Virtual Brain Exercises

Brain exercises can be an excellent way to maintain and enhance cognitive function. For instance, the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study found that older adults who engaged in cognitive training activities showed improvements in memory, reasoning, and processing speed that lasted up to 10 years.

There are numerous online brain games and exercises, such as Lumosity and BrainHQ, that are designed to help keep the aging brain limber. They are user friendly and allow people to track their progress over time, which can be motivating and rewarding. Most offer free games and puzzles, with an option to upgrade to additional activities for a fee.

Real-Life Brain Exercises

Challenging fine motor skills through hobbies like knitting or assembling jigsaw puzzles can keep the brain active. These pursuits also require hand-eye coordination, which strengthens neural connections. “These activities can improve concentration, which can be associated with improved memory. The better someone can attend to a task and acquire information, the more likely they will remember it later on,” says Lisa D. Ravdin, PhD, associate professor and director of the Weill Cornell Medicine Neuropsychology Service. Taking up painting is another example of an endeavor that bolsters creativity and aids in maintaining focus and precision. “These activities have the added benefit of reducing stress and promoting relaxation, which can also be beneficial to memory,” says Dr. Ravdin.

Learning and Socialization

Learning a new language can enhance cognitive flexibility and memory and enhance problem-solving abilities. “Continuous learning and problem-solving can enhance cognitive reserve and promote brain function,” says Dr. Ravdin. Online platforms like Duolingo https://www.duolingo.com/ or Rosetta Stone https://www.rosettastone.com/ make it easy to learn a new language at your own pace. “Learning new skills and techniques provides a cognitive challenge, which helps keep the brain active and engaged,” says Dr. Ravdin. “That said, learning a new language can be overly challenging and may not be for everyone. Studies show our ability to acquire a second language is strongest during early developmental stages when the brain is primed for learning language.”

Another great way to strengthen memory skills is by playing cards— either online (cardsmania.com) or at your local senior center. “Participating in activities with others has the added benefit of socialization, which can significantly enhance quality of life and cognitive health,” says Dr. Ravdin.

Online or Pencil and Paper

Brain exercises are a fun and engaging way to promote overall mental agility. Online games and puzzles are popular and appeal to people who are comfortable using computer websites and smartphone apps. However, easily accessible pencil-and-paper crossword puzzles and Sodoku games also offer excellent opportunities to stimulate memory skills and invigorate your mind. Whether you opt for virtual brain exercises or real-life activities, Dr. Ravdin says, “choose games and exercises that you find enjoyable and engaging, as this will encourage consistent practice.”

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If tingling, numbness, or pain in your hand, as a result of carpal tunnel syndrome, is affecting your ability to sew, garden, or do other hands-on activities, there are several treatment options to consider. The primary goal is to relieve pressure on the median nerve, which runs through the carpal tunnel in your wrist.

Conservative treatments are usually recommended first. Splinting with a wrist brace, especially at night, prevents further irritation of the median nerve. The brace looks like a fingerless glove that has a rigid support that keeps the wrist in a neutral position. You can buy one at your local drug store, which makes it an excellent first step. However, it may take weeks to see improvement, and the relief might be minimal. Corticosteroid injections offer a more direct approach by reducing inflammation and swelling in the carpal tunnel. These injections can provide significant relief; however, the effects can be temporary, and repeated injections are generally not recommended due to potential side effects like weakening of the surrounding tissues. Acupuncture can also be an effective alternative for managing carpal tunnel syndrome; however, it is generally considered less predictable compared with traditional methods.

For persistent or severe cases, surgical intervention might be warranted. Carpal tunnel release surgery involves cutting the ligament pressing on the median nerve, thereby relieving pressure. This procedure has a high success rate and can provide long-term relief, but it may take several months for full strength and sensation to return.

Ultimately, the best treatment depends on the severity of your symptoms and how they affect your daily life. Discuss your options with an orthopedic specialist, who can tailor a treatment plan that’s best for you, ensuring that you can continue to enjoy your activities pain-free.

