Being a dementia caregiver for a loved one does not have that same appeal. And yet there are similarites in the call to serve. It is with love, determination, courage, and a sense of duty that many people become dementia caregivers. The experience is profoundly life changing.

Dementia, be it Alzheimer’s, Lewy body disease, vascular dementia, or a consequence of Parkinson’s disease, is one of the most feared conditions. Its trajectory is filled with many unknowns, and there’s no escaping the progressive decline. While each person’s journey is unique, there are plenty of similarities and even opportunities to deepen relationships and understandings of what it means to care for a loved one under such extremely difficult conditions. The key is knowing you are not alone. Other people have been there, are there, and are willing to support you and your loved one on this journey.

The UCLA ADC Program

The UCLA Alzheimer’s and Dementia Care (ADC) program is designed to help people with dementia and their families with the complex medical, behavioral, and social needs associated with Alzheimer’s disease and other types of dementia. For example, Paula, a caregiver in the ADC program who took care of her husband Sam, described her caregiver journey this way: “Sometimes we don’t have a choice on whether we want to take on this caregiving role. I would advise you to develop a sense of patience. Looking back, there were times when I could have been more patient because I was looking for the old Sam. Try your best to look for the person you know and remember the person you love. That person is still in there. Slow down and take it easy. Live in the moment. Get help and support. Reach out.”

UCLA gerontological nurse practitioner Michelle Panlilio, DNP, GNP-BC, also knows these challenges well. Her interest in dementia care stems from her own experience caregiving for her grandmother. Dr. Panlilio has been an integral part of the UCLA ADC program for over a decade, working with countless patients and caregivers. As the National Lead Dementia Care Specialist, she disseminates the ADC program to health-care systems nationwide. Dr. Panlilio believes that there are three key components that are vital to caregivers: educating yourself about the disease process and prognosis, attending support groups or receiving one-on-counseling, and practicing self-care. “The number one thing I recommend is to reach out for help,” she advises. “Even if you are not in the UCLA program, there are people out there to help you.”

Good Days and Bad Days

Just like the disease trajectory can be a winding road with good days and bad days, so too is the caregiver journey. Feeling overwhelmed is part of the process. So is heartbreak, confusion, and a sense of helplessness. Dr. Panlilio compares dementia caregiving to a marathon. To be there for the long haul, you must pace yourself and know there will be plenty of obstacles on the path, including caregiver guilt, anger, and depression.

“Anyone reading this article may find themselves having to take care of someone with dementia, be it a parent, a spouse, or even a child with early-onset dementia, which is a diagnosis received under the age of 65,” explains Dr. Panlilio. “Families often have a hard time figuring out how to provide the best care for their loved one with dementia. As a result, it is very common for caregivers to experience stress, strain, and depression.”

Recognizing Depression

Depression symptoms in caregivers are both similar and different compared with general depression. Sadness, for example, is common to both, but caregivers have the added responsibility of having to take care of a loved with a progressive disease.

“Family caregivers often tell us they are withdrawing from friends and activities because of the responsibilities involved,” Dr. Panlilio says. “Being a caregiver for someone with dementia can be an isolating experience. Caregivers often report emotional and physical exhaustion, sleeplessness, poor concentration, and difficulty coping.”

UCLA ADC participant Kevin joined the program to provide better care for his mother. He shares this:

“There isn’t an “easy” way to get through this. Seek out all the resources because many of them are free. It’s easy to put our own needs aside when we are busy taking care of our loved one, but you need to take care of yourself to take care of the person with dementia. Attend support groups to learn how to become a caregiver for the long term. Having that information empowered me to make better decisions for myself and my mom.”

How Support Groups Help

Support groups offer a community of encouragement and solace. “Group meetings are an excellent way to learn about the disease and how other people cope as their loved one progresses through the different stages of the disease,” Dr. Panlilio says.

Dementia caregiver support groups can be found through local chapters of the Alzheimer’s Association (alz.org), area medical centers, and senior centers. Attending in person is quite valuable, but there also are virtual online meetings.

However you choose to attend, support groups offer the opportunity to commiserate, vent, share, discover new ways to cope, and even laugh. It’s a place to learn how other caregivers deal with such situations like repetitive questions, reluctance to shower, and why power of attorney and health-care proxy are essential legal documents to secure.

If you’re not ready to participate in a group, seek out one-on-one counseling. Your loved one’s physician may have some recommendations. The ­Alzheimer’s Association has a 24/7 helpline (800.272.3900) staffed with knowledgeable people that can help you anytime day or night. They can also help you find a support group near you.

