Archives 2017

By Meredith Kimple

Our elderly parents start to wear the same outfit for three days in a row.

We may notice that their hair is unusually messy, that there is always food stuck in their teeth, or that they have started to smell. Our senior loved ones’ hygiene, or lack thereof, is of great concern to us, especially if they were typically well groomed in the past. We may feel embarrassed for them, or worry that their dignity will be compromised if they live in a state of uncleanliness, and these fears are certainly valid.

However, if our senior loved ones suddenly stop taking care of themselves, we need to examine the underlying causes for this change. While shifts in self-care practices are often par-for-the-course as a person ages, this does not mean we should take them lightly.

Why do many older people have poor hygiene?

There are a number of reasons, but we’ll look at three of the primary problems:

1. Physical Challenges

Tasks that were once easy have become difficult and dangerous due to age-related physical limitations. Your senior loved one may not be as steady on their feet, so getting out of a bathtub or shower, while wet, could lead to slipping and falling. They may have trouble brushing their teeth, flossing, and doing the laundry; their solution might be to simply ignore these activities until they are absolutely necessary. Whether self-care tasks are physically difficult or daunting for our older relatives, their hygiene suffers for it.

2. Cognitive Impairment

Seniors who have Alzheimer’s disease or dementia often forget to bathe or perform other basic self-care tasks. They may not remember how to take a shower, and certain parts of the process can be confusing or terrifying. They may believe that they have already performed that part of their routine, even if they haven’t.

3. Psychological Changes

Depression can destroy a person’s motivation to practice self-care and other hygiene-related tasks. Elderly depression is often overlooked and underestimated, but it is not at all uncommon, as seniors are forced to adjust to many difficult changes and events. Grooming activities may also be an area in which our older loved ones attempt to exercise control; they might feel powerless or frustrated by a recent lack of independence, and as a result, neglect cleaning as a form of rebellion.

We must first identify which of these factors are impacting our senior loved ones’ ability to perform essential hygiene tasks; each of the aforementioned issues requires a different approach.

If an older person finds bathing physically difficult, there are tools to help make the process easier and less strenuous. A shower chair is an excellent option for seniors who have trouble standing for long periods of time or who have a poor sense of balance; installing railings in the bathroom can also lessen their risk of falling. A hand-held showerhead and a loofah on a stick can help them clean areas that would otherwise be too hard to reach due to their mobility constraints. Modifications like these will allow them to retain independence for as long as possible, but eventually they may need assistance with bathing and other hygiene-related tasks.

Cognitive impairments often prevent older people from properly taking care of themselves; those who have dementia or Alzheimer’s disease may require the involvement of others to ensure that they are practicing good hygiene. Establishing a routine is very important, but that alone is not always enough. Those suffering from cognitive impairments may not know how to bathe, or the process may terrify them to the point that they neglect it entirely; if you are their primary caregiver, you may need to assist them with these tasks. Though it can be difficult, creating a comfortable environment and responding to their needs will help to reduce their anxieties and give them a sense of security.

If you are concerned that your senior loved one has stopped practicing self-care because of depression, express your concerns to their regular physician, who will know how best to proceed. Depression is by no means uncommon among the elderly; many feel isolated and overwhelmed by the difficult and painful changes that age brings. Helping them get involved in activities or taking them on regular outings may improve their mood and give them a reason to practice good hygiene; however, depression is not something people can simply “get over.” Therapy and medication can go a long way towards helping older individuals manage their depression, but it often remains a work in progress. Similarly, feelings of powerlessness can lead our older loved ones to resent our well-meant concerns over their hygiene. Choosing whether or not to bathe or change clothes may be their way of grappling for control over some small aspect of their lives.

Patience, understanding, and a willingness to listen are key when it comes to addressing these problems. Though cleanliness is important in its own right, not practicing good hygiene can cause more serious health issues, like rashes, sores, and even infections. Beyond that, engaging in self-care is tied to our self-esteem. An older individual who does not bathe or maintain cleanliness might think that it no longer matters if they appear or smell their best. They may not feel the need to practice good hygiene because they have been removed from the social sphere they once occupied; they may not think such activities are “worth the trouble.”

For the sake of their dignity, safety, and self-respect, we as their loved ones must support and encourage them. This does not mean that we unflinchingly hold them to our standards of cleanliness; while not always ideal, a sponge bath is better than not bathing at all, and wearing the same shirt two days in a row won’t kill them.

Rather, our commitment to helping them maintain good hygiene should be a commitment to reinforcing their worth. Starting a conversation about cleanliness is very difficult, and the reality is, our senior loved ones might be offended if we raise our concerns. Present your worries and then offer to help them make adjustments so that the process of self-care becomes easier and enjoyable once more.

By Meredith Kimple

“Trust your gut.”

How often have we heard that phrase? Such advice implies that the gut is the source of our deepest instincts, of an innate, pure knowledge; it subscribes to the belief that our “gut feelings” are uninhibited by the restrictions of rationality or the flaws in reason. However, the reality is that a strong connection exists between gut and mind, to the point that the enteric nervous system is often referred to as “the second brain.”

