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At one time or another, everybody has bouts of sleeplessness. House noises, screaming babies, caffeine, or a bed partner who snores, often make it difficult to fall asleep and stay asleep. Eventually, you learn to limit the amount of coffee you drink, the screaming babies grow up, and the snoring bed partner, well ... still snores. Other causes of chronic sleeplessness are sleep apnea, acid reflux, jet lag, swing-shift employment, and ongoing stress that causes insomnia. Sleep Helps Your Brain Repair Itself Discoveries made by Oregon Health and Science University researchers show that sleep deprivation increases the risk of Dementia later in life and may quicken its progression for those who already have the disease.1 Their data show that insufficient sleep increases the production of beta-amyloid proteins that compose the plaques associated with various kinds of Dementia.1 Taking a different approach, the University of California Berkeley Sleep and Neuroimaging Lab researchers have evidence demonstrating the importance of deep non-REM (rapid eye movement) sleep in preventing memory loss. 2 The deep non-REM sleep phase, among other functions, appears to prevent the buildup of beta-amyloid proteins. Their work shows there is a correlation between the accumulation of beta-amyloid proteins, sleep disorders, and Alzheimer's disease. 2 Also, insufficient sleep is a risk factor associated with other health conditions, including obesity, heart disease, and diabetes - all of which increase the likelihood of Dementia later in life. What to do?? First, remember that risk factors do not cause disease but increase the likelihood of having Dementia sometime in the future. Second, and most importantly, modifying behaviors and habits associated with Dementia, such as smoking and obesity, can reduce risk. Sufficient sleep depends on the age of the individual. Seven to 10 hours of sleep per night is considered healthy for adults. 3 However, for adults older than 65, six to eight hours of sleep per night is both normal and healthy. 3 Many older people, believing less than 8 hours of sleep per night is abnormal, resort to sleeping pills. Unfortunately, using medication to ensure sleep increases the risk of Dementia and worsens Dementia for those with the disease. People acquire habits and behaviors that unknowingly make it challenging to fall asleep and stay asleep. The National Sleep Foundation offers the following tips to get a good night's sleep.3 Stick to a sleep schedule – even on the weekends. Develop a relaxing routine to prepare your body for sleep. Use your bed only for sleep and sex. If you have trouble sleeping, avoid afternoon and early evening naps. Exercise daily. Make the room where you sleep comfortable and free from disturbing noise or other distractions. Sleep on a comfortable mattress and pillows. Avoid alcohol, cigarettes, and heavy meals in the evening. Wind down - an hour before bed, choose a calming activity such as reading. If you can't sleep, go into another room and do something relaxing or immensely boring until you feel sleepy. Notes: 1. How a lack of sleep can increase YOUR risk of Dementia: Lack of rest prevents the brain from clearing out toxins that trigger Alzheimer's', http://www.dailymail.co.uk/health/article-3387246/How-lack-sleep-increase-risk-dementia-Lack-rest-prevents-brain-clearing-toxins-trigger-Alzheimer-s.html (accessed May 17, 2016) 2. Lack of Sleep May Lead to Dementia: New Research Finds It Makes Brain Vulnerable, https://alumni.berkeley.edu/california-magazine/online/lack-sleep-may-lead-dementia-new-research-finds-it-makes/ (accessed Nov 12, 2022) 3. Healthy Sleep Tips, https://sleepfoundation.org/sleep-tools-tips/healthy-sleep-tips (accessed May 17, 2016) Content Contributor: Janet Yagoda Shagam, Ph.D., is a freelance medical and science writer and the author of " An Unintended Journey: A Caregiver's Guide to Dementia.", available through Amazon. The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse or guarantee products, comments, suggestions, links, or other forms of content within blog posts provided to us with permission or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

Imagine a woodland, blanketed with knee-high snow. On foot, you need to cross. Those first few crossings are tough, lifting your feet high, then crushing the snow underneath. With repetition, you’ve built a path and your crossing is made faster and easier. One day an interesting birdsong catches your attention and you stray from your worn path, starting a new one. For several days, you follow the new path hoping to catch a glimpse of the elusive bird. Now you have two worn paths. Every so often, exploring the reaches of the woodlands, you create and then retrace new paths. A large tree breaks under the weight of the snow, completely blocking your first, main path. Because you branched out, explored new areas, you have options. Applied to the brain in a general way, this scenario represents the real-world value of neuroplasticity. Our brain function relies on fast and accurate communication of sensory inputs and responses, traveling through chains of brain cells (neurons) where chemical neurotransmitters serve as the language of that communication. Well-used neuron chains are in effect the snow-packed paths in the woodland. Neuroplasticity describes how experience and environment trigger the brain to form new connections and pathways. Should a brain injury occur - stroke, trauma, or other - neuroplasticity allows for workarounds that can compensate for impaired function. This capacity is crucial to rehabilitative therapies. 1 But neuroplasticity is also key to managing risk and slowing the progression of neurocognitive disorders, including those resulting in Dementia. New and novel experiences, no matter the type, lay down new pathways connecting different areas of the brain, building cognitive resilience. These pathways allow for learning a new task or committing to memory the sights, sounds, and sensations of a new destination. They open up a network of routes for neuro-communication that can be used for a range of functions much broader than the original task or experience would suggest. While repetition builds stronger pathways, a recent investigation suggests that prolonged experiences such as physical exercise or stress can change the language of communication between neurons, substituting one neurotransmitter for another. A study of mice running in a wheel demonstrated both the switch-up in neurotransmitters and an overall improvement in coordination and motor learning.2 Not only did they run faster, but the mice also had an improved ability to walk a tightrope and balance on a rotating rod. This process, the neurotransmitter switch, is of interest to researchers examining mechanisms behind stress-induced diseases. It will also be important as we learn how targeted exercise might be used as a treatment for other diseases. Another related area of study with great potential is neurogenesis- the creation of new neurons. Neurogenesis is regulated by neurotransmitters – think of the study of mice in the running wheel. While neurogenesis is slowed by stress and aging, rates can be accelerated by physical exercise and brain exercise, for example learning new concepts or skills. Of course, many other molecular mechanisms also affect the process of neurogenesis.3 Neuroplasticity is as complex as it is crucial to our cognitive health. A technical summary would be that curiosity, physical activity, and novel experiences enhance neuroplasticity through mechanisms such as the neurotransmitter switch and neurogenesis. A practical summary though - while the main path may be easy, it would serve us well to tread more paths. Even better, use different tools like skis, snowshoes, or crampons, and skills like using a bird guide, binoculars, and journaling your experiences. 