Learn All You Can

© Halfpoint Images | Getty Images
Taking time out for fun with friends can help you relax and better care for your loved one.

UCLA recently launched a monthly webinar series called Better Caregiving for All (https://www.adcprogram.org/better-caregiving-for-all). Accessible nationwide via Zoom, it delivers live and recorded content for on-demand viewing. The material covered each month addresses the needs of people who have not been the focus of traditional caregiver education (for example male caregivers, long-distance caregivers, and early- onset dementia caregivers). Each session includes a local content expert and caregivers who share their knowledge and experience.

Learning all you can about the trajectory of the disease can help you prepare in many ways, including emotionally and strategically. For example, no one wants to go to a memory care home, but it’s impossible to promise someone that this won’t happen. How can you know when this is truly necessary? How can you choose the best one? What resources might be available to help you keep your loved one at home for a bit longer? What can you do if your loved one becomes aggressive, sexually inappropriate, or refuses to take medications? The caregiver education page on the UCLA website (https://tinyurl.com/UCLACaregiverEd) has a wealth of resources available to answer those concerns and many more.

The short caregiver videos (located on that same website above) cover subjects in role-play scenarios. They portray real-world experiences and offer strategies for dealing with common behaviors, explaining why they may be happening and what can be done to minimize them. For example, if you are irritable and rush someone, the person with dementia can pick up on your emotional energy and react with agitation or even violence. How you respond to challenging situations influences your loved one. Not that you should expect yourself to be perfect, but these videos provide options that can help guide you.

The UCLA webinar lecture series presented provides information about disease diagnosis and other subjects like addiction, managing late-stage disease, and in-home and residential placement.

Practicing Self-Care

It can seem like an indulgence to take that yoga class, go for a long walk, or meet friends for a movie, but it’s not an indulgence: It’s a necessity. “Caring for a person with dementia is intense, and caregiver burnout is real,” says Dr. Panlilio. “What many caregivers don’t understand is depth of responsibilities. Caregivers need to be healthy and well so they can take good care of their loved one.”

When you have so many responsibilities, it may seem impossible to eat healthfully, rest adequately, and stay connected to friends. Remember, this is not a sprint, it’s a long-term journey. Be patient with yourself and just make a plan, talk to friend, or go read something at a café. Small actions can help rejuvenate you.

Of course there will be times of extreme stress, grieving, and anger. Think of self-care as a strategy that helps bolster your physical energy and mental clarity to meet the demands of dementia caregiving more effectively. It can help you to provide support over the long haul without overly compromising your own health and well-being.

The post Minimizing Dementia Caregiver Burnout appeared first on University Health News.

What if you could reduce the mileage, or rather, the wear and tear, on your brain and keep it finely tuned along the way?

While you can’t slow the passage of time, you can take steps that may help keep your brain operating smoothly and reduce the risk of accelerated aging. Study findings, published recently in Nature Communications, outlined 15 categories that can affect parts of the brain that are especially vulnerable to accelerated aging and dementia. They include:

• Blood pressure

• Cholesterol

• Diabetes

• Weight

• Alcohol use

• Smoking

• Depressive mood

• Inflammation

• Pollution exposure

• Hearing

• Sleep

• Socialization

• Diet

• Physical activity

• Education

Of those 15 categories, the researchers noted that diabetes, traffic-related air pollution, and alcohol could be par­ticularly detrimental to regions of the brain that tend to degenerate earlier in aging. Daniel Saldana, PhD, a clin­ical neuropsychologist with Massa­chusetts General Hospital, says that while those elements are well-estab­lished threats to brain health, and not especially surprising findings, it’s still important to acknowledge them as serious risk factors that you should try to manage as best as possible.

“There is a lot of literature on how these factors affect the brain and are harmful for the aging process,” Dr. Saldana says. “For instance, certain types of alcohol over long periods of time and/or binge drinking can speed up the aging process. There are also studies depicting how individu­als with Alcohol Use Disorder (AUD) can present with brain volume reduc­tion across diverse brain regions, with effects being more pronounced in adults over the age of 65.”

He adds that recent research has implicated type 2 diabetes as a major risk factor for accelerated brain aging, as it appears to increase atro­phy of the brain’s gray matter.

Other studies recently suggest that air pollution exposure may con­tribute to the buildup of toxins in the brain.

