What’s new in Alzheimer’s research?

Photo of real female scientists looking into a microscope, Photo taken behind the glass.June is Alzheimer’s and Brain Awareness Month, so I’ve gathered several new studies that you may find interesting and helpful.

You don’t only avoid holes in your teeth by keeping good oral hygiene, researchers at the University of Bergen have discovered a clear connection between gum disease and Alzheimer´s disease. The researchers have determined that gum disease (gingivitis) plays a decisive role in whether a person develops Alzheimer´s or not.

“We discovered DNA-based proof that the bacteria causing gingivitis can move from the mouth to the brain,” says researcher Piotr Mydel at Broegelmanns Research Laboratory, Department of Clinical Science, University of Bergen (UiB).

The bacteria produces a protein that destroys nerve cells in the brain, which in turn leads to loss of memory and ultimately, Alzheimer´s.

Brush your teeth for better memory

Mydel points out that the bacteria is not causing Alzheimer´s alone, but the presence of these bacteria raise the risk for developing the disease substantially and are also implicated in a more rapid progression of the disease. However, the good news is that this study shows that there are some things you can do yourself to slow down Alzheimer´s.

“Brush your teeth and use floss.” Mydel adds that it is important, if you have established gingivitis and have Alzheimer´s in your family, to go to your dentist regularly and clean your teeth properly.

A new longitudinal study has shown that a nutritional drink* designated a “food for special medical purposes” containing the multinutrient combination Fortasyn Connect® can benefit patients with the earliest stages of Alzheimer’s disease (AD), mild cognitive impairment, who are at risk of progressing to the dementia stage of AD, report scientists in the Journal of Alzheimer’s Disease Reports.

Opioid analgesics were associated with a 30% increase in the risk of pneumonia in persons with Alzheimer’s disease, a recent study from the University of Eastern Finland shows. The risk was most pronounced in the first two months of use. This is the first study to investigate the association between opioids and pneumonia in this population. The results were published in the Journal of Alzheimer’s Disease.

Various clinical trials indicate what effects can be expected from standardized intervention programs on the basis of existing evidence. Little is known about the way in which such programs can be implemented in actual care practice. However, it may be possible to use data from clinical practice to estimate the potential of drug prescriptions to delay or reduce the development of dementia. The goal of the present study was to investigate the relationship between antihypertensive drug use and dementia in elderly persons followed in general practices in Germany.

Researchers found seniors who ate more than 300 grams of cooked mushrooms a week were half as likely to have mild cognitive impairment

Singapore, Singapore – A team from the Department of Psychological Medicine and Department of Biochemistry at the Yong Loo Lin School of Medicine at the National University of Singapore (NUS) has found that seniors who consume more than two standard portions of mushrooms weekly may have 50 per cent reduced odds of having mild cognitive impairment (MCI).

A portion was defined as three quarters of a cup of cooked mushrooms with an average weight of around 150 grams. Two portions would be equivalent to approximately half a plate. While the portion sizes act as a guideline, it was shown that even one small portion of mushrooms a week may still be beneficial to reduce chances of MCI.

Copenhagen, Denmark – A new study suggests that vital exhaustion – which can be perceived as an indicator of psychological distress – is a risk factor for future risk of dementia. Researchers from the Department of Public Health, University of Copenhagen have, in collaboration with the National Research Centre for the Working Environment, and the Danish Dementia Research Centre, shown that being distressed in late midlife is associated with a higher risk of dementia in later life. The findings contribute to our understanding of psychological distress as an important risk factor that should receive more focus when considering prevention initiatives in relation to later dementia.

Psychological distress can be defined as a state of emotional suffering sometimes accompanied by somatic symptoms. Vital exhaustion is operationalized as feelings of unusual fatigue, increased irritability and demoralization and can be considered an indicator of psychological distress. Vital exhaustion is suggested to be a response to unsolvable problems in individuals’ lives, in particular when being incapable of adapting to prolonged exposure to stressors. The physiological stress response, including cardiovascular changes and excessive production of cortisol over a prolonged period, may serve as the mechanism linking psychological distress with an increased risk of dementia.

Morgantown, WV, USA – A research team led by Dr. Kim Innes, a professor in the West Virginia University School of Public Health, has found that a simple meditation or music listening program may alter certain biomarkers of cellular aging and Alzheimer’s Disease in older adults who are experiencing memory loss. Study findings, reported in the Journal of Alzheimer’s Disease, also suggest these changes may be directly related to improvements in memory and cognition, sleep, mood, and quality of life.

