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The health benefits that various foods and diets to improve overall health or lower risk for disease is a newsworthy topic. Some articles promote that eating fiber-rich fruits, vegetables, and whole grains helps us to maintain a healthy weight, as well as lowering our risk for colon cancer. Others assert the Mediterranean diet – one which encourages replacing red meat for fish and chicken, saturated fats with olive oil, and refined carbohydrates with whole grains – reduces the risk for heart disease, certain cancers, and diabetes. There are many research studies touting the benefits of red wine on lowering cholesterol blood levels and thereby reducing the risk for heart disease, strokes, cataracts, and colon cancer. Though a controversial area of research, some studies indicate drinking moderate amounts of red wine may slow declines in brain function. With respect to consuming wine and other alcoholic beverages, moderation is the keyword. However, most people are unsure of how much a moderate amount is. According to the Dietary Guidelines for Americans, a low to moderate alcohol consumption is no more than one drink a day for women and older adults, and two for men. One drink is usually 1 1/2 ounces or 15 grams of alcohol, which equals approximately 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof liquor. (See Note 1 below.) These dietary guidelines refer to the amount consumed on any single day and not as an average over several days. In other words: Do not save your daily allocation for a weekend binge. Alcohol-related brain damage, (ARBD) conditions that include Wernicke-Korsakoff Syndrome and alcoholic Dementia, is the result of drinking too much alcohol over the course of several years. Though both types of ARBD exhibit dementia-like symptoms, neither condition is true dementia. The difference between ARBD and Dementia such as Vascular, Lewy body, or Alzheimer’s disease is in the ability to treat or stop the progression of symptoms. Consuming more than the recommended amounts of alcohol does increase the likelihood of developing Alzheimer’s disease and Vascular Dementia later in life. However, researchers have yet to establish the numerical relationship between alcohol consumption and risk for Dementia. The reasons are many and include research entirely dependent on reported observations and evaluating the variables that, in combination with alcohol consumption, affect the long-term risk for Dementia. However, one can state with certainty the more you drink the greater the likelihood of developing dementia later in life. High alcohol consumption also increases the risk for stroke, heart and liver disease, and depression – all of which are well-known dementia risk factors. Note: 1. U.S. Department of Health and Human Services and U.S. Department of Agriculture, 2015. 2020 Dietary Guidelines for Americans. 8th Edition, Washington, DC; 2015, (accessed June 15, 2015). 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. Please visit our Author's page to learn more and find this title. 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

The concept of keeping a gratitude journal has gained attention as a focal point for brain writings and research. Forbes published an article within recent years that explored the value of keeping a gratitude journal. Something happens neurologically when we reflect on our choices, relationships, and special events in our lives. Actively reflecting starts to hardwire neurological changes in the brain. If you’re constantly focusing on emotions that make you fearful, angry and resentful, they eventually get hardwired into your brain. The opposite outcome holds true for gratitude. Research has found that keeping a gratitude journal can help pull you out of negative patterns and start you on a course that leads to positive thoughts and actions. Gratitude journals have been shown to be even more effective than simply focusing on having positive thoughts in your day. Keeping one has many different benefits: One of the biggest improvements comes with the ability to open up new relationships, or to communicate better in your current relationships. Reflecting and being grateful for the people that help you in life expands your empathy, and empathy is one of the cornerstones of healthy relationships. It also improves physical health. Research, published in 2012 in the Journal of Personality and Individual Differences, found that people stuck in negative emotional patterns feel pain more intensely than people who practice gratitude and positive thinking on a daily basis. Keeping a gratitude journal also helps people manage depression and feelings of aggression. A study published by the Journal of Applied Psychology found that people who wrote in a gratitude journal for 15 minutes at night before going to bed experienced better quality of sleep on a regular basis. It also has a positive impact on self-esteem. Sitting down to reflect on what you’ve accomplished and what you’re grateful for ingrains the value of the experience in your memory. This also helps to reduce social comparisons, because focusing on what you appreciate about yourself impedes the negative impulse to judge others. Gratitude journaling has also been shown to be a therapeutic tool that can help people deal with conditions like PTSD and other stress-related disorders. It costs little more than a cheap composition notebook or simply maintaining a special file on your computer’s hard drive. I think you’ll find if you take the time to reflect on your life and the things you’re grateful for, results will be nothing short of amazing. Contributor: Dr. Michael Trayford is a Board-Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. 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 of America does not provide medical advice. Please consult your doctor.

