Response to daily stressors could affect brain health in older adults

November 20, 2018  
Filed under Aging Parents, Health & Wellness

Taking typical daily annoyances such as a long wait at the doctor’s office or a traffic jam on the freeway in stride may help preserve brain health in older adults, while emotional reactions could contribute to declines in cognition, a new study from Oregon State University has found.

“These results confirm that people’s daily emotions and how they respond to their stressors play an important role in cognitive health,” saidRobert Stawski, an associate professor in OSU’s College of Public Health and Human Sciences and the study’s lead author. “It’s not the stressor itself that contributes to mental declines but how a person responds that affects the brain.” Read more

Spotting Fraudsters: Don’t Become a Victim

November 5, 2018  
Filed under Aging Parents, News

By: Dr. Stacey Wood, Ph.D.

 

Fraud takes many different forms these days, with identity theft being foremost among them. Just about anyone can become a victim. Some groups are at greater risk than others of falling victim to identity theft. The groups most at risk for identity theft are children and adults with caregivers, users of social media, business owners, high-level employees, college students, and young adults. Learning how to protect yourself is essential for avoiding fraud.

Read more

5 Ways to Stop Spam Calls 

November 2, 2018  
Filed under Aging Parents, News

By Sid Kirchheimer, courtesy AARP Bulletin, October 2018

Unwanted phone calls and text messages continue to surge, no matter what efforts lawmakers and regulators take to curb them. In the first four months of this year, call-blocking service YouMail reports, more than 12 billion robocalls were made to American homes. That’s about 4 million every hour, and a steady increase from last year. Live calls from telemarketers have also continued to increase. Read more

Is Staying in Their Home Really the Best Choice for Retirees?

October 4, 2018  
Filed under Aging Parents, News

When asked, many retirees express a strong preference for staying in their home as long as possible. After all, it is often where they raised their children and is located near their faith community and familiar shopping spots. In her new book, Your Home Sweet Home, financial planner Penelope Tzougros helps people dispassionately evaluate whether staying put or going makes the best economic sense.

Tzougros shares the stories, insights, fears and clever solutions her clients made when facing the same dilemma. She also presents analytical tools, worksheets and a Decision Guide to create a step-by-step process for sorting out fears, facts and finances.

“Ultimately,” she says, “this is not a real estate decision but a decision about what retirees need to have the best life possible.” She adds, “And the reality is that when a house’s maintenance costs are draining people’s savings, it is no longer an asset.”

Extensively interviewed on TV, radio and in print, Tzougros produced and directed the television show Money Makeover. She has worked with thousands of retirees and is known for her ability to explain complicated financial concepts with elegant simplicity. She can discuss:

  • How to figure out if your home is the cheapest place you can live.
  • Calculating the relative costs of different housing options – and why almost everyone makes critical miscalculations.
  • The biggest mistakes seniors make when considering whether to stay in their home or move.
  • Whether you stay or move, critical timing mistakes to avoid.
  • The true and hidden costs of moving vs. maintaining your house.
  • How to move beyond your inevitable fears and discover clever solutions that can serve your long-term interests.

About the Author

Penelope S. Tzougros, Ph.D., ChFC, CLU, is a Financial Consultant, author, speaker and founder of Wealthy Choices, a Registered Investment Advisor. Although she is based in Boston, she is registered in all 50 states and offers securities and advisory services through LPL Financial, Member FINRA/SIPC. In addition to Your Home Sweet Home, she is the author of Wealthy Choices: The Seven Competencies of Financial Success, and Long-term Care Insurance: How to Make Decisions That Are Right for You. Tzougros holds a master’s degree from Harvard, a doctorate from the University of Toronto, and has taught at Northeastern University and Hellenic College.

The trust older patients place in doctors can compromise their medical care: study

September 13, 2018  
Filed under Aging Parents, News

Placing trust in doctors to advocate for their health needs, older adults rarely ask for referrals to specialists, specific prescriptions, express concerns or follow-up after medical visits, according to a new study from Case Western Reserve University.

The findings highlight a disconnect between the expectations of older adults and the realities of a changing health-care system, where doctors have less time to spend with patients.

“These findings are concerning,” said Eva Kahana, Distinguished University Professor and Pierce T. and Elizabeth D. Robson Professor of the Humanities at Case Western Reserve. “Our data suggests older generations are clinging to how health care used to be, when doctors had more personal relationships and continuity with patients.”

“When patients incorrectly assume actions and advocacy by doctors, this leads to major problems,” Kahana said, “especially for older adults living with one of more chronic illnesses, such as diabetes and high blood-pressure.”