Sixty older adults with subjective cognitive decline (SCD), a condition that may represent a preclinical stage of Alzheimer’s disease, participated in the randomized, clinical trial. While SCD has been linked to increased risk for dementia and associated with certain neuropathological changes implicated in Alzheimer’s disease development, including elevated brain levels of beta amyloid, this preclinical period may also provide a critical window for therapeutic intervention.


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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

 

Grief and Relief: When caregiving ends

GedankenCaregiving for a person with dementia is one of the most difficult things anyone will have to do. The pain and suffering is intense, but the rewards are plenty. Even though the person you are caring for cannot express gratitude, on some level they know and appreciate your sacrifice. They are eternally indebted to you. As Lou Gehrig said in his farewell speech, “When you have a wife (caregiver) who has been a tower of strength and shown more courage than you dreamed exists—that’s the finest I know. So I close in saying that I might have been given a bad break, but I’ve got an awful lot to live for.”

Kim Mooney, the Board President of Conversations on Death, and Director of Community Education for Tru Community Care, Colorado’s first hospice, has said that as caregivers “the sacrifices you made changed the course of your life. As you once again look at finding a new course, you will over time grieve your loved one and what you let go of or stored away. You will also begin to discover the things you learned from giving so much. As you recognize and honor what you did, it will begin to shape the meaning of your life now. Whatever the challenges ahead in rebuilding, that understanding can give you the strength, commitment, and satisfaction to make your life more meaningful than ever.”

So, what’s next? Stop, take a deep breath, and think about your journey: where you came from, what you did, and how you feel. When my husband’s final health crisis was over and after I buried him, I realized that I hadn’t fully breathed for years and that my body was strangled with tension and fatigue. I had meditated, eaten fairly well (besides the times I was too tired to cook and made a dinner out of popcorn and ice cream), danced, exercised, and practiced yoga. All these things helped keep me calm, and brought me back to my “self.” But being on call for years took its toll. And after it was all over, while ensnared in the tentacles of grieving, I felt relief. Relief that I wouldn’t feel the pain of watching Morris lose yet another function. Relief that I wouldn’t have to fill another prescription or talk to a physician about my husband’s condition. Relief that I didn’t have to travel the 15 miles to visit him in the memory care home, where I’d inevitably get depressed. Relief that I could stay home and not have an obligation other than caring for myself.

And yet, the final letting go of my role as caregiver was uncomfortable and felt strangely similar to sending my children out into the world. How would I define myself if I were no longer a caregiver? How would I fill up the time I had spent caring for my husband for an entire decade, one fifth of my life? Creating a new identity takes time, practice, and patience. And we are told by grief counselors to not rush things. Do not make a major change in your life, such as moving out of the house you’ve lived in for years, or to another state. But day-by-day, it’s okay to acknowledge that we are not the same person who heard the dreaded words from our loved one’s doctor: “You have dementia, most likely of the Alzheimer’s type.”

As caregivers we take a journey through fire and ice and land on solid ground surrounded by calm waters. Then it’s time to swim to shore and get our bearings. Be patient, be kind to yourself, and set out to discover different activities, small and large, that ease you to calmer waters. Here are some ways to help you get there:

  1. Choose at least one healing modality in this book and integrate it into your life. Dance, do yoga, try journaling, find someone to walk with, etc.
  2. Clean out your closets and drawers.
  3. Wash the garage floor and then paint it.
  4. Take a cooking class.
  5. Join a health club or YMCA.
  6. Take a Zumba® fitness class.
  7. Ride your bike.
  8. Join a hiking club.
  9. Learn how to sew or knit.
  10. Serve food at a community table or sort food at a food bank.
  11. Plant a garden.
  12. Play a musical instrument.
  13. Learn a new language.
  14. Travel! Visit friends and family.
  15. Take long nature walks.
  16. Make it a habit to soak in a bath with Epsom salts.
  17. Get a puppy or kitten.
  18. Volunteer at the Humane Society.
  19. Read to elementary school children.
  20. Join a book club.

My journey to calmer waters

My husband’s illness changed the course of my family’s lives in ways that were unexpected, devastating, and empowering. I developed into a strong matriarch and quickly learned how to take charge of my husband’s care, family business, and my children, without the help of my partner. And not having a partner, with whom I would typically make important decisions with, was one of the hardest things of all about being a partner to someone with Alzheimer’s disease.

Not having a partner, with whom I would typically make important decisions, was one of the hardest things of all about being a partner to someone with Alzheimer’s disease. Deciding where and when to place Morris in a memory care home, figuring out how to finance it, and deciding when to enlist the help of hospice were the kinds of decisions I would have discussed with my husband.