Risk Factor Management

Rather than focus on managing a few risk factors, the researchers emphasized that improvements in every area should be the goal, noting that there are interrelationships throughout the list of 15 categories. Maintaining a healthy weight, for example, may help improve sleep and blood pressure. Addressing hearing loss may help make social­ization easier and improve some depression symptoms.

Dr. Saldana also notes that various studies may implicate some risk fac­tors as being more important than other characteristics or behaviors when it comes to the risks they pose to brain health. “One study might indicate that hypertension is more deleterious than diabetes or that smoking has the most deleterious effects on aging, while other studies may indicate differently,” Dr. Saldana explains. “I think the takeaway point is that it is pretty widely agreed upon that, to varying degrees, all of these are risk factors that are modifiable. Furthermore, several studies would likely suggest that comorbid condi­tions, such as hypertension and dia­betes, are worse than having either of the conditions alone. As a neuropsy­chologist, I may often get patients with several comorbid cerebrovascular and metabolic risk factors, and I have to consider how the combined effects of these deleterious conditions are impacting the normal aging process.”

“Last In, First Out”

While your entire brain is vulnerable to problems with circulation, sleep, or cer­tain other factors, the researchers responsible for the Nature Communica­tions study noted that one region of the brain may face heightened risk of accel­erated aging. The prefrontal cortex (PFC) is one of the last parts of the brain to fully mature, reaching its full development in your 20s. The PFC, sometimes referred to as the “personal­ity center” of the brain, is responsible for personality expression and several higher-order functions, such as plan­ning, organization, and decision-mak­ing. It also influences certain types of behavior, such as how you respond to stress and other stimuli.

This region is also among the first to experience the negative effects of aging and neurocognitive conditions, such as Alzheimer’s disease. The later development and early deterioration are why the PFC cortex is considered part of the ‘last in, first out (LIFO)’ network.

But it isn’t just alcohol use, high blood pressure, and other controllable factors that can speed up aging in the LIFO network. The researchers also identified variations in the genome—your complete set of genes and genetic material—that affect the LIFO net­work and play a role in cardiovascular deaths, Alzheimer’s disease, and Parkinson’s disease, among other con­ditions. The genetic variations also affect two antigens of a little-known blood group called the XG antigen system. These genetic discoveries were new and unexpected findings, the researchers said.

“One of their interesting or novel findings is that they opened up new possibilities for research into the role of these genetic factors and the possi­bility of their relationship in the aging process,” Dr. Saldana said of the research team.

Making Changes

“What is good for the body is typi­cally good for the brain,” Dr. Saldana says. “Therefore, good nutrition, exercise, remaining cognitively active, and socialization are also posi­tive and protective factors in the aging process. Even engagement in leisurely activities such as gardening, painting, playing music, etc., can be neuroprotective.”

If you want to be more proactive about brain health, have a frank con­versation with your doctor(s) about lifestyle changes, medications, and other treatments that will help you manage your risk factors.

“Maintain a healthy and balanced diet, as approved by your physician and perhaps even as advised by a nutritionist. This, together with exer­cise, can improve vascular health and stave off comorbid disease processes such as high cholesterol, diabetes, and high blood pressure.”

Dr. Saldana adds that it is never too late to start making positive changes for your cognitive and phys­ical health.

“Importantly, when we talk about modifiable risk factors, the key word is ‘modifiable,’” he says. “These are risk factors that are hypothesized to be minimizable through the inclu­sion of activities and practices that are neuroprotective and promote healthy aging.”

The post Learn to Manage the Many Risk Factors That Lead to Accelerated Brain Aging appeared first on University Health News.

Using hearing aids significantly increased the likelihood of a longer life for adults with hearing loss—but only if the hearing aids were used regularly, according to a study. For 10 years, researchers tracked the status of nearly 1,900 adults who had been shown to have hearing loss and who had completed questionnaires about their hearing aid use. The patients who used hearing aids regularly (at least once a week or at least five hours a week) were 25 percent less likely to die during the study period compared with those who never used hearing aids. Previous research has shown that untreated hearing loss can result in social isolation, increased risk of falling, and a reduced life span. The researchers noted that people who regularly use hearing aids may be more socially active and less isolated, and that they fall less, and these factors might explain the increased longevity.

Some Women with Early-Stage Breast Cancer May Safely Skip Radiation

Postmenopausal women in their 50s and 60s who have been diagnosed with early stage HR+ breast cancer and skip radiation treatment after breast-conserving surgery have a very low risk of disease recurrence within five years, according to an Emory University study.

