Category Archives: Memory

The secrets to hydrating your brain and body to ward off cognitive and health issues

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Summer refreshing and extra hydrating infused water in bottles with fruits and berries

It’s too darn hot. But there are ways to keep cool.

  1. Turn up the air conditioner, which raises your gas and electric bill, not to mention puts a strain on the electric grid.

2. Wear little to no clothing, but then you’d probably have to stay home all day.

3. Sit in a cold pool for hours, but then you’d look like a wrinkled prune.

4. Or learn the new science of increasing your hydration.

Did you know that when your brain isn’t hydrated you can experience cognitive issues? You might forget words or get confused. In fact, when my mother was hospitalized toward the end of her life for dehydration, a psychiatrist called to tell me “Your mother has full-blown dementia. I’d like to put her on an Alzheimer’s drug.” I responded by saying, “No she doesn’t. I spoke to her yesterday and she sounded fine.” As my mother’s medical health proxy, I did not give the doctor permission to put her on any drug. In fact, after she was infused with saline solution she bounced back to her normal status and was released from the hospital.

The book QUENCH: Beat Fatigue, Drop Weight, and Heal Your Body Through the New Science of Optimum Hydration by Dana Cohen, MD and Gina Bria (Hachette Books, 2018) reveals the science behind hydration (which I’m not going to get into in detail here) and ways to hydrate your body other than drinking water all day.

Why is it important to stay hydrated?

Our body is 50-65% water. It needs water to stay hydrated and flush out toxins. The brain, which is 70% water, gets dehydrated just like your body. When it’s dehydrated, neurotransmission — which is heavily dependent on water — is impaired, resulting in poor memory, concentration, and impaired abstract thinking. The next time your mind is muddled, drink a tall glass of water and notice the difference.

Water supports the flow of blood throughout the body, and helps the body eliminate waste. Water enables us to sweat in order to help cool the body, and is crucial to hormonal balance. Dana Cohen adds that staying hydrated is the most important thing we can do to prevent chronic illness, and suggests that many of the chronic conditions that people attribute to eating too much sugar and gluten and getting too little exercise may be due to not giving the body the hydration it needs for optimum health.

How much water do you need?

Drinking half your body weight in water in ounces is the general rule. So if you weigh 120 pounds, you should aim for drinking 60 ounces of water a day.

The book QUENCH provides lists of foods that contain a lot of water that are just as valuable as drinking liquids, and suggests that we eat our water. Food contains minerals, which are electrolytes, that help regulate chemical reactions and maintain the balance between fluids inside and outside your cells.

For example, sodium is the most abundant electrolyte in the body. It’s important for keeping the right balance of fluid in your cells and helps cells absorb nutrients. So make sure you’re eating plenty of fruits and vegetables both for the electrolytes and the water they naturally provide.

Eat Your Food

The Top 12 Hydrating Fruits are watermelon, starfruit, strawberries, grapefruit, cantaloupe, pineapple, raspberries, blueberries, kiwi, apples, pears, and grapes.

The Top 12 Hydrating Vegetables are cucumbers, Romain lettuce, celery, radishes, zucchini, tomatoes, peppers, cauliflower, spinach, broccoli, carrots, and sprouts.

Dr. Dana Cohen and Gina Bria recommend drinking a tall glass of warm or hot water with a squeeze of lemon and a pinch of salt first thing in the morning. It provides electrolytes and an instant hydrating boost.

They also suggest drinking a hydrating shake with greens such as 1 cup of spinach, juice of 1/2 lime, 1/2 cup of coconut milk, 1 to 2 cups of water, a cored and quartered apple, and 1/2 cucumber. If you like, add herbs like mint, parsley, basil, and celery. Blend everything in a blender, rather than extract the juice in a juicer in order to get the benefits of fiber.

Stay away from carbonated and caffeinated drinks. herbal teas and fresh fruit or vegetable juices are great in summer. Just remember that fruit juices are high in sugar and calories. Coconut water is cooling and helps to replenish electrolytes, which is especially important during and after an illness.

Enjoy these smoothie and popsicle recipes. They provide hydration, vitamins, and minerals, and are perfect for kids as well as for folks with dementia and Alzheimer’s who may forget to eat or lose interest in food.

Popsicles

Watermelon and Kiwi–makes 8

4 kiwis, peeled and sliced

3 cups of pureed watermelon

Place kiwi inside the sides of the popsicle molds. Pour in the watermelon. You can make this with other fruits: watermelon and strawberries, etc. Add basil or mint; lemon or lime juice with or without the rind.

For a beautiful popsicle with 3 layers: Add watermelon puree but leave room for 2 more layers. Freeze for 30 minutes. Take out of the freezer and pour in a small amount of coconut milk, the full-fat canned variety. Freeze again. Take out and add pureed kiwi and freeze. This is a treat for the eyes as well as your taste buds.

Strawberries and Cream–makes 8

2 cups of pureed strawberries (leave some chopped for texture)

2 cups cream of vanilla yogurt.

Blend and freeze.

Coco-Mango–makes 4-6

2 cups pureed mango

1/2 cup canned coconut milk

Optional: Add coconut flakes.

Blend and freeze.

Orange Cream–makes 4-6 popsicles

1 cup orange juice

1 cup vanilla yogurt

Blend together and freeze.

Protein shake recipes

My favorite delicious and easy-to-make shakes

Banana Berry Shake

  • 1 frozen banana
  • ¼ cup sliced strawberries
  • 8 ounces of milk or non-dairy drink such as soy, almond, or coconut milk
  • 1 scoop of whey protein powder
  • Blend together until smooth.

Berry Sunrise Shake

  • 1/3 cup frozen blueberries
  • 3 medium strawberries
  • 8 ounces of orange juice
  • 1 scoop of whey protein powder
  • Blend together until smooth.

Stay cool and enjoy your summer!