I became a compassionate caregiver, not just for Morris, but for other residents of the memory care home where he lived the last two years of his life. I went through a lot—as all caregivers do—but I’ve come through. I’ve recreated my life, and have learned to look forward with hope, wonder, delight, and inspiration after giving so much of myself to the person I vowed to spend my life with.

There are days that go by without my thinking about Morris. After all, it’s been over eight years since he’s been gone. It’s still hard for me to look at family photos because our family was happy, and a link is missing. I know for my children the hardest thing is that their own children are growing up without knowing their grandfather, who would have loved to be a part of their lives. We will always miss him, but our happy memories fill in the gaps, and we honor him eery year on his yahrzeit the anniversary of a Jewish loved one’s death.

I have a new love in my life and grandchildren to enjoy and cherish. I feel good and I am happy! As my beloved teacher Swami Kaleshwar always said, “Life is short, make it sweet.” I will and I do.


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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Communicating with someone who has dementia

Confused Senior Man With Adult Daughter At Home

Confused Senior Man With Adult Daughter At Home

It’s difficult communicating with people who have dementia for several reasons. They may have diminished hearing, but most often times they are unable to express themselves because they have forgotten words in addition to losing memories and a sense of self.

Here is a list of tips that come from a caregiver’s guide published by the Aging Services Division of the Denver Regional Council of Governments. The author is unknown.

  • Trouble remembering the right words
  • Repeating words with which they are still familiar
  • Creating new words when they can’t recall the names of people or items
  • Problems with organizing words in a coherent manner
  • Falling back on the language used during childhood
  • Losing their train of thought
  • Speaking less and relying primarily on nonverbal communication and gestures
  • Cursing or using inappropriate words even if they never did so before

The following tips can ease working with persons with dementia

  • Remembering that this person is an adult first and foremost. Keep in mind that they deserve respect and dignity
  • Be calm in your interactions and be aware of your body language. Your family remember is looking to you and your behavior for clues on how to behave him/herself.
  • Speak slowly and in short, simple sentences. Avoid complex directions or dialogue.
  • Avoid arguing with or criticizing the person, even if she is delusional in his/her thinking. Always validate the emotion behind the statement.
  • Indicate by facing your family member and maintaining eye contact that you are listening and trying to understand what is being said.
  • Support your loved one’s attempts to converse even if he or she is having difficulty.
  • Do ot interrupt.
  • Speak in a relaxed and gentle tone of voice.
  • Keep a friendly face toward your loved one when either of you is speaking.
  • Approach the person from the front, identify yourself, and address him or her by name.
  • Only ask one question at a time and allow sufficient time for your family member’s response before you continue.
  • Talk about other people using their names rather than pronouns.
  • Never quiz your loved one, e.g., “Don’t you know who that is? Don’t you remember?”
  • Furnish assistance as needed but avoid finishing your family member’s sentences.
  • Never talk about your loved one as if he or she isn’t there.
  • Draw on your innermost resources to display understanding and thoughtful patience, and try to remain flexible.
  • Rely on nonverbal communication such as pointing and touching to help facilitate understanding.
  • Use lots and lots of touch and praise. compliment frequently to make up for lowered self-esteem due to losses in abilities.

And most importantly, be kind. Put yourself in the other person’s shoes. How would you like to be spoken to and listened to?


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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Mushrooms may reduce risk of mild cognitive impairment by 50%

Mushrooms - morchella mushrooms, boletus mushrooms, oyster mushrooms, on white background.If  you eat golden, oyster, shiitake and/or white button mushrooms, as well as dried and canned mushrooms, you’re in luck! A team from the Department of Psychological Medicine and Department of Biochemistry at the Yong Loo Lin School of Medicine at the National University of Singapore (NUS) has found that seniors who consume more than one and one-half cups of mushrooms weekly may reduce their odds of having mild cognitive impairment (MCI) by 50%. 

What is MCI?

Mild cognitive impairment causes cognitive changes that are serious enough to be noticed by people experiencing them or to other family and friends. The changes are not severe enough to interfere with daily activity. People with MCI that involves memory problems are more likely to develop Alzheimer’s disease or other dementias than people without MCI. Approximately 15-20 percent of people age 65 or older have MCI.

Mushrooms might be a key to reducing MCI

The correlation between eating mushrooms and reducing risk of MCI is surprising and encouraging, according to Assistant Professor Lei Feng, who is from the NUS Department of Psychological Medicine, and the lead author of this work.

The six-year study, which was conducted from 2011 to 2017, collected data from more than 600 Chinese seniors over the age of 60 living in Singapore. The research was carried out with support from the Life Sciences Institute and the Mind Science Centre at NUS, as well as the Singapore Ministry of Health’s National Medical Research Council. The results were published online in the Journal of Alzheimer’s Disease on 12 March 2019.

