JustCare

Tag: Cognition

  • Why see a geriatrician?

    Why see a geriatrician?

    Today, more than 55 million Americans are over 65. The US has an older population than it has ever had. Sadly, the physician population has not grown to meet the needs of older Americans reports Pamela Paul for The New York Times.

    How many board-certified geriatricians are there in the US? Just over 7,000. Only one for every 10,000 older adults. The number has shrunk more than 25 percent in the last 25 years.

    Older adults with multiple chronic conditions can fare much better with treatment from a geriatrician. Much like with children, taking care of older adults is different from taking care of working people. As we age, our brains and bodies change.

    While there are a range of doctors who treat older adults, many of them have never received appropriate training to do so. That training can be invaluable. We have less muscle mass, smaller kidneys and weaker immunological systems by the time we are 65.

    When it comes to geriatric care, physicians should be looking at both the prescription drugs and over-the-counter drugs you take, your cognition, your movement and what you most care about. Geriatricians must consider which of a patient’s medical needs are most important. Patients’ life desires should rank high, be it going on vacation or having better balance. Physicians need to keep in mind that patients might not be able to follow a treatment plan.

    Geriatricians work to help promote as good health as possible. For example, my dad’s geriatrician got my dad off of a few of the prescription drugs he was taking after testing their efficacy over a several month period and finding that they were not benefiting him. His geriatrician also kept a doctor who saw my dad in the emergency room from prescribing him a new and costly medication he did not need. And, that’s not all.

    My dad’s geriatrician arranged for a nurse to visit him every two weeks to check his blood because he was on a blood thinner. She prescribed physical therapy for him because he was shuffling his feet when he walked and she worried about his risk of falling. After talking to him and me about his social network, she thought it would be helpful if he had more social interactions. So, she arranged for the hospital social worker to see him and help him find a program that engaged him socially.

    Why aren’t more physicians becoming geriatricians? It’s a fulfilling profession. But, it’s not glamorous. It requires spending more time with patients. It’s challenging because patients are ultimately not going to improve a lot. It requires an extra year of training over primary care. And, the pay is relatively low, averaging about $258,000 a year.

    Here’s more from Just Care:

  • Six warning signs of dementia

    Six warning signs of dementia

    Dana Smith reports for the New York Times on six warning signs of dementia, memory loss included. Keep in mind that each of these signs alone should not cause concern. But, taken together, they are cause for visiting the doctor. To read more about signs of dementia on JustCare, click here.

    Financial problems: People with dementia can experience problems handling their finances long before losing their memory. In many cases, they struggle to stay on top of their bills and can’t manage their expenses. Some will spend money excessively or give money away without appreciating what they’re doing.

    Sleep problems: Again, lots of adults have sleep issues. But, people with dementia might have a change to their circadian rhythm and need to sleep at odd hours and be awake in the very early morning when it’s still dark. Some people with dementia will act out their dreams while they sleep, physically moving and talking. It’s not normal sleep walking or sleep talking; it’s more hitting and screaming.

    Changes in personality: People with dementia might withdraw from social activities, stay home more,  and become less agreeable and conscientious before they show other signs of mental decline. For example, hey might struggle to finish projects. They will continue to be disagreeable and less trusting of others as their dementia progresses.

    Challenges driving: Driving  requires the driver to perform multiple mental tasks at once. When driving becomes a challenge, it’s a sign that the driver is suffering from dementia. The driver might not see a stop sign or nearly miss hitting another car or otherwise not follow the rules of driving. If that’s the case, you might want to take action to prevent the person from driving.

    Loss of smell: People with dementia often lose their ability to smell long before they experience other symptoms. Dementia can cause loss of smell.

    In addition, people with dementia might struggle for words, might misplace things, or become confused more easily.

    Here’s more from Just Care:

  • What to do if someone you love struggles to use a computer

    What to do if someone you love struggles to use a computer

    Modern technology can be a godsend for handling affairs speedily. But, there often comes a time when older adults struggle to use their smart phones, computers and tablets, and caregivers need to step in. What should you do if someone you love starts having difficulty using a computer?

    Judy Graham reports for Kaiser Health News that millions of older adults (nearly three in four) depend on computers to pay their bills, access their bank statements, and connect with their families and friends. Blocking their use of a computer may disconnect them from things they care deeply about. More than four in ten (42 percent) of them own smartphones.

    We all know how easy it is to forget a password and not be able to access online accounts. It can be particularly difficult for older adults. Problems could be related to people’s vision, coordination or cognition. When struggling to use a computer stems from loss of mental function or dementia, it’s likely time for caregivers to act.

    Learn what’s confusing: Ask about what’s confusing on the computer and smart phone. And, if possible, sit down at the computer with the people you love to see what they can and cannot do.

    Share passwords: It’s wise to create shared passwords so that you too have access to the programs your loved ones use. If you want to check their accounts online, make sure you have power of attorney or, at the very least, their written agreement to do so. Otherwise, it’s a federal crime!

    Reduce confusion: One easy fix is to delete any apps that are confusing older adults. In fact, the fewer the apps, likely the better. Why should they struggle?