Earlier studies have suggested that women who are 65 and older might do just as well if they skip radiation treatments. Now, this study found the same might hold true for even younger postmenopausal women. The research team first gave sensitive genetic tests to each patient, to gauge their tumor’s likelihood of recurrence after lumpectomy. If tests revealed a low risk of recurrence, the patient was given the option to skip radiation therapy and instead continue taking five years of hormonal treatments. Of the 186 patients who could be fully evaluated, all were still alive five years after their lumpectomy, and 99 percent were found to be free of breast cancer at that time.

Regular Sleep Schedules Are Critical to Good Mental Health

Older women who stick to a set sleep and wake schedule are more likely to avoid feelings of depression and anxiety, according to a University of Michigan study. For the study, researchers analyzed sleep patterns and assessed the psychological health of close to 1,200 postmenopausal women. The study showed that women with a sleep midpoint (the halfway point in time between falling asleep and waking up) that fell outside 2 a.m. and 4 a.m. were 72 percent more likely to report significant depression symptoms. Each hour of sleep schedule irregularity increased a woman’s chances of experiencing significant depressive symptoms by 68 percent and significant anxiety symptoms by 62 percent. Previous studies regarding sleep irregularity have found that not sticking to a regular bedtime and wake-up schedule and getting different amounts of sleep each night can put a person at higher risk for obesity, high cholesterol, hypertension, and diabetes.

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It’s normal to have a lot of questions, just as you might about any other health concern or treatment plan, says David Mischoulon, MD, PhD, director of the Depression Clinical and Research Program at Massachusetts General Hospital. And it’s just as important that you share any concerns or questions you have with your therapist, particularly if you are new to therapy.

But before you even schedule that first appointment, Dr. Mischoulon suggests taking a moment to ask yourself one very important question: Why do you feel the need for a psychotherapeutic approach, as opposed to other treatments, such as medication management? “Psychotherapy, like all forms of treatment, must have a measurable goal, and it is therefore important to determine what type of approach might be best for you, depending on what you want to accomplish/obtain,” he says.

Consider the following as a partial list of questions to ask as you consider therapy and begin treatment:

“What Type of Therapy Is Best?”

Dr. Mischoulon explains that there are many different types of psychotherapies available. “For example, the traditional psychoanalytic therapy that is usually depicted in the media focuses on dealing with deep-rooted issues that may go all the way back to childhood, and which may be impacting your ability to have a rewarding and successful life where you are now,” he says. “This type of treatment can often take a long time—on the order of years—to produce tangible results. Cognitive behavioral therapies (CBT) are designed to be more of a short-term intervention, typically eight to 12 weeks of weekly sessions, and tend to focus on specific target symptoms and behaviors that the therapist will seek to help you modify.”

Dr. Mischoulon adds that, with CBT, most individuals need longer than the recommended periods of treatment, because the skills that one learns in CBT often erode if they are not reinforced by the structure of the therapy setting.

One advantage of CBT is that insurance carriers are more likely to cover its cost compared with psychoanalytic therapies. “Certain types of personality disorders can be treated with dialectical behavior therapy (DBT), which focuses primarily on control of one’s emotions,” Dr. Mischoulon says. “These are just a few examples of available psychotherapies. I recommend that people do some research online to read about the different kinds of therapies, discuss them with their current treaters, and then decide what type of therapy they would like to try.”

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“How Do I Find the Right Therapist?”

Once you determine the type of therapy you’d like to pursue, you can focus on finding a therapist with that particular orientation or expertise. “Ideally, when selecting a therapist, it is best to go with the recommendation of another professional rather than selecting one at random or asking a friend for their therapist’s number,” Dr. Mischoulon advises. “A therapist that did good work for a friend of yours may not necessarily be the best choice for you, since your friend’s problems and issues may be very different from yours. Some individuals may choose to meet with more than one potential therapist, in order to determine which therapist is most optimal for their individual needs. Therapists are usually okay with this, and in fact may begin by having two or three introductory sessions, after which you and the therapist will decide if the ‘fit’ is good and whether embarking on a full course of therapy is appropriate.”

Don’t feel self-conscious about talking with more than one professional before you begin therapy. Just as it’s important to get a second opinion about a medical diagnosis or treatment, finding the right match for depression therapy (or therapy for any reason) can make all the difference.

“Will I Need Medication?”

Dr. Mischoulon notes that some people can be treated successfully with medication alone or with psychotherapy alone or with a combination of the two treatments.

