While Alzheimer’s disease is most common among peopled aged 65 and older, its effects are being felt more and more by young people. In fact, 1 in 6 millennial caregivers—at an average age of 27—is caring for someone living with Alzheimer’s or another form of dementia, according to a recent report from UsAgainstAlzheimer’s and the USC Roybal Institute on Aging.

Lisette Carbajal was in her 20s when she noticed her father’s symptoms. According to Lisette, “One of the reasons why I’m so vocal about my dad’s disease is because I hope that no one else my age, 20 or 30 years from now, has to take care of their dad beginning at 20 years old.”

With the prevalence of Alzheimer’s disease and other dementias in the U.S. expected to grow from 5 million today to nearly 16 million by 2050, more millennials like Lisette will likely face caregiving responsibilities in the future. The following are key themes connecting these dynamic caregivers.

Navigating the Health Care System is a Priority

Millennials are playing an increasingly larger role in health care as they navigate the system for their care partners. The most common caregiving activities include communicating with health care professionals (70%) and performing nursing tasks (54%)—often without access to specialized training or support.

The Lack of Support is a Major Pain Point

Millennial dementia caregivers feel that emotional distress is a major caregiving hardship (79%), and nearly 4 in 5—an overwhelming majority—report that accessing affordable outside help is very difficult.

Caregiving is Limiting Economic Opportunity

Caregivers often take time off work or work fewer hours, and for millennials, this means doing so at a time when professional growth is critical to earning potential. About 1 in 3 millennial dementia caregivers states that caregiving interferes with work, and 1 in 3 reports severe interference with work (e.g., cutting back hours, losing job benefits, being fired). This economic burden is an acute pain point for caregivers with only a high school education or less.

To better support young caregivers at the frontlines of the dementia crisis, UsAgainstAlzheimer’s is working with youth leaders like the Youth Movement Against Alzheimer’s and Hilarity for Charity to build intergenerational bridges, raise the visibility of young caregivers, and advance policy and programming solutions to our shared challenges. It’s clear that young people have a stake in promoting brain health and healthy aging. Learn more and stay connected by joining us.

About the Author Jason Resendez

Jason leads UsAgainstAlzheimer’s efforts to address brain health disparities impacting Latino families through coalition building, community-based research collaborations, and patient advocacy. He is the co-author of Latinos & Alzheimer's Disease: New Numbers Behind the Crisis, released with the USC Roybal Institute on Aging, and co-project lead of the Alzheimer's & Dementia Disparities Engagement Network.

The brain controls many aspects of thinking—remembering, planning and organizing, making decisions, and much more. These cognitive abilities affect how well we do everyday tasks and whether we can live independently.

Some changes in thinking are common as people get older. For example, older adults may have:

• Increased difficulty finding words and recalling names
• More problems with multi-tasking
• Mild decreases in the ability to pay attention

Aging may also bring positive cognitive changes. People often have more knowledge and insight from a lifetime of experiences. Research shows that older adults can still:

• Learn new things
• Create new memories
• Improve vocabulary and language skills

The Older, Healthy Brain

As a person gets older, changes occur in all parts of the body, including the brain.

• Certain parts of the brain shrink, especially those important to learning and other complex mental activities.
• In certain brain regions, communication between neurons (nerve cells) can be reduced.
• Blood flow in the brain may also decrease.
• Inflammation, which occurs when the body responds to an injury or disease, may increase.

These changes in the brain can affect mental function, even in healthy older people. For example, some older adults find that they don't do as well as younger people on complex memory or learning tests. Given enough time, though, they can do as well. There is growing evidence that the brain remains "plastic"—able to adapt to new challenges and tasks—as people age.

It is not clear why some people think well as they get older while others do not. One possible reason is "cognitive reserve," the brain's ability to work well even when some part of it is disrupted. People with more education seem to have more cognitive reserve than others.

Some brain changes, like those associated with Alzheimer's disease, are NOT a normal part of aging. Talk with your healthcare provider if you are concerned.

Brain Regions

The brain is complex and has many specialized parts. For example, the two halves of the brain, called cerebral hemispheres, are responsible for intelligence.