The researchers found that the compound called ergothioneine (ET), a unique antioxidant and anti-inflammatory which humans are unable to synthesize on their own, is the key to possibly reducing MCI. Ergothioneine is found in liver, kidney, black beans, kidney bean and oat bran. But the highest levels are found in bolete and oyster mushrooms.

Other compounds contained within mushrooms may also be advantageous for decreasing the risk of cognitive decline. Certain hericenones, erinacines, scabronines and dictyophorines may promote the synthesis of nerve growth factors. Bioactive compounds in mushrooms may also protect the brain from neurodegeneration by inhibiting production of beta amyloid and phosphorylated tau, and acetylcholinesterase, the culprits of Alzheimer’s disease.

How much do you need to eat?

In the study, a portion was defined as three quarters of a cup of cooked mushrooms with an average weight of around 150 grams. Two portions would be equivalent to approximately half a plate. While the portion sizes act as a guideline, it was shown that even one small portion of mushrooms a week may still be beneficial to reduce chances of MCI.

An article in Science Daily said this: According to Robert Beelman, professor emeritus of food science and director of the Penn State Center for Plant and Mushroom Products for Health, it’s preliminary, but you can see that countries that have more ergothioneine in their diets, countries like France and Italy, also have lower incidents of neurodegenerative diseases, while people in countries like the United States, which has low amounts of ergothioneine in the diet, have a higher probability of diseases like Parkinson’s Disease and Alzheimer’s,” said Beelman. “Now, whether that’s just a correlation or causative, we don’t know. But, it’s something to look into, especially because the difference between the countries with low rates of neurodegenerative diseases is about 3 milligrams per day, which is about five button mushrooms each day.”

 

Mushroom recipes

Cooking mushrooms does not seem to significantly affect the compounds. Roasted or baked mushrooms are simple to make and delicious, and go well with most foods as a side dish or topping.

Wash and slice musthrooms. Lightly oil shallow baking pan large enough to hold mushrooms in single layer. Add mushrooms and toss with 2 to 3 tablespoons oil. Add garlic; season with salt; roastfor 20 minutes stirring on occasion; mushrooms should be browned. Season with pepper.

For baked mushrooms with parmesan, thyme and lemon simply toss with olive oil, Paremesan cheese, garlic, thyme, lemon zest and lemon juice.

For more mushroom recipes google for mushroom risotto, mushroom gravy, cream of mushroom soup, creamy mushroom pasta, mushroom and barley soup.


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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

What happens to your body when you’re a stressed caregiver?

Woman having a headacheStatistics show the stress of care giving can result in chronic disease for the caregiver and take as many as 10 years off one’s life. In comparison to caregivers of people in all categories, caregivers of Alzheimer’s patients in particular rate their health more poorly, take worse care of themselves, and spend more money on their health care. Feeling more tired and depleted, they evaluate themselves as less healthy, engage in fewer health-promoting behaviors, and use more health services.

Given the demands on caregivers’ time and energy, they may neglect their own self-care by sleeping less, eating too much or too little, not exercising, or not managing their own health problems. Neglect of their own health may worsen pre-existing illnesses or increase vulnerabilities to new stress-related problems.

The Physiology of Stress

Walter Cannon described the fight or flight response in 1929.  Adrenaline is the fight-or-flight hormone: It causes cells, especially muscle cells, to speed up energy production so that the body will be ready to fight a foe or run away. It is needed for short blasts of stress.

  • Pupils dilate to sharpen vision.
  • Heart rate and blood pressure increase to accelerate the delivery of oxygen to fuel the muscles and critical organs.
  • Blood flow is diverted from non-critical areas such as the gastrointestinal tract to the critical areas such as the heart, skeletal muscles and liver.
  • Liver releases glucose and fatty acids into the bloodstream. Glucose is for immediate energy; fat is needed when the fight-or-flight response lasts longer than expected.
  • Bronchial tubes dilate to maximize the exchange of oxygen and carbon dioxide.

Cortisol bolsters us in long-lasting stress situations. But when the body is dealing with chronic stress, the adrenals get “stuck” in the on position and the whole system goes into chronic “fight or flight.”

  • Glucose that is dumped into your bloodstream goes unused, so your body has to produce an enormous amount of insulin to handle it. Eventually, this may result in hypoglycemia or diabetes.
  • Fat that is dumped into your blood also goes unused, so it clogs your arteries, leading to cardiovascular disease.
  • If you drink caffeine, the stress hormone cortisol becomes elevated, which can set you up for countless health problems including: poor quality of sleep, impaired immunity and age-related deterioration.

