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Category: Memory

Facebook Live Recap: Alzheimer’s Association International Conference Highlights

On Tuesday, August 27th we went live with Sarah Harlock, Program Director of the DENT Integrative Center for Memory, as she discussed Alzheimer’s Association International Conference Highlights. At this conference, researchers from all around the world came together to share information. A lot of the conference focused on lifestyle, which will be what Sarah focused on. 

 

The Finger Studies

 

A program in Finland conducted a 2-year study and looked at lifestyle factors. This was the first randomized control trial that proved that these lifestyle factors can prevent cognitive decline. This study was so successful that the “Worldwide Finger Study” has been initiated, where about 10 countries have signed up to replicate The Finger Study in their own country. 

 

The Pointer Study
 

In the United States, The Pointer Study will be starting soon. This two-year study will be operating out of specific universities in California, North Carolina, Texas, and Illinois.

“I am not sure if they have started recruiting yet. If they haven’t, they will be shortly,” said Sarah Harlock. “I am looking forward to hear more from The Pointer Study. I think we are going to see some really interesting data come out of that.”

 

Modifiable Risk Factors
 

At the conference, there were plenty of researchers that touched upon Modifiable Risk Factors. These are things that we can change, as opposed to Genes, which we cannot change. “These are modifiable, meaning we can control some of this,” explains Harlock. 

These Modifiable Risk Factors include: smoking, depression, physical activity, social stimulation/social isolation, diabetes, and diet. All of these factors are things that we have some sort of control over. They also have a big impact on the risk of developing cognitive impairment. It is really important to address these factors to reduce our risk. 

 

Same study, different results
 

A challenging part of research is that one week you can see an article that sounds great and has very positive results, and then a week later see a report that says the exact opposite. At the conference, that exact situation happened. 

Two studies contradicted each other. Study #1 showed that the genetic high-risk group, meaning they have a genetic factor that increases their risk of developing Alzheimer’s Disease, were able to reduce their risk of developing cognitive decline using the mentioned lifestyle elements. Study #2 shows that lifestyle factors did not change the risk of cognitive decline in the high-risk genetic group. 

 

Why are there differences? How can there be conflicting results? 
 

“It turns out that between these two studies, the ages they were looking at were different, the way they defined genetic risk was different, the way the measured cognitive impairment was different – they were not using the same assessment tools, and the length of time that they were following the subjects was different too – by several years,” Sarah Harlock explains. 

It can be hard to determine what is accurate and what to follow as these studies come in. There is a lot of research going on right now, and at DENT Neurologic Institute, we will report the most accurate information possible.

These Modifiable Risk Factors may not be news to everyone. We have known for a while that smoking is not good for you. It is not good for your heart, and whatever is not good for your heart is not good for your head. 

 

Physical Exercise
 

The amount of studies done on exercise is tremendous. One study presented at the conference was called the “Intense Physical Activity And Cognition Study”. This study found that intense exercise is more beneficial to you that moderate to light exercise.

“I am just going to say that any exercise is better than no exercise,” says Harlock, “but what this study showed is that having an exercise that was more intense and got your heart rate up, had a more protective effect than those who did light exercise.”

Another study that was talked about was the “Fitness for the Aging Brain” study. In this study, participants were put through an exercise program, and then they measured their cognition at 6 months, 12 months, and 18 months. The results showed a positive effect on their cognition. 

“What was interesting was that they tried to follow up with people 10 years later,” says Harlock. “They were not able to reach everyone in that study, but they were able to reach some. When they looked at the data, they did not see so much a cognitive benefit. Instead, they saw a benefit through the reduction of falls.”

Those who were participating in the exercise program were falling at a much lower rate than the non-exercise group. Benefits beyond cognition can be contributed to exercise. 

 

Diet
 

Every country and region has different access to food. Because of that, no specific diet was identified to be the solution. Basically, the studies have suggested a healthy diet.

“I always tell people that if you have any questions about what a healthy diet is, contact your insurance company and ask for information,” says Harlock. “You can also talk to your primary care doctor. It is individualized based on your own unique needs and any conditions you might have.”

No “superfood” was brought to the spotlight either. There was a huge emphasis on a healthy diet. If you are someone who needs assistance, you can also get a referral to a dietitian from your primary care doctor or your health insurance company. 