The cerebral hemispheres have an outer layer called the cerebral cortex. This region, the brain's "gray matter," is where the brain processes sensory information, such as what we see and hear. The cerebral cortex also controls movement and regulates functions such as thinking, learning, and remembering.

For more information about parts of the brain, see Know Your Brain from the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health.

How Brain Cells Work

The healthy human brain contains many different types of cells. Neurons are nerve cells that process and send information throughout the brain, and from the brain to the muscles and organs of the body.

The ability of neurons to function and survive depends on three important processes:

• Communication. When a neuron receives signals from other neurons, it generates an electrical charge. This charge travels to the synapse, a tiny gap where chemicals called neurotransmitters are released and move across to another neuron.
• Metabolism. This process involves all chemical reactions that take place in a cell to support its survival and function. These reactions require oxygen and glucose, which are carried in blood flowing through the brain.
• Repair, remodeling, and regeneration. Neurons live a long time—more than 100 years in humans. As a result, they must constantly maintain and repair themselves. In addition, some brain regions continue to make new neurons.

Other types of brain cells, called glial cells, play critical roles in supporting neurons. In addition, the brain has an enormous network of blood vessels. Although the brain is only 2 percent of the body's weight, it receives 20 percent of the body's blood supply.

Source: National Institute on Aging

Alzheimer’s disease is an illness of the brain. It causes large numbers of nerve cells in the brain to die. This affects a person’s ability to remember things and think clearly. People with Alzheimer’s disease become forgetful and easily confused. They may have a hard time concentrating and behave in odd ways. These problems get worse as the illness gets worse, making your job as caregiver harder.

It’s important to remember that the disease, not the person with Alzheimer’s disease, causes these changes. Also, each person with Alzheimer’s disease may not have all the problems we talk about in this book.

The following sections describe the three main challenges that you may face as you care for someone with Alzheimer’s disease:

1. Changes in communication skills
2. Changes in personality and behavior
3. Changes in intimacy and sexuality

Each section includes information on how to cope with these challenges.

 3. Challenge: changes in intimacy and sexuality

Intimacy is the special bond we share with a person we love and respect. It includes the way we talk and act toward one another. This bond can exist between spouses or partners, family members, and friends. Alzheimer’s disease often changes the intimacy between people.

Sexuality is one type of intimacy. It is an important way that spouses or partners express their feelings physically for one another.

Alzheimer’s disease can cause changes in intimacy and sexuality in both the person with Alzheimer’s disease and the caregiver. The person with Alzheimer’s disease may be stressed by the changes in his or her memory and behaviors. Fear, worry, depression, anger, and low self-esteem (how much the person likes himself or herself) are common. The person may become dependent and cling to you. He or she may not remember your life together and feelings toward one another. Sometimes the person may even fall in love with someone else.

As the caregiver you may pull away from the person in both an emotional and physical sense. Some may be upset by the demands of caregiving. Others may also feel frustrated by the person’s constant forgetfulness, repeated questions, and other bothersome behaviors.

Most caregivers learn how to cope with these challenges, but it takes time. Some learn to live with the illness and find new meaning in their relationships with people who have Alzheimer’s disease.

How to cope with changes in intimacy

Remember that most people with Alzheimer’s disease need to feel that someone loves and cares about them. They also need to spend time with other people as well as you. Your efforts to take care of these needs can help the person with Alzheimer’s disease to feel happy and safe.

It’s important to reassure the person that:

• You love him or her
• You will keep him or her safe
• Others also care about him or her

When intimacy changes, the following tips may help you cope with your own needs:

• Talk with a doctor, social worker, or clergy member about these changes. It may feel awkward to talk about such personal issues, but it can help.
• Talk about your concerns in a support group.
• Think more about the positive parts of the relationship.
• Get more information. Some books, articles, and DVDs/videos can help you understand how Alzheimer’s disease affects intimacy.

How to cope with changes in sexuality

The well spouse/partner or the person with AD may lose interest in having sex. This change can make you feel lonely or frustrated. Here are some possible reasons for changes in sexual interest.