The study shows that older adults (defined as 65 and older) are less likely to advocate for their own health concerns the more they trust the role is being taken on by their doctors.

The findings are especially relevant for minorities and the sickest of patients, who have less access to health care and face particular challenges in finding responsive care, according to previous research.

Among of the study’s other findings:

  • Older adults who feel comfortable advocating for their own care feel more empowered;
  • Compared to white patients, African-American patients were less satisfied with their physicians;
  • Latino patients expressed greater satisfaction with their medical care than white and African-American patients;
  • The perceived emotional support of physicians was associated with patients’ satisfaction.

“Our findings strongly suggest that families of older patients should be ready to step in as advocates for their older relatives,” Kahana said. “And it’s helpful for doctors to be more aware of how older patients see them.”

Published in the journal Clinical Interventions in Aging, the study is based on data from a diverse pool of 806 older adults from a large retirement community in Clearwater, Florida, and others in Orlando, Miami and Cleveland, where Case Western Reserve is located.

Read more

Older Americans Who Neglect Oral Care Put Overall Health At Risk

June 19, 2018  
Filed under Aging Parents, Health & Wellness

 

Conscientious parents constantly remind their children to brush and floss, and routinely schedule dental checkups to make sure their teeth and gums are healthy – and staying that way.

But youngsters aren’t the only ones who who can use such reminders. Older Americans need to put a priority on their oral health as well, and research shows that as a group they aren’t doing so.

In fact, the statistics are grim. The Centers for Disease Control and Prevention reports that almost every single American over age 65 (96 percent) has had a cavity, and 20 percent have untreated tooth decay. Another 65 percent suffer from gum disease, an ailment that has been linked to a host of other problems, such as strokes, heart disease and diabetes.

“Anyone who thinks they can ease up on dental care as they age is making a big mistake,” says Dr. Harold Katz, a dentist, bacteriologist and developer of TheraBreath Healthy Gums Oral Rinse (www.therabreath.com).

“Not only do poor dental habits affect what’s going on in your mouth, they also affect your overall health.”

Some of the CDC’s findings that Katz says are troubling include:

  • Tooth loss. Nearly one in five adults aged 65 or older have lost all of their teeth. Complete tooth loss is twice as prevalent among adults aged 75 and older (26 percent) compared with adults aged 65 to 74 (13 percent).  The CDC points out that having missing teeth, or wearing dentures, can have a detrimental effect on nutrition. “It’s not surprising that people who have lost teeth, or wear denture, often are going to choose soft food they chew easily,” Katz says. “They will pass up fresh fruits and vegetables that are more nutritious, but are more difficult for them to eat.”
  • Oral cancer. Cancers of the mouth (oral and pharyngeal cancers) are primarily diagnosed in older adults; median age at diagnosis is 62 years. “That’s another reason it’s important for older people to have regular checkups,” Katz says. “Your dentist can check for signs of oral cancer during those visits.”
  • Dry mouth caused by medications. Most older Americans take both prescription and over-the-counter drugs, many of which can cause dry mouth. Reduced saliva flow increases the risk of cavities. Saliva helps prevent tooth decay, gum disease and bad breath, and also lubricates the mouth, making it easier to eat, swallow, speak and taste food. “Sometimes dry mouth might just cause mild discomfort,” Katz says. “At other times it can lead to significant oral disease that can compromise the person’s health, dietary intake and quality of life.”

“As  you age, proper oral care is just as important as ever,” Katz says. “It’s not something you want to ignore because your overall health is at stake.”

 

4 Common Retirement  Planning Mistakes

June 14, 2018  
Filed under Aging Parents, Health & Wellness, Money

And How to Avoid Them

Constructing a smart retirement income plan isn’t easy. Throughout the working years there are many factors to consider, such as salary, expenses – monthly and unforeseen – debt and college for the kids, just to name a few. Read more

Where to Retire

June 14, 2018  
Filed under Aging Parents, Feature Stories

And Things to Consider When Deciding

By Melissa Erickson

In addition to being a huge financial decision, retirement is not only a question of when, but where. Careful consideration and weighing all the factors are imperative to avoid a costly mistake. Read more

Better Sleep Can Prevent Cognitive Decline

June 11, 2018  
Filed under Aging Parents, Health & Wellness

Better Sleep Can Prevent Cognitive Decline

Psychiatrist and Sleep Expert Offers Tips on Sleep and Brain Health

By Dr. Alex Dimitriu

 

Menlo Park, CA, June 2018 – Sleep is as important to our health as good nutrition and regular exercise. Not getting enough sleep is detrimental to daytime functioning – to our mood, energy, concentration and reaction time – and over the long term, it contributes to obesity and the risk of serious illness. But according to psychiatrist and sleep specialist Dr. Alex Dimitriu, sleepless nights have implications well beyond making you sleepy the next day. “Some of the most exciting research in sleep science is studying the effects of sleep on the brain and what happens when you deprive your brain of restorative sleep,” he says. “New research suggests that sleeping less than seven to eight hours a night can be linked to memory loss, cognitive decline, and even Alzheimer’s disease.”