 

Sleep
 

Short-term memory

Sleep was another hot topic at the conference, as it is very important to memory and cognition. There are specific brain wave activities that occur in your sleep that help the hippocampus – the part of the brain responsible for short-term memory. 

“These brainwave activities that happen during sleep encode information that is gained during the day,” Sarah Harlock explains. “So, if there is disruption in your sleep, there’s an opportunity for the process of encoding, remembering or storing this information to be disrupted. Again, sleep just becomes critical.”

There is that older generations do not need as much sleep – and that is simply not true. Studies are showing that people need 7 to 8 hours of sleep a night to avoid the amyloid deposit or amyloid buildup in the brain, which is common in Alzheimer’s. 

Getting enough sleep is imperative, and insomnia is certainly an issue that can negatively impact your cognitive health. Recently, research has determined that insomnia can increase your risk of developing Alzheimer’s disease.

Insomnia and Sleep Apnea

Menopausal women are at a higher risk of insomnia than men of the same age. Researchers are identifying this as a possible reason that more women are developing Alzheimer’s than men.

Sleep Apnea is another issue that increases the risk of not only Alzheimer’s, but cardiovascular issues too.

“Again, it is really important that you are paying attention to your sleep,” emphasizes Harlock. “Trying not to nap during the day, watching your caffeine intake, and reducing screen time right before bed are all things that can certainly help with your sleep hygiene.”

It could be possible that a sleep test is needed. The DENT Sleep Center has a fully equipped diagnostic laboratory, including six private suites where patients sleep while being monitored by trained technicians.

 

Social Stimulation
 

This is another key component that is part of the Finger Study, and part of the modifiable risk factors. For the mental stimulation aspect, they talked about formal education. Beyond formal education, there is lifelong learning that we can be doing that will help assist us with building up brain reserves. This goes beyond watching TV.

“You need to be doing more for your brain,” says Harlock. “Find activities that are enjoyable, challenge your brain, and make you think about things in a new way.”

As people age, it is not uncommon to see them become more isolated. They may have mobility issues that stop them from doing social activities or going to the gym. They might also no longer have their driving privileges and can no longer enjoy the things they use to. 

 

Combining the Modifiable Risk Factors
 

Not everything has to happen in isolation. Our social activities can happen at an exercise program, our exercise can happen while as we’re walking to the library or our mental stimulation, we can eat a healthy meal while with friends. Combining these lifestyle choices so you don’t think about setting up a whole new plan for getting through your day will help make sure you tackle all of these elements. 

 

5 Key Points
 

Key Point 1 – Modifiable Risk Factors can counteract genetic risk for Alzheimer’s

Making adjustments to your lifestyle to support at least 4 of these Modifiable Risk Factors can reduce your risk of Alzheimer’s by 60%, as opposed to those who do not make any efforts, or only do one of them. 

“This is exciting,” Harlock says, “and very, very important to adhere to the healthy lifestyle as it may counteract the genetic risk for Alzheimer’s disease. A lot of people say that Alzheimer’s is in their genes, and there is nothing they can do about it. The reality is, there is something they can do about it.”

Key Point 2 – Cognitive Stimulation can counteract some negative things, like air pollution

These studies are showing that we may be able to reduce our risk of having a higher cognitive reserve built through formal education and cognitive stimulation. This benefits the aging brain by reducing the risk of dementia among people who were exposed to high levels of air pollution.

“That was a really interesting study that came out as well,” says Harlock, “So this idea of brain reserve and cognitive stimulation and so on can counteract some of the negative things – like air pollution.”

Key Point 3 – Early Adult to Midlife smoking can be associated with cognitive impairment 

The conference confirmed that early adult to midlife smoking can be associated with cognitive impairment, as early as when people are in their 40’s.

“So, once again it’s one of those things that if you are smoking, talk to your doctor about this. We do know that it’s one of those modifiable risk factors,” explains Sarah Harlock.

Key Point 4 – Drinking too much can increase the risk of dementia

Alcohol use disorder can significantly increase the risk of dementia in older women. Studies in the past have discussed diets that promote a small or moderate amount of alcohol as safe or beneficial to the brain. A study presented at the conference presented that too much alcohol increases the risk of dementia in women later in life.