“This is an important conversa­tion to have with your prospective treater,” he says. “The work of psy­chotherapy requires a certain amount of engagement and emotional energy, which can be hard to generate when you are, say, in an episode of deep depression. In some cases, a trial of  an antidepressant can help to lift you out of the deep depression and bring you to a place where you can more readily do the work of psychother­apy. While we now conceptualize psychiatric illnesses as primarily bio­logical in origin, we also know that situational factors can contribute to symptoms and interact with our bio­logical predisposition. In many cases, a combined approach of medication plus psychotherapy can be the opti­mal way to treat psychiatric conditions.”

“When Will I Start Feeling Better?”

When you are in therapy, it is not unusual to question from time to time whether you are making progress.

“It’s important that you and the therapist agree on the goal or goals to be accomplished and review them periodically to assess for progress,” Dr. Mischoulon says. “When this is not done, some therapies can go on for long periods of time without a sense on the part of either the thera­pist or the patient as to whether the treatment is succeeding or not. Keep in mind that outcomes such as ‘feel­ing better’ are not necessarily the optimal way of framing your goals of therapy.  Ideally you want an out­come that is tangible and measur­able, and that you can attain over time.”

He explains that you need to understand for yourself what ‘feeling better’ means to you, and what it would look like in real-world terms. Arriving at this vision can take time.

“In any case, communication between the patient and the therapist is key to making sure that the therapy is proceeding as desired and not becoming bogged down or derailed,” Dr. Mischoulon says.

The post 4 Key Questions to Ask When You’re Starting Therapy for Symptoms of Depression appeared first on University Health News.

Women who get a false-positive mammogram result have a higher chance of getting breast cancer later on, according to a study. The risk of a subsequent breast cancer diagnosis is highest for women between ages 60 and 75, in the four to six years immediately following the incorrect result. A false-positive mammogram result occurs when the test suggests the presence of cancer when there is no cancer. This can be caused by various factors, such as benign (noncancerous) lumps, calcifications, or other conditions that may appear suspicious on a mammogram. False-positive results can lead to additional tests, such as biopsies or imaging studies. The study looked at data from over 45,000 women who initially got a false-positive result, as well as over 450,000 women whose results were negative. The researchers say their findings reinforce the need for consistent, long-term follow-up in women who have had false-positive mammogram results.

Positive Personality Traits May Reduce Dementia Risk

People with positive personality characteristics were less likely to be diagnosed with dementia than those who had negative personality characteristics, according to a review of data on 44,000 people from eight separate studies. Researchers evaluated information about positive characteristics such as how conscientious, extroverted, and open to new experiences people were, as well as negative characteristics such as how anxious, fearful, and irritable people were. High scores on negative traits and low scores on positive traits were associated with a higher risk of dementia diagnosis. They compared those results to symptoms of dementia from cognitive tests and brain pathology (from autopsies) and found no physical distinctions in the brains to indicate why a positive frame of mind was associated with a lower risk of dementia. They suspect that positive personality traits could make people more able to cope with and work around cognitive impairments.

Stress Levels Are Worse in Women Who Have Blockage-Related Heart Attack

Stress and depression were common among women at the time of heart attack and for two months after, according to a study of close to 500 female patients who completed questionnaires measuring their stress and depression symptoms, at the time of their heart attack and again two months later. The study also showed that women who had heart attacks due to coronary artery blockages had higher stress levels than those who had heart attack without a blockage. Little is known about what causes heart attack in patients who do not have an arterial blockage, and this study suggests that reducing stress may be a preventive strategy. The findings highlight the need for heart disease patients to be screened for mental health issues including stress, anxiety, and depression.

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Some of the key benefits of exercise for older adults include bone loss prevention, osteoarthritis pain relief, and prevention of chronic disease, such as diabetes and obesity. Exercise can even help reduce cognitive decline. One study found that participants over the age of 60 showed fewer Alzheimer’s disease biomarkers when they performed 30 minutes of exercise every day. If all of that isn’t enough, consider that exercise eases anxiety and depression symptoms, and can create an overall sense of well-being.

Find an Activity You Enjoy

To reap the many physical and mental benefits of exercise, it must be done on a consistent basis—hence the importance of finding something you enjoy. You may need to try new things before something resonates. “Breaking out of your comfort zone is fine, but you may need to make modifications for your particular medical conditions or physical limitations, so it’s important to speak to your doctor about participating in new activities,” says Jaclyn H. Bonder, MD, Medical Director, Women’s Health Rehabilitation, Weill Cornell Medicine. “For instance, if you want to work on your balance, there are medical conditions that influence whether you should choose strengthening with weights, Pilates or tai chi, and your doctor can provide guidance on that.”