The well spouse/partner may feel that:

• It’s not okay to have sex with someone who has Alzheimer’s disease
• The person with Alzheimer’s disease seems like a stranger
• The person with Alzheimer’s disease seems to forget that the spouse/partner is there or how to make love

A person with Alzheimer’s disease may have:

• Side effects from medications that affect his or her sexual interest
• Memory loss, changes in the brain, or depression that affects his or her interest in sex

Here are some suggestions for coping with changes in sexuality:

• Explore new ways of spending time together.
• Focus on other ways to show affection. Some caregivers find that snuggling or holding hands reduces their need for a sexual relationship.
• Some may try other nonsexual forms of touching, such as giving a massage, hugging, and dancing.

Publish by National Institute on Aging.

It’s important to remember that the disease, not the person with Alzheimer’s disease, causes these changes. Also, each person with Alzheimer’s disease may not have all the problems we talk about in this book.

The following sections describe the three main challenges that you may face as you care for someone with Alzheimer’s disease:

1. Changes in communication skills
2. Changes in personality and behavior
3. Changes in intimacy and sexuality

Each section includes information on how to cope with these challenges.

2. Challenge: Changes in Personality and Behavior 

Because Alzheimer’s disease causes brain cells to die, the brain works less well over time. This changes how a person acts. You will notice that he or she will have good days and bad days.

Here are some common personality changes you may see:

• Getting upset, worried, and angry more easily
• Acting depressed or not interested in things
• Hiding things or believing other people are hiding things
• Imagining things that aren’t there
• Wandering away from home
• Pacing a lot of the time
• Showing unusual sexual behavior
• Hitting you or other people
• Misunderstanding what he or she sees or hears

Also, you may notice that the person stops caring about how he or she looks, stops bathing, and wants to wear the same clothes every day.

Other factors that may affect how people with Alzheimer’s disease behave

In addition to changes in the brain, the following things may affect how people with Alzheimer’s disease behave.

How they feel:

• Sadness, fear, or a feeling of being overwhelmed
• Stress caused by something or someone
• Confusion after a change in routine, including travel
• Anxiety about going to a certain place

Health-related problems:

• Illness or pain
• New medications
• Lack of sleep
• Infections, constipation, hunger, or thirst
• Poor eyesight or hearing
• Alcohol abuse
• Too much caffeine

Problems in their surroundings:

• Being in a place he or she doesn’t know well.
• Too much noise, such as TV, radio, or many people talking at once. Noise can cause confusion or frustration.
• Stepping from one type of flooring to another. The change in texture or the way the floor looks may make the person think he or she needs to take a step down.
• Misunderstanding signs. Some signs may cause confusion. For example, one person with Alzheimer’s disease thought a sign reading “Wet Floor” meant he should urinate on the floor.
• Mirrors. Someone with Alzheimer’s disease may think that a mirror image is another person in the room.

How to Cope with Personality and Behavior Changes

Here are some ways to cope with changes in personality and behavior:

• Keep things simple. Ask or say one thing at a time.
• Have a daily routine, so the person knows when certain things will happen.
• Reassure the person that he or she is safe and you are there to help.
• Focus on his or her feelings rather than words. For example, say, “You seem worried.”
• Don’t argue or try to reason with the person.
• Try not to show your anger or frustration. Step back. Take deep breaths, and count to 10. If safe, leave the room for a few minutes.
• Use humor when you can.
• Give people who pace a lot a safe place to walk. Provide comfortable, sturdy shoes. Give them light snacks to eat as they walk, so they don’t lose too much weight, and make sure they have enough to drink.

Use distractions:

• Try using music, singing, or dancing to distract the person. One caregiver found that giving her husband chewing gum stopped his cursing.
• Ask for help. For instance, say, “Let’s set the table” or “I really need help folding the clothes.”

Other ideas:

• Enroll the person in the MedicAlert®+Alzheimer’s Association Safe Return® Program. If people with Alzheimer’s disease wander away from home, this program can help get them home safely (www.alz.org or 1-888-572-8566).
• Talk to the doctor about any serious behavior or emotional problems, such as hitting, biting, depression, or hallucinations.

How to Cope with Sleep Problems

Evenings are hard for many people with Alzheimer’s disease. Some may become restless or irritable around dinnertime. This restlessness is called “sundowning.” It may even be hard to get the person to go to bed and stay there.