Hearing connects us to the world, helping us communicate, work, socialize and be alert to potential danger. Hearing impairment, likely affecting over 30% of seniors, touches all aspects of daily living. It contributes to depression, loneliness, poor job performance, and in the long run, may lead to Dementia. It is thought by some, that untreated hearing loss could be responsible for 9% of Dementia worldwide. The good news is that healthy lifestyle choices that include correction of hearing loss, might possibly delay or prevent one-third of Dementia cases. Here is a guide to understanding hearing loss and what to do about it: What causes hearing loss? Age Genetics (family history) Chronic illness (type-2 diabetes, hypertension, cardiovascular, autoimmune, and infectious diseases) Medication (diuretics, antibiotics, chemotherapy, others) Environment (noise, pollution, industrial chemicals) Head trauma Smoking And more... We can’t change our genetics, but we can take steps to affect the other factors. What are the types of hearing loss? Peripheral hearing loss occurs in the ear, while central loss involves parts of the brain that process auditory signals. Hearing loss is often a mix of both types. How does hearing loss cause Dementia? It increases social isolation, reduces stimulation to the brain, and/or it may arise from the same brain changes that cause dementia. What does testing involve? To be thorough, take three tests: Ear testing: wear headphones while identifying short sounds played at different volumes and pitches. Central auditory processing (CAP) evaluation: checks speech reception and word recognition using the Staggered Spondaic Word Test (SSW) and the Synthetic Sentence Identification with Ipsilateral Competing Message test (SSI-ICM). Cognition: The Montreal Cognitive Assessment (MOCA), available online, for free, in multiple languages and dialects, is one page and takes ten minutes. MOCA detects mild cognitive impairment and early dementia. What treatment is available? Hearing aids make sounds louder and easier to pick up. Middle or inner (cochlear) ear implants boost signals that go to the brain. Treatment slows mental decline and improves cognitive test scores, so sooner is better. What lifestyle strategies support hearing? : Moderate alcohol consumption Bone-strengthening exercise Antioxidant (Mediterranean, DASH) diets Stop smoking Correcting hearing loss improves life enjoyment, daily function, and brain health. Take action today to help counter this modifiable risk factor for Dementia. References: www.ncbi.nlm.nih.gov/pubmed/29964378 www.ncbi.nlm.nih.gov/pubmed/29735277 www.ncbi.nlm.nih.gov/pubmed/29212633 www.thelancet.com/commissions/dementia2017?code=lancet-site www.ncbi.nlm.nih.gov/pubmed/29937713 www.ncbi.nlm.nih.gov/pubmed/30011159 www.ncbi.nlm.nih.gov/pubmed/29430246 www.ncbi.nlm.nih.gov/pubmed/28894825 www.ncbi.nlm.nih.gov/pubmed/27806352 www.ncbi.nlm.nih.gov/pubmed/29937713 Contributing Blogger: Jennie Ann Freiman, MD, author of The SEEDS Plan. 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 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.

Blood pressure and health is a frequent topic of a casual conversation between friends. However, many people are not aware of the relationship between blood pressure and the risk of having dementia later in life. Blood pressure is a measure of the force blood exerts against the inner walls of the blood vessels and arteries as the heart pumps blood throughout the body. The first or higher number, the systolic pressure, determines the pressure in the arteries when the heart muscle contracts. A higher than normal pressure, one that is greater than 120, causes the heart to work harder and increases the risk for heart attacks, and strokes. The second number, the diastolic pressure, determines the pressure in the arteries when the heart muscle relaxes between heartbeats. A lower than normal blood pressure is having a systolic pressure below 90 or a diastolic lower than 60. Most doctors consider chronically low blood pressure a problem only if it causes noticeable symptoms such as dizziness, fainting, or rapid and shallow breathing. Some causes for too-high or too-low blood pressure are cardiovascular and neurological abnormalities present at birth and the side effects of certain medications. Conditions and behaviors such as blood pressure, chronic kidney disease, heart disease, obesity, smoking, and insufficient exercise are all causes for having high blood pressure. Risk factors associated with having low blood pressure include advanced age, medications such as the alpha-blockers used to treat high blood pressure, as well as having diseases such as diabetes, Parkinson's disease, severe infections, and certain heart conditions. High blood pressure, independent of its cause, increases the risk of having Dementia. However, the good news is there are ways to decrease the risk for Alzheimer's disease and vascular dementia - the two most common types of Dementia. Some of these include reducing stress, eating a heart-healthy diet, getting regular exercise, and stopping smoking. It’s also important to follow your doctor’s instructions and take your blood pressure medication as prescribed. Changing lifelong habits is often easier said than done. It’s difficult to reduce stress and to find the time to exercise when juggling the responsibilities of a tightly scheduled day. When eating out, or socializing with family, friends, and coworkers, it is a challenge to manage large portions and to choose foods that are low in saturated fats, salt and added sugar. Support groups as well as your friends and family can be your best allies in helping you to achieve a healthier lifestyle. However, be sure to tell your friends and family the reason for making these lifestyle changes is to reduce your risk for dementia. Maybe, just maybe, your explanation will be the motivation they need to make similar healthful changes. 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.” 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