Taking care of your gut is extremely important for all people, but for seniors, it can literally mean the difference between sickness and health. The bulk of the body’s immune system lies in the gut, and the bacteria contained there produce the majority of the body’s serotonin, a neurotransmitter that stabilizes our mood.

As we age, an imbalance in the microbiota of our gut can leave us vulnerable to infection, sickness, digestive issues, and even depression. Aging in and of itself does not cause this imbalance, but certain aspects of the aging process can have a negative impact on the variety of our gastrointestinal bacteria. An increase in the medications one takes, health conditions that arise and worsen with age, and a poor diet can reduce or alter the diverse flora of the human gut.

Probiotics are live bacteria that can help to restore or preserve the balance in the gut, and can be obtained either through eating fermented foods, like yogurt, or by taking dietary supplements.

Although they do not entirely prevent illness and infection, probiotics can lessen the duration and severity of certain conditions, like inflammatory bowel syndrome (IBS), diarrhea caused by viruses and antibiotics, colds, allergies, and even eczema. Seniors are often more susceptible to gastrointestinal issues because their gut health has been compromised by antibiotics; a daily probiotic can help strengthen their immune systems while reducing their abdominal discomfort.

Not only are probiotics a safe, effective way to maintain bacterial balance in the gut, but new research shows they may also improve cognitive function.

For years, the aforementioned connection between mind and gut has given scientists reason to believe that probiotics might also provide cognitive benefits. Previous studies on mice revealed that both memory and learning faculties were strengthened by probiotic use, but there was still very little evidence that the same results could be achieved in human subjects.

Last year, researchers from Kashan University of Medical Sciences and Islamic Azad University conducted a 12-week study to observe the impact of probiotics on the cognitive function of 52 men and women with Alzheimer’s, aged 60 to 95. One group received milk treated with probiotic bacteria, while the other received milk that had not been treated; at the beginning and end of the study, participants had their blood drawn and were subjected to the MMSE questionnaire, a tool for measuring cognitive function.

The group that received the probiotic-fortified milk saw a modest, though significant, increase in the average of their scores at the end of the study; the average score of the control group actually decreased slightly. Though probiotics did not remedy participants’ cognitive impairment, this was the first study to offer evidence of their impact on cognitive function.

The study shows that there does seem to be a powerful connection between mind and gut, and one that is much stronger than previously thought. While more evidence is needed to bolster these incredible results, such an outcome can only lend additional merit to probiotics’ long list of benefits to the human body.

Probiotics are not miracle workers, but they can help our senior loved ones maintain a healthy gut; they make digestion smoother, strengthen the immune system, stabilize and improve mood, reduce IBS and IBD-related discomfort, and might improve cognitive function. In past blog posts, we’ve looked at health issues that are perhaps more obvious; when we think of senior health, many of the same conditions probably come to mind. Heart disease. Alzheimer’s disease. Dementia. Diabetes.

Of course, these conditions are very important, and they deserve to be discussed and studied. But there are other aspects of senior health that are not given top priority in our hierarchy of concerns; they are things we might take for granted, or which do not seem quite so significant in the face of more devastating ailments.

A healthy gut is, in many ways, a pillar of our overall health. If there is an imbalance in the microbiota of their gastrointestinal system, our senior loved ones may be vulnerable to illness and discomfort. Encourage them to add fermented food products like yogurt to their diet, or talk to them about taking a probiotic dietary supplement; their physician can recommend the probiotic that will best suit their needs, and should always be consulted before adding one to their regimen.

It’s not enough to just “trust our gut.”

We have to take good care of it, too.

By Meredith Kimple

As technology evolves at a break-neck speed, we often hear cautionary reminders that we are becoming too reliant on our cellphones, tablets, and computers. While there is nothing wrong with encouraging us to detach from these objects, such warnings ultimately sell the truly helpful aspects of new technology short.

Older people may be the most resistant to these developments, and understandably. But there’s a new incentive to invest in your interactive screen of choice; recent research shows that activities like regularly using email may help protect against dementia.

The Mayo Clinic conducted a study that followed nearly 2,000 cognitively normal individuals over the age of 70 for a span of four years. Participants received neurocognitive evaluations every 15 months for the duration of the study, and were ultimately labeled either cognitively normal or mildly impaired. Researchers found that individuals who engaged in certain activities at least once or twice a week experienced less cognitive decline than those who only performed them a few times a month, if that.

What were these activities?

You might guess something like puzzles or knitting, or perhaps regular social interaction, but the activity that had the greatest bearing on participants’ cognitive health was computer use.

Those who used a computer a few times per week lowered their risk of new-onset mild cognitive impairment by roughly 30 percent; other activities, including arts and crafts, social interaction, and games, brought a 20 percent decrease. Even participants who were genetically predisposed to developing cognitive impairment or Alzheimer’s disease saw some benefit from engaging in weekly computer use.