Here are some tips that may help:

• Help the person get exercise each day, limit naps, and make sure the person gets enough rest at night. Being overly tired can increase late-afternoon and nighttime restlessness.
• Plan activities that use more energy early in the day. For example, try bathing in the morning or having the largest family meal in the middle of the day.
• Set a quiet, peaceful mood in the evening to help the person relax. Keep the lights low, try to reduce the noise levels, and play soothing music if he or she enjoys it.
• Try to have the person go to bed at the same time each night. A bedtime routine, such as reading out loud, also may help.
• Limit caffeine.
• Use nightlights in the bedroom, hall, and bathroom.

How to Cope with Hallucinations and Delusions

As the disease progresses, the person with Alzheimer’s disease may have hallucinations. During a hallucination, a person sees, hears, smells, tastes, or feels something that isn’t there. For example, the person may see his or her dead mother in the room. He or she also may have delusions. Delusions are false beliefs that the person thinks are real. For example, the person may think his or her spouse is in love with someone else.

Here are some things you can do:

• Tell the doctor or Alzheimer’s disease specialist about the delusions or hallucinations.
• Discuss with the doctor any illnesses the person has and medicines he or she is taking. Sometimes an illness or medicine may cause hallucinations or delusions.
• Try not to argue about what the person with Alzheimer’s disease sees or hears. Comfort the person if he or she is afraid.
• Distract the person. Sometimes moving to another room or going outside for a walk helps.
• Turn off the TV when violent or upsetting programs are on. Someone with Alzheimer’s disease may think these events are really going on in the room.
• Make sure the person is safe and can’t reach anything that could be used to hurt anyone or himself or herself.

How to Cope with Paranoia

Paranoia is a type of delusion in which a person may believe— without a good reason—that others are mean, lying, unfair, or “out to get him or her.” He or she may become suspicious, fearful, or jealous of people.

In a person with Alzheimer’s disease, paranoia often is linked to memory loss. It can become worse as memory loss gets worse. For example, the person may become paranoid if he or she forgets:

• Where he or she put something. The person may believe that someone is taking his or her things.
• That you are the person’s caregiver. Someone with Alzheimer’s disease might not trust you if he or she thinks you are a stranger.
• People to whom he or she has been introduced. The person may believe that strangers will be harmful.
• Directions you just gave. The person may think you are trying to trick him or her. Paranoia may be the person’s way of expressing loss. The person may blame or accuse others because no other explanation seems to make sense.

Here are some tips for dealing with paranoia:

• Try not to react if the person blames you for something.
• Don’t argue with him or her.
• Let the person know that he or she is safe.
• Use gentle touching or hugging to show the person you care.
• Explain to others that the person is acting this way because he or she has Alzheimer’s disease.
• Search for missing things to distract the person; then talk about what you found. For example, talk about a photograph or keepsake.
• Have extra sets of keys or eyeglasses in case they are lost.

How to Cope with Agitation and Aggression

Agitation means that a person is restless and worried. He or she doesn’t seem to be able to settle down. Agitated people may pace a lot, not be able to sleep, or act aggressively toward others. They may verbally lash out or try to hit or hurt someone. When this happens, try to find the cause. There is usually a reason.

For example, the person may have:

• Pain, depression, or stress
• Too little rest or sleep
• Constipation
• Soiled underwear or diaper

Here are some other causes of agitation and aggression:

• Sudden change in a well-known place, routine, or person
• A feeling of loss—for example, the person with Alzheimer’s disease may miss driving or caring for children
• Too much noise or confusion or too many people around
• Being pushed by others to do something—for example, to bathe or remember events or people—when Alzheimer’s disease has made the activity very hard or impossible
• Feeling lonely and not having enough contact with other people
• Interaction of medicines

Here are suggestions to help you cope with agitation and aggression:

• Look for the early signs of agitation or aggression. Then you can deal with the cause before the problem behaviors start.
• Doing nothing can make things worse. Try to find the causes of the behavior. If you deal with the causes, the behavior may stop.
• Slow down and try to relax if you think your own worries may be affecting the person with Alzheimer’s disease. Try to find a way to take a break from caregiving.
• Allow the person to keep as much control in his or her life as possible.
• Try to distract the person with a favorite snack, object, or activity.