1 Ackerman, Courtney E., MA. What is Neuroplasticity – A Psychologist Explains. Accessed 4/15/2020 from https://positivepsychology.com/neuroplasticity/ 2 University of California Television. 30 June 2017. “Neuroplasticity: Our Adaptable Brain with Nick Spitzer”. [Show ID: 32521] Accessed 15 April 2021 from https://www.youtube.com/watch?v=DXA_iTG3XSM 3 Ming, Guo-Li, and Hongjun Song. “Adult neurogenesis in the mammalian brain: significant answers and significant questions.” Neuron vol. 70,4 (2011): 687-702. doi:10.1016/j.neuron.2011.05.001 Accessed 15 April 2021 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3106107/ Contributor: Karen R. Ogden, team member , Dementia Society of America. The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

Everyone forgets things here and there. If you’re having more memory lapses than usual, you may worry that you could have Dementia. You may not know that another possibility is mild cognitive impairment: It’s the term used to describe someone whose memory or reasoning skills have diminished somewhat but whose changes aren’t as dramatic as Dementia. “There’s a measurable decline in cognition that’s more than we’d expect based upon age and education,” says Daniel L. Murman, MD, director of the behavioral neurology division in the department of neurological sciences at the University of Nebraska Medical Center in Omaha, “[but] it’s not severe enough to impact the ability to perform everyday activities such as driving, finances, shopping, cooking.” Someone with mild cognitive impairment may care for themselves and live independently. Outcomes of mild cognitive impairment As time passes, some people with mild cognitive impairment experience greater cognitive changes and are diagnosed with Dementia, a syndrome, caused by any number of underlying diseases and disorders. Others remain steady, never progressing beyond mild cognitive impairment, yet never improving. Still, others only experience mild cognitive impairment temporarily; their cognition eventually returns to normal. Because there are a variety of outcomes, people who are diagnosed with mild cognitive impairment shouldn’t assume that Dementia is inevitable. “If you took 100 people with a diagnosis of mild cognitive impairment – especially those that have memory loss as part of their cognitive changes – about 10 to 15 percent per year do show progression,” Murman says. “That means that 85 to 90 percent don’t.” Causes of reversible mild cognitive impairment Certain conditions – including vitamin deficiency, underactive thyroid, sleep apnea, depression and anxiety – may cause mild cognitive impairment. Getting diagnosed with mild cognitive impairment sooner, rather than later, may help a doctor discover and treat an underlying condition, leading to a positive outcome. “Symptoms may either stabilize or improve to the point that they’re no longer diagnosed with mild cognitive impairment,” Murman says. Ways to prevent mild cognitive impairment Simple lifestyle changes may help you reduce your risk of mild cognitive impairment. Try these brain-healthy strategies: Eat a healthy diet. Stay physically active. Engage in problem-solving and other cognitively challenging activities. Get the recommended 7 to 8 hours of sleep. Manage high blood pressure with medication as prescribed. Limit your alcohol intake. Take steps to lower your stress levels. Contributor: Lisa Fields is a full-time freelance writer who specializes in health, psychology, sleep, nutrition, and fitness. Her work has been published by Reader’s Digest, WebMD, Women’s Health, Good Housekeeping, Self, and many other publications. Learn more about Lisa at https://www.writtenbylisafields.com . The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, paid or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

Your brain is one of the most critical parts of your body. It helps you think, feel, and move. But what happens when your brain gets hurt? Scientists have found that brain injuries can sometimes lead to brain diseases later in life. Let’s explore how this happens and what we can do to protect our brains. What is a Brain Injury? A brain injury happens when something damages the brain. This can be caused by: A blow to the head (like in sports or car accidents) A fall (especially in older adults or young children) A stroke (when blood flow to the brain is blocked) A lack of oxygen (like drowning or choking) Brain injuries can be mild, like a concussion, or severe, like a traumatic brain injury (TBI). Some injuries heal quickly, while others cause lasting damage. What is a Brain Disease? A brain disease is a condition that affects how the brain works over time. The Dementia Society of America ® provides a list of the more common brain diseases: Alzheimer’s disease (AD) – may cause Dementia, which includes memory loss and confusion. Cerebrovascular disease (VaD) – may cause Dementia, which may include instability/falls, as well as personality and other cognitive changes. Lewy Body Dementia (LBD) – may cause Dementia and can include memory loss, tremors, and hallucinations. Frontotemporal Degeneration (FTD) – may cause Dementia, which can include behavioural challenges and issues with speech and mobility. Parkinson’s disease (PD) – may affect movement and balance. Some portion of those living with PD will develop Dementia. Chronic Traumatic Encephalopathy (CTE)  – often linked to repeated head injuries, and a cause for developing Dementia. Brain diseases can make it harder to think, move, or remember things as one ages. How Brain Injuries Can Lead to Brain Diseases When the brain gets injured, it tries to heal itself. But sometimes, the damage is too severe, and over time, this can lead to brain diseases. Here’s how: Inflammation in the Brain After an injury, the brain becomes inflamed, like a bruise on your body. If inflammation lasts too long, it can damage brain cells and increase the risk of brain diseases. Repeated Head Injuries and CTE Athletes who play football, boxing, or soccer often experience repeated hits to the head. Over time, these injuries can lead to CTE, which affects memory, mood, and thinking. Damage to Blood Flow Injuries can harm blood vessels in the brain, making it harder for the brain to get oxygen. Poor blood flow increases the risk of strokes and Dementia. Buildup of Toxic Proteins Some brain injuries cause the brain to produce harmful proteins, which are linked to diseases like Alzheimer’s and Parkinson’s. How to Protect Your Brain There are several ways to protect your brain: Wear a helmet  when riding a bike, playing sports, or doing risky activities. Buckle your seatbelt  to avoid head injuries in car accidents. Prevent falls  by keeping floors clear and using handrails. Stay active  with exercise, which keeps blood flowing to the