The results of the study corroborate earlier findings that certain mentally stimulating activities can offer a degree of protection against mild cognitive impairment. You might think that in order to take full advantage of these benefits, these activities must have been performed for many years. However, research suggests that beginning these practices at a more advanced age can still decrease one’s risk.

Another study showed a possible connection between mentally stimulating activities and a reduced risk for suffering delirium, a state of sudden confusion that the elderly sometimes experience after a major procedure. Researchers found that the 32 percent of participants who developed post-operative delirium engaged in fewer leisure activities than their counterparts who were not delirious. The activities that most reduced their risk for delirium were reading books, playing computer games, and using email. Researchers concluded that the more time older individuals invested in these leisure activities, the less likely they were to develop delirium after surgery. Because delirium can increase an older person’s risk for decline and dementia, regular engagement in mentally stimulating activities may be vital for preserving their cognitive health.

In both studies, computer use played a surprising role in lowering seniors’ risk for developing a cognitive impairment. But why might this surprise us? Reading, even when done on the computer, helps to keep our minds sharp. Using a computer requires practice and to a certain extent, keen concentration.

Yet, since the advent of in-home television, society has denounced the convenient practice of gleaning information from screens.

Though we rush to buy the newest smart phone upgrade and gladly spend hours on social media, deep down, we harbor a fragment of guilt. As a culture, we simultaneously glorify and decry the ever-changing face of technological advancement. Feelings towards the latest innovations are highly charged, and perhaps most so among the elderly population.

Our senior loved ones grew up without computers and cellphones, and depending on their age, without television. While many older people have embraced the most recent developments in technology, others are frustrated and afraid of it. Part of this may be an ornery loyalty to the traditional ways of doing things, or a belief that computers and smartphones offer nothing to their demographic. However, these dismissals may attempt to mask an inability to use the technology.

Because computer-related activities seem to have a positive effect on seniors’ “cognitive reserve”, encouraging our loved ones to jump on the bandwagon may help to preserve their mental faculties. We should do everything we can to help them feel comfortable using a computer; search for local classes geared towards senior learning, and offer to demonstrate basic applications, like email.

While computer usage is certainly not the only mentally stimulating activity, being able to access email and search the Internet provides a link to public life. It’s a great way to keep in touch with long-distance friends and family, stay up-to-date on the news, or watch TV shows and viral videos. Computers can help seniors with limited mobility maintain a strong connection with the world, and this inclusivity may help boost their self-esteem.

If we each made a list of things we couldn’t live without, we’d probably have a number of entries in common: food, water, our cellphones, our computers, and perhaps, our cars.

Driving enables us to live independently, but for many of us, it is a privilege that we take for granted; when we are no longer able to drive, we become acutely aware of our powerlessness. As we age, our bodies undergo inevitable physical changes, and some of those changes involve visual acuity, reflexes, muscle strength and mobility–all physical attributes that are necessary for safe driving.

Physical Changes

• Hearing loss and vision impairments that result from age can make driving significantly more difficult.
• Pain in the legs, arms, and neck can hinder an older driver from reacting as the situation requires, because their movement may be restricted.
• Some health conditions and the medications used to manage them might impact a senior’s ability to safely drive.

Cognitive Changes

• Elderly people generally have a harder time multi-tasking than younger adults. Because driving involves absorbing and processing a variety of visual stimuli, older people may not be able to concentrate to the degree necessary for quick decision-making on the road;
• Dementia and other cognitive impairments can impede a senior driver’s ability to determine where they are going, as well as their knowledge of driving mechanics.

Whether it’s a change in vision, decrease in mobility, or an inability to concentrate, these age-related impediments can put the lives of older drivers at risk. After the age of 70, fatal crash rates tend to increase. This is not to say that all seniors should stop driving once they reach a certain age; the onset of risk factors for an accident differs among older drivers, and some are still able to drive long after others have had to surrender their keys.

Most seniors do not willingly cease to drive. As new health conditions and limitations become part of their reality, the idea of sacrificing their independence becomes unthinkable. In giving up the ability to move and do as they please, some seniors may suddenly be faced with the belief that they have become “old,” and in the worst sense of the word. They may feel irrelevant or isolated without a car, and their self-esteem may plummet.

Usually, an older person will stop driving either because of an accident that warrants the removal of their license, or as the result of some sort of familial intervention. But how do we start that difficult conversation?

Remember first and foremost that your older loved one’s feelings about driving are valid. You are suggesting that they sacrifice a precious freedom, and although you are absolutely in the right, you have to anticipate and respect their resistance to such a massive change.

Provide them with concrete examples of their dangerous driving: dents in the car, citations, running a red light or stop sign, nearly colliding with other drivers at an intersection. Remind them that not only are they putting their safety at risk when they operate a vehicle, but the safety of other drivers as well.