You also can:

• Reassure him or her. Speak calmly. Listen to the person’s concerns and frustrations. Try to show that you understand if the person is angry or fearful.
• Keep well-loved objects and photographs around the house. This can make the person feel more secure.
• Reduce noise, clutter, or the number of people in the room.
• Try gentle touching, soothing music, reading, or walks.
• Build quiet times into the day, along with activities.
• Limit the amount of caffeine, sugar, and “junk food” the person drinks and eats.

Here are things the doctor can do:

• Give the person a medical exam to find any problems that may cause the behavior. These problems might include pain, depression, or the effects of certain medicines.
• Check the person’s vision and hearing each year.

Here are some important things to do when the person is aggressive:

• Protect yourself and your family members from aggressive behavior. If you have to, stay at a safe distance from the person until the behavior stops.
• As much as possible, protect the person from hurting himself or herself.
• Ask the doctor or Alzheimer’s disease specialist if medicine may be needed to prevent or reduce agitation or aggression.

How to Cope with Wandering

Many people with Alzheimer’s disease wander away from their home or caregiver. As the caregiver, you need to know how to limit wandering and prevent the person from becoming lost. This will help keep the person safe and give you greater peace of mind.

Try to follow these tips before the person with Alzheimer’s disease wanders:

• Make sure the person carries some kind of ID or wears a medical bracelet. If the person gets lost, an ID will let others know about his or her illness. It also shows where the person lives.
• Consider enrolling the person in the MedicAlert®+ Alzheimer’s Association Safe Return® Program (see www.alz.org or call 1-888-572-8566 to find the program in your area). This service is not affiliated with the National Institute on Aging. There may be a charge for this service.
• Let neighbors and the local police know that the person with Alzheimer’s disease tends to wander.
• Keep a recent photograph or video recording of the person to help police if the person becomes lost.
• Keep doors locked. Consider a keyed deadbolt, or add another lock placed up high or down low on the door. If the person can open a lock, you may need to get a new latch or lock.
• Install an “announcing system” that chimes when a door is opened.

How to Cope with Rummaging and Hiding Things

Someone with Alzheimer’s disease may start rummaging or searching through cabinets, drawers, closets, the refrigerator, and other places where things are stored. He or she also may hide items around the house. This behavior can be annoying or even dangerous for the caregiver or family members. If you get angry, try to remember that this behavior is part of the disease.

In some cases, there might be a logical reason for this behavior. For instance, the person may be looking for something specific, although he or she may not be able to tell you what it is. He or she may be hungry or bored. Try to understand what is causing the behavior so you can fit your response to the cause.

Here are some other steps to take:

• Lock up dangerous or toxic products, or place them out of the person’s sight and reach.
• Remove spoiled food from the refrigerator and cabinets. Someone with Alzheimer’s disease may look for snacks, but lack the judgment or sense of taste to stay away from spoiled foods.
• Remove valuable items that could be misplaced or hidden by the person, like important papers, checkbooks, charge cards, jewelry, and keys.
• People with Alzheimer’s disease often hide, lose, or throw away mail. If this is a serious problem, consider getting a post office box. If you have a yard with a fence and a locked gate, place your mailbox outside the gate.
• Keep the person with Alzheimer’s disease from going into unused rooms. This limits his or her rummaging through and hiding things.
• Search the house to learn where the person often hides things. Once you find these places, check them often, out of sight of the person.
• Keep all trash cans covered or out of sight. People with Alzheimer’s disease may not remember the purpose of the container or may rummage through it.
• Check trash containers before you empty them, in case something has been hidden there or thrown away by accident. You also can create a special place where the person with AD can rummage freely or sort things. This could be a chest of drawers, a bag of objects, or a basket of clothing to fold or unfold. Give him or her a personal box, chest, or cupboard to store special objects. You may have to remind the person where to find his or her personal storage place.

Publish by National Institute on Aging.

It’s important to remember that the disease, not the person with Alzheimer’s disease, causes these changes. Also, each person with Alzheimer’s disease may not have all the problems we talk about in this book.