Adrenal exhaustion–The adrenal glands produce or contribute to the production of about 150 hormones. When they are stressed, they become exhausted. Once the adrenal buffer is gone, you become a prime candidate for asthma, allergy, fibromyalgia, chronic fatigue syndrome, autoimmune disorders, hypoglycemia

Alcohol, caffeine, sugar and salt put added stress on the adrenals.

Stimulate, such as caffeine increase the effects of your body’s own stimulating neurotransmitters: norepinephrine and dopamine, which are similar to adrenaline in their effects. Caffeine and these natural stimulants provide short-term energy, focus and even a lifted mood. But in the long-term, caffeine depletes your stores of norepinephrine and dopamine, leaving you more tired, sluggish and down than you were before the caffeine habit.

Psychological stress can impact cardiovascular function and lead to cardiovascular disease, and possible stroke/heart attack.

Stress and sleep

Adequate sleep repairs your body, sharpens your mind and stabilizes emotions. Lack of sleep triggers the body to increase production of cortisol, which makes it harder to fall asleep and stay in a deep sleep because on some level your body and brain think they need to stay alert for danger.

  • Loss of sleep as a result of caring for a loved one can lead to serious depression.
  • As little as five nights of poor sleep can significantly stress the heart.

Weight gain and insulin resistance

  • Increased cortisol production leads to weight gain. The adrenals increase gluconeogenesis, which provides the body with glucose from protein, rather than carbohydrates. This decreases serotonin and melatonin, which results in poor sleep and leads to food cravings for carbohydrate-rich foods in order to uplift mood, which releases more serotonin and insulin. This leads to more stress and insulin production to regulate glucose, which may lead to fat storage, weight gain and insulin resistance. It becomes a vicious cycle.
  • Insufficient sleep is also associated with lower levels of leptin, a hormone that alerts the brain that it has enough food, as well as higher levels of ghrelin, a biochemical that stimulates appetite. Consequently, poor sleep may result in food cravings.

Exercise

  1. Insufficient sleep may leave us too tired to burn off extra calories with exercise.
  2. When your body is stressed and prepared to fight or run it’s full of stress hormones. If you’re sedentary, those hormones will continue to circulate and cause damage to your body. Vigorous exercise, however, burns off those hormones. Exercise also releases the neurotransmitter serotonin and endorphins, the body’s natural pain relievers.
  3. Doctors from Nottingham Trent University suggest the chemical phenylethylamine is released during exercise and could play a part in uplifting mood as a result of exercise. Phenylethylamine is a naturally produced chemical that has been linked to the regulation of physical energy, mood and attention.

Impact of food on mood and physiology

Hazards of caffeine

  1. Caffeine stresses the adrenal glands and can contribute to anxiety, insomnia, depression, irritability, anxiousness—not good for caregivers. In fact, studies show that those who drink the most coffee often suffer from chronic depression. It depletes the body of B1, biotin, inositol, vitamin C, calcium, potassium, and zinc. It increases thirst because it is dehydrating, over stimulates and weakens the kidneys, pancreas, liver, stomach, intestines, heart, and nervous system.
  2. Can increase production of cortisol, leading to stronger cravings for fat and carbohydrates. This increases blood glucose, release of insulin and fat stored in the abdomen.
  3. Increases dopamine levels, making you feel good until it wears off
  4. May interfere with restful sleep
  5. Try not to drink coffee after 2pm
  6. Simple carbohydrates increase insulin production.

People who are stressed often crave and overeat sugar and simple carbohydrates, like chips, cookies and white bread or pasta, because those foods provide a fast release of the feel-good chemical serotonin. But eating this way causes a blood-sugar crash a couple of hours later, leaving you tired and moody. The more of these foods that you eat the more you crave. Although these foods are high in calories, they contribute few nutrients and deplete the body of essential vitamins and minerals, raise triglycerides, and contribute to inflammation and excess weight.

  1. Lack of water/fiber can rob the body of nutrients because of problems with digestion and assimilation
  • HFCS and other artificial sweeteners can interfere with your natural production of neurotransmitters. Aspartame (NutraSweet and Equal) competes with tryptophan by blocking its conversion into serotonin. Artificial sweeteners contribute to numerous adverse symptoms, as compiled by the Food and Drug Administration and include everything from menstrual changes, weight gain, and headaches to severe depression, insomnia and anxiety attacks.

High fructose corn syrup (glucose and fructose) can lead to a decrease in leptin production leading your body into thinking it’s hungry so you eat more, especially processed foods. HFCS can lead to insulin resistance and higher levels of triglycerides, as well as obesity, hypertension and cardiovascular disease.