Bodyweight and risk for Dementia are both confusing and complex topics. One can find reports that state obesity increases the risk for dementia as well as ones that indicate the opposite –that being underweight is the risk factor. And to make things even more confusing, there is evidence that indicates being overweight may protect some people from Dementia.* It’s needless to say, these unexpected findings are difficult to explain and generate considerable discussion and controversy both in the media and between researchers. However, what these seemingly conflicting findings show is a risk – the factors that influence the likelihood of having Dementia is difficult to assess. A too high body mass index (BMI), which uses an equation to calculate a numerical rating of your health based on height and weight, is only one of many known risk factors. Therefore the big challenge is how to determine the combined effects of having multiple risk factors, such as diabetes, insufficient exercise, and smoking. Does having additional factors make having dementia three times more likely than being overweight alone? Or perhaps the risks compound and put people at 10 times the risk for Dementia? Is it possible that having a high BMI becomes protective when combined with habits and activities known to reduce risk? As you can see, the number of environmental, behavioral, health-related, and genetic influences is huge and the combinations of risk factors are infinite. Another challenge is separating associative risks from those that cause the outcome. For example, obesity is associated with increased risk for diabetes, but in itself does not cause diabetes. What causes diabetes is the inability of the pancreas to produce sufficient insulin. And, as it turns out, having diabetes is a risk factor associated with having dementia later in life. Therefore, based on what we currently know about BMI and risk for Dementia the best answer is, “it depends.” This means, at this time, the best we can do to reduce risk is to make a lifelong commitment to what current clinical research shows are health-promoting habits. * The Lancet Diabetes and Endocrinology, http://www.thelancet.com/journals/landia/article/PIIS2213-8587(15)00033-9/abstract , Accessed: September 2016. 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 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

Traumatic brain injury (TBI) describes situations in which an external force, such as a fall or a blow to blow to the head, causes extreme pain that is often accompanied by a short or a long period of unconsciousness. People who experience multiple traumatic brain injuries are at high risk of developing dementia later in life. (1) However, the critical phrase "increase risk for" means that TBIs do not cause dementia but increase the likelihood of dementia sometime in the future. In a recent and extensive review of the research literature, Sharan Shively, MD, Ph.D., and colleagues report that a history of moderate and severe TBIs increases the risk of having late-life dementia 2 - to - 4 times that of people who have never experienced a traumatic brain injury. (2) To come to this conclusion, Shively and colleagues reference earlier studies that compare the presence or absence of later-in-life dementia in people who suffered concussions of sufficient severity to cause loss of consciousness to individuals who report never having experienced that degree of head trauma. (2) People who experience multiple traumatic brain injuries are at high risk of developing dementia later in life. (1) The syndrome, associated with having multiple traumatic brain injuries, was initially described in 1928. Called dementia pugilistic, or "punch drunk," was first observed in boxers who suffered repeated knock-outs. (3) It took many more years of casual observation before medical researchers linked a history of repeated sports and military-related head injuries to the onset of dementia symptoms later in life. The condition, chronic traumatic encephalopathy (CTE), now receives considerable coverage in the public media. Signs and symptoms of CTE usually begin eight to 10 years after traumatic brain injuries. They include difficulty thinking, impulsive behavior, memory loss, substance abuse, and suicidal thoughts or behavior. (4) Over time, the changes caused by CTE worsen and progress to aggressive behaviors, tremors, and speech and language difficulties. (4) More than one-third of people with CTE eventually show signs of other degenerative brain diseases such as dementia and Parkinson's disease. (3) Undoubtedly, ongoing and future research will improve our understanding of traumatic brain injuries and their relationship to later-in-life dementia. In the meantime, you can reduce the likelihood of receiving a head injury by trip-proofing your home, being observant of hazards such as low tree branches and open kitchen cabinet doors, as well as by wearing a helmet to prevent sports-related injuries. Even if you have experienced multiple head injuries, you may be able to reduce your overall risk of developing dementia by implementing lifestyle changes that include such things as maintaining a healthy weight, eating a heart-healthy diet, as well as participating in an assortment of physical, social, and mental activities. Notes: 1. Alzheimer's: Can a head injury increase my risk? http://bit.ly/3trmpdM. (accessed November 12, 2022) 2. Shively et al., "Dementia Resulting from Traumatic Brain Injury" https://www.researchgate.net/publication/229011632_Dementia_Resulting_From_Traumatic_Brain_Injury_What_Is_the_Pathology (accessed March 22, 2016) 3. What Is Chronic Traumatic Encephalopathy?, http://www.brainline.org/content/2010/12/what-is-chronic-traumatic-encephalopathy.html (accessed April 7, 2016) 4. Chronic Traumatic Encephalopathy, https://www.mayoclinic.org/diseases-conditions/chronic-traumatic-encephalopathy/symptoms-causes/syc-20370921 (accessed April 6, 2016) 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 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