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 Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

21 Ways to Ease Traveling with Someone who has Dementia 

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My husband, Morris, loved to travel so much that he memorized plane and train schedules for fun. Until he developed Alzheimer’s, that is. When he was unable to convert dollars into the local currency on our 25th anniversary trip through France and Spain, I realized something was very wrong. He followed me like a puppy dog around Barcelona and was afraid to hop on the subway. I was forced to read maps (not something I’m great at) and choose where to go and what to see, without any input. It was like traveling with a young child. My suspicion that he had Alzheimer’s was confirmed when we returned home.

That winter we went to an all-inclusive resort on the Riviera Maya, south of Cancun, to escape from our new reality. The last-minute get-away helped alleviate the stress of worrying about the future. But I couldn’t totally relax because I quickly learned that you can’t trust someone with dementia to find their way back to an unfamiliar hotel room.

Since he had been an avid lap-pool swimmer, I later took Morris on a quick trip to Glenwood Springs for a soak in the mineral pools. I was concerned that he would have trouble getting dressed in the locker room without my help. My first question to the staff was, “Do you have a family changing room?”

They actually have two, complete with toilet, sink, shower, and fold-down bench. There are also three ADA (American Disabilities Act) accessible rooms in the new restroom facility near the kid’s area at the west end of the property. 

Changing was easy. But Morris was afraid to get into the pool. I later learned that people with Alzheimer’s have difficulty with depth perception and peripheral vision. Their eyes might be healthy, but changes in the brain affect the way they process visual information and alters their perception of the world and how they understand it.

I wish I had known this before our family took a trip to Arches National Park. Morris was terrified as we slowly made our way through the Devil’s Garden. And I became impatient with him, not realizing that he probably felt as though he was about to fall off a cliff.

The good news is that you can travel with someone who has dementia. It’s a bit of a challenge, but it’s doable in the early stages. It just takes more planning, patience, and time. Our family took several fun trips to Hawaii with Morris after his diagnosis. They were even more special than our previous trips because we wanted to enjoy every precious moment together.

21 Tips for Traveling with Someone who has Dementia

It’s inevitable that routines will be disrupted while traveling. Here’s how to make it easier on yourself and the person you are caring for.

  1. Don’t leave home without an ID bracelet or wearable GPS unit that can’t be easily removed by your traveling companion. List the person’s name and your cell number on the ID. If the person can still use a cell phone, make sure your number is the emergency contact.
  2. Keep a current photo of your care recipient with you in case you get separated. And carry a laminated card that briefly explains that they have dementia. Showing this to service people helps to avoid frustration, impatience, confusion, and embarrassment.
  3. Consider staying in a hotel rather than with relatives who may be alarmed by or unfamiliar with dementia symptoms. If there’s any sort of drama in the household, this will only add to everyone’s confusion and frustration.
  4. Let the hotel staff know ahead of time of special needs. Ask for a vase of flowers to be placed in your room. They always seem to freshen up the environment.
  5. Bring an aromatherapy diffuser that plugs into the wall. I like the Vivitest Aromatherapy Diffuser because it diffuses for 6 to 8 hours, and turns off automatically. It’s available here: https://www.amazon.com/dp/B08TQPC4VZ?th=1
  6. Aromatherapy works like magic to allay anxiety. Put a few drops of lavender oil, sage, geranium, rose, or ylang ylang oil on a pillowcase, or handkerchief that you can stick in a shirt pocket, or in a diffuser. Try out different blends before your trip to see what your traveling companion prefers. Essential oils and diffusers are available at natural food stores and online.
  7. Try to avoid noisy, crowded situations that might provoke anxiety, fear, or confusion. Instead, visit tranquil environments such as art museums and galleries, botanical gardens, and special interest museums. If you’re meeting friends or family, picnic in a beautiful park. If children are included, choose a park with a playground.
  8. Have afternoon tea, cookies, and fruit in your hotel room, and allow time for a nap.
  9. Ice cream treats always work when the going gets rough!
  10. If you’re flying, book a direct flight and limit flight time to under four hours.
  11. Pack everything in a light backpack to carry on board, if possible, to avoid waiting at baggage claim. Carry documents and medications with you.
  12. Leave the lace-up shoes at home. Velcro shoes or slip-on shoes are a must.
  13. Most airports have a seating area a few feet from where you pick up your belongings, where you can put yourselves back together.
  14. Just beyond that is a handicapped seating area where you can hitch a ride on an electric cart that brings you to your gate.
  15. Use the family restrooms, rather than the public restrooms. Your traveling companion will appreciate the help.
  16. Take advantage of early boarding.
  17. Bring your own food, snacks, and water. Make sure you don’t bring anything that qualifies as a liquid. That includes yogurt.
  18. Let flight attendants know about special needs. They are more than willing to help.
  19. Don’t worry about your companion getting locked inside the cabin restroom. It is possible to open the door from the outside.
  20. Bring an iPad or headphones for entertainment and relaxation.
  21. Sit back and try to relax!

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: TheCaregiver’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 Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Cataract surgery reduces dementia risk

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It seems that almost all my friends are needing cataract surgery. And that’s probably a good thing. Because studies are indicating that cataracts increase your risk of developing dementia.

What is cataract surgery?

Nine in ten people develop cataracts by the time they’re 65, and an estimated 2 million (mostly older) Americans get cataract surgery every year.

A cataract is an opacification or clouding of the natural lens of the eye. The surgery involves the removal of the lens and replacement with an intraocular lens or artificial replacement for the lens of your eye. It’s considered one of the safest, most effective, and most common procedures performed today.

Research shows a link between vision loss and dementia

A recent study in JAMA Internal Medicine analyzed the relationship between cataract surgery and the risk of developing dementia. The researchers discovered that people who had cataract surgery had a 29 percent lower risk of developing dementia when compared to people who didn’t have the surgery. https://pubmed.ncbi.nlm.nih.gov/34870676/

The research also found that glaucoma did not affect the risk of dementia.

How does cataract removal protect brain health?