brain. Eat brain-healthy foods  like fish, nuts, and leafy greens. Give your brain rest  after an injury—don’t rush back to sports or work too soon. Conclusion Brain injuries can have profound effects, and sometimes, they lead to brain diseases later in life. By understanding the risks and protecting our brains, we can stay healthier and stronger for years. Take care of your brain—it’s the only one you’ve got! Author:  AI-Assisted Human-Edited Staff Writer We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts that have been provided to us with permission, paid or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org Additional Reading: Centers for Disease Control and Prevention (CDC). Traumatic Brain Injury & Concussion. https://www.cdc.gov/traumaticbraininjury/ National Institute of Neurological Disorders and Stroke (NINDS). Traumatic Brain Injury: Hope Through Research. https://www.ninds.nih.gov Alzheimer’s Association. Head Injuries and Dementia Risk. https://www.alz.org Mckee, A. C., Stein, T. D., Kiernan, P. T., & Alvarez, V. E. (2015). The Neuropathology of Chronic Traumatic Encephalopathy. Brain Pathology, 25(3),  350–364. DOI: 10.1111/bpa.12248 Smith, D. H., Johnson, V. E., & Stewart, W. (2013). Chronic Neurodegenerative Consequences of Traumatic Brain Injury: From CTE to Alzheimer’s Disease. Brain Injury, 27(3),  365-372. DOI: 10.3109/02699052.2013.865357 Mayo Clinic. Concussions and Brain Injuries. https://www.mayoclinic.org

Many people want to keep their brains sharp, especially as they age. In the U.S., over-the-counter (OTC) supplements for brain health have become popular. These products claim to improve memory, focus, and brain function. But do they work? The Dementia Society of America ® explains what these supplements are, what’s in them, and whether they help your brain. What Are Brain Health Supplements? Brain health supplements are pills, powders, or drinks that people buy without a doctor’s prescription. They are sold in stores and online, often labeled as “memory boosters” or “focus enhancers.” These supplements contain ingredients like: Omega-3 fatty acids – found in fish oil – may support brain function.  B Vitamins – contribute to energy levels and brain cell health.  Ginkgo Biloba – a plant extract that some believe enhances memory.  Caffeine – present in coffee and tea, it can increase alertness.  Herbs such as ashwagandha – thought to reduce stress. Do Brain Health Supplements Actually Work? Scientists   are still unsure if these supplements improve brain function. Some studies suggest that certain ingredients, like omega-3s and B vitamins, may support brain health, especially for people who don’t get enough from food. However, many other ingredients have little to no scientific proof that they work. There Is No Magic Pill  – The U.S. Food and Drug Administration (FDA) does not test supplements for effectiveness before they are sold. This means companies can claim their products help the brain, even without strong evidence. Not a Cure for Memory Loss  – Some supplements say they prevent the diseases that cause Dementia or Alzheimer’s disease, but no supplement has been proven to do this. The Dementia Society of America reminds the public that people should be careful of products that make these claims. Are There Any Risks? While most brain supplements are safe, some have side effects or may interact with medications. Too Much of a Good Thing  – High doses of specific vitamins, like B6 or B12, can cause nerve problems. Blood Thinners  – Ingredients like Ginkgo Biloba may thin the blood and cause bleeding problems. Fake or Unregulated Products —Some supplements do not contain what they promise since the U.S. supplement industry is little regulated. Better Ways to Support Brain Health Instead of relying on supplements, scientists recommend proven methods to keep your brain healthy: Eat a Brain-Boosting Diet  – Foods like fish, nuts, berries, and leafy greens help brain function. Exercise Regularly  – Physical activity improves blood flow to the brain. Get Enough Sleep  – The brain needs rest to function correctly. Stay Mentally Active  – Reading, puzzles, and learning new things help keep your brain sharp. Stay Social  – Talking to friends and family helps memory and mental well-being. Conclusion While brain health supplements are popular in the U.S., there is little evidence that they enhance memory or focus. Some ingredients may have mild benefits, but do not cure memory loss or brain diseases. Instead of relying on supplements, people can keep their brains strong by eating well, exercising, and staying mentally active. A healthy lifestyle is the best way to support brain health for life! Author: AI-Assisted Human-Edited Staff Writer We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts that have been provided to us with permission, paid or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org Additional Reading: National Institutes of Health (NIH) – Office of Dietary Supplements. Dietary Supplements for Cognitive Function, Dementia, and Brain Health. https://ods.od.nih.gov/ U.S. Food and Drug Administration (FDA). Caution on Dietary Supplements for Brain Health and Memory Claims. https://www.fda.gov/ National Center for Complementary and Integrative Health (NCCIH). Can Supplements Help with Memory and Thinking? https://www.nccih.nih.gov/ Harvard Medical School. Brain Supplements: What Works and What Doesn’t? https://www.health.harvard.edu/ American Academy of Neurology (AAN). The Truth About Over-the-Counter Memory Supplements. https://www.aan.com/

A recent editorial in JAMA Neurology (1) suggested that there may be a general decline in Dementia risk in the future because of better brain health due to worldwide improvements in the standard of living, education, and prevention and treatment of serious diseases. This provocative speculation contradicts the more common and dire predictions of a significant increase  in Dementia as the world’s population ages. In this article, we explore the latest ideas about normal aging and cognitive decline with an eye on the future.      Most older people remember many ordinary things, like how to sing a familiar song and tie a shoe. Many people currently live into their 90s and beyond without any significant signs of cognitive impairment. It may take them longer to recall a word or a name, but their general language ability, vocabulary, and reasoning capacity can remain relatively intact. What does tend to decline in normal aging is mental flexibility. Reliable recollection of facts, events, and practical knowledge becomes more complex, and it may become challenging to use newly learned information. Multitasking and executive functioning that requires speed, verbal, and mathematical reasoning typically slow down, especially after age 70. In his book “Why We Remember” (2), Charan Ranganath suggests that we think of memory like a desk cluttered with crumpled-up scraps of paper. If you think about urgently rooting around on that messy desk, trying to find something important that you’ve scribbled on one of those crumpled scraps, you may begin to feel what it’s like to lose access to your memory. Mild Cognitive Impairment (MCI) occurs when there is more difficulty with memory and thinking than expected at a person’s age. Although a person with MCI can still be independent, they may struggle with