The health benefits that various foods and diets to improve overall health or lower risk for disease is a newsworthy topic. Some reporters state that eating fiber-rich fruits, vegetables, and whole grains helps us to maintain a healthy weight as well as may lower the risk for colon cancer. Others assert the Mediterranean diet, one which encourages replacing red meat for fish and chicken, saturated fats with olive oil, and refined carbohydrates with whole grains, reduces the risk for heart disease, certain cancers, and diabetes. Many research studies are touting the benefits of red wine on lowering cholesterol blood levels and thereby reducing the risk of heart disease, strokes, cataracts, and colon cancer. Though a controversial area of research, some studies indicate drinking moderate amounts of red wine may slow declines in brain function. With respect to consuming wine and other alcoholic beverages - moderation is the keyword. However, most people are unsure of how much is a moderate amount. According to the Dietary Guidelines for Americans, a low to moderate alcohol consumption is no more than one drink a day for women and older adults, and two for men. One drink is usually one 1/2 ounce or 15 grams of alcohol, which equals approximately 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof liquor. (Note 1) These dietary guidelines refer to the amount consumed on any single day and not as an average over several days. In other words - do not save your daily allocation for a weekend binge. Alcohol-related brain damage, (ARBD) conditions that include Wernicke-Korsakoff syndrome (WKS) and alcoholic Dementia are the result of drinking too much alcohol over several years. (Note 2) Though both types of ARBD exhibit Dementia-like symptoms, neither condition is true-Dementia. (Note 2) The difference between ARBD and Dementia such as Alzheimer's disease is in the ability to treat or stop the progression of symptoms. Consuming more than the recommended amounts of alcohol does increase the likelihood of developing Alzheimer's disease and vascular dementia later in life. However, researchers have yet to establish the scientifically measurable relationship between alcohol consumption and risk for Dementia. The reasons are many and include research entirely dependent on reported observations and evaluating the variables that, in combination with alcohol consumption, affect the long-term risk for Dementia. However, one can state with certainty, the more you drink, the greater the likelihood of developing dementia later in life. High alcohol consumption also increases the risk for stroke, heart and liver disease, and depression – all of which are well-known Dementia risk factors. Notes: 1. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition, Washington, DC; 2015, http://health.gov/dietaryguidelines/2015/guidelines/ (accessed June 15, 2015). 2. What is Alcohol-related Brain Damage?, https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=98 (accessed June 16, 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. Please visit our Author's page to learn more and find this title. 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

“Use it or lose it" is a common expression we hear referring to physical and athletic abilities, maintaining hands-on skills, or the capabilities that come with formal education. Similar to how physical fitness improves health and quality of life, brain fitness as a product of intellectual stimulation may reduce risk or help slow or lessen the impacts of Dementia. Researchers and healthcare professionals use the terms “brain reserve” and “cognitive reserve” to describe the protective factors that brain anatomy and education have on the onset and progression of dementia. Often, researchers and clinicians do not distinguish between the two and use the term cognitive reserve. However, there are subtle differences between the two kinds of reserve. One can think of brain reserve as computer hardware and cognitive reserve as operating software. Brain reserve, rather than reducing the risk for Dementia, is brain resiliency or the ability to maintain adequate function in the face of increasing brain damage. In this case, researchers believe it is inborn brain architecture along with the number of neurons and connections between brain structures that create resiliency. Physical methods such as using microscopes to examine pieces of brain tissue and medical imaging technologies to locate areas of high and low brain activity are the ways researchers assess brain reserve. Cognitive reserve is the effect brain exercise has on making the brain better able to resist the behavioral and intellectual declines Dementia cause. Researchers and clinicians use behavioral assessments to evaluate cognitive resiliency, such as the mini-mental status exam. Brain fitness is one of the best ways to reduce the risk of age-related dementia. And should Dementia enter your life, brain fitness may help to slow or lessen the impacts of the disease. Participating in physical activities such as baseball, flying radio control airplanes, hiking, or dancing requires both coordination and the ability to make split-second decisions. Fortify Your Brain Hands-on learning refers to making something or acquiring a new skill. Whether self-taught or with the assistance of a knowledgeable person learning how to build furniture, watercolor, construct a raised-bed garden, or become proficient at using Photoshop, requires high-level thinking and problem solving, concentration, and creativity. Levels of participation in both physical, hands-on activities and formal education reduce the risk for Dementia and make the brain better able to resist the behavioral and intellectual declines of Dementia. Sadly, the progressive nature of Dementia eventually overwhelms the cognitive reserve that once supported adequate behaviors and abilities. When this happens, there is a rapid decline in cognition as well as in the ability to perform tasks of daily living such as getting dressed without assistance. 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 A mazon . 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

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