  • Cataracts can reduce vision, which may lead to depression. Depression is a risk factor for dementia.
  • One study found that the integrity of the eye is essential for the structure and function of the brain. “Cataract patients often present with accelerated age-related decreases in brain function, but the underlying mechanisms are still unclear.” https://pubmed.ncbi.nlm.nih.gov/29548900/ Vision impairment can lead to reduced sensory input to the brain, and this leads to less brain stimulation and loss of brain function.
  • People who have vision loss may be less engaged in physical activity and social interaction. This can lead to an increased risk of dementia.

Ways to help prevent cataracts

  • Eat a Mediterranean-based diet including foods that are high in vitamin C, vitamin E, lutein and zeaxanthin. Low levels of lutein and zeaxanthin are associated with cataracts, whereas higher levels help to reduce the risk of developing cataracts.
  • Lutein and zeaxanthin are carotenoids and are found in spinach, Swiss chard, kale, parsley, pistachios, green peas, egg yolks, sweet corn, and red grapes. They are best absorbed when eaten with a healthy fat such as olive oil or avocado.
  • Wear sunglasses to protect your eyes from UV rays.
  • Quit smoking. Smoking increases the free radicals superoxide and hydroxyl radicals that damage the lipids and proteins in the eyes. This causes deposits to form on the lens of the eyes and leads to cataract formation.
  • Maintain healthy blood sugar levels. People with diabetes are more likely to develop cataracts.
  • Restrict consumption of alcohol, which can increase the risk of cataracts by increasing the body’s inflammatory response, free radical production in the eyes, and dehydration. Dehydration affects the proteins in the lens of your eyes.
  • Get regular eye exams.

Get more bang for your buck

If your eye doctor is suggesting that you have surgery to remove cataracts, do it sooner than later. Because cataract surgery will not only sharpen your vision, it may very well sharpen your mind.

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: TheCaregiver’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 Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Aging and Memory Loss: What’s normal, what’s not, and how to seek help (this article appeared in the Daily Camera’s Aging at Altitude Special Section, spring 2022)

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Most of us have had “senior moments” where we’ve run into a friend and momentarily forget their name. Or we search the house for eyeglasses that are perched on our head. Or we walk in circles trying to locate our car in the mall parking lot. Those forgetful moments are fairly typical of being a member of the 21st century with a headful of thoughts and responsibilities.

Putting the car keys in the refrigerator might be something you do if you’re distracted, but storing a dozen cans of pineapple in the dishwasher, or forgetting how to drive home are not normal memory slips. These types of forgetfulness could be a sign of cognitive impairment or a dementia. But the latest research is showing that if you treat early signs of mental decline, you can slow down and possibly reverse cognitive decline.

Ilene Naomi Rusk, Ph.D. is a neuropsychologist, functional brain health coach, and director of The Healthy Brain Program at the Brain and Behavior Clinic (2523 Broadway #200, Boulder, CO, 303-938-9244). Dr. Rusk acts like a detective to fully understand the root causes of a person’s psychological and brain health issues. Then she works with the patient and a functional medicine team with personalized diagnostics, and treatment or interventions, from brain training to nutrition guidance.

“It’s good for everyone to have baseline neuropsychological testing in mid-life even if you have no memory issues,” says Rusk. Most people think cognition is memory, but it’s much more than that. It’s memory, learning, attention and focus, visual and spatial skills, and how we absorb information, retain it and then share it. Cognition is also how we process things visually, auditorily, and spatially.”

There are different categories of cognitive health versus cognitive impairment that can clue me into whether or not someone is headed towards dementia, says Rusk.

“Subjective Cognitive Impairment (SCI) is when you notice a change in your cognition and think ‘I’m a little different than I used to be’, but other people can’t tell and it wouldn’t show up on a memory test.

“The next category is Mild Cognitive Impairment (MCI). This is when you notice changes in your thinking and people around you may or may not notice changes. With MCI you might also have some challenges on neuropsychological tests that show empirical changes. This is a staging system,” says Rusk. “With MCI there’s a great opportunity to intervene, and we want to intervene as early as possible because once you have Mild Cognitive Impairment it’s easier to slip into dementia,” she adds.

The best thing is to tell your doctor if you have concerns and then go to see someone to get properly assessed.

“I recommend that people go directly to a neuropsychologist or neurologist after they’ve spoken to their family physician to look for root causes. There are so many prevention strategies and a new functional medicine methodology to approach cognitive decline. Functional Medicine practitioners look at blood sugar control, blood pressure, gut health, latent, mold, infections, inflammatory markers, stress, sleep patterns, chronic loneliness, and trauma. These are all important things when looking at modifiable root causes of cognitive impairment,” says Rusk.

“We no longer think that Alzheimer’s is only a disease of the brain. That’s definitely an endpoint,” she says. “Everything from dental health to herpes is being looked at, and the amyloid theory of Alzheimer’s is even being questioned by some people. I see trauma healing and stress reduction as important interventions. Chronic stress affects so much in our physiology and unhealed trauma leaves physiologic imprints.

 It’s also important to know,” she adds, “that 70% of dementias are of the Alzheimer’s type and 30% of dementias fall into other categories such as Frontal Temporal Dementia, Parkinson’s, Lewy Bodies, etc. getting properly diagnosed is very important.

The brain pathology of Alzheimer’s often starts 20 years before there are clinical signs. “A person goes from no dementia to SCI, MCI, early stages of dementia, mild, moderate, and severe stages,” says Rusk. “My goal is prevention, and my favorite thing to do is talk to young people about brain health. If we can intervene early, the decline can be delayed and even sometimes prevented.”

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: TheCaregiver’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 Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Should you move your loved one to a memory care home?

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Forgetful senior with dementia

Moving my husband to a memory care home was the hardest thing I’ve ever done. But I knew that if I didn’t, I’d pay dearly with my own deteriorating health. After caring for Morris for 8 years, I was stressed and diagnosed with a serious disease. When I asked my doctor what he would do in my situation, he paused before saying “You need to take care of yourself.”