I generally take care of my feet, but no matter what I do I cannot escape an ingrown toenail on the third toe of my left foot that keeps coming back. What can I do?

A recurring ingrown toenail despite a diligent foot-care routine can be frustrating and painful. The primary reason for this persistent issue often lies in the way the nail grows or how pressure is applied to the toe. Factors like tight-fitting shoes, improper nail trimming, or even genetic predispositions can contribute to the problem. In some cases, repeated activities that put stress on the nails—such as an exercise routine that includes running—can exacerbate the condition.

First, ensure proper nail care. Trim your nails straight across, avoiding rounded corners, which can encourage the nail to grow into the skin. Opt for comfortable, well-fitting shoes that provide ample toe space. If these measures do not resolve the problem, soak your foot in warm water several times a day to help reduce swelling and alleviate pain.

If you have tried all of these measures and none are effective, it’s probably time to consult a foot specialist. A podiatrist can assess the situation and may recommend procedures like lifting the nail to allow it to grow out properly or, in more severe cases, removing part or all of the nail in a minor surgical procedure called a partial nail avulsion. This involves removing the problematic section of the nail and sometimes the underlying nail bed to prevent regrowth in that area. The procedure is quick and done under local anesthesia, providing long-term relief with minimal risk. Consistent follow-up care and adhering to your podiatrist’s advice can help prevent future occurrences.

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Acute vs. Chronic.

Under acute stress, you may feel a jolt of energy and notice your visual focus and thinking sharpen and your motivation increase. You are faster and stronger, and even your immune system is primed for action. When this moment of acute stress passes, your vital signs (and everything else) return to normal.

Chronic stress is different. If you’re under continuous stress for long stretches of time, such as from a high stress job, financial insecurity, living in fear of violence, or caring for a chronically ill loved one without adequate support, your body never gets the chance to return to baseline.

Health Impacts.

Long-term exposure to stress affects your whole body. It may increase your risk for health problems including high blood pressure, heart attack, stroke, type 2 diabetes, and mental health issues like depression, anxiety, and addiction. See “Possible Health Effects of Chronic Stress” for more information.

Day-to-day symptoms of chronic stress, such as trouble concentrating, crankiness, changes in appetite, fatigue, insomnia, and turning to mind-altering substances for relief, can interfere with productivity and relationships and add to the negative health impacts of chronic stress.

Managing Stress.

If you are feeling stressed a lot of the time, it’s important to identify the source and find healthy ways to reduce or relieve that stress (and avoid unhealthy ways, such as overeating, smoking, illicit drug use, or excessive alcohol consumption). If you can directly address the source of your stress (by discussing job responsibilities with management, for example), do so. If this is not possible, take steps to manage the stress in your life with the tips in the “Take Charge!” box. Your whole body will thank you!

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On the Increase

A study presented at the 2024 Annual Meeting of the American Academy of Orthopedic Surgeons in February pointed to a significant rise in sports-related injuries over the two-decade follow-up period, with the injury rate increasing from 55,684 in 2012 to 93,221 in 2021. The data also suggested that cycling increased in popularity between 2012 and 2021. Another recent study (BMC Geriatrics, May 27) looked at data collected from 1,109 older adults who sustained a fracture and visited a trauma center between June 2020 and July 2023. Among the participants, 144 had suffered a fracture while engaged in sports. The analysis showed that the average age of people who suffered a sports-related fracture was 74. “Sports-related fractures were most likely to happen outdoors, with men particularly susceptible,” Dr. Bloom says. “This fits with previous studies indicating that older men are more likely to participate in sports compared with older women.”

Specific Sports More Risky

In the BMC Geriatrics study, the sports most likely to be associated with fractures were outdoor walking intended as exercise (as opposed to more leisurely walking to get from one place to another), cycling, and mountain hiking, all of

which were linked with lower-extremity fractures. Having an underlying disease, such as diabetes, high blood pressure, or a heart condition, did not increase the risk of injuries. “Suffering a stroke lowered the risk,” Dr. Bloom observes. “The lower risk may reflect the fact that stroke often is followed by a decrease in muscle strength. This may limit a person’s ability to participate in sports.”