The following sections describe the three main challenges that you may face as you care for someone with Alzheimer's Disease:

1. Changes in communication skills
2. Changes in personality and behavior
3. Changes in intimacy and sexuality

Each section includes information on how to cope with these challenges.

1. Challenge: changes in communication skills

Communication is hard for people with Alzheimer’s disease because they have trouble remembering things. They may struggle to find words or forget what they want to say. You may feel impatient and wish they could just say what they want, but they can’t.

It may help you to know more about common communication problems caused by Alzheimer’s disease. Once you know more, you’ll have a better sense of how to cope.

Here are some communication problems caused by Alzheimer's Disease:

• Trouble finding the right word when speaking
• Problems understanding what words mean
• Problems paying attention during long conversations
• Loss of train-of-thought when talking
• Trouble remembering the steps in common activities, such as cooking a meal, paying bills, getting dressed, or doing laundry
• Problems blocking out background noises from the radio, TV, telephone calls, or conversations in the room
• Frustration if communication isn’t working
• Being very sensitive to touch and to the tone and loudness of voices

Also, Alzheimer’s disease causes some people to get confused about language. For example, the person might forget or no longer understand English if it was learned as a second language. Instead, he or she might understand and use only the first language learned, such as Spanish.

How to cope with changes in communication skills

The first step is to understand that the disease causes changes in these skills. The second step is to try some tips that may make communication easier. For example, keep the following suggestions in mind as you go about day-to-day care.

To connect with a person who has Alzheimer's Disease:

• Make eye contact to get his or her attention, and call the person by name.
• Be aware of your tone and how loud your voice is, how you look at the person, and your “body language.” Body language is the message you send just by the way you hold your body. For example, if you stand with your arms folded very tightly, you may send a message that you are tense or angry.
• Encourage a two-way conversation for as long as possible. This helps the person with Alzheimer’s disease feel better about himself or herself.
• Use other methods besides speaking to help the person, such as gentle touching to guide him or her.
• Try distracting someone with Alzheimer’s disease if communication creates problems. For example, offer a fun activity such as a snack or a walk around the neighborhood.

To encourage the person with Alzheimer's Disease  to communicate with you:

• Show a warm, loving, matter-of-fact manner.
• Hold the person’s hand while you talk.
• Be open to the person’s concerns, even if he or she is hard to understand.
• Let him or her make some decisions and stay involved.
• Be patient with angry outbursts. Remember, it’s the illness “talking.”
• If you become frustrated, take a “timeout” for yourself.

To speak effectively with a person who has Alzheimer's Disease:

• Offer simple, step-by-step instructions.
• Repeat instructions and allow more time for a response. Try not to interrupt.
• Don’t talk about the person as if he or she isn’t there.
• Don’t talk to the person using “baby talk” or a “baby voice.”

Here are some examples of what you can say:

• “Let’s try this way,” instead of pointing out mistakes
• “Please do this,” instead of “Don’t do this”
• “Thanks for helping,” even if the results aren’t perfect

You also can:

• Ask questions that require a yes or no answer. For example, you could say, “Are you tired?” instead of “How do you feel?”
• Limit the number of choices. For example, you could say, “Would you like a hamburger or chicken for dinner?” instead of “What would you like for dinner?”
• Use different words if he or she doesn’t understand what you say the first time. For example, if you ask the person whether he or she is hungry and you don’t get a response, you could say, “Dinner is ready now. Let’s eat.”
• Try not to say, “Don’t you remember?” or “I told you.”

Published by the National Institute on Aging

Stages of Alzheimer's Disease and What they Mean 

Alzheimer’s disease consists of three main stages: mild (sometimes
called early-stage), moderate, and severe (sometimes called latestage).
Understanding these stages can help you plan ahead. 

Mild Alzheimer’s disease.

In mild Alzheimer’s disease, the first stage, people often have some memory loss and small changes in their personality. They may forget recent events or the names of familiar people or things. Sometimes they may no longer be able to solve simple math problems. People with mild Alzheimer’s disease also slowly lose the ability to plan and organize. For example, they may have trouble making a grocery list and finding items in the store.

Moderate Alzheimer’s disease.