ordinary tasks and may feel easily frustrated, disorganized, and overwhelmed. In a 2014 study (3) of people whose average age was 70, about 30 percent of people who had been diagnosed with MCI later developed Dementia. Dementia involves a further decline in memory and thinking skills, most commonly due to damage to the brain from a variety of causes. A specific disease-modifying drug for Dementia is not currently available, but some symptoms and underlying causes can be treated. Mild Dementia is characterized by increased confusion, and reading and writing can become difficult or impossible. Repetitive or inappropriate questions and inaccurate answers can make conversation challenging, and it is not unusual for people living with Dementia to become disoriented, leave a safe place, and get lost. There is likely to be impulsive behavior, a diminished capacity for empathy, and, eventually, difficulty recognizing family and friends. At its most severe, a person with Dementia may become utterly dependent on others to manage their basic activities of daily living. A definitive diagnosis of Dementia is complicated because the clinical evidence (seen by a doctor in their office or experienced by loved ones at home) of Dementia is very varied. That said, Alzheimer's disease (AD) pathology, specifically, is defined by physical damage to the brain tissue: clumps of proteins in the brain in the form of beta-amyloid plaques and neurofibrillary tangles. There is a highly accurate commercially available blood test (4) that detects these proteins, and there are two drugs approved by Medicare (lecanemab and donanemab) that dissolve some of the beta-amyloid plaque. Still, they have relatively modest benefits and will not reverse a person’s memory loss or provide lasting improvements. Lecanemab, for example, is said to delay the progression of AD by about five months (5). These drugs require an extensive commitment of time and money, and they have a high risk of serious side effects. Drug regulators in several countries have declined to approve the drugs out of concern that the risks outweigh the modest benefits, and several major US healthcare institutions have opted not to give the drug to anyone with a problematic genetic profile (6). As part of the search to identify cognitive impairment at the earliest possible point so that effective treatments can be developed to prevent and delay the development of Dementia, the concept of Subjective Cognitive Decline (SCD) has recently appeared in the cognitive continuum (7).  It is derived from the requirement by Medicare that the physician ask a patient over 65, at their annual wellness visit, whether they’ve been having any issues with their memory. Participants 60 years and older with normal cognition who participated in the large Framingham Heart Study were asked slightly different variations of that single question, “Do you feel your memory is becoming worse?” Study participants were followed for up to 12 years. If they had answered “Yes,” indicating SCD, it was found that, over time, they had an increased risk of developing cognitive decline and all-cause dementia. On average, SCD preceded the development of MCI by 4.4 years, AD by 6.8 years, and all-cause Dementia by 6.9 years. This supported the premise that SCD could be an early or pre-symptomatic manifestation of impending neurodegeneration, and early detection is believed to improve the potential for treatment and prevention of further decline. While research continues to focus on diagnosis, treatments, and cures, considerable emphasis has shifted toward studying lifestyle and environmental modifications that can reduce the risk and delay the development of cognitive decline. Investing in preventative health (8,9), like being fitted for hearing aids, has been shown to reduce brain damage due to normal biological aging (10). A 2024 article (11) estimates that “…nearly 50 percent of all Dementia cases are preventable…” Experts agree that along with physical exercise or staying socially active, engaging in cognitively stimulating activities or hobbies can help protect against cognitive decline by building mental muscle or “cognitive reserve” (12,13). And these activities have virtually no downsides! Some healthy lifestyle and environmental modifications that have been scientifically validated to reduce the risk of cognitive decline are listed below and discussed here (14). Eat healthily, the so-called MIND diet. Find a way to exercise regularly to whatever degree is possible for you. Breaking a sweat builds your brain. If you aren’t working or socially active, consider volunteering or getting involved somewhere to be socially and intellectually stimulated. Try to get the best medical care possible if something seems to be physically or psychologically wrong. Ask your doctor to adjust medications that affect cognition. Correct even mild hearing or vision loss; reduced activity in the brain due to age-related sensory changes can lead to faster rates of atrophy and an increased risk of cognitive decline and dementia (15). Address sleep problems: untreated, they may contribute to cognitive decline and affect the brain's resilience (16). Moderate or eliminate alcohol consumption and stop using tobacco products. Minimize stress. Widespread prioritizing of healthy habits will have a measurable impact on the future incidence of cognitive decline. Perhaps, hopefully, our grandchildren will learn whether improved brain health, supplemented by the development of targeted treatments and cures, will result in a decrease in the future risk of cognitive decline. Contributing Author: Carol A. Butler, Ph.D. Authors' opinions are not necessarily those of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, paid or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org References Vemuri, P. 2024.  Improving trends in brain health explain declining dementia risk? JAMA Neurology , 81(5):442-443. Published online March 25, 2024.  Ranganath, C. 2024. Why We Remember . Doubleday, New York. Roberts RO et al. 2014. Higher risk of progression to dementia in mild cognitive impairment cases who revert to normal. Neurology Jan 28; 82(4): 317-325. Palmqvist, S. et al. 2024. Blood biomarkers to detect Alzheimer disease in primary care and secondary care. Jama, 332(15):1245-1257.   van Dyck CH et al. 2023. Lecanemab in early Alzheimer’s disease. NEJM , 388:9-21. Bogdanich, W. and Kessler, C. What Drugmakers Did Not Tell Volunteers in Alzheimer’s Trials. New York Times October 23, 2024. Kang, M. et al. 2024.  Subjective cognitive decline and longitudinal assessment and risk for cognitive impairment. JAMA Psychiatry , published online July 3, 2024.Van Dyck, C. et al. 2022. Taquet, M. et al. 2024. The recombinant shingles vaccine is associated with lower risk of dementia. Nature Medicine .30, 2777-2781. https://rdcu.be/dXxnR    Veronese, N. et al. 2022. Influenza vaccination reduces dementia risk, a systematic review and meta-analysis. Ageing Research Reviews , 73. https://doi.org/10.1016/j.arr.2021.101534 Marinelli J. et al. 2022. Association between hearing loss and development of   dementia using formal behavioural audiometric testing within the Mayo Clinic Study of  Aging (MCSA): a prospective population-based study. The Lancet Healthy Longevity.  3(12): E817-824. Livingston G et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet Commissions 404 (10452): 572-628. Krivanek TJ et al. 2021. Promoting Successful Cognitive Aging: A Ten-Year Update. J Alzheimers Disease June 1; 81(3): 871-920. Blumen, H. et al. 2024. Cognitive reserve proxies are associated with age-related cognitive decline- not age-related gait speed decline. Neurobiology of Aging . 141:46-54. Butler, C. 2024. Lifestyle modifications for brain health. https: www.dementiasociety.org/post/lifestyle-modifications-for-brain-health Smith, D. 2024. How hearing and vision loss increase the risk of dementia. https://www.nytimes.com/2024/08/08/well/mind/hearing-vision-dementia-risk.html Ho, P. et al.2024. Sleep, 24-hour activity rhythms, and subsequent amyloid-B pathology . JAMA Neurology , 81(8): 824-834.