Morris was mostly able to take care of his personal hygiene, with some help in the shower, etc. But he wasn’t able to drive, and he needed help getting dressed. He could feed himself if I put the food in front of him. He still enjoyed watching movies, although I’m sure he couldn’t follow the plot. He liked being taken out to lunch, but he couldn’t read a menu. In other words, he needed a lot of help. I didn’t feel that he was a danger to himself or to me, but I didn’t leave him alone in the house for more than a quick trip to the grocery store. However, I was burned out and had received a diagnosis that no one ever wants to hear — the kind that requires a lot of self-care, rest, and good nutrition.

So I was relieved to learn that our spot on the waiting list at my chosen memory care home was towards the top of the list. And I was especially glad, thanks to my therapist’s advice, that I had looked for a place the previous year so that in case of an emergency I didn’t have to frantically scramble to find a home for my husband . . . a place where I felt confident that the caregivers would treat him with kindness, compassion, and respect.

How do you know when it’s time to move someone to a long-term facility?

Of course, every situation is unique, especially since no two dementia patients or families are alike. Some families consist of an elderly couple who live by themselves with no family nearby. A person with dementia may live on their own. Or an older parent may be looked after by an adult child or grandchild who lives nearby or in another state. But in every case, it’s vital to have safety measures in place. That may involve moving the person with dementia into a family member’s home or into a long-term care facility. Families that have several siblings — adult children of the affected parent — share the caring responsibility by having the parent rotate throughout the year, staying with each child for a few months at a time.

Here are some indications of when it’s time to make that move

  • The caregiver is burned out and stress is affecting his/her mental, emotional, and physical health.
  • When it becomes obvious that the person being cared for is unable to take care of their basic needs.
  • S/he wanders off and doesn’t know how to get back home.
  • S/he is isolated, lonely, and depressed.
  • Your loved one is angry and verbally or physically abusive.
  • S/he has mobility issues and tends to fall.
  • The person with dementia has Sundowner’s syndrome and gets agitated at the end of the day. This is a sign that they are becoming unable to live alone.

Making the decision to move a loved one into a memory care home is one of the hardest decisions you will ever make. Just remember that when you’re a caregiver for someone with dementia, it’s important to take care of yourself, too. Because if you don’t and you get sick, then who will take care of you?

Take the advice of my therapist and start looking for a home where your loved one will be well cared for. Or have a family meeting and make a caregiving plan that suits everyone. Here are a couple of other blogs that may be helpful. https://barbracohn.com/2019/08/03/the-20-most-important-things-to-consider-when-looking-for-a-memory-care-home/

https://barbracohn.com/2013/04/03/is-it-is-it-time-to-move-your-loved-one-to-a-memory-care-home/

Please be gentle with yourself.

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: TheCaregiver’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 Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Is your care partner driving you nuts?

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Stressed caregiver

It’s hard to maintain equanimity and patience when your care recipient is constantly repeating him/herself. Of is following you around the house like a puppy dog. Or is accusing you of “stealing” their wallet, or is getting up several times during the night so you’re unable to get the sleep you need for your own health and in order to take care of them without losing your cool.

When I couldn’t handle my husband’s early stage Alzheimer’s behavior, I’d simply leave the house and walk around the block. But as the disease progresses and it isn’t safe to leave your care partner alone in the house, that’s not always possible.

Here are 16 things that might help you keep your sanity, and your care partner’s too. 

  1.  Simplify communication by asking one question at a time. Break down complex ideas, and give only one choice, i.e. when helping your care partner get dressed simply ask “Do you want to wear the blue or green shirt?” Don’t ask open-ended questions. Ask questions with yes or no answers, if possible.
  2. Before speaking, make sure the television, radio, and music are turned off. Look directly in the eyes of your care partner. Use their name and maintain eye contact.
  3.  Provide a gentle physical touch. Just stroking someone’s arm, shoulders or head can reduce agitation.
  4. Put on soothing music. Or, if your care partner loves dance music (Big Band or Rock n/Roll, Latin), turn up the volume and dance!.
  5. Reduce or avoid use of caffeine, sugar, tobacco and alcohol.
  6. Reduce clutter, noise, and the number of visitors.
  7. Bring out the family photo albums to help the person reminisce about happier times. They may not remember what they ate 30 minutes ago, but chances are they will remember special events from the past.
  8. Go for a walk together, or drive to a park where you can sit together and watch children play, or the ducks swim in a pond.
  9. Schedule a relaxing massage for both of you. It will do you good!
  10. Ice cream works like magic. Go for a drive to your favorite ice cream shop.
  11. If your care partner accuses you of stealing their money, let them keep a small
    amount of money in a wallet. When they make an accusation, simply pull out the
    wallet to show them the money is still in there. In case they hide the wallet
    and you’re unable to find it, have a spare one on hand that looks identical to
    the original one.
  12.  If you need to bring your care partner to an appointment, leave plenty of
    extra time for getting dressed, eating, moving from the house to the car, etc.
    If you feel rushed and stressed, they will pick up on your feelings and start
    mirroring them.
  13. Use essential oils to immediately diffuse feelings of sadness, depression, anxiety, etc. Lavender oil is the most frequently used fragrance. You can also try bergamot, grapefruit,
    lemon, orange, clary sage, geranium, rose, and ylang ylang, frankincense, and myrrh. Put the oil in a diffuser or spray bottle to mist your collar or pillow. Find a fragrance that is pleasing to your care partner. It’ll help him/her also.
  14. It’s important to get at least 6 hours (preferably 7 or 8) of sleep every night. Of course, this isn’t always possible if you are caring for someone and need to get up at night, or are worried about paying the bills, taking care of the car, getting a new stove, etc. If you can’t get in the hours at night, put your feet up for 10 minutes during the day when your care partner naps. Or take a power nap. It really helps.
  15. Get help! Hire someone to come in a couple of times a week so you can get out of the house. If your budget doesn’t allow it, contact your county’s area agency on aging or senior care services agency for information about respite care.
  16.  When all else fails, maintain your sense of humor. Towards the end of my husband’s
    10-year Alzheimer’s journey, for some reason, we both shared a lot of
    meaningless laughs, probably because the whole damn journey was so exhausting
    for both us and what else was there to do? I had already shed more tears than I
    had in all the years leading up to the diagnosis.