This is the middle stage of Alzheimer’s disease. Memory loss and confusion become more obvious. People have more trouble organizing, planning, and following instructions. They may need help getting dressed and may start having problems with incontinence. This means they can’t control their bladder and/or bowels. People with moderate-stage Alzheimer’s disease may have trouble recognizing family members and friends. Sometimes they may not know where they are or what day or year it is. They also may lack judgment and begin to wander, so people with moderate Alzheimer’s disease should not be left alone. Late in the day they may become restless and begin repeating movements. Also, they may have trouble sleeping. Personality changes can become more serious. People with moderate Alzheimer’s disease may make threats, accuse others of stealing, curse, kick, hit, bite, scream, or grab things.

Severe Alzheimer’s disease.

This is the last stage of Alzheimer’s and ends in the death of the person. Severe Alzheimer’s disease is sometimes called latestage Alzheimer’s disease. In this stage, people often need help with all their daily needs. Without help they may not be able to walk or sit up. Often they may not be able to talk and often cannot recognize family members. They may have trouble swallowing and refuse to eat.

Published by National Institute on Aging.

What does your brain have to gain from a healthy heart?

There are many reasons to focus on having a healthy heart at any age. For senior adults maintaining a healthy heart and brain can help preserve your independence and quality of life.

Making positive lifestyle choices is the best way to affect positively both your heart health and brain health. Forming new habits in areas like physical health and exercise, diet and nutrition, cognitive activity, and social engagement — can help keep your body and brain healthy and potentially reduce your risk of cognitive decline.

Growing evidence indicates that people can reduce their risk of cognitive decline by adopting key lifestyle habits. When possible, combine these habits to achieve maximum benefit for the brain and body. Start now. It’s never too late or too early to incorporate healthy habits.

• Physical exercise: even moderate walking, if done regularly, increases oxygen content in the brain. This  helps to create new brain cells as well as grow new neurons and the release of natural endorphins that improve mood, reducing the need for artificial anti-depressants (Banner Alzheimer’s Institute)
• Nutrition: plays a very important role in developing a healthier heart and brain. It is believed that most people will benefit with a diet that is low in sodium and has a good balance of fruit, vegetables, protein, carbohydrates and fiber (Alzheimer’s Association)
• Stress free living environments: Senior adults who live in an environment that is stress free, offers daily nutritious meals, an active lifestyle and socialization have seen an increase in their physical and mental health (Mather Lifeways Institute on Aging)
• Brain exercise: Just like physical exercise, brain exercises can help slow down progressive diseases like memory loss and dementia. Studies have also shown that learning something new (maybe something that has been on your bucket list for a long time) challenges your brain in new ways

In three short weeks we will experience a brand new year. The end of the year is often a time when we reflect on what we want our future to look like. I hope that you will take time during this wonderful holiday season to relax and decide on ways you can help your heart and your brain!

Jon Scott Williams
Executive Director
Fellowship Square-Mesa

The most recent comprehensive research analysis from hundreds of studies finds three practices may reduce cognitive decline.

Strong evidence that anything prevents Alzheimer’s disease is lacking, but a few changes can likely delay memory loss, according to a 2017 review by the National Academies of Sciences, Engineering and Medicine.

Specific memory training, consistent exercise and controlling high blood pressure offer the best hope, the committee concluded. Members examined the best research on ways to limit or prevent cognitive impairment, the loss of ability to think clearly and make decisions,that often afflicts older adults.

The number of Americans with Alzheimer’s is more than 5 million, and growing as the overall population ages. Treatments such as Aricept (donezepil) and Namenda boost working brain cells with unaffected neurons, but there is no cure.

Cognitive Training, Exercise and Blood Pressure Control

“Even though clinical trials have not conclusively supported the three interventions discussed in our report, the evidence is strong enough to suggest the public should at least have access to these results to help inform their decisions about how they can invest their time and resources to maintain brain health with aging,” said Dr. Alan Leshner, chair of the committee and CEO emeritus of the American Association for the Advancement of Science.

“The strongest evidence was in the area of cognitive training,” Petersen said.

Do crossword puzzles or Sudoku qualify? They won’t hurt, but studies show gains from specialized training called mnemonic strategies.