Bad habits, i.e. forgetting to eat, eating on the run, not eating breakfast all contribute to unstable blood sugar and adrenal exhaustion, which makes you grab foods that aren’t good for you, so you end up feeling irritable, moody, and even more stressed.


You get the picture? It’s important to take care of yourself, especially when you are taking care of someone else. I don’t want to overwhelm you with information or preach to you. Here’s a short checklist to help you stay healthy and balanced.

  • Eat a serving of high-quality protein with every meal and snack
  • Focus on complex carbohydrates (whole grains, veggies and fruits), and eliminate junk foods (refined carbs).
  • Enjoy unlimited amounts of fresh veggies.
  • Eat a good breakfast!
  • Eat 3 balanced meals and 1-2 snacks/day.
  • Magnesium, B complex, fish-oil, walnuts, flax seeds, dark leafy greens, and high quality all help reduce stress and uplift mood.
  • Meditate or find some quiet time for yourself
  • Exercise! At least take a short walk everyday.
  • Put on a funny YouTube video and laugh.
  • Use aromatherapy.
  • Do the best you can.

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Calmer Waters: Spring 2019 book signings and events

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Especially for folks in the Denver-metro area: You are warmly invited! Please drop by at a book signing to say hello, or attend the caregiver symposium or conference (or both!) for lots of great information, networking and support. Respite care is available for both events. Click on the links to find out more.

Falling in love while caring for your spouse with Alzheimer’s

This is a controversial and delicate topic. Is it possible to judge someone unless we’ve walked in their shoes? Watch the video and let me know what you think.

In the meanwhile, you might want to check out my article “Sexual intimacy between care partners” at The topic of sex is often uncomfortable in the best of relationships in the best of times. The topic is especially prickly when one of the partners has Alzheimer’s disease.

 

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

What are you doing for your brain health?

Brain Nutrition

MIND diet includes salmon, beans, greens, nuts, berries

This week is Brain Health Awareness Week, and I’m reposting this piece so you can evaluate your diet and make improvements to support your brain–and heart health. Here’s to your healthy brain and heart!

Have you heard of the MIND diet? It’s the Mediterranean diet and DASH diet slightly remade and combined to form the MIND diet. (MIND is an acronym that stands for the Mediterranean-DASH intervention for Neurodegenerative Delay.)

In a study published in September 2015 in Alzheimer’s & Dementia, the nutritional epidemiologist Martha Clare Morris and her colleagues at Rush University Medical Center borrowed concepts from the Mediterranean diet and the DASH diet. The result is the MIND diet.

The study followed 923 participantsages 58 to 98 years, for an average 4.5 years, and found the MIND diet lowered Alzheimer’s risk by about 35 percent for people who followed it moderately well and up to 53 percent for those who adhered to it rigorously. While more study is needed to better understand the long-term impact of the diet, Morris’s team’s second paper on the MIND diet notes that it’s superior to the DASH and Mediterranean diets for preventing cognitive decline. But it should be noted that high adherence to all three diets may reduce risk of Alzheimer’s disease.

Food to eat on the MIND Diet

  • Green leafy vegetables: a minimum of 6 servings a week (kale, Swiss chard, spinach, collard, etc.)
  • Nuts: a minimum of 5 servings a week (walnuts, pistachios, almonds, cashews, etc)
  • Berries: a minimum of 2 servings a week
  • Beans: a minimum of 3 servings a week (garbanzo, red, black, kidney, white, pinto, etc.)
  • Whole grains: a minimum of 3 servings a day (millet, oats, brown rice, quinoa, wheat berries, etc.)
  • Fish: at least 1 serving a week
  • Poultry (like chicken or turkey): at least twice a week
  • Olive oil as the primary oil used
  • Wine: no more than 1 glass a day

Foods to limit or avoid

  • Red meat: no more than 4 servings a week
  • Butter and margarine: no more than 1 tablespoon (tbsp) daily
  • Cheese: no more than 1 serving a week
  • Sweets: no more than 5 servings a week
  • Fried or fast food: no more than 1 serving a week

To summarize the MIND DIET—

On a daily basis you eat at least three servings of whole grains, a salad and another vegetable, along with drinking a glass of wine. The jury is still out on whether a little alcohol consumption is better for the brain than none at all. I just heard a panel of researchers and neuroscientist address this issue. If you don’t consumer alcohol, there is certainly no reason for you to start now. But if you do, limit your consumption to one glass of wine a day.)

It’s advised that on most days you should snack on nuts, and every other day eat half a cup of beans. At least twice a week eat poultry and a half-cup serving of berries (blueberries are best), and eat fish at least weekly. Olive oil is the preferred cooking oil.