How planting seeds can boost brain health.   Did you know that the simple act of growing a plant from seed is not just a garden adventure but also a scientifically proven way to improve brain health? In this article, we’ll explore the scientific aspects of how nurturing a seed into a thriving plant can positively affect our brains, providing a green pathway to enhanced cognitive well-being.   Nature Connection Scientific studies have shown that connecting with nature, even in small ways like growing plants, has profound effects on the brain. When we engage with plants, the brain releases chemicals such as dopamine and serotonin, which are associated with happiness and well-being. The sights, smells, and textures of plants activate different regions of the brain, promoting a positive and relaxed state.   Stress Reduction Growing a plant from seed has been linked to stress reduction through the regulation of cortisol, the stress hormone. Studies indicate that interacting with plants can lower cortisol levels in the body. Cortisol, when chronically elevated, can have negative effects on the brain, contributing to anxiety and impaired cognitive function. The act of gardening, including planting and caring for seeds, helps to manage cortisol, creating a more relaxed and stress-resistant brain.   Cognitive Stimulation Growing a plant involves various cognitive activities, such as planning, problem-solving, and learning about plant care. Engaging in these cognitive tasks stimulates neural plasticity — the brain’s ability to form new connections between neurons. Scientific research suggests that cognitive stimulation promotes a healthy and resilient brain by enhancing neural plasticity, contributing to improved memory and cognitive function.   Exercise and Brain Blood Flow Gardening, including the physical work associated with growing plants from seeds, is a form of exercise. Exercise is known to increase blood flow to the brain, delivering essential nutrients and oxygen. The improved circulation supports the growth of new neurons and strengthens existing neural connections. This scientifically proven link between physical activity and enhanced brain blood flow emphasizes the importance of gardening as a brain-boosting activity.   Mood Enhancement The act of gardening, from planting seeds to witnessing the growth of plants triggers the release of endorphins — the brain’s natural feel-good chemicals. Scientifically, endorphins act as mood enhancers, creating a sense of happiness and reducing feelings of stress and discomfort. Growing a plant from seed becomes a natural way to promote positive emotions and uplift the overall mood, contributing to improved mental well-being.   Memory Consolidation Growing plants from seeds involves continuous learning about plant varieties, growth patterns, and optimal care practices. Scientific studies suggest that engaging in learning activities supports memory consolidation or the process of solidifying new information in the brain. The cognitive engagement and learning associated with gardening contribute to improved memory and the retention of new knowledge.   Gut-Brain Connection Surprisingly, the soil used for planting seeds is teeming with microbes, and scientific research has uncovered a fascinating relationship between soil microbes and brain health. The gut-brain connection, a collection of nerves and chemical signals, plays a crucial role in mental well-being. Exposure to soil microbes during gardening has been linked to positive effects on mood and cognitive function, highlighting the intricate connection between the microbial world and brain health.   Sense of Control The sense of control and accomplishment gained from growing a plant from seed has scientific implications for stress resilience. Studies show that people who feel in control of their environments are better equipped to cope with stress. The act of nurturing a seed into a plant provides a tangible sense of control, contributing to increased resilience in the face of life’s challenges.   Conclusion The science behind growing a plant from seed unveils a host of benefits for brain health. From the release of mood-enhancing chemicals to the stimulation of cognitive functions and the regulation of stress hormones, the act of nurturing a seed into a thriving plant is a scientifically backed strategy for building a better brain.   As we dive into the proven benefits of gardening, we discover that the simple joy of growing plants isn’t just a green-thumb adventure; it’s a journey toward a healthier, happier brain. So, the next time you plant a seed, remember that you’re not just tending to a plant; you’re scientifically cultivating a garden of well-being, where the roots of nature’s magic intertwine with the branches of brain health. What Can I Do? Seeds of Better Brain Health Go get some dirt. For some, that’s easy — dig into your backyard with a shovel. For others, it might mean going to a local hardware store and buying a bag that’s still light enough to carry. Put a small amount of dry dirt in a bucket and squeeze it in your hands. Take some time to smell and feel the dirt, but before you make a mess, do rinse off! While you’re at it, get some seeds, add a pot, then sun and water, and grow something. Is there a greenhouse, grocer, or flower or plant shop nearby? Consider stopping in and asking for the smallest plant that’s already begun life. Take it home and tend to it by reading about how to grow your little green friend. There are plenty of websites, videos, and apps online to learn how. Volunteer at a farm cooperative or visit a pick-your-own farm. You can search your local area online at pickyourown.org . Additional selected reading: Ulrich, R. S. (1984). View through a window may influence recovery from surgery. Science, 224(4647), 420-421 . Van Praag, H., Kempermann, G., & Gage, F. H. (2000). Neural consequences of environmental enrichment. Nature Reviews Neuroscience, 1(3), 191-198 . Soga, M., & Gaston, K. J. (2016). Extinction of experience: the loss of human-nature interactions. Frontiers in Ecology and the Environment, 14(2), 94-101 . Lowry, C. A., Smith, D. G., Siebler, P. H., Schmidt, D., Stamper, C. E., Hassell Jr, J. E., ... & Reber, S. O. (2016). The microbiota, immunoregulation, and mental health: implications for public health. Current Environmental Health Reports, 3(3), 270-286 . Bratman, G. N., Hamilton, J. P., & Daily, G. C. (2012). The impacts of nature experience on human cognitive function and mental health. Annals of the New York Academy of Sciences, 1249(1), 118-136 . Click here to go to the magazine.