Mnemonic memory programs include face-name recognition and name-face learning, number mnemonics, story mnemonics, and the method of loci, where key details are kept along a familiar route or place you recall.

Additionally, training programs often entail instruction on how to take advantage of environmental supports, called external memory aids.

“Can you, in fact, find a new way to try to remember a list of grocery items?” Peterson asked. Also, try figuring out restaurant tips in your head, he advised, instead of using a calculator or your smartphone.
Commercial products have not proven they help, Petersen cautioned. See sidebar for information about common commercial brain games.

Exercise Helps Your Aging Brain

Several studies indicate that exercise is important.

“Here we're talking about modest aerobic exercise,” Petersen said. Brisk walking and cycling are good choices.

“How much? Maybe 150 minutes a week—30 minutes five times, 50 minutes three times—can have an effect on reducing cognitive impairment later in life,” Petersen said.

A preponderance of documentation demonstrates the health benefits of physical activity. Some of these benefits, such as stroke prevention, are causally related to brain health.

“Is it going to prevent Alzheimer's disease?” asked Peterson. “I can't say that. But I think it may have an effect on reducing cognitive impairment.”

Control Blood Pressure to Help Brain Function

Managing hypertension by controlling blood pressure seems to delay vascular dementia, according to the committee. High blood pressure damages delicate blood vessels in the brain.

Controlling blood pressure is particularly important during midlife, from ages 35 to 65. There is also strong evidence that using antihypertensive medications and making lifestyle changes to manage blood pressure can help prevent stroke and cardiovascular disease.

Conclusions

None of the evidence is strong enough to justify a public education campaign, the committee of experts found. But it did point to the need for more and larger randomized, controlled research.

“We’re all urgently seeking ways to prevent dementia and cognitive decline with age,” said Dr. Richard Hodes, director of the National Institute on Aging.

________________________________________
Sources:

“Interventions to prevent cognitive decline, dementia,” ScienceDaily.

“More Bad News For Brain-Training Games,” NPR.

“No Effect of Commercial Cognitive Training on Neural Activity During Decision-Making,” Journal of Neuroscience.

“What Can Prevent Alzheimer’s? Here’s What the Evidence Shows,” NBC News.

“Memory training interventions for older adults: A meta-analysis,” National Center for Biotechnology Information.

“Lifestyle Program May Slow Cognitive Decline,” American Academy of Neurology.

“A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial,” The Lancet Journals.

Blog posting provided by Society of Certified Senior Advisors
www.csa.us

Logic has no place in Memory Care...But Dignity does

It's hard to believe that life expectancy was just 47 years in 1900 and that major cause of death was dysentery (diarrhea).  People are living much longer and while the longevity dividend allows us many benefits. We are presently faced with multiple incurable brain diseases of which Alzheimer’s is the best known.  Worldwide dementia is affecting every population some more than others but every person you know has someone they love living with dementia.  Treatments will expand and cures will come, they always do, but for now we must make decisions with the information we have.

Communities with Memory Care

When looking for a community with memory care do not get distracted by the whistles and bells or bright shiny objects.  Look for a community where resident comfort matters.  Recreational activities should be available 24/7 to accommodate those schedules that have flipped and become active at night.  Understand that your loved ones are trying to cope with brain failure. They can no longer articulate discomfort or voice the source pain as before.  Often discomfort and pain are expressed by lashing out or what appears to be episodes of extreme irrational fear.  But properly trained caregivers can still reach the core of each person’s soul and spirit.

The best memory care communities never win arguments with residents using logic. In fact, logic has no place in modern memory care communities.  Instead holding a resident's hands, rubbing their palms, and hugging allows trained caregivers to communicate safety and comfort allowing them to thrive.  Residents must be approached in their reality, wherever that is no matter how bizarre their reality may seem, not ours.  Scheduling showers, telling a resident when they can or cannot eat or sleep should not be tolerated by family but is too common.  The focus must be and can only be on the resident living in the moment.  The best approach is to treat every resident with dignity doing everything on their terms and their way... "When we know better we do better" paraphrased Maya Angelou.

By Jon Scott Williams

Executive Fellowship Square-Mesa

www.FellowshipSquareMesa.org