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 Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

I’m a little worried about my memory

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Woman forgot to pick her granddaughter up from preschool.

Yesterday I had my annual wellness exam. It was the first time that my doctor asked me if I had any memory concerns. It made me sit up straight and realize that I am definitely in the age group of people who start showing signs of mild cognitive impairment. I nodded or shook my head in response to her questions and then said, “When I walked into my bedroom the other door I completely forgot why I had gone in there. My little granddaughters were playing hide and seek and when I said, ‘I don’t know why I came in here,’ they looked up at me confused and wondered why I was acting a little strangely.'”

Was I concerned? Yes, a little. I’ve done that before, but this time I was frozen for a few seconds. And actually, lately I’ve noticed that my spelling isn’t as sharp as it used to be. Neither is my long-term memory.

I’m even more concerned because I took the MindCrowd test, a short memory test in which you need to read and memorize 12 pairs of words. https://mindcrowd.org/?gclid=CjwKCAjwo4mIBhBsEiwAKgzXOEWhBjIHYSm0c42NvHNYAb2HDr6sMLfSCYjOc-zYq4D7-5FkW6mSmBoC-OIQAvD_BwE You’re given one word and asked to complete the pair, before the screen moves rather quickly to the next pair. To be honest, I didn’t do very well, and I was a little nervous while I was taking the test. It was more difficult for me than the Mini Mental Exam, which is given to people who are evaluated for Alzheimer’s disease.

As I said to my doctor, I know I don’t have Alzheimer’s disease. I’m kind of an expert on the disease and symptoms because I cared for my husband who had younger-onset Alzheimer’s disease for 10 years. And I wrote a book about our journey. https://www.amazon.com/Calmer-Waters-Caregivers-Alzheimers-Dementia/dp/1681570149/ref=sr_1_2?dchild=1&gclid=CjwKCAjwo4mIBhBsEiwAKgzXOHgn8mAm0UZQiBHyTLv7S_v_CYHJ-ruG_G0MyWUNV9myn59vmJfbvxoCuFAQAvD_BwE&hvadid=241894911837&hvdev=c&hvlocphy=9028817&hvnetw=g&hvqmt=e&hvrand=18354321622967658254&hvtargid=kwd-23474874821&hydadcr=22532_10344436&keywords=calmer+waters&qid=1627596739&sr=8-2

But I, and lots of my girlfriends, are somewhat concerned that we’re developing mild cognitive impairment. Should we be worried?

Here’s what I know

Approximately 12-18% of people age 60 or older are living with Mild Cognitive Impairment (MCI).

Researchers have found that more people with MCI than those without it go on to develop Alzheimer’s disease or a related dementia. An estimated 10 to 20% of people age 65 or older with MCI develop dementia over a one-year period.

MCI is more common in men (19 percent) than in women (14 percent), according to a 2010 study in the Neurology. https://www.nia.nih.gov/news/mild-cognitive-impairment-more-common-older-men-older-women

  • MCI prevalence was higher among people with the APOE e4 gene, a known risk factor for late-onset Alzheimer’s, a form of the disease that usually occurs at age 65 or older.
  • A greater number of years spent in school was significantly associated with decreased MCI prevalence, from 30 percent among participants with less than nine years of education to just 11 percent in those with more than 16 years of education.
  • MCI prevalence was higher in participants who never married, as opposed to those currently or previously married.

Signs of cognitive decline

  • Forgetting appointments and dates.
  • Forgetting recent conversations and events.
  • Feeling increasingly overwhelmed by making decisions and plans.
  • Having a hard time understanding directions or instructions.
  • Losing your sense of direction.
  • Losing the ability to organize tasks.
  • Becoming more impulsive.

I don’t forget appointments, but I do forget events that occurred in the past decade or so. But then again, I’m good at remembering details about many events that others don’t remember. I typically don’t get overwhelmed about making decisions and plans. But then again, I had tons of work this summer and did get a little overwhelmed. I don’t have a hard time understanding directions, unless it’s something like installing a toilet or putting together a new machine, which I will gladly leave for my handyman. I rarely lose my sense of direction, but then again, it’s not as acute as it once was and I do get turned around while hiking sometimes. I never have trouble organizing tasks. In fact, I often multi-task. I am not typically impulsive.

What happens physically to the normal aging brain?

The brain changes more than any other part of the body. Yes, even more than our complexion that withers and wrinkles. Physically, the frontal lobe and hippocampus, the areas involved in higher cognitive function and encoding new memories starts to shrink around age 60 to 70. Fewer synaptic connections are made, which may contribute to slower cognitive processing. White matter, consisting of myelinated nerve fibers that carry nerve signals between brain cells, shrinks, and neurotransmitters that play a role in cognition and memory deceases.

Normal brain aging

  • Difficulty learning something new: Committing new information to memory can take longer.
  • Multitasking: Slowed processing can make planning parallel tasks more difficult.
  • Recalling names and numbers: Strategic memory, which helps with remembering names and numbers, begins to decline at age 20.
  • Remembering appointments: Without cues to recall the information, the brain may put appointments into “storage” and not access them unless something jogs the person’s memory.

So what do I think? Am I developing MCI? I certainly hope not, and I really don’t think so. I spend a lot of time using my cognitive skills. I’m a writer, and am at my best while sitting at the computer writing words. But my memory is definitely not what it used to be, nor is it as good as my mother’s was when she was well into her 80s. But I take ginkgo, phosphatidylserine, B vitamins, and Lion’s mane mushroom, and I know they help because when I don’t take them, my mind is fuzzy. I’m not going to worry, because worrying does no good but add stress. But I will continue to eat a plant-based Mediterranean diet, which is proven to stave off premature aging, and try to get enough sleep and exercise

P.S. I repeated the MindCrowd test and scored really well!