Fun Exercise Options

Ideally, exercise routines for older adults should incorporate a blend of aerobic exercise, strength/resistance training, and stretching/flexibility exercises. “These elements work together synergistically to improve your overall health in many ways, including enhancing your cardiovascular health, preventing falls, supporting your joints, and decreasing pain,” says Dr. Bonder.

Sometimes exercise is more enjoyable with a friend. If you lack a fitness partner, a community-based program, such as an exercise class at your local senior center or YMCA, can provide the social connection and motivation you need to stick with it. Exercising in a group setting also provides an added layer of safety for people with mobility limitations who can benefit from supervision during activity.

Activities to Consider

Below are some options that can help you improve your mobility, build strength, enhance your balance and coordination, and expand your social circle.

Pickleball: Pickleball is worth considering if you are looking for a new sport to get and keep your attention. The pickleball court is much smaller than a tennis court, which means it is easier to keep the ball in play. Pickleball can give you a good aerobic workout without as much stress and strain on joints and muscles as other racquet sports.

Yoga: Yoga is a low-impact activity that helps build up your muscles, improve your flexibility, and strengthen your bones without straining your joints. Look for an introductory yoga class to help you master basic poses. Some yoga programs are specially designed for older adults and include seated and standing options.

Pilates: Like yoga, Pilates offers an effective workout while being gentle on joints. It focuses on building a strong core to improve balance and stability and has been shown to reduce the symptoms of arthritis, multiple sclerosis, and Parkinson’s disease. Many of the exercises are performed in sitting or reclining positions.

Benefits of Staying Active

Another benefit to finding your fitness passion is that it can enhance your social life. Engaging in an exercise you love allows you to connect with like-minded individuals who share similar interests. Whether it’s joining a bowling league or attending group fitness classes, you’ll have the opportunity to meet people and build relationships.

There are countless benefits to staying fit, but it may take time to find activities that spark joy. You may have to break out of your comfort zone and try new things. Remember that the goal is to find an exercise or sport that you enjoy so you will be eager to regularly participate.

The post Find An Exercise You Love to Ensure Routine Participation appeared first on University Health News.

Uma Naidoo, MD, director of Nutritional and Lifestyle Psychiatry at Massachusetts General Hospital, suggests five nutrients that should be part of your regular diet in order to support your cognitive well-being.

Folate. Folate, also known as vita­min B9, is used for cell development throughout your body. “Deficiency may interfere with DNA synthesis and repair and overall cellular function in the brain, possibly leading to chronic fatigue, depression, and psychosis,” Dr.Naidoo explains.

You can find folate in:

• Leafy greens

• Legumes

• Asparagus

• Green peas

• Organ meats

• Brussels sprouts

Omega-3 fatty acids.  Omega 3 fatty acids are one of the essential fatty acids that you need to obtain through food because your body does not produce any, and they are crucial for cardio­vascular and cerebrovascular health. “Lack of omega-3s in your diet has detrimental effects on cognitive func­tion,” Dr. Naidoo says.  “Scientific studies demonstrate that dementia patients often have low omega-3 levels

may help protect the healthy brain and delay cognitive decline in mild cases.”

Low omega-3 levels have also been associated with chronic inflammation,

potentially contributing to depression symptoms, Dr. Naidoo adds.

You can find omega-3s in:

• Chia and flax seeds

• Algae

• Sardines

• Wild sockeye salmon

• Mackerel

• Herring

• Oysters

• Walnuts

• Soybeans

• Avocados

• Extra-virgin olive oil

Vitamin D

Vitamin D is a fat-soluble vita­min known for its role in calcium absorption, as well as bone growth,

mineralization, and remodeling. But in the brain, vitamin D acts as a neuro­steroid and plays a role in protecting against depression and anxiety disorders. “Studies demonstrated that vitamin D decreases inflammation and toxic destruction of cells, and controls the release of nerve growth factor, which is essential for hippocampal and cortical neuron function. Deficiency in vitamin D plays a crucial role in regulating stress response.”

About 80% of our vitamin D comes from direct sunlight expo­sure. But you can find vitamin D in:

• Egg yolks

• Herring

• Mushrooms

• Oysters

• Salmon

• Sardines

• Shrimp

• Fortified nut milks

• Canned tuna fish

Vitamin C. Vitamin C (L-ascorbic acid) is essential for properbrain functioning, as it’s vital for the biosynthesis of certain neurotransmitters and is a crucial antioxidant in the brain. “Vitamin C deficiency has been associated with fatigue, mood disturbance, anxiety, lack of focus and memory, sleep disturbance, and inattentiveness,” Dr. Naidoo says.