If they refuse to consider your points, try enlisting the help of their doctor.  A doctor can order tests to determine whether or not your loved one should continue driving, and their recommendations may be taken more seriously. Recruit other family members and your loved one’s close friends to give your appeals more weight; if more than one person thinks they should give up driving, they may have a harder time dismissing your concerns.

To ease their fears, propose alternative transportation options. If you live close by, offer to drive them to appointments and other outings. Help them find a driving service or public transportation. It is vital that they don’t feel cut off from the world; if they live in a rural or suburban area where driving by car is the only way to get around, it might be time to consider moving them to an area where there are more transportation options for them to utilize.

If you help them find a substitute for driving that still provides them with a sense of independence, the transition will be slightly less difficult. But giving up their ability to drive will be a major adjustment, so offer them plenty of support and encourage their desire to be self-sufficient.

The good news is that cars are safer than they used to be, and many older adults take initiative with certain precautions, like not driving at night. As a significant portion of the population ages, we need to find new ways to tackle the problem of compromised driving. Whether there are more frequent and strict tests to determine driving capabilities, or whether it’s something decided among families, we’ll need to develop better procedures for assessing eligibility.

If public transportation is broadened and improved in this country, cars will not be quite as essential to one’s independence. Perhaps as the older generations age we will see these steps taken to fill a widespread need; in the meantime, what we can offer our senior loved ones is support, understanding, and patience.

By Meredith Kimple

When a senior loved one is diagnosed with Alzheimer’s disease, we are suddenly barraged with a variety of new questions and concerns. How will they carry out their daily tasks as the disease progresses? How rapidly and to what extent will their comprehension be compromised? What medical care will they need, and should they enter an assisted living facility or move in with family?

What if they wander outside the home and become lost, or worse, hurt themselves?

An estimated three out of five people diagnosed with Alzheimer’s exhibit wandering behavior, and across all stages of the disease. We might have certain preconceived notions about what wandering entails. But people who suffer from Alzheimer’s are not necessarily on autopilot when they wander, and they do not always attempt to leave the house. As with other aspects of the disease, there has been no general consensus about what causes those with dementia to wander; it often begins as a result of boredom, perceived necessity, frustration, or stress.

What are the warning signs that your senior loved one might have a tendency to wander? The reality is that anyone with dementia has the potential, but the following are a few of the signs that usually precede wandering:

1. Restlessness.

They might find it difficult to stay in one place; they might walk around the house without purpose, pace in the same vicinity for an extended period of time, or engage in repetitive movements.

2. Confusion.

Your senior loved one might become disoriented when entering an environment that is either new or altered in some way. They may get lost in areas that offer too much stimulation, like the grocery store or the mall. But they also may have difficulty in identifying familiar places, like the rooms in their own home.

3. Repetition of Tasks.

They may continuously perform the same task without actually completing it; for example, they may think they are organizing their room, but are only moving the same few items around over and over again.

4. Following an old routine.

A person with Alzheimer’s may try to return to a past residence or the site of a former job, or attempt to run unnecessary and irrelevant errands.

5.  Delayed Return.

If they regularly go for walks, they may take longer than usual to arrive home; this might be a sign that they are starting to lose their way while walking, or forgetting the route that leads back to their house.

Wandering is not dangerous in and of itself; if it occurs within the safety of the home, under supervision, it poses few threats. However, when a person with Alzheimer’s wanders outside alone, they are rendered completely vulnerable to a number of risks. They might become confused and lose track of the way home, or they may not recognize their surroundings at all. Others may try to rob or take advantage of them while they are lost, and, worst of all, they may be seriously injured.

In order to keep our loved ones safe, there are several concrete steps we can take to limit their wandering:

1. Establish a regular routine.

Structure can be very beneficial to people with Alzheimer’s. A daily routine may help combat boredom and stress, both of which can trigger wandering in those with dementia. If you notice that the wandering occurs at a certain time of day, plan activities to occupy their attention during that period.

2. Provide security.

Anything we can do to assuage their fears and reassure them that they are not lost is very important. Make sure that they are never left unsupervised in the home or out in public, and try to avoid crowded, noisy places that might disorient them. Be patient if your loved one insists on going to an old residence or office, and instead of invalidating their desire, tell them that they should stay with you at home for the time being. Hide all car keys so that they can’t drive off.

3. Adapt the environment.

Install alarms and locks that are either out of reach or out of sight. Obscure doorknobs by covering them in fabric or painting them to match the door. Hide the door behind a curtain. Reduce in-home dangers by blocking the stairs with a baby-gate and removing clutter from the floors.

4. Help them meet basic needs.

Wandering may at times be motivated by the need to eat, drink, or use the bathroom. Ensuring that they meet these needs regularly may help prevent some of their wandering.

It’s best to have a plan in place in the event that your senior loved one does wander and become lost. Know your surroundings; make sure that you can contact your neighbors, and familiarize yourself with any physical dangers in the vicinity, like stairs, hills, busy roads, or bodies of water. Keep in mind any places that your loved one may try to reach, such as the site of an old job, a former residence, or their place of worship. Search for no more than 15 minutes before calling the police. Consider buying identification jewelry that includes your loved one’s name, address and your phone number; people with Alzheimer’s may not remember these details while lost.