    Minimize scamming: Make sure that the older adults whom you care for know not to give anyone their Social Security, Medicare or credit card information. Scams abound. Scammers are pros at pretending to be a relative or a government agency staffer in order to obtain this information.

    Manage purchases: Get permission to unsubscribe your loved ones from marketing emails. If appropriate, ask to install a parental control app that can block use of online devices at certain times.

    Replace a credit card with a stored value care: A stored value card limits the amount of money that can be spent. Or, reduce the credit amount on the credit card.

    Notify credit bureaus not to open new accounts in the name of your loved ones.

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  • Eat more plants . . . reduce your risk of Alzheimer’s

    Eat more plants . . . reduce your risk of Alzheimer’s

    Two studies in the past few years provide the best evidence to date that a largely plant-based diet, with moderate amounts of fish and dairy—a Mediterranean diet—can help keep one’s brain healthy and reduce risk of Alzheimer’s.

    Researchers who studied the MIND diet, a kind of Mediterranean diet, which calls for eating more berries and leafy green vegetables, found that even following the diet moderately reduced participants’ risk of developing Alzheimer’s disease by 35% over the four and a half years. In short, they found that you do not need to eat bushels of kale or spinach. Two servings of vegetables daily, two servings of berries each week, and one meal of fish each week seemed to be enough. At the same time, you do need to eat less unhealthy food, such as butter and fast food. Those who followed the diet more rigorously reduced their risk of developing Alzheimer’s by 53%.

    In the MIND study, researchers observed people’s dietary intake over time. This type of study can’t say anything about cause and effect, which can only be learned by dividing people into groups and randomizing some to follow the diet and some not (a control condition). Researchers in Spain completed just such a study.

    The Spanish researchers showed that those randomized to follow a Mediterranean diet, which they combined with either extra olive oil or nuts, showed improved measures of memory and other brain functions. The participants were tested after a median of four years on the diet. Although they had no memory or other cognitive problems to begin with, they did have risk factors for heart disease, such as smoking, diabetes and obesity.

    The food included in a Mediterranean diet is rich in antioxidants and anti-inflammatory compounds, which many studies have shown are good for heart health, and decreasing risk factors like high blood pressure and diabetes. Since these are also risk factors for Alzheimer’s disease and other dementias, this is one reason why eating lots of foods high in anti-oxidants and anti-inflammatory compounds helps preserve brain function. Berries, dark, leafy green vegetables, and nuts are especially high in antioxidants and anti-inflammatory action.

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    This post was originally published on June 10, 2015.

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  • Can eating more mushrooms prevent cognitive decline?

    Can eating more mushrooms prevent cognitive decline?

    There are hundreds of studies on the benefits of different foods and vitamins for your heart, your brain, your muscles and more. More often than not, these studies recommend eating more green leafy vegetables and nuts. The latest study, out of the National University of Singapore (NUS), finds that eating more mushrooms may prevent cognitive decline in older adults.

    Did you even know that mushrooms could have special health benefits? According to this new study, older adults who eat a half plate (300g) of mushrooms each week could reduce their risk of mild cognitive impairment–memory loss or forgetfulness or attention deficits–by half. The senior research fellow on the NUS study suggests this benefit may stem from the compound ergothioneine (ET), which is found in most mushrooms.

    ET (ergothioneine) is an antioxidant and anti-inflammatory. People cannot synthesize ET on their own. But, you can find ET in a variety of mushrooms, including golden, oyster, shiitake, white button mushrooms, dried and canned mushrooms. Keep in mind that there is no evidence that taking supplements containing ergothioneine is beneficial; it is not the same as eating mushrooms, and supplements have risks.

    Moreover, there is not enough evidence to say definitively that eating mushrooms forestalls cognitive decline. Still, there’s no harm in eating more mushrooms. If you don’t like mushrooms, there are other evidence-based ways to forestall cognitive decline.

    Keeping mentally and physically healthy may prevent cognitive decline and dementia, according to other research. Managing high blood pressure, having a social network , exercising, keeping a healthy weight, managing hearing loss, not smoking and drinking only small amounts of alcohol all may help.

    The NUS study was conducted between 2011 to 2017.

    Here’s more from Just Care:

  • Lifestyle changes could help reduce risk of memory loss as we age

    Lifestyle changes could help reduce risk of memory loss as we age

    Some estimates suggest that as many as one in five people over 65 have mild cognitive impairments. When these impairments are caused by medication side effects or depression, they can be reversed with treatment, Dementia cannot be reversed, but certain behaviors might forestall its onset. A recent Mayo Clinic study finds that lifestyle changes could help reduce the risk of memory loss as we age.  In addition to eating a healthy diet and exercising, participating in artistic activities could really help keep our minds from slipping.

    Researchers at the Mayo Clinic found that people who engage in artistic activities in middle and older age had a 73 percent lower risk of developing a mild cognitive impairment. People who engaged in crafts had a 45 percent lower risk. People who socialized had a 55 percent lower risk. And, believe it or not, people who used a computer had a 53 percent lower risk.