P.P.S. No, I never forgot to pick up my granddaughter from preschool. 🙂

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 Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

New drug cites a 22% reduction in cognitive decline in early stage Alzheimer’s.

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The FDA hasn’t approved a new drug for Alzheimer’s disease in more than 17 years. It looks like that is about to change. Aducanumab isn’t a cure by any means, but it’s the first drug to get this far in an approval process that actually modifies the underlying pathology of Alzheimer’s, and helps delay cognitive decline in early stage Alzheimer’s.

How does Aducanumab work?

Amyloid-beta is a protein that is normally present in the brain. In the Alzheimer’s brain the abnormal levels of the protein clump together to form amyloid plaques. Researchers think that these clumps lead to brain cell death.

Aducanumab is a monoclonal antibody that targets amyloid-beta.

Researchers developed it using Neurimmune’s proprietary Reverse Translational Medicine Platform. Neurimmune scientists discovered Aducanumab with a team of researchers at the University of Zurich. The human antibody targets the aggregated amyloid-beta. Through this interaction, Aducanumab could reduce the number of amyloid plaques present in the brain. This ultimately may slow neurodegeneration and disease progression.

Aducanumab in clinical trials

In 2007, Neurimmune licensed the exclusive rights to Biogen, which sponsored several clinical trials investigating Aducanumab in humans. Together, Neurimmune’s and Biogen’s scientists published a study in Nature 2016 that described how one year of monthly intravenous infusions of Aducanumab reduces brain beta amyloid in a dose- and time-dependent manner in patients with pre-dementia or mild Alzheimer’s disease. 1https://www.nature.com/articles/nature19323

The history of the clinical trials of Aducanumab is confusing. If you want to read the details about the trials continue reading. If you want the bottom line , scroll down and read from *But Biogen reversed course and decided to continue the trials.

On March 21, 2019, the manufacturer (Biogen) announced it had ended two Phase 3 clinical trials of Aducanumab for Alzheimer’s. The drug had failed a “futility analysis,” which means a clinical trial is stopped when the interim results suggest that it is unlikely to achieve statistical significance.1

But then just five months later, Biogen announced that they were applying for FDA marketing approval. They explained that data gathered in the three months between the start of the futility analysis and the decision to end the trial hadn’t been used in the original analysis. After adding the additional three months of data, they realized that a subset of patients who had been given higher doses saw significant benefits on measures of cognition and function, including memory, orientation and language. Those patients also saw benefits in daily living activities.2

The OptumRx Pipeline Surveillance team observed that despite the positive reported outcomes, Aducanumab has only demonstrated a statistically significant improvement in one of the two pivotal trials. Further, in the one positive trial, the reported improvements were small, and the true clinical relevance of the findings remain uncertain.

Researchers have completed three Phase 1 trials. These were assessing Aducanumab in healthy volunteers (NCT02782975) and in Alzheimer’s disease patients in the U.S. (NCT01397539) and Japan (NCT02434718).

A fourth, randomized, double-blind, and placebo-controlled Phase 1 trial (NCT01677572), PRIME, enrolled 192 pre-dementia and mild Alzheimer’s patients at 32 sites in the U.S. The goal was to assess the safety and effect of different aducanumab doses versus a placebo on amyloid plaques. Researchers measured this with positron emission tomography imaging.

Interim results from the first 165 patients showed that all doses of Aducanumab (given as monthly infusions into the bloodstream) significantly reduced amyloid plaques in the brain in a time- and dose-dependent manner. During the first year, 40 patients from both groups discontinued treatment. Little to no change was apparent in the placebo group after one year. The greatest reduction was present at higher doses. Aducanumab also appeared to slow the rate of cognitive decline. Researchers measured this as a change in the clinical dementia rating sum of boxes (CDR-SB) and the mini-mental state examination (MMSE).

They presented results from a long-term extension of the PRIME trial at the 2017 Clinical Trials on Alzheimer’s Disease meeting. In total, 143 patients from the initial trial opted to continue in the long-term extension study, where all patients received Aducanumab. This included data from patients who had been on Aducanumab for up to three years. During this time, patients who received Aducanumab continued to experience a time- and dose-dependent reduction in amyloid plaque levels.

Biogen also began two large-scale randomized, double-blind, and placebo-controlled Phase 3 clinical trials in people with early-stage Alzheimer’s disease. The first trial, called ENGAGE (NCT02477800), aimed to enroll 1,350 patients at 187 sites in North America, Australia, Europe, and Asia. The second trial, called EMERGE (NCT02484547), also sought to enroll the same number of patients at 194 sites in North America, Europe, and Asia.

The goal of both trials was to assess the efficacy of Aducanumab, given once a month at low and high doses by infusion into the bloodstream. Researchers measured the effectiveness of the treatment by changes from the start of the study in the CDR-SB, MMSE, Alzheimer’s disease assessment scale-cognitive subscale 13 items (ADAS-Cog 13), and Alzheimer’s disease cooperative study-activities of daily living inventory mild cognitive impairment version (ADCS-ADL-MCI) scores over a 78-week period. They had expected to complete the trials in 2022.

The company halted the trials because an independent data monitoring committee found that they were unlikely to meet their primary objective. This was based on initial data from the trials and not on safety concerns. Follow-up visits and closing-out activities for both trials are now complete.

The Phase 2 EVOLVE trial (NCT03639987) began in late 2018 to evaluate the safety of continued dosing of Aducanumab in participants with mild cognitive impairment due to Alzheimer’s disease or with mild Alzheimer’s disease dementia. This trial also was halted in March 2019 as a result of the committee’s findings.

*But Biogen reversed course and decided to continue the trials.

A later analysis based on additional follow-up data, showed that EMERGE met its primary goal. Patients receiving the highest dose of Aducanumab experienced a significant reduction in the progression of cognitive and functional impairments. Although ENGAGE failed to meet its primary goal, Biogen stated that data from the sub-group of patients who had sufficient exposure to the medication also showed significant benefits. These and other supportive findings formed the basis of the company’s BLA (Biologics License Application) submitted to the FDA requesting the approval of Aducanumab for the treatment of Alzheimer’s disease.