A recent study published in the journal Neuron has helped to shed light on the biological origin of wandering behavior. Researchers found that course-plotting capabilities are compromised by the build up of tau protein in the entorhinal cortex (EC), a part of the brain largely responsible for memory and navigation. Within the EC, there are nerve cells called excitatory grid cells that fire as we move through a space; these grid cells form a map of the environment around us that enables us to find our way in any area.

They observed the impact a build-up of tau had on the excitatory grid cells of mice; the protein only damaged the excitatory cells, creating a severe imbalance in the mice’s internal grids. The findings support the theory that tau in the EC does contribute to wandering in those with Alzheimer’s disease.

Though further research is needed, the results of the study offer the possibility for treatment in the future; researchers believe that they may one day be able to correct the imbalance with the right therapy. Dr. Karen E. Duff, who co-led the study, even thinks that the results of the study may make it possible for navigation-based cognitive tests to be administered as a screening for early stage Alzheimer’s.

Wandering is a behavior that can make us, as caregivers and relatives, feel utterly powerless. Alzheimer’s can transform aspects of our loved ones in what seems like the blink of an eye; we make adjustments, and we do everything possible to create the semblance of order in the midst of constant, inexplicable change.

The truth is that we may not be able to keep our loved ones from wandering. Despite our best efforts, they may still slip away from us. But understanding where this behavior comes from can only help to prepare us for those terrifying moments. There are steps we can take to better ensure their safety, and in preparing for the worst, hopefully we can acquire some peace of mind.

Obesity is on the rise in the United States with an estimated 36.5 percent of adults affected; this means that approximately one-third of the adult population has the condition. Rates are highest among those between the ages of 40 and 59, as well as those over the age of 60. It is widely known that a substantial excess of fat in the body can lead to a host of health troubles, including type 2 diabetes, heart disease, and even some forms of cancer.

For older adults, an inability to maintain a healthy body weight can have an additional consequence; new research has shown a potential link between obesity and cognitive impairment later in life.

A recent study conducted by scientists from the Indiana University Center for Aging Research has revealed a possible connection between a high BMI (body mass index) and a weakened reception to memory training. Researchers observed roughly 2,800 cognitively normal participants over a span of ten years, the majority of whom were white and female with an average age of 74 years. For the duration of the study, scientists compared the degree of progress made by those with a normal BMI, those who were overweight, and those who were obese.

Results indicated that while a high BMI seemed to have little to no impact on reasoning or processing speed training, it significantly affected the benefits a participant gained from memory training; those who were considered obese received approximately one-third the benefit attained by their lower BMI counterparts. Though scientists are not sure exactly how obesity brings such an outcome, Dr. Daniel O. Clark, primary author of the study, referenced imaging studies that showed an association between obesity and a faster loss of hippocampal volume. The hippocampus is the part of the brain that is responsible for memory, and the implication is that older individuals who are obese may not have the same capacity to benefit from memory training as those who have a lower BMI. Dr. Clark also references prior research indicating that safe, intentional weight loss can actually lead to improvements in memory.

While not directly related to obesity, another recent study has found evidence that sedentary adults with no genetic risk factors for dementia have the same likelihood of developing the condition as those who do. Individuals who carry a variant of the genotype “apolipoprotein E” have a greater risk of developing dementia than those who do not, but researchers found that people who are primarily sedentary, but not carriers, exponentially increase their risk by their inactivity.

People who have a sedentary lifestyle, whether by choice or because of a medical condition, may have trouble maintaining a healthy body weight, and prolonged inactivity often leads to obesity. For a variety of reasons, seniors may have greater difficulty fitting exercise into their lives than the young or middle aged; they may have a disability or other impairments that make any physical activity impossible, they may tire more easily, or they may not be able to exercise the way they used to and become discouraged. If they aren’t active or eating well, they will put on weight very quickly, which in turn may put them at an increased risk for dementia.

How can we help our older loved ones build safe, effective exercise into their daily routine?

The good news is that health professionals estimate an intentional weight loss of as little as 5 to 10 pounds can yield significant benefits for a senior. There is no need for strenuous exercise to see at least some improvement. With this in mind, there are plenty of exercise options for those with mobile impairments and those who need a gentler form of physical activity.

There is a post on this blog about the benefits of Tai Chi for the elderly; this thoughtful exercise is perfect for older adults who are still mobile but who may not feel confident in their ability to balance. Tai Chi can also be adapted for seniors who are not secure enough to stand while performing the motions.

Water activities are another great way to get our older loved ones moving again. Walking around in a pool and swimming are forms of exercise that do not strain the joints and free the senior body from the limitations imposed by gravity.

If none of these are feasible, encourage your senior loved one to talk with their doctor about seeing a physical therapist. A physical therapist will help them develop a safe and effective exercise regimen tailored to their level of ability.