 

Our brains don’t sleep when we do.

During waking hours, the brain is bombarded with more stimuli than it can process. When we go to sleep, the brain goes to work, making order out of chaos and archiving memories for later retrieval. It does this by strengthening critical neural connections, discarding unimportant ones, and solidifying new memories.

 

“We’ve all noticed, and research has confirmed that ‘sleeping on it’ helps us recall a newly learned task,” says Dr. Dimitriu. “This explains why people suffering memory deficits can recall a name from forty years ago but not what they had for lunch yesterday. Their brains have become less efficient at making new connections and storing new memories. Better sleep may improve this key brain function.”

 

As with every organ in the body that converts fuel into energy, the brain produces waste that accumulates during waking hours and is cleared out while we sleep. There is more space between brain cells while we’re asleep, making it easier for cerebrospinal fluid to flush out toxins. Researchers are just beginning to understand this cleansing process – called the glymphatic system – but it appears that the more waste that’s littering the brain, the easier it is for degenerative diseases to take hold. Among these waste products is beta-amyloid, the toxic protein best known for its presence in the brains of people with Alzheimer’s disease. The glymphatic system, which becomes less efficient as we age, does its work while we sleep, raising the possibility that better sleep can improve the processes that flush beta-amyloid and other toxins from the brain.

 

Older adults with dementia suffer sleep disturbances that have generally been considered a consequence of diseases such as Alzheimer’s. Now researchers are looking into whether sleep problems might themselves be a risk factor for cognitive decline, dementia, and Alzheimer’s. In a recent study funded by the National Institutes of Health, it was found that losing just one night of sleep led to an immediate increase in beta-amyloid in the brain. These beta-amyloid proteins clump together to form the amyloid plaques that impair communication between neurons and are a hallmark of Alzheimer’s disease. Dr. Dimitriu notes: “While previous studies have shown that sleep deprivation elevates the level of beta-amyloid proteins in the brains of mice, this is one of the first to show that sleep may play an important role in clearing beta-amyloid in the human brain. This is an important step in helping us understand the pathology of Alzheimer’s and potentially how to prevent it.”

 

Reversing cognitive decline

“We are seeing more and more evidence that sleep plays a critical role in maintaining brain function as we age,” Dr. Dimitriu continues. “The question of reversing cognitive decline by improving sleep is another interesting avenue for investigation.” A 2014 study tested a novel therapeutic program for reducing mild cognitive impairment based on the idea that clinical trials in pursuit of a “magic bullet” drug have yielded little but that a combination of therapies that address multiple targets in the underlying pathology of Alzheimer’s might have an additive or synergistic effect. The program included life style changes, including sleep optimization, as well as a regimen of medication and supplements designed to optimize metabolic factors implicated in Alzheimer’s, correct imbalances, reduce beta-amyloid, and more. “The study was small but showed impressive results,” says Dr. Dimitriu. “Clearly this combination approach shows promise.”

 

Improving sleep

Everyone has trouble falling asleep occasionally. For most of the millions of Americans who regularly struggle to get to sleep or stay asleep, improving sleep habits can restore a restful night’s sleep. Dr, Dimitriu makes these recommendations:

 

·        Don’t eat a heavy meal or drink a lot of liquid close to bedtime. Reduce or eliminate stimulants such as caffeine and nicotine during the day and alcohol in the evening.

·        Exercise regularly – but early in the day, not within several hours of bedtime.

·        Stick to a sleep schedule, going to bed and waking at the same time each day, including weekends. Avoid naps or limit them to 30 minutes; don’t nap after 3:00pm.

·        Keep your room cooler than during the day. Use a fan or noise machine to mask distracting sounds. Try room-darkening shades if morning light wakes you too early.

·        Take about 30 minutes to wind down before going to bed. Do something relaxing, like reading or listening to quiet music. If you can’t fall asleep after 20 minutes, do something relaxing for 20 minutes, or until you feel sleepy.