In August 2020, Aducanumab was granted priority review by the FDA, meaning that the agency plans to expedite the review process to determine whether they will approve the medication. 

Are there any negative side effects from taking Aducanumab?

Researchers said a majority of the test subjects taking Aducanumab showed no negative side effects. In some cases, however, patients experienced swelling in the brain called “amyloid-related imaging abnormalities” (ARIA) and headache.

How is the drug administered?

Intravenous doses of Aducanumab are given about 4 weeks apart over approximately 52 weeks for a total of 14 doses. Qualifying patients can continue into the long-term extension at a dose approximately 4 weeks apart for up to an additional 112 doses.

When will Aducanumab become available?
The FDA process for reviewing applications for approval, called New Drug Applications or NDAs, usually takes around 10 months. Biogen has said the Aducanumab application has about 4,500 files with more than 2.5 million pages of data and information. Biogen believes a decision will be made by June 7, 2021. Though the FDA would continue to monitor the effects of the drug, to ensure no unexpected side effects from prolonged usage, after approval the drug can be made available widely. People with Alzheimer’s disease may have a new medication to take soon.

How much will it cost?

Aducanumab is expensive, with the annual cost projected to be around $50,000 for the recommended dosage, based on one infusion per month. Even if the drug is approved by the FDA, the Centers for Medicaid and Medicare Services can determine for themselves how much Medicaid and Medicare will cover Aducanumab if the cost is high. PET brain scans to detect amyloid beta plaques would probably be necessary to determine aducanumab coverage, and those are expensive as well.

Where can I buy it?

I ordered Memantine for my husband from Europe before it was available in the U.S. India manufacturers provide many of the drugs sold in the U.S. I found this website for an Indian Pharmaceutical company which sells Aducanumab throughout the world. https://indianpharmanetwork.co.in/buy-aducanumab.php

The problem, of course, with buying Aducanumab from an Indian pharmacy is that you’d have to find a doctor who is willing to administer it intravenously. Since it is expected to be approved this summer, it’s probably more prudent to wait until you can get it prescribed by your doctor. But keep in mind that you might be able to save money by ordering it from India even after it is approved by the FDA.

Although Aducanumab isn’t a cure for Alzheimer’s, it is the first drug that is showing some promise for providing more time to individuals with this insidious disease.

References

  1. The Lancet. A resurrection of aducanumab for Alzheimer’s disease. Published December 4, 2019. Accessed January 7, 2020.
  2. Bio Space. Biogen Alzheimer’s Plans Met with Hope, Some Skepticism. Published: December 6, 2019. Accessed January 7, 2020.

Does dementia increase a person’s risk of getting Coronavirus?

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Elderly woman looking sad out the window.Although dementia in itself doesn’t increase one’s risk, there are other factors that might contribute to a person’s increased risk.

Does the patient have any underlying conditions such as high blood pressure, diabetes, auto-immune disease, lung diseases including asthma and COPD, cancer? All of these increase risk of serious symptoms associated with the COVID-19 virus.

If a person with dementia is living at home, s/he may be at increased risk if they forget to wash their hands or socially distance. And, of course, as we are all well aware of, patients in care  facilities are at higher risk simply for the fact they are communally living together. Caregivers come in and out of the facility, go to their homes, and may be interact with others. See Should you move a family member back home from a care facility?

What can you do?

  • If your loved one is living at home and can still read, place sticky notes around the house  (refrigerator, bathroom, kitchen sink) in appropriate places to remind him/her to wash their hands.
  • Call often to check in. Use Zoom or Skype, Facetime, if the person can manage technology. Amazon’s new Portal, which is like a large iPad that is kept plugged in, is an easy device. Check it out: It’s a smart, hands-free video calling device with Alexa built-in.
  • Make sure your loved one has adequate food. If s/he can still prepare meals, drop off their groceries. If they have trouble in the kitchen, bring home-cooked meals or make arrangements with an organization such as Meals on Wheels that can deliver foods.
  • If you have to go inside the person’s home, make sure you have on a mask and gloves, and maintain physical distance as much as possible.
  • A person with dementia is probably not keeping a clean, tidy home, which is important to health and wellness. Try to clean around the person. Have him or her sit in front of the TV or at the kitchen table, while you vacuum and clean the bathroom. Then move him/her to another room in order to clean the kitchen.
  • The main thing is to stay in daily contact. Have the grandkids write notes and draw pictures to send in the mail. If you live in the same town, visit from the lawn and have your loved one sit on the front or back porch.
  • Set up a daily schedule for your loved one. Keep it posted on the fridge. For example: 8:00–wake up, toilet, brush teeth, shower. 8:30 Take meds, eat breakfast. 9:30 Do fitness routine, etc. Do 10 sit-to-stands while watching TV. Walk through the house for 10 minutes a couple times a day.
  • It’s important to protect our loved ones physically but to engage them socially to prevent loneliness and to keep them mentally stimulated. Here’s a great way for seniors whose dementia is minimal.

Well Connected (formerly called Senior Center Without Walls), is a telephone-based national program that offers free weekly activities, education, friendly conversation, classes, support groups, and presentations to individuals 60 years or older anywhere in the United States for English and Spanish speakers. There are activities occurring throughout the day, every day 10:00 am-8:00 pm, Mountain Time, depending on the day. Sessions run between 30 minutes to one hour.

Play a game, write a poem, go on a virtual tour, meditate, share a gratitude, get support, and most importantly, connect and engage with others every day. Well Connected is a community consisting of participants, staff, facilitators, presenters, and other volunteers who care about each other and who value being connected. All groups are accessible by phone and many are accessible online.