Falling asleep and staying asleep are incredibly important for brain health and cognitive function. Sleep may be affected by specific causes of Dementia, but in addition, some studies show that poor sleep might actually contribute to the development of a Dementia. Many people struggle with getting adequate sleep due to various factors, including stress, activity level, and poor sleep hygiene. Electronics have found their way into many aspects of modern life. Adults and children have more access to LED screens and electronic entertainment today than at any other time in history. While many of these tablets, smartphones, and TV screens can improve the quality of communication, they can also negatively impact your brain health. The Nielsen organization reports that, on average, adults watch 33 hours per week, while children average 24 hours. Most of this viewing time occurs in the evening hours, shortly before bed, or while lying in bed before trying to go to sleep. When you’re watching a television program, it engages the brain. You can often find yourself reacting to the program, formulating questions about what will happen next, or even emotionally reacting to what’s on the screen. When this happens, it often results in the brain releasing stress hormones like adrenaline and cortisol, which stimulate the body and continue to keep the brain engaged. You start to set up a cycle in your brain that encourages it to stay awake and alert at precisely the same time that it’s supposed to be calming down to prepare for sleep. Ditch the Bedroom TV! Your bedroom should be set up as an environment that is conducive to getting a good night’s sleep. Removing the television from your bedroom removes unneeded stimulus. Going to sleep each night in a positive sleep environment trains your brain to recognize the timing and routine of the sleep-wake pattern. This allows you to fall asleep more quickly and stay asleep throughout the night. This can also be a significant factor in reducing your dependency issues regarding sleep aids and medications. Contributor: Dr. Michael Trayford is a Board-Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For more information, please visit https://apexbraincenters.com/cognitive-decline-asheville-nc/ . Contributing authors' opinions are not necessarily those of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, paid or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

#Livestrong #DespiteDementia #DementiaSociety My older friend often says, “No matter the weather, the sky is always blue.” This does not mean he is an overly optimistic person. Instead, despite his many infirmities, he lives daily as though it is a gift. He takes pleasure in his garden, family, and friends, as well as in the slow but steady progress he makes in his sculpture studio. His response to the annoyances we all experience and the things one cannot change is a hearty Brooklyn-ese, “What evah.” The diagnosis of Dementia, though not what we wish for, is an invitation to indulge yourself in all the things that give you pleasure or might like to do. Some people call these indulgences their “bucket list.” Enjoy Life! Many people have spent a considerable portion of their adult lives avoiding certain types of food. Although eating a healthful diet is still essential – indulge! It’s okay to eat a decadent dessert, an entire bag of chips, or any of the other foods you crave. Travel the world with your fork, knife, and spoon. Try a new cuisine. Explore the worlds of wine, cheese, and artisan beer. Since it’s always nice to travel in the company of others – extend an invitation to a themed potluck dinner or lunch at an ethnic restaurant. Don’t limit yourself to adventurous eating. This is an excellent time to become an adventurous tourist. Go to those “I’ve always wanted to visit “places. And it doesn’t have to be anything fancy such as a trip to Iceland to see the Northern Lights. Explore your nearby surroundings with the eyes of a tourist. Living life to its fullest includes giving family and friends the gift of your time with them. And you might be surprised to discover that grocery shopping and housework affirm your independence and abilities. To paraphrase my friend’s words, “Living a full life makes every day a blue-sky day.” The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, paid or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

First, Dementia is not a disease. That’s news to many people. Instead, Dementia is a syndrome where one or more progressive diseases, conditions, or disorders affect the brain structure sufficiently enough to limit one’s ability to perform activities of daily living, along with a host of other cognitive changes. Yes, that’s a mouthful. And that may be why some medical professionals will initially use the linguistic shortcut to say that someone likely has “Dementia” without much more detail. They may not know at that moment what’s causing the cognitive impairments, so calling it Dementia is a way to name it in a general sense. But wait, let's back up. If Dementia is not a disease, how do I know what disease or disorder(s) I have and what I should do about it? The glib answer is: it depends. Depends on what? It depends on a bunch of different criteria, such as: What is your age? What are your mental state and physical ability to withstand the rigors of testing? What are your medical history and your family's medical history? What are your exact symptoms? Are you possibly depressed? Do you have memory loss alone, or do you have hallucinations, too? Are you wobbly on your feet, or do your feet kind of stick to the floor, etc.? These symptoms and many more are clues to building the case for a more definitive cause(s) of your cognitive issues. Also, have you been tested? Did the doctor do a mini-cognitive assessment or depression screening? How about an in-depth neuropsych exam, done a couple of times over a multi-month period? Did you have an MRI, CT scan, or PET scan? How about a blood test or spinal fluid test? Was there a plausible reason to do genetic testing? All these tests may add to the knowledge doctors can bring to bear on a more precise diagnosis. Suffice it to say, for this post, we're mainly concentrating on the clinical presentation, in essence, how you act, what the cognitive screening test indicated, what you think about the situation, how it's progressing if it is, and what your loved ones are observing. And for many, that's the first level of evaluation. Then, after you receive a diagnosis of "possible" or "likely" Dementia, from a clinical perspective, your doctor may want to do additional testing (which we hope they do) to dig a bit deeper. And until more is known, they are likely to focus on your neurological health, suggesting different treatments and therapies to help manage your symptoms in the short term. You may also be told to do advance care planning in anticipation of forthcoming changes. But there are brain-healthy activities that you can do that may benefit you now and in the future. These ideas are ways to cope with