You can find vitamin C in:

• Cherries

• Broccoli

• Brussels sprouts

• Chili peppers

• Kale

• Kiwifruit

• Lemons

• Oranges

• Papaya

• Strawberries

• Sweet yellow peppers

Zinc. Zinc is an essential mineral that is involved in numerous aspects of cellular metabolism. “It is necessary for the activity of over 300 enzymes that aid in metab­olism, digestion, nerve function and systems in the body,” Dr. Naidoo says. “Several studies suggest an association between low levels of zinc and risk of depression.”

You can find zinc in:

• Shellfish

• Beans

• Meat

• Nuts

• Poultry

• Fish

• Whole grains

• Eggs

• Grass-milk dairy products

2 Things Your Brain Can Do Without

Knowing what your brain needs for optimal functioning throughout your life is important, but it’s just as critical to know what not to feed your brain… or at least not very much.

Added Sugars

“To start making healthy alterations earlier in life is to our great benefit,” Dr. Naidoo says.

“Research shows that long-term overconsumption of sugar in our youth may potentiate neurocognitive deficits well into adulthood, while diets rich in simple sugars, particu­larly during development, are associ­ated with increased inflammation, memory impairments, and less plas­ticity of the hippocampus (the part of the brain controlling memory).” Hidden sources of added sugars include sodas, “low-fat” snack foods, canned soups, store-bought salad dressing, ketchup, and pasta sauces.

Ultra-processed Foods

A diet high in ultra-pro­cessed foods puts you at risk of having shorter telomeres—the “cap” on our DNA that, when longer, promotes healthy cellular aging. “Shortening our telomeres may mean that we are at risk of degenerative disease earlier in life,” Dr. Naidoo says. “From fast food to portable snacks and white flours/ sugars, processed foods are ubiqui­tous in today’s world. In particular, processed meats and cheeses may be particularly deleterious, as their metabolites have been shown to increase the risk of dementia.”

Alcohol is also considered a pro­cessed food (and a toxin), so be sure to limit its consumption, too.

The post 5 Key Nutrients Your Memory Hungers For… and 2 Items to Avoid appeared first on University Health News.

While previous studies have established a link between long-term exposure to various types of air pollution and reduced brain health, recent research suggests that just five days of exposure to air pollutants may raise the risk of stroke. The study, published in Neurology, the medical journal of the American Academy of Neurology, examined exposure to pollutants such as nitrogen dioxide, ozone, carbon monoxide, and sulfur dioxide. Among the findings were that five days of exposure to carbon monoxide were associated with a 26 percent increase in stroke risk, while nitrogen dioxide exposure was associated with a 28 percent increased stroke risk. Researchers also explored the impacts of different sizes ofparticulate matter: PM1 (air pollutants less than 1 micron in diameter), PM2.5 (2.5 microns or less), and PM10 (10 microns or less). Exposure to PM2.5 pollutants (which include inhalable particles from motor vehicle exhaust and fuels burned by power plants and other industrial facilities) was associated with a 15 percent increase in stroke risk. While avoiding air pollution isn’t always possible, you should consider paying close attention to air quality alerts and wearing an N95 mask when outside in areas with high levels of air pollution.

Study Identifies Health Concerns Associated with Loneliness and Isolation

The terms “loneliness” and “isolation” are sometimes used interchangeably. While they are related, they mean different things. And, according to recent research, loneliness and isolation can have distinct impacts on your health. Research published in the journal Social Science and Medicine—Population Health sought to determine whether one was more dangerous than the other. After reviewing four years of health records of nearly 14,000 adults (ages 50 or older), researchers found that social isolation was a stronger predictor of early mortality and physical health problems. Loneliness, however, was more strongly associated with mental health concerns, such as sadness and feelings as if life no longer had meaning. Loneliness is the feeling of being alone, regardless of how much social contact you have. You can feel lonely when you’re by yourself or in a crowd. Conversely, you can be content by yourself for long periods of time and not miss the company of others. Social isolation is a more external sensation, referring to a lack of social interaction, whether in person or through other means, such as online or phone communication. If you are feeling lonely or socially isolated, regardless of your circumstances, reach out to your doctor, friends, or family to share your feelings and discuss ways to address them in a healthy and consistent way.