All exercise should be approved by your older loved one’s doctor before they add it to their routine.

Having a lower body weight provides a number of benefits to seniors; with fewer pounds to carry, walking is less strenuous. They may feel more alert and more in control of their bodies. Their risk of diabetes and heart disease may decrease. Certainly, the fact that obesity may negatively impact cognitive function is only the newest incentive to maintain a lower weight. Because obesity can lead to and exacerbate multiple severe health issues, it is crucial that we help our parents, grandparents, and older loved ones access the resources they need to keep as active as possible.

By Meredith Kimple

While some of us pursue healthier choices for a fit physique, many of us are also concerned with keeping our bodies functioning at their best. A part of this maintenance should include eating foods that support our brain health.

In our youth, we are blessed with excellent cognitive function naturally, but as we age, we must actively bolster the brain’s faculties to maintain sharpness. Certain foods have been linked to memory improvement and are beneficial to our body’s overall wellness; by adding them to our diet, we may be able to stave off cognitive decline and preserve our mental health well into old age.

So, what are these exotic miracle foods?

It may disappoint you to learn that they are things you already eat! And even if you don’t eat them now, they are easily obtained:

1. Blueberries

There have been a number of studies that show the positive effect these little berries have on cognitive function. Blueberries are full of compounds called anthocyanins, which promote anti-inflammation in the body; research suggests that blueberries help boost neural signaling in the brain and may even improve short-term memory loss.

And the best part is, they can be added to just about anything. Put them on your morning cereal or oatmeal, add them to salads and smoothies, or just grab a handful for a refreshing afternoon snack.

2. Fish

A study at the University of Pittsburgh found that participants who ate baked or broiled fish at least once a week had brains with a larger volume in the areas associated with memory. Omega-3 fatty acids are prevalent in oily fish, like salmon, and have been found to aid in the memory of facts and object recognition. Omega-3 is also great for heart health, so incorporating fish into your diet can bring twice the benefits.

Fresh fish that is baked or broiled is preferable to fried, but try swapping out a meat dish for fish at least once a week.

3. Walnuts

These meaty nuts even resemble a human brain! Packed with Vitamin E, they may help slow or prevent cognitive decline. A UCLA study found that adults who ate walnuts showed consistently greater cognitive function than those who did not, regardless of ethnicity, gender, and age. While more research is needed to verify those results, walnuts are a great source for healthy fat, and like salmon, contain Omega-3, making them beneficial for heart health as well.

4. Leafy Greens

Bad news for those of us who loathe spinach.

Whether it’s kale, spinach, or collards, leafy greens are bursting with nutrients like Vitamin K and beta-carotene that help slow cognitive decline. A recent study showed that eating as few as two servings of leafy greens a day gave participants the cognitive function of someone 10 years younger, compared to those participants who ate none.

And if you have a real aversion to your greens, never fear. These powerful nutrients can also be found in brightly colored fruits and vegetables! Still, trying to add more greens to your meals is highly recommended.

5. Green Tea

We know that green tea is full of antioxidants, but recently a university in China conducted a study to show that it may in fact be beneficial for spatial learning and memory too. Green tea contains an antioxidant called ECCG (epigallocatechin-3 gallate) that produces highly adaptive neural progenitor cells. This cell production seems to improve both impaired spatial memory and object recognition. Green tea may therefore be helpful in slowing or even improving aspects of cognitive degeneration.

Brewed green tea has stronger properties than canned or bottled, and is very easy to find. If you’re someone who drinks coffee or black tea frequently, try swapping it out for green tea from time to time. It will give you energy while helping you preserve cognitive function.

6. Eggs

Eggs have long been dubbed “brain food.” They contain a large amount of choline, a nutrient that aids in the communication between cells in the brain and the body. Choline can help to preserve brain chemistry as the body ages, which can protect against cognitive decline.

Vegetable omelets are a great way to incorporate multiple brain foods into one simple dish.

These are just a handful of the foods that can provide our brains with some protection against cognitive decline; other foods that can promote healthy cognitive aging include tomatoes, broccoli, avocados, and dark chocolate.

Planning meals in advance and having these foods handy can ensure that we eat in a way that is not just beneficial to our bodies, but to our minds. And these are not recommended to seniors only; there is some evidence that the longer we eat brain-healthy foods, the stronger our guard against cognitive decline. By incorporating these nutrients into our diets, we and our older loved ones can take an active role in maintaining our cognitive function for as long as possible.

None of the foods in this list are miracle workers, and none are foolproof drugs that can guarantee protection. Research has yet to provide answers that can satisfy all of our questions, but it confirms what has been previously theorized; it is no coincidence that many of the foods that are beneficial to our brains are also good for our hearts, and for our overall health.

So as we enter a new year, consider adding these brain-empowering foods to your diet, rather than focusing only on what you can remove.