What is the DASH diet?

The healthy DASH diet plan was developed to lower blood pressure without medication in research sponsored by the US National Institutes of Health, Dietary Approaches to Stop Hypertension. The first DASH diet research showed that it could lower blood pressure as well as the first line blood pressure medications, even with a sodium intake of 3300 mg/day!  Since then, numerous studies have shown that the DASH diet reduces the risk of many diseases, including some kinds of cancer, stroke, heart disease, heart failure, kidney stones, and diabetes. It has been proven to be an effective way to lose weight and become healthier at the same time.

The DASH diet eating plan is a diet rich in fruits, vegetables, low-fat or non-fat dairy. It also includes mostly whole grains; lean meats, fish and poultry; nuts and beans. It is high fiber and low to moderate in fat. It is a plan that follows US guidelines for sodium content, along with vitamins and minerals. In addition to lowering blood pressure, the DASH eating plan lowers cholesterol and makes it easy to lose weight. It is a healthy way of eating, designed to be flexible enough to meet the lifestyle and food preferences of most people.

How is it different from the Mediterranean diet? It can be considered to be an Americanized version of the Mediterranean diet, and to be easier to follow, since it has more specific guidelines. But if you love tabouli, hummus, and olives, you might prefer the Mediterranean diet.

Although there are similarities among all three diets, the MIND diet is the only one that encourages the consumption of foods that have been found to promote cognitive health.

There is a saying that “what’s good for your heart is good for your brain.” So please start switching over to the MIND diet while eliminating foods high in calories and low in nutrients. You will feel better and your brain will stay healthier longer.


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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Urinary incontinence, UTIs, and dementia

Incontinence inscription isolated

There are lots of reasons that people develop incontinence. This blog focuses on people with dementia: their care and ways to prevent urinary tract infections, a serious consequence of incontinence in the elderly.

People with Alzheimer’s disease and dementia often have problems with urinary incontinence. This can be a result of not realizing they need to urinate, forgetting to go to the bathroom, not being able to find the toilet, or limited mobility.

Ways a caregiver can help

  • Avoid giving drinks like caffeinated coffee, tea, and sodas that may increase urination. It is important, however, that healthy liquids including water, smoothies, and fresh fruit juices are not restricted. Hydration is vital to overall health and to prevent urinary tract infections.
  • Keep pathways clear and the bathroom clutter-free, with a light on at all times.
  • Make sure you provide regular bathroom breaks–at least every 2-3 hours.
  • Mark the bathroom door with a large sign that says “Bathroom.”
  • Provide a portable commode or a toilet frame with handrails or grab bars to make getting on and off easier. Make sure it’s the right height.
  • Supply underwear that is easy to get on and off.
  • Use absorbent underclothes for trips away from home and/or adult diapers.
  • When going to a restaurant or public place such as a movie theater, try to sit as close to the bathroom as possible.
  • Limit liquid intake after dinner

Talking to the doctor

  • Ask if it’s possible to cut back on prescribed medications such as water pills that increase urination
  • Does the patient have undiagnosed diabetes? Diabetes increases urination.
  • Is an enlarged prostate the problem? Rule out any medical issues that increase urination or block urination.

Preventing urinary tract infections

Urinary tract infections, commonly called UTIsare more common in people who are elderly, bed-ridden and incontinent. Symptoms can include general weakness, confusion, nausea, dizziness, sudden incontinence or increased severity of incontinence. Often these symptoms seem connected to other conditions that are unrelated to a UTI, and can make it difficult to determine that the cause is an infection.

  • The most important method of prevention is to keep the genital area clean and healthy. Wipe from front to back to avoid transferring bacteria to the urinary tract, especially in women.
  • Remove used diapers from front to back.
  • Dry the skin when changing or after bathing since bacteria grows better in moist areas.
  • Use recommended hygienic products for washing that are not drying to the urogenital area.
  • Keep the patient hydrated since urination can flush out unwanted bacteria from the urinary tract.
  • Try to make sure your loved one gets help to empty their bladder entirely, since urine remaining in the bladder can help bacteria thrive and multiply.
  • Help to prevent constipation by providing plenty of fruit (applesauce, apples, berries, prunes, figs) and other foods high in fiber, such as oatmeal, legumes, peas, chia seeds, carrots, beets, broccoli, Brussels sprouts, popcorn, nuts, and whole grains.