About 1 in 20 Adults Experience Chronic Pain and Anxiety or Depression

Chronic pain has long been recognized as a risk factor for depression and anxiety. There can be a considerable psychological burden accompanying a physical condition that affects an individual’s everyday functioning and quality of life. Research has shown that chronic pain and symptoms of anxiety and depression are biologically linked, but until recently the preva­lence of chronic pain co-occurring with depression or anxiety wasn’t well understood. Researchers set out to better understand how many people face these twin challenges and what impact this co-occurrence has on their lives. Their findings, published in the journal PAIN, suggest that about one in 20 U.S. adults experience chronic pain along with symptoms of anxiety or depression, and that this combination results in functional limitations in daily life. One finding noted that adults with chronic pain are about five times more likely to report anxiety or depression symptoms compared with those without chronic pain. The research also suggests that about half of adults with anxiety or depression also have chronic pain. Nearly three-quarters of the people with co-occurring chronic pain and anxiety or depression experience limitations at work, while about 55 percent report difficulty participating in social endeavors. The next phase of research may look at whether individuals being treated for chronic pain are also receiving mental health care, and assess whether the combination of treatments is easing symptoms.

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“Researchers are aiming for precision medicine,” says Jennifer L. Kruse, M.D., Health Sciences Associate Clinical Professor Director, UCLA Department of Psychiatry. “The idea is to identify individual characteristics ahead of time that can help determine which medication would be most beneficial for a particular patient.”

Right now, the saliva tests aren’t able to identify the ideal drug for an individual. What they can do is identify how a person metabolizes specific agents within medications.

Insights on Drug Metabolism

The tests are designed to look at individual genetic differences in the activity level of proteins responsible for metabolizing most antidepressant medications. Therefore, if the test reports that you are an “ultrarapid” metabolizer of certain medicines, you will break it down faster than normal, and thus you may need a higher dose to achieve a similar blood level and/or similar effect, compared with someone who breaks down the medicine at a normal rate. Conversely, a slow metabolizer may have higher blood levels of the same drug in their system for a longer time, compared with a normal metabolizer. Therefore, the slow metabolizer might have more side effects and may need a lower dose.

“If a patient tells me they are very sensitive to medication side effects, they might be a slow metabolizer of various medicines,” Dr. Kruse explains. “So rather than predicting which drug will work best for you, the test might help predict that you are more likely to have side effects from certain medications. It doesn’t mean you can’t take those medicines, but you might benefit from much smaller dosages than usual.”

Oversimplified Reporting

One popular company provides information about medications in broad categories labeled green, yellow, or red. This format makes it simple to understand for patients and for providers, but the oversimplification can be misleading. For example, the red category reflects significant gene-drug interaction, the yellow is moderate gene-drug interaction, and the green means no gene-drug interaction.

“For results that come back in the red category, the person may be a fast (“ultrarapid”) or a poor (slow) metabolizer, meaning they either quickly break down a medicine, or they break it down more slowly. For ultrarapid metabolizers, you would expect that they may need a much higher dose of the medication for effectiveness, and vice versa for slow metabolizers, who may respond to very low doses and who might have more side effects at usual doses,” Dr. Kruse explains.

But how a drug works is not solely based on how slowly or quickly we break down a medicine. Dr. Kruse describes a female patient who was incredibly sensitive to medication side effects and had tried many different antidepressant medicines, some with benefit for her depression symptoms, but with intolerable side effects. For that reason, Dr. Kruse used a pharmacogenomics test to see whether this would help guide care. She expected the results to show that the patient was a poor metabolizer of certain medicines, but she wasn’t. “Surprisingly, she was a fast metabolizer,” says Dr. Kruse. “The metabolism piece is just one small aspect of how and why these medications work. We have different genes and other individual factors that impact the receptors in our brains and the way the medicines act on our bodies and brains in terms of benefits and side effects.”

Limited Indications for Use

Though some medical providers have broadly adopted the testing, Dr. Kruse recommends judicious use. “I order it occasionally. For example, we know there is a genetic aspect that makes some people of Asian descent vulnerable to getting a severe rash if they use a particular medication (oxcarbazepine). If I want to use that medication on such a patient, then genetic testing for that purpose is warranted.”

Dr. Kruse stresses that these tests should not be used as the sole determining factor in medication selection. They are just one tool in a clinician’s arsenal. Clinical judgment, patient history, and symptoms remain paramount in antidepressant medication selection.

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