By Meredith Kimple

One of the first posts I wrote for this blog focused on insomnia in the elderly; an inability to sleep at night is often misunderstood as a normal part of aging. Our senior parents and grandparents who seem to fall asleep any time they sit down, regardless of time or place, are not necessarily tired because they are advanced in age. There are a number of factors that may contribute to their fatigue, ranging from a disrupted circadian rhythm to sleep apnea.

Insomnia is not the first thing that comes to mind when we consider senior health issues, but it can still have a critical impact on an older person’s overall wellness. We might be more likely to associate widespread, well-known conditions with senior health; heart disease, adult-onset diabetes, hearing loss, dementia, and impaired mobility in the elderly may be some that first come to mind.

But how many of us think of depression?

Depression is a medical condition that most of us are familiar with, but despite the great strides we have made in the de-stigmatization of mental illness, the mental health of the elderly may be easy to overlook. That is not meant to imply carelessness on the part of loved ones or caregivers; depression presents differently in seniors than it does in younger individuals, so the symptoms can be more difficult to spot.

Because aging brings with it an abundance of changes in health, ability, and independence, an older person’s depression is often misconstrued as a natural reaction to life’s vicissitudes.

So how can we determine if our senior loved ones are suffering from depression?

The following are some of the more common symptoms:

• Persistent feelings of guilt, worthlessness, and hopelessness
• Strong feelings of anxiety and emptiness
• Loss of interest in favorite activities
• Increased irritability and restlessness
• Difficulty concentrating and making decisions
• Insomnia or oversleeping
• Involuntary weight gain or loss
• Aches, cramps, and physical pains that persist
• Thoughts of suicide or self-harm**

An elderly person dealing with depression may not show all of these symptoms, but if they show any combination from the list for at least two weeks straight, then they should see a doctor. Pay attention to the duration of the symptoms; we all have days where we’re sad, or feel hopeless and empty, but someone who has depression will feel that way for weeks and months at a time.

There are certain factors that increase an older person’s risk of developing depression. For example, women are more likely to have depression than men. Seniors who do not have a significant other are more at risk than those who are married or dating. Those who have a disability, chronic illness, or brain disease are more likely to have depression than an otherwise “healthy” senior. And of course, social isolation and the experience of stressful life events (such as a divorce, or the loss of a spouse) can increase a senior’s risk. A family history of depression should also be considered, as well as prior suicide attempts or episodes of self-harm.

Helping a senior loved one receive the treatment they need may prove challenging, but it is vital that they do for the sake of not only their mental health, but their overall health as well. Depression can have a negative impact on a senior’s ability to rehabilitate after an injury or surgery, and is associated with a greater risk of death from cardiac disease and other chronic illnesses. Mental health is important in its own right, but it has an enormous influence on physical health in that it can determine one’s ability to recover from trauma. Depression can render an elderly person even more vulnerable, so seeking treatment immediately is crucial.

Luckily, depression can be treated using a variety of methods:

1. Use of Antidepressants.

Taking antidepressants is often an effective way to treat depression. Because an older body may take longer to process the medication and cannot handle a high dosage, results will not be instantaneous. It is important that once they start taking an antidepressant, they don’t stop without consulting their doctor; it may take weeks or months for the medication to make a difference, so a lot of patience is required. While this method is usually effective, there are some drawbacks. Certain side effects and the long-term cost may lead to an older patient refusing to take the medication; additionally, interactions with other drugs can impair the effectiveness of the antidepressant.

Talking with a professional can be helpful in treating depression. Psychotherapy can aid the patient in changing their negative thought patterns and habits, as well as helping them work through stressful situations in a healthy way. This method can be as effective as taking antidepressants, and is a good alternative if an older person cannot add another medication to their regimen. Of course, if medication is necessary, supplementing with psychotherapy can strengthen a senior’s treatment plan. Psychotherapy can provide insight into one’s relationships and feelings, as well as coping mechanisms to help with future distress.

3. Alternative, Complementary Therapies.

While they are not a substitute for medical intervention, activities like yoga, daily walking, and other physical exercises may help to relieve some people’s depression. Physical activity can improve one’s mood, and is a great way to focus the mind and body. Their doctor should be consulted before additional exercise is added to their daily routine.

Though depression is common in the elderly population, it often goes undiagnosed. There is still to this day a stigma that accompanies mental illness, and for the older generations this is especially pronounced. They may perceive depression as a weakness, personal failure, or a burden on others; for seniors who are not familiar with the symptoms of the condition or who have never known someone with depression, it may be difficult to acknowledge what they are suffering from, or to acknowledge that they are suffering at all. They may perceive their thoughts and feelings as “normal” and try to carry on through the pain because they don’t want to worry their friends and family.

We must be their support system.

They may not be willing to discuss how they feel with us, but we can let them know that we are there for them. We can encourage them to see a doctor who can start them on an appropriate treatment, and help them keep track of appointments. We can assure them that they are not alone, and that while what they are feeling is not abnormal, they deserve to feel better. Include them in your activities, and help them get involved in classes, exercise groups, or community service.