“Alcohol is something that needs to be moderated and make sure that you are using safe levels,” says Harlock.

Key Point 5 – We must be looking at the condition much earlier than they are now

Rather than waiting for signs of memory loss, language problems, or cognitive issues, we need to be looking at and adjusting our lifestyle choices much, much earlier than we are now. 

 

Never too early or too late
 

There was a study called My Brain Robbie that was aimed at school-aged children and them adapting to a healthy lifestyle. The children ended up taking the information home to their parents, which helped the parents make healthier choices as well. 

“You are never too young to start these healthy brain habits,” says Harlock. “But, it is also important to note that is it never too late to start them, either.”

Making these healthy choices can not just lower your risk of developing these conditions, but it may slow down cognitive loss. Click here if you or someone you know is interested in DENT’s Memory Center.

Facebook Live Recap: Managing Difficult Caregiver Emotions

On June 12th at noon, we went live with Sarah Harlock, Program Director for the Dent Integrative Center for Memory. We discussed Managing Difficult Caregiver Emotions, a topic that comes up regularly in support groups, classes, and general discussion.

Caring for someone with Alzheimer’s Disease or Dementia poses some special and unique challenges. As a result, caregivers very frequently experience higher levels of anxiety and stress.  Reports have shown that 30% – 40% of family caregivers who are caring for someone with Alzheimer’s or Dementia are experiencing depression. Caregivers can also experience: frustration, fear, guilt and resentment.

 

The diagnosis aftermath

 

When someone receives that diagnosis, there is no question that is is very difficult.  It is hard on the caregivers as well. Everyone’s life changes after that diagnosis. “I want people to recognize that it is not all doom and gloom,” Sarah says, “It can feel very heavy and negative. But, there are moments of joy and really important moments that are going to happen on this care-giving journey.”

 

New relationships, skills, and strengths

 

Through support groups or classes, there are new people you will meet during your journey. You also may form a new form of an existing relationship, such as sibling who are taking care of a loved one together, or partners who were independent, but start to depend on each other after the diagnosis.  New skills will be developed throughout this process. You might be in control of banking for the first time, or have to take over cooking. Strengths will be developed from this.

“When you have the opportunity, if you can step back and just reflect on all the things you have done and learned and all the effort you have put in into care-giving, I hope you are as amazed by yourself as we, as professionals, are when we talk to you. The love and compassion that people put into care-giving is really amazing”, Sarah adds in.

 

The different emotions

 

Since these diseases are things that change over time, it is realistic to think that your emotions will also change over time. Be prepared that down the road, you may have more struggles or you could develop supports to help aid you in care-giving. Emotions are signals, and some of these signals mean that you need to make a change to alleviate difficulties. Two emotions come up frequently for care-giving: guilt and depression. 

 

Guilt

 

Guilt is complex, but there is a purpose for guilt. It brings our behavior in alignment with our moral compass.

Sarah explains this feeling: “Think of an example where you you’ve done something wrong. You’ve wronged somebody or hurt their feelings. Whether you meant to or not, if it caused pain to another person, you feel it. I don’t know about you, but I feel it in the pit of my stomach. I know I have done something that doesn’t fit with who I really am or the person that I should be. So, that feeling in the pit of my stomach is a signal that my behavior was not in alignment with my moral compass, and I need to pull my behavior back in line.” 

What caregivers are often experiencing is “unjust guilt”. You are feeling guilty, but you didn’t cause this pain to this person and you did not wrong them. Sometimes we bring it on ourselves and sometimes, other people expect us to do more. Very often, it is our own expectations of ourselves that fuels that guilt. 

Caregivers can also feel guilt after losing their cool and maybe yell back or snap at the person they are care-giving for. There is never any harm in asking for forgiveness. Again, this is a signal that you need to be taking some steps or making some changes. It is important to be comfortable with the fact that being is “perfect” caregiver may not be attainable.  Your intentions are good but your time, resources and skills are limited. Try to get comfortable with that gap between perfection and reality, and stop beating yourself up for it. 

 

Depression

 

Statistics say that 30% – 40% of care-givers of people with dementia will experience and suffer from depression. It is important that care-givers, or someone who supports a care-giver, monitors the emotional health of a care-giver. 