a new Dementia diagnosis, even if it's not a definitive one: Establish a daily routine Doing the same things every day may help you adopt a comforting rhythm. It may also keep you from losing things if you train yourself to put your glasses or keys in the same place. Be sure to include daily chores on your list of things to do. “We want them to do as much as they can without being overwhelmed,” says Rehan Aziz, MD, associate professor of psychiatry and neurology at the Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey. “If they can still set the table and prepare simple meals... those are things we want to maintain. We don’t want [them] to lose those skills.” If you need prompting throughout the day to maintain your routine, keep an oversized calendar in the kitchen listing your schedule, from your morning walk to your family dinner. Get moving Grab your sneakers or your favorite bathing suit: Research has shown that physical activity can improve your mood, which may lift your spirits if you need a boost. Be cautious about exercising too vigorously if you’re at risk of falling; consider swimming or water aerobics instead of walking or hiking. Aim for half an hour of exercise daily for better mental and physical health. Manage your well-being If news about your health makes you depressed or anxious, find a therapist who treats older adults or people with Dementia. “If they’re having a difficult time with the diagnosis, which is not unreasonable, we can refer them to meet with individual therapists for supportive talk therapy,” Aziz says. “If they’re feeling particularly depressed, you might consider medications that might help.” Connect with loved ones Communicate with friends and relatives regularly. Staying close to the important people in your life may help you feel less isolated. Phone calls, video calls, and in-person visits are all good options to help you keep in touch and ways to cope with a new dementia diagnosis. The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, paid or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org Lisa Fields is a full-time freelance writer specializing in health, psychology, sleep, nutrition, and fitness. Her work has been published by Reader’s Digest, WebMD, Women’s Health, Good Housekeeping, Self, and many other publications. Learn more about Lisa at https://www.writtenbylisafields.com .

Caring for someone living with Dementia can be a tough job. It's a role filled with emotional highs and lows, requiring a lot of patience and strength. Finding ways to manage stress and emotions is crucial for caregivers. One effective method may be Cognitive Behavioral Therapy (CBT). Let's explore how CBT can help Dementia caregivers lead a healthier and more balanced life.   Understanding Cognitive Behavioral Therapy   First, what exactly is Cognitive Behavioral Therapy? CBT is a type of talk therapy in which you sit with a therapist and talk through your feelings and thoughts. The key idea behind CBT is that our thoughts, feelings, and actions are connected, and changing negative thoughts can help improve our emotions and behaviors.   Stress Reduction   Caregiving can often feel like a 24/7 job with no breaks. This continuous stress can lead to burnout, where a person feels extremely tired and unable to cope. CBT comes into play by teaching care partners techniques to handle their stress better. For example, a therapist might help a caregiver identify stressful thoughts and work on changing them. Instead of thinking, "I can't do this anymore," CBT would help them think, "This is hard, but I can handle it."   Better Emotional Management   It's normal for caregivers to experience various emotions, from sadness and frustration to guilt and anger. These feelings are natural, but they can be overwhelming. CBT helps by offering tools to manage these emotions more effectively. Caregivers learn to recognize their emotional triggers and understand how to calm themselves when things get tough.   Improved Relationships   CBT can also improve caregivers' interactions with the person they're looking after. Sometimes, misunderstandings or communication gaps can create additional stress. CBT techniques help caregivers communicate better by teaching them to express their needs and feelings clearly without becoming upset or angry, easing the situation and strengthening their relationship with the person they care for.   Coping with Change   As Dementia progresses, the person's abilities and behaviors can change dramatically, which can be challenging for caregivers to handle. Often, at the beginning, the relationship is relatively balanced; it is a type of partnership. We prefer to refer to someone acting as a "care partner" in this situation. However, over time, the burden of caring usually shifts to the person who is not living with Dementia, and their role evolves to giving care. In other words, they are now a "caregiver." In these cases, CBT typically helps them adapt to these changes by setting realistic expectations and learning to accept things they cannot change. It teaches them to focus on what they can control: their reaction and attitude towards the situation.   Encouraging Positive Thinking   One of the core parts of CBT is cultivating a habit of positive thinking. Caregivers are often so focused on the needs of the person they are looking after that they forget to see the good moments. CBT encourages them to notice and appreciate these joyous times, which can boost their morale.   Enhancing Self-Care   Finally, CBT emphasizes the importance of self-care. For caregivers, taking care of themselves is often at the bottom of their to-do list. CBT sessions can include setting goals for self-care activities, such as regular exercise, hobbies, or spending time with friends. These activities help reduce stress and prevent caregiver fatigue.   Conclusion   Caring for someone with Dementia is no easy task, and caregivers need to have support systems in place. Cognitive Behavioral Therapy is a valuable tool that offers this support. It helps caregivers manage stress, handle emotional ups and downs, improve communication, cope with changes, and appreciate the positive aspects of caregiving.   If you're a caregiver feeling overwhelmed, consider CBT. It could be a step towards better managing your duties and enjoying them more. Remember, taking care of your mental health is just as important as the physical care you provide. Contact the Association for Behavioral and Cognitive Therapies here to find a CBT therapist. Author: AI-Assisted Human-Edited Staff Writer We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, paid or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