Let them know that you love them, and often.

Our society is cultivating a greater awareness of the importance of mental health in maintaining a healthy lifestyle, and people are more willing than ever to be candid about their experiences with mental illness. However, depression is still frequently overlooked in the elderly. As their family and friends, we must be vigilant; do not take mentions of self-harm or suicide lightly. Help them pursue treatment, and offer them your support as they begin their healing process.

Depression is not a normal part of aging, but aging brings a host of new challenges that not everyone can easily adjust to. It is of the utmost importance that we help our older loved ones live lives that are emotionally healthy and fulfilling.

Here is a great article by Sam Ferris on Houzz about modifications to the bathroom for seamless transitioning into later years:

https://www.houzz.com/ideabooks/60576589/list/11-ways-to-age-proof-your-bathroom .

Check it out!

By Meredith Kimple

How many times do we get teased for a little snoring at night?

While all snoring has the potential to annoy those around us, some snoring might be indicative of sleep apnea. This chronic, but treatable, condition impairs an individual’s ability to breathe regularly while asleep, either via an obstruction in the upper airway (obstructive sleep apnea) or as a result of the brain failing to trigger a breath (central sleep apnea).

Despite sleep apnea’s presence across all age groups, it is especially prevalent among seniors. As we age, our throat muscles and tissue are more relaxed, so that when we sleep our airway can become obstructed; being overweight can also increase our risk of developing the condition. At best, sleep apnea’s effects on the senior body are limited to daytime sleepiness and an increased difficulty concentrating. At worst, the body’s inability to breathe while sleeping can be fatal.

But there may be another risk for seniors who have sleep apnea.

Two studies have linked sleep apnea with early onset cognitive impairment in the elderly. The Journal of the American Medical Association published a study that observed the relationship between sleep apnea and cognitive impairment in approximately 300 healthy, elderly women over a span of five years. None of these women had any memory problems prior to the start of the study, but a third suffered from sleep apnea, averaging 15 instances of breathlessness per hour. At the end of the study, more than a third of the women had developed dementia or were experiencing memory troubles. The participants who had sleep apnea made up 44 percent of the women who developed cognitive impairments, while those who did not made up only 31 percent.

The researchers concluded that, even considering other factors like weight and age, sleep apnea had the greatest impact on the results of the study. The connection between the two conditions has to do with the blood oxygen levels of each participant; the episodes of breathlessness caused by sleep apnea cut off the oxygen supply to the brain, which, when occurring multiple times an hour over many years, can impair a senior’s cognitive function. Those participants who had low blood oxygen levels because of sleep apnea were more likely to develop dementia.

Another study published in Neurology shows evidence that the breathing disruptions of sleep apnea can have a massive impact on seniors’ cognitive health. Dr. Ricardo Osorio, of NYU’s Center for Brain Health, and his colleagues observed a group of 2,000 individuals aged 55 to 75, ranging from those who were cognitively normal to those who had Alzheimer’s disease. The participants were questioned about their snoring and sleep apnea, and then bi-annually over the next two to three years, they returned to monitor any cognitive changes.

The majority of participants who reported having sleep apnea developed mild cognitive impairments, and more astonishingly, their symptoms emerged 12 years earlier than in those who don’t suffer from respiratory disruptions at night. Dr. Osorio noted that those who were treating their sleep apnea with a CPAP machine seemed to experience cognitive decline at around the same age as those who do not have the condition.

It goes without saying that more research is needed to cement the link between sleep apnea and impaired cognitive function, but given the positive correlation evident in the aforementioned studies, recognizing and treating the condition as soon as possible can’t be a bad idea.

If you or a senior loved one snores at night, how can you determine whether or not it really is sleep apnea?

The following are some of the more common symptoms:

• Loud snoring, particularly when lying on their back
• A long pause in breathing, anywhere from a few seconds to over a minute, followed by choking or gasping
• Daytime grogginess
• Difficulty concentrating and remembering
• Waking up with a headache and / or dry mouth
• Sharp mood swings and heightened irritability

But the only way to know for sure is to have a sleep study done at a hospital or clinic. That said, you could always monitor an older loved one by recording their snoring at night; this way you can listen for any irregular breathing.

There’s also a smartphone app in development that can monitor the breathing of a person with sleep apnea.

Once your loved one has been diagnosed with sleep apnea, there are a variety of treatments by which to manage it. The most common method is to use a CPAP machine, a mask connected to an apparatus that helps maintain regular breathing throughout the night. Wearing a mask may be uncomfortable or difficult to put on at first, but it’s important to help them with these adjustments to ensure that they receive the treatment they need.

If you do notice the above signs in an older loved one, it’s very important that you talk with them. Those who have sleep apnea often are totally unaware that they snore and stop breathing while they’re asleep, so it’s crucial that you inform them and encourage them to talk to their physician. Sleep apnea may have a significant impact on seniors’ cognitive functioning and overall health, but luckily it’s easily treated.