·        Sleeping on your side, particularly on your left side, may improve circulation while you sleep.

·        Don’t use a computer, tablet or smart phone right before going to bed! The light from the screen stimulates the brain and makes it hard to fall asleep.

 

“We’ve long known that sleep is important for overall health and especially for brain function,” Dr. Dimitriu concludes. “Now, as we uncover the mechanisms at work, we have the opportunity to make great strides in preventing and treating cognitive decline and degenerative disease.”

 

Alex Dimitriu, MD, is double board-certified in psychiatry and sleep medicine and is the founder of the Menlo Park Psychiatry and Sleep Medicine Center in Menlo Park, CA. 

Increasing our awareness of stroke

May 31, 2018  
Filed under Aging Parents, Health & Wellness

By Matthew Sullivan, M.D.

 

National Stroke Awareness Month may be behind us, but work is always needed to combat one of the deadliest diseases on earth. We have all likely experienced the devastating effects of a stroke in either the life of a family member or in someone close to us. As a physician, I see the consequences of this terrible disease every day. There are many ways to work to reduce the impact of stroke in our community and as with any significant public health threat, it starts with all of us refreshing a few key pieces of knowledge.

 

Sometimes known as a cardiovascular accident (CVA), a stroke is actually a decrease in the blood flow to an area of the brain. This can happen in one of two ways—a blockage of blood flow within an artery (an ischemic stroke, the most common form) or by leakage of blood from a damaged blood vessel (a hemorrhagic stroke, less common).

 

Brain cell death due to decreased oxygen occurs within minutes and results of this can be catastrophic. In the United States, stroke is the leading cause of significant disability and is the fifth leading cause of death. It is the second leading cause of death worldwide. The numbers surrounding this disease are fairly staggering from both a personal and public health point of view, but the good news is that many strokes and their tragic outcomes can be prevented.

 

There are risk factors we cannot change, such as our age, race, gender and family history. Importantly, age is the biggest factor as chances of a stroke double in each sequential decade after age 55. Women are actually at greater stroke risk than men overall—each year, strokes kill twice as many women as breast cancer. More men have strokes prior to the age of 75 (three-quarters of all strokes happen after this age). Black and Hispanic men are also at increased risk.

 

Despite some risks that we are stuck with, there are modifiable risk factors as well. This means everyone has the ability to reduce their risk of having a stroke. Quitting smoking, eating healthier (the Mediterranean diet), increasing exercise, controlling high blood pressure, losing weight, improving your cholesterol, cutting alcohol intake, treating atrial fibrillation and controlling your blood sugars if you are a diabetic all top the list. While these things may look fairly simple, they are some of the most difficult behavior changes I talk about with my patients.

 

Change and motivation for change happen in different ways for all of us. If some of these things seem like too great a task to take on, try setting a small, achievable goal at first and slowly building from there. When in doubt about how to improve your own risk, you can (and should) talk to your primary care provider. Even a seemingly small behavior or behavior change can have a large impact. Consider that:

 

  • Smoking even one cigarette a day increases the risk of stroke by 30 percent;
  • Reducing blood pressure to healthy levels can reduce your risk by 40 percent;
  • Increased physical activity (even by walking more) can reduce risk by 25 percent.

 

Preventing a stroke is the best possible outcome. Sometimes we find ourselves in less than ideal circumstances. If a stroke does happen, the speed at which you get medical attention is key to preventing some of its worst effects. A good way to remember the signs of stroke is to “act F.A.S.T. ” This stands for:

 

  • F ace – check for drooping and asymmetry;
  • A rm – check for weakness and numbness;
  • S peech – listen for difficulty speaking;
  • T ime – call 911 and get medical help as soon as possible (time equals brain).

 

When you suspect that you or someone you love is having a stroke, don’t wait—get medical attention immediately.

 

Stroke is one of the most common and catastrophic diseases we face. I’m writing because I’ve seen how devastating the results of stroke can be, yet there are real, concrete steps we can all take to reduce that risk. By remembering to “act F.A.S.T.,” we can get timely treatment which may prevent a devastating outcome. By making a lifestyle change (or two), we can avoid a stroke entirely. Small changes can truly make a big difference.

 

Learn more at stroke.org and strokeassociation.org.

 

Editor’s note: Matthew Sullivan, M.D. , is a family medicine physician on staff at Green Mountain Family Practice in Northfield. You can reach him at 802-485-4161 or matthew.sullivan@cvmc.org

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