Well Connected offers 75 different programs. People can join a particular group, call in the same time each week, hear the same voices on a regular basis and make friends. This has a positive impact on their emotional and physical life. “The gratitude activity, which is offered twice a day, is especially popular and well attended,” says Wade, Social Call director (see below). “Participants share something they are grateful for. This allows for an increase in social connectedness. We also have fun and intellectual programs that help individuals feel valued, stimulated and engaged, and sometimes we invite presenters from the outside in.”

Wade pointed out that Well Connected, is not just for people with mobility concerns. We get folks who are active, people who are married and individuals in a co-housing situation. Anyone can feel lonely, she says. “We take a survey every year and the results indicate that 85% of our participants feel more intellectually stimulated and  socially connected. And on a daily basis, we get calls of gratitude from participants who say, ‘this program saved my live,’” says Wade.

Well Connected also offers a program called Social Call, in which volunteers call participants for a weekly phone visit. For more information, email coviaconnections@covia.org or call 877-797-7299.

Well Connected is an award-winning program of Covia, formerly called Episcopal Senior Communities. For more information: To register call 1-877-797-7299,  https://covia.org/services/well-connected/

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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 Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

High blood pressure is a risk for (MCI) mild cognitive impairment

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Close up of digital monitor device with cuff showing high diastolic and systolic blood pressureDid you know that high blood pressure puts you at risk for developing Mild Cognitive Impairment (MCI)? The problem is, MCI can eventually develop into dementia and Alzheimer’s disease.

A recent study involving 9,400 adults that was published in JAMA (January 28, 19) indicates that you can reduce your risk of MCI by lowering your blood pressure.  Adults in their 50s or older with high blood pressure participated in a clinical trial led by scientists at the Wake Forest School of Medicine in Winston-Salem, NC. The purpose of the trial was to evaluate the effect of blood pressure control on risk of dementia. The participants received either intensive blood pressure control or standard treatment.

Intensive control was used to bring systolic blood pressure below 120 millimeters of mercury (mm Hg), while the purpose of standard treatment was to lower it to under 140 mm Hg. Systolic blood pressure is the pressure in the arteries when the heart contracts. It is the top number in a blood pressure measurement, as in 120 mm Hg over 70 mm Hg.

The results revealed that significantly fewer of those who received intensive blood pressure control went on to develop Mild Cognitive Impairment, compared with those on the standard treatment. The lead investigator Dr. Jeff D. Williamson said that “three years of lowering blood pressure not only dramatically helped the heart, but also helped the brain.”

However, the study did not show that intensive blood pressure control reduced the incidence of dementia. The authors suggested that low numbers and the study finishing earlier than planned could be reasons for this.

What is Mild Cognitive Impairment? 

MCI is a condition in which the individual has some loss of mental acuity, such as forgetting appointments, losing the flow of a conversation, and difficulties making decisions and keeping track of finances, as well as trouble with reasoning. The individual is still able to care for him or herself and live a fairly normal life.

Approximately 15 to 20 percent of people 65 and older have MCI. People living with MCI are more likely to develop Alzheimer’s disease or other dementias. But MCI doesn’t always lead to dementia. In some cases, MCI remains stable or resolves on its own. Some medications may result in symptoms of MCI, including forgetfulness or other memory issues.

There are no pharmaceutical drugs approved in the U.S. for the treatment of MCI. However, the study discussed above, is a good indication that high blood pressure that is controlled through changes in lifestyle can help prevent MCI.

Why is high blood pressure dangerous?

It’s called the “silent killer” because it is insidious. It often has no warning signs or symptoms.

If your blood pressure is high it causes strain on the vessels carrying blood throughout your body. This can injure the vessels and lead to plaque buildup as a response to injury. Eventually, this can lead to narrow blood vessels and then clotting of passageways, which can cause damage to the heart and/or brain. High blood pressure ultimately increases your risk for getting heart disease, kidney disease, dementia, and for having a stroke.

Taking Your Blood Pressure

When your doctor takes your blood pressure, he/she is measuring the pressure in your arteries as your heart pumps. The heart contracts and relaxes during each heartbeat. When it contracts, the blood is being pumped out of the two ventricles (chambers) and your blood pressure goes up. Systolic pressure (the top number in the blood pressure reading) is the peak reading of the pressure produced by this contraction.

When the heart relaxes, blood fills the ventricles and your blood pressure goes down. The diastolic pressure (the bottom number in the blood pressure reading) measures the pressure between the beats as the heart relaxes.

What’s normal blood pressure?

High blood pressure used to be considered 140/90 or higher.

According to the National Heart, Lung and Blood Institute (a division of the Institutes of Health), normal blood pressure is now considered to be lower than 120/80 according to the guidelines released in November 2017.

The guidelines state that for BP above 115/75, every rise of 20/10 mm Hg doubles the risk of cardiovascular disease. Since 2017, the American Heart Association has advised that people with high BP should receive treatment at 130/80 rather than 140/90.

In the new guidelines, the AHA also recommends that doctors only prescribe medication in cases of a previous heart attack or stroke, or in the presence of risk factors such as: age, diabetes, or chronic kidney disease. Rather, at the earlier stages of hypertension, another word for high blood pressure, patients should make lifestyle changes. Here are a number of ways to do that:

10 Ways to support healthy blood pressure and prevent MCI

  1. Eat a nutritious, high-fiber, low-fat heart healthy diet. Learn about the MIND diet.
  2. Beware of your intake of sodium.
  3. Include foods high in phytonutrients—fruits and veggies.
  4. Take nutritional supplements proven to support a healthy heart: magnesium, potassium, B vitamin complex, vitamin D3, CoQ10, Grape seed extract, Resveratrol, Quercetin.
  5. Avoid decongestants if possible. These drugs can raise blood pressure.
  6. Practice a stress reduction technique such as yoga or meditation.
  7. At the minimum, take a walk 3-4 times a week.
  8. Stop smoking and reduce consumption of alcohol.
  9. Drink 6 to 8 glasses of water every day.
  10. If you snore, have sleeping problems, or are sleepy during the day, discuss sleep apnea with your physician.

Give yourself the gift of peace and get plenty of rest and sleep.

Happy Holidays!

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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 Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.