Vascular Dementia is a type of Dementia that is caused by damage to the blood vessels in the brain. This damage can lead to a variety of cognitive and functional impairments, including memory loss, difficulty with thinking and problem-solving, and changes in mood and behavior. Living with Vascular Dementia can be challenging for both patients and caregivers. Patients may need to adapt to new challenges in their daily lives, such as difficulty managing finances, remembering appointments, and taking medications. Caregivers may experience emotional and physical stress as they provide support to their loved ones. Understanding Vascular Dementia Other types of Dementia, such as Alzheimer's disease, are caused by the death of brain cells. Vascular Dementia is different because the damage to the brain is caused by a lack of blood flow. This can happen due to a stroke, a series of small strokes, or a narrowing of the blood vessels in the brain. The Signs And Progression of The Condition The signs and progression of Vascular Dementia can vary depending on the cause of the damage to the brain. However, some common signs of Vascular Dementia include: Memory Loss: Difficulty remembering recent events, names, and faces. Trouble Thinking And Problem-Solving: Difficulty concentrating, making decisions, and following instructions. Changes In Mood And Behavior: Mood swings, irritability, depression, and anxiety. Problems With Coordination And Balance: Difficulty walking, moving around, and maintaining balance. Speech Problems: Difficulty understanding and speaking. The progression of Vascular Dementia can also vary depending on the cause of the damage to the brain. However, it is generally a progressive condition, meaning that the symptoms will get worse over time. Coping Strategies for Patients Adapting To Daily Challenges: Patients with Vascular Dementia can experience a variety of challenges in their daily lives, such as difficulty remembering appointments, taking medications, and managing finances. There are a number of strategies that patients can use to cope with these challenges, such as: Creating a Routine: Having a regular routine can help to provide structure and predictability in the day. This can be especially helpful for patients who have difficulty with memory and thinking. Using Memory Aids: Memory aids, such as calendars, pill organizers, and to-do lists, can help patients to stay organized and on track. Asking for Help: Patients should not be afraid to ask for help from family, friends, or professionals. There are a number of resources available to help patients with Vascular Dementia, such as support groups, home care services, and financial assistance programs. Importance of Routine and Familiarity: Patients with Vascular Dementia often benefit from a sense of routine and familiarity. This can help them to feel more grounded and in control. Caregivers can help to create a routine by following a set schedule for activities and meals. They can also make sure that the patient's environment is familiar and comfortable. Memory Aids and Reminders: Memory aids and reminders can be helpful for patients with Vascular Dementia. This may include using a calendar, setting alarms, and creating lists. Caregivers can also help patients to use memory aids by writing down important information and reminding them of appointments and tasks. Engaging In Cognitive Exercises and Activities: Cognitive exercises and activities can help to slow the progression of Vascular Dementia and improve cognitive function. This may include playing games, doing puzzles, and reading. Caregivers can encourage patients to participate in cognitive exercises and activities by providing them with resources and support. It is important for patients with Vascular Dementia to find coping strategies that work for them. There is no one-size-fits-all approach, and what works for one person may not work for another. It is also important for patients to be patient with themselves and to not get discouraged if they do not see results immediately. With the right support, patients with Vascular Dementia can live meaningful lives. For the Caregivers: Supporting Your Loved Ones Caring for a loved one with Vascular Dementia can be a challenging and rewarding experience. Caregivers can support their loved ones by: Recognizing and Addressing the Emotional Impact on Caregivers: Caring for a loved one with Vascular Dementia can be emotionally and physically demanding. Caregivers may experience feelings of grief, anger, guilt, and frustration. It is important for caregivers to recognize these emotions and to seek support if needed. Creating a Safe Environment: Caregivers can help to create a safe environment for their loved ones by removing hazards and making sure that the environment is well-lit. They can also teach their loved ones how to use assistive devices, such as walkers and wheelchairs. Effective Communication Techniques: Communication can be challenging for patients with Vascular Dementia. Caregivers can use effective communication techniques, such as speaking slowly and clearly, using simple language, and avoiding distractions. They can also repeat information as needed and ask questions to make sure that their loved ones understand. The Importance of Self-Care: Caregivers need to take care of themselves in order to be effective caregivers. This may include getting enough sleep, eating healthy foods, and exercising regularly. Caregivers should also find time for activities that they enjoy and that help them to relax. Building a Supportive Community There are a number of resources available to help patients and caregivers cope with Vascular Dementia. These resources include: Local Support Groups: Support groups can provide a safe space for patients and caregivers to connect with others who understand what they are going through. Online Resources and Forums: Online resources and forums can provide information and support to patients and caregivers. The Role of Professional Counseling and Therapy: Professional counseling and therapy can help patients and caregivers to cope with the emotional and psychological challenges of Vascular Dementia. Navigating the Emotional Journey Living with Vascular Dementia can be an emotional rollercoaster. Patients and caregivers may experience a range of emotions, including grief, anger, guilt, and frustration. It is important to acknowledge these emotions and to find healthy ways to cope with them. One way to cope with the emotional journey of Vascular Dementia is to practice acceptance and understanding. This means accepting that the condition is progressive and that there is no cure. It also means understanding the changes that the patient is going through and how they are feeling. Another way to cope with the emotional journey of Vascular Dementia is to celebrate small victories and moments of connection. Even on difficult days, there are often small moments of joy to be found. These moments can be a source of hope and strength for patients and caregivers. Conclusion Living with Vascular Dementia can be challenging, but it is not impossible. With the right support, patients and caregivers can cope with the challenges of the condition and live meaningful lives. The Dementia Society of America is a great resource for patients and caregivers of Vascular Dementia. We offer a variety of resources, including support groups, educational materials, and advocacy services.