“I do remember a phone call from a couple. She had just received the diagnosis and she she was devastated by this diagnosis. Her husband was saying ‘I’m literally calling you from our bed. We’re lying in bed, we can’t even get up and start our day.’ And that’s how pervasive this very heavy, heavy depressive feeling was for them”, says Sarah.

There is a significant portion of care-givers that actually qualify as clinically depressed and are suffering from the diagnostic criteria of major depression. This is not just the feeling of being blue, and it passes in a day. We are talking people experiencing pervasive and a consistently low mood.

Depression can come out in a lot of different ways besides sadness. It can come out in a short-temper, lack of focus, or inability to complete tasks. “The first thing that I recommend it that you talk to your primary care doctor. I think that is really important. If you don’t want to take medication, there are other things you can do.”

 

The importance of exercise and diet

 

There is all kinds of evidence out there that talks about the impact of exercise on mood. Start with something enjoyable. It could be a walk up and down your driveway. If you can’t leave your loved one and your loved one can’t join you,  some movement chair exercises are very appropriate and effective. 

Additionally, your diet can play a very large role in how you are feeling.

“If your diet is heavily processed if it is loaded with sugars you know it’s it’s definitely going to have an impact on your mood and your energy levels so where you can you want to make sure that you’re introducing fresh fruits and vegetables and that you are trying to make your diet as healthy as you can, because that also will impact energy levels and mood”, Sarah explains.

 

Finding joy in small moments

 

Finding moments of joy throughout your day can be really tough. It is a thing caregivers struggle with. There are many different things you can do, but a gratitude journal is a great way to start. Find one thing in your day that made you smile and feel good.  It could be a nice sunset, something someone said that made you laugh, a great article you read, a funny video, or drinking a nice cup of coffee while it is still hot.

Once you start looking for those moments, you find them more often. These are not things that will improve your mood overnight, but gradually. 

 

Caregiver counseling

 

Sarah also mentions counseling: ” I would also encourage you to consider counseling. We have people that actually specialize in counseling very specific challenges of caregiving. Those kinds of opportunities exist as well.” Sometimes, it takes that objective person to get our thoughts out of our head and help us organize them. That objective person can help you recognize how you are feeling, what your goals are, and how you want to get there.

Not all techniques work for everyone. It is worth giving them a try. Ignoring any emotions you experience while caregiving will not help, so finding ways to manage them is incredibly important. “There has never been a need for you to be a perfect caregiver – only a caregiver that cares”, Sarah Harlock says.

 View the entire presentation by clicking here.

 

 

 

 

The content of this post is intended for general educational and informational purposes only; it does not constitute medical advice.  Readers should always consult with a licensed healthcare professional for diagnosis and treatment.

 

5 Steps to Take After a Memory Disorder Diagnosis

A memory disorder diagnosis can seem overwhelming and intimidating. Whether you are living with a diagnosis, or caring for someone with a memory disorder, there are many variables to consider when planning for the future. 

Sarah Harlock, Program Director for the DENT Integrative Center for Memory, shared five important initials steps to take after receiving a memory disorder diagnosis. 

  1. Gather important documentation.

    • Power of Attorney

    • Health Care Proxy or MOLST (Medical Orders for Life Sustaining Treatment)

    • Veterans Discharge papers etc.,

  2. Get some information about the diagnosis. You do not need to learn everything about the illness but have a sense of the types of challenges you may be faced with.

  3. Learn more about supportive services that are available such as community based programs, health services, and levels of care. Gather information to determine costs and how one enrolls in these services. 

  4. Make a plan (nothing is written in stone,) just create an outline of services you think you might like to try when necessary.

  5. Breathe! You have to learn to live with this diagnosis, and there is a lot of living still to do

While there are many other steps to take and adjustments you may need to consider, completing these initial steps will help you and your care partner begin planning for challenges that may arise in the future. 

For more details about programs and services, questions about making a plan, or more information about cognitive changes, please contact Sarah Harlock, Program Director for the DENT Integrative Center for Memory, at 716-250-2000, ext. 1107. 

The content of this post is intended for general educational and informational purposes only; it does not constitute medical advice.  Readers should always consult with a licensed healthcare professional for diagnosis and treatment.