    By contrast, researchers found that having high blood pressure or suffering from depression in middle age increased the risk of developing a mild cognitive impairment.

    The researchers studied 256 people with an average age of 87, who had neither memory or thinking problems when the study began. People over 85 represent the fastest growing age group in the United States. The full study is available online in the journal Neurology.

    Here are more ways to reduce risk of memory loss and improve your health:

    Visit www.eldercare.gov to find the area agency on aging (AAA) in the community. AAA’s can provide information on free and low-cost activity programs for adults 60 and older.

  • Vitamin B12 supplements

    Vitamin B12 supplements

    Is there any evidence that vitamin supplements benefit a healthy person? You’ve heard me ask this question before, about vitamin E supplements , about vitamin B6 supplements, and about vitamin C supplements. The answer is no. And, the answer is no for vitamin B12 supplements as well.

    Forget the advertisements. There is no rationale for otherwise healthy people to take a vitamin B12 supplement to improve their cognitive function or for any other reason.

    Not only should you stop before buying vitamin supplements–watch John Oliver for a funny explanation here, but there is also concern that supplements you buy at the drug store or vitamin superstore are not what you think they are. Because the FDA does not regulate these supplements, they may not be safe or as described on their label, either as pure or as strong.

    This all said, you should talk to your doctor if you are feeling weak or tired, or have sensory problems, including tingling in your feet or hands or you are experiencing memory problems. Some people cannot absorb B12 from food or are not receiving enough in their food because of dietary choices (e.g, vegetarians) and may benefit from an oral B12 prescription or an injection after laboratory testing demonstrates a B12 deficiency. It could prevent further decline or even reverse these conditions.  And, if you are a vegan you should talk to your doctor about taking a B12 supplement because the way to get B12  is through eating clams, salmon, trout, liver, beef, cereal and eggs and drinking milk, most of which  is lacking in a vegan’s diet.

    Keep in mind though that you should not decide on your own to take a B12 supplement no matter what symptoms you have. Vitamin B12 supplements should be used cautiously if you have any of a number of health conditions or if you are allergic to cobalt. So, do not go out and buy a vitamin B12 supplement without first talking to your doctor.

  • How does age affect your cognitive abilities?

    How does age affect your cognitive abilities?

    A recent study published in Psychological Science, by Laura Germine and Joshua Harshorne, looks at the age at which different types of cognitive abilities peak across a person’s lifespan. There’s no single answer. Not surprisingly, older adults are better at tests that involve experience and practice than younger adults.

    In brief, the researchers find a lot of age variability depending upon the particular cognitive ability.  Some of these abilities peak and may even begin to decline in high school; others don’t peak until early adulthood; and, still others don’t peak until people’s 40s or later.  According to the authors, “not only is there no age at which humans are performing at peak on all cognitive tasks, there may not be an age at which humans perform at peak on most cognitive tasks.”

    Older adults tend to be better at math, vocabulary, and comprehension. They are also better at judging people’s emotions by looking in their eyes. Younger people do better on memory tests.

    There are many ways to keep your mental skills strong: Click here to find out what to eat to reduce your risk of dementia. Click here to learn about how lifestyle changes affect cognition. Click here to learn how walkable communities are good for your memory. And, click here to read about a Social Security-based policy solution for improving mental functioning in older adults.

  • New data reveals that higher Social Security income helps the memory and mental functioning of older adults

    New data reveals that higher Social Security income helps the memory and mental functioning of older adults

    As the population ages, it’s important that our policies help to prevent, reduce or delay cognitive impairments. We want to be sure that for as long as possible people can carry out daily activities. And, we want to avoid the financial and emotional costs that come with dementia. New research by Padmaja Ayyagari and David Friswold suggests that higher Social Security income helps the memory, knowledge, language and overall cognition of older adults.

    Ayyagari and Friswold’s August 2015 National Bureau of Economic Research paper reveals the positive impact of Social Security income on cognitive function for older adults. It looks at whether the 1977 reduction in Social Security income for those born after 1917 led to a reduction in cognition.

    Specifically the research shows that a $1,000 increase in Social Security annual income improves working memory 2.2%, knowledge, language and orientation 1.1%, and overall cognition 1.4%. It also shows that a $1,000 increase in Social Security annual income reduces the chance of being diagnosed as demented by 1.9% and the change of being diagnosed as cognitively impaired by 1%.

    The authors suggest that the cost of increasing Social Security benefits could be offset by lower Medicare and Medicaid costs; higher Social Security benefits would mean fewer people needing costly treatment for cognitive impairments.

    Prior research has shown that higher income can mean less financial stress and better access to care, both of which are associated with better cognition. Stress has been shown to reduce cognition for older adults. There is also a strong link between depression and reduced cognition. Stress and depression cause higher levels of corticosteroids that can affect memory.

    Watch Robert Reich explain that we can afford to increase Social Security benefits and there are more reasons to do so.  A look at the international data on retirement income shows that Social Security benefits in the United States are stingy for a wealthy country. And, unless something changes in the next couple of months, Social Security benefits will not increase in 2016, a rare occurrence, at great cost to millions of older adults and people with disabilities.