The dangers of UTIs

Urinary tract infections are notorious for causing delirium and delusional behavior in the elderly. When younger people get a urinary tract infection, they typically experience painful urination, an urgent need to urinate, lower abdominal pain, back pain on one side, and fever and chills. However, an older adult might not experience those symptoms. As we get older our immune system changes and it responds differently to infection. Instead of pain symptoms, seniors with a UTI may show increased signs of confusion, agitation or withdrawal. In older adults with dementia, these behavioral changes may come across as part of that condition or signs of advanced aging. If the underlying UTI goes unrecognized and untreated for too long, it can spread to the bloodstream and become life-threatening. In fact, I have a dear friend who died from a UTI that quickly became septic.

If you suspect a UTI

  • Get medical help, especially if your loved one has fever or complains of nausea or back pain. An antibiotic will be prescribed. Make sure the entire prescription is taken even if the symptoms subside. Otherwise, the infection can come back with a vengeance.
  • If it is appropriate, have the patient drink unsweetened cranberry juice on a regular basis, and/or take a cranberry/D-Mannose supplement to help stave off future infections.
  • Give the patient plenty of water to flush out the harmful bacteria
  • Apply a heating pad to the lower abdomen and/or back to help with discomfort
  • A pain reliever such as Advil can help alleviate pain and fever

Urinary tract infections are nothing to mess around with. Please get your loved one medical help if you suspect an infection.


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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”—Winner of the 2018 Book Excellence Award in Self-Help—in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Motivating family members to help

Until age eight, I lived in an extended family house with my parents, brother and me on the top floor, my grandparents on the middle floor, and my aunt, uncle and cousin on the bottom floor. We all took care of each other, no questions asked. It was a close, loving family.

But that was then, this is now. Times have changed. People move away, and families don’t always stick together. I was lucky that my daughter and her newly-wed husband live near me and helped care for my husband (her father) who had Alzheimer’s disease. Every Sunday afternoon they took him out to a movie or to lunch. It gave me a break and it uplifted his spirit. My son, who was in graduate school, came home when he could to take his dad to a football game. And friends took my husband out to lunch on a regular basis.

But I needed extra help so I hired two graduate psychology students. I had promised myself that I wouldn’t become a martyr to my husband’s illness. I took care of myself by pursuing my interests and meeting with friends. Because I had time for myself, I had more energy to be present for my husband. Still, caring for someone with Alzheimer’s disease was a daunting task, as is caring for anyone with a chronic disease.

It really does take a village to provide care for someone with a chronic illness. If you have family that offers to help, you are lucky. Sadly, it’s often the case that one family member bears the brunt of the caregiving, which can lead to conflict and bad feelings.

What can you do to encourage family and friends to help?

  • If your loved one has Alzheimer’s or another form of dementia you are well aware of the difficult task of caregiving. But if your sister or brother, son or daughter, etc. only sees the ill person once in a while they might not realize the full impact of the disease. Try to plan a respite day or weekend by having another family member care for your loved one. This is the best way to help your family realize how much care your loved one needs and what the task requires.
  • Plan a conference call and divvy up the caregiving. If your family is spread out, encourage a rotation of caregiving. In some cases, the ill person stays with a daughter or son for a few months and then moves on to stay with another family member. This eliminates guilt and bad feelings among siblings. The logistics are complicated, but it can work.
  • If it is impossible for others to share in the physical caregiving because of where they live or other circumstances, encourage family members to take on a specific responsibility such as: refilling medications, driving to and/or making doctor appointments, providing meals, researching community assistance programs that include respite care and volunteer programs, setting up automatic bill payments and/or dealing with financial issues, providing a housecleaner or cleaning the house once a month, mowing the lawn, shoveling the snow, etc.
  • Speak your truth. Do you need a night out with friends? Time to go for a walk or to the gym? Say so, and don’t be afraid of offending anyone. The worst that can happen is that your sister or brother, or son or daughter will say “no.”
  • Is it possible for you to get paid for the help you provide? Discuss the options with your financial planner and other family members.
  • Ask a family member to create an online caring community such as “Share The Care” https://sharethecare.org/getting-started/ or “Caring Bridge.”  “Share The Care” is a system that creates a support network among caregivers that lets everyone share responsibilities. “Caring Bridge” https://www.caringbridge.org/how-it-workshelps you create a site that enables you to share updates about your loved one, coordinate help, and get emotional support.
  • It’s a fact of life that you can’t force another family member to help. Even if you do get help, you might be the one who does the disproportionate amount of caregiving. Try to accept it and be grateful that you will not feel guilty for not being there for your loved one. You are appreciated and even if your loved one can no longer communicate, he or she appreciates you and loves you. Just know that you are doing the best that you can . . . and that is all you can do.. 

Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”—Winner of the 2018 Book Excellence Award in Self-Help—in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.