was just 12 years old, her 45-year-old father was diagnosed with the disease. He died four years later. She talked about how her tall, handsome father was completely debilitated by the disease, to the point where he was literally afraid of his own reflection. When he saw himself in the mirror, he couldn’t understand why there was a strange man in his home. Anne shared that she lost much of her childhood taking care of her father.

Many people have been unaware of the fact that Alzheimer’s is not just a disease of the elderly. The Alzheimer’s Association estimates that as many as 200,000 Americans have early-onset Alzheimer’s, most of them in their 40s and 50s. Recently, more attention has been paid to this form of the disease, as seen in the April 2015 issue of the Regency News.

Early-onset Alzheimer’s has been described as particularly cruel, as it strikes at a time when patients are often beginning to reap the rewards of working hard and raising a family.

This can be particularly hard on caregivers. Early-onset Alzheimer’s often creates even greater burdens for families than the more common late-onset form of the disease. Trying to care for a spouse with the disease – who most likely can no longer work – while raising a family brings a whole new set of challenges to caregiving. That’s why, often, caregiving duties also fall on the children of these families, as demonstrated by Anne in the story above.

Individuals with early-onset Alzheimer’s and their caregivers face a unique set of challenges. Because no one expects a younger person to have the disease, it may be misdiagnosed, and people may not understand or have sympathy for someone living with it. Employers may think someone is simply “losing it” or a spouse may become irritated that their partner in life seems to be letting important tasks go undone.

One of the first things caregivers may face is the question from people who say “S/he’s too young to have Alzheimer’s.” That’s why it’s important for caregivers to become educated. Families should also know that early-onset Alzheimer’s has a genetic component to it, which means that it runs in families. The genetic connection is much stronger in early-onset Alzheimer’s, meaning that if a person’s parent or grandparent is diagnosed with the disease, the person’s chances of developing the condition are much higher compared to those who have a parent or other relative with later-onset Alzheimer’s.

There is a genetic test that can tell if a person has an increased chance of getting the disease. Getting tested is a very personal decision. Before deciding on whether or not to get the test, it’s important to speak with a healthcare professional about the options. For instance, a positive result could affect a person’s ability to obtain life or disability insurance. On the other hand, getting tested could lead to an accurate diagnosis, allowing patient and family to plan ahead, ensure the family will be taken care of, and get treatment. Although there is no cure for Alzheimer’s, there are some treatment options available that may help ease its symptoms.

Washington University in St. Louis is currently conducting clinical trials for people with Autosomal Dominant Alzheimer’s Disease (ADAD), the scientific name given to familial or early-onset Alzheimer’s. The Dominantly Inherited Alzheimer Network Trails Unit (DAIN-TU) is testing drugs to see if there is any way to prevent, delay, or possibly even reverse the effects of the disease in the brain. Study subjects are people at risk for the disease (defined by someone who has either a parent or a sibling with ADAD). For more information, visit http://dian-tu.org.

Learn More

The National Institute on Aging’s Alzheimer’s Disease Education and Referral Center website contains consumer resources about early-onset Alzheimer’s disease.

The Alzheimer’s Association offers information and support for people affected by younger/early onset Alzheimer’s.

Source: IlluminAge Communication Partners. Copyright 2015 IlluminAge

Discussing important and very private issues with loved ones who are growing older can be a challenge. Studies show that few families have these types of conversations until a major event occurs—a sudden health crisis, the loss of a spouse, or even a holiday visit by children during which it becomes apparent that Mom or Dad is having trouble living independently.

But waiting until a crisis occurs is not a good planning strategy. Although it is critical to bring up these subjects before a crisis arises, it’s best to keep the conversation casual. Don’t overwhelm Mom and Dad; let them feel your love and concern. And remember: helping your parents to plan for the future is not only important for their well-being as they age, but it will make a difference in your financial, emotional and physical health as well.

Topics to think about and discuss as a family:

1. Living options—Do your parents want to stay in their current home as long as possible? Or are they considering “downsizing” or moving to a senior living community? Discuss what they would prefer if they were to experience a decline in health and need greater assistance with the activities of daily living. Home care? Adult day services? Assisted living?
2. Home modifications—Is your parents’ home keeping up with their needs? What repairs and modifications could make their house, apartment or condominium safer and more convenient?
3. A plan to stay physically active—Study after study shows that regular physical activity is the most important contributor to healthy aging. No matter what a person’s condition, adding exercise is of benefit. Encourage your loved ones to add more exercise to their lifestyle.
4. A goal to remain socially connected—Meaningful social interaction is vital to the physical, emotional and intellectual health of people of every age. For most seniors, spending time with children is richly rewarding—but did you know that recent studies show that seniors who socialize not only with family members but also with non-family members have better emotional, intellectual and physical health?
5. Estate planning—Do your parents have an up-to-date will? If their plan is to pass property to family members, have they talked to a financial advisor about the best way to do that? How can their assets help provide for their own care in case of a decline in health or incapacity?
6. Advance healthcare planning—Have your parents completed advance directives for healthcare, including a healthcare power of attorney and living will? Have you discussed with them what their wishes are if they were to be incapacitated and unable to make their own healthcare decisions?
7. Medicare, Social Security, VA benefits, retirement—Are your parents taking advantage of all the benefits available to them? Do they have the best supplemental Medicare policy? Part D drug plan? Do they know the deadlines to sign up for benefits in order to avoid penalties?
8. Long-term care insurance—Many people erroneously believe that Medicare pays for a nursing home or home health care services. But in reality, long-term care is not covered by Medicare, and paying for it can quickly deplete financial resources. Investigate whether your parents are good candidates for long-term care insurance. And if they already have a policy, is it from a reputable company?
9. Fall prevention—Especially if they have already experienced falls, many older adults are reluctant to discuss this topic. But did you know that fall protection is actually an important part of planning for the future? Falls are one of the leading causes of incapacity…and this is one risk factor for incapacity that we can take proactive steps to avoid.
10. Avoiding crime and fraud—Unfortunately, criminals and con artists often target vulnerable seniors. Scams and unethical sales methods aimed at older people can cause serious financial loss. Seniors who have been victimized are often ashamed to discuss the incident. So bring up the subject and educate yourself and your parents about crooked sweepstakes, identity theft and unscrupulous salespersons.

These topic suggestions are intended to provide a framework for seniors and family members as they talk and plan together. And if the “teamwork” aspect isn’t working as well as you’d like, consider adding outside new members to the team! Your loved one’s healthcare provider, a geriatric care manager, financial planner or eldercare attorney can all provide valuable help and guidance.

Remember that you share a common goal in this planning: that you and your loved ones are able to live life as fully and joyfully as possible.

Source: IlluminAge. Copyright 2014 IlluminAge