Many Benefits

Dr. Bloom says it is wonderful that more older people are getting involved in sports, since there is much trial evidence underlining the benefits of vigorous physical activity. It boosts cardiovascular health, slows age-related loss of muscle mass and bone density, can reduce your risk of falls by improving your balance, eases stress, helps you sleep better, and limits weight gain. Research also has linked high levels of physical activity with better brain function in older age. “Another great thing about sports is that many of them are sociable activities: You can walk, cycle, and play pickleball or other racket sports with friends,” Dr. Bloom adds. “It’s vital to maintain those social connections as you get older, since studies have suggested that social interaction may confer protection against cognitive impairment.”

But these data also highlight the risks associated with sports—and Dr. Bloom cautions that they also likely underestimate injury rates. “Many people who sustain sprains, strains, and lacerations while playing sports often seek medical care from their primary-care doctor or a local walk-in clinic instead of attending emergency departments and trauma centers,” she says. The data also suggest that older adults are participating in a wider variety of sports and/or participating in sports that are more likely to result in injury, especially if they require a level of strength, agility and balance that you don’t have. “It would be interesting to see data that includes an assessment of the participants’ degree of mobility and individual skill level along with other factors that may contribute to injury, such as weather conditions and whether someone was wearing suitable shoes and protective clothing,” Dr. Bloom says.

Pace Yourself

Staying safe while engaged in sports starts with managing your expectations when it comes to how much you can still do. The heart and lungs work less efficiently in older age, so less oxygen is transferred to the blood. Appetite decreases, meaning that most older adults eat less than they should. As a result of these changes, endurance, muscle mass and strength decline as you age. Your balance also may be affected by age, particularly if you have vision or hearing issues or take certain medications (including some blood pressure drugs). These factors don’t mean that you cannot or should not continue to enjoy the sports you’ve always loved, but you may have to slow down slightly to conserve your energy and avoid fatigue. One thing you might want to try is alternating between vigorous sports, such as pickleball or tennis one day and more leisurely options, such as golf, the next.

Starting from Sedentary

If you’ve been leading a sedentary life and/or have chronic underlying health issues, it’s particularly important to objectively assess your fitness level before taking up a sport. “If you need help doing this, ask your doctor to refer you to a physical therapist who can work out a safe sports regimen for you,” Dr. Bloom says. “You also might want to consult a personal trainer who works with older adults—your local gym or senior center may be able to recommend one.” Be patient—instead of launching yourself into your chosen sport, you may need to gradually build up your strength and cardiovascular fitness levels, perhaps by starting a walking program and pushing yourself farther and faster over time.

If you want to try a new sport, find out about it. “You’ll need background information about whether it’s important to wear special types of footwear, a helmet, and/or safety goggles, about the level of endurance and/or agility the sport requires, whether it’s a sport that involves rapid acceleration and deceleration and relies on you having good balance,” Dr. Bloom says. “Even if you’re very fit and want to challenge yourself, you don’t want to risk injuries that might have been highly preventable with a bit of preparation.” See What You Can Do for other strategies that will help you stay safe while playing sports.

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Defining Superfoods. Superfoods are nutrient-dense and considered beneficial for supporting health. Rich in vitamins, minerals, antioxidants, and other compounds, they support various functions and help protect against diseases.

Nutrient Density and Health Benefits. The main characteristic of superfoods is their high nutrient density. This means they provide a significant amount of nutrients for relatively few calories, making them an excellent choice for those looking to maintain a healthy weight and support health. Some of these key nutrients include:

1. Antioxidants: These compounds help neutralize harmful free radicals in the body, reducing oxidative stress and inflammation. This can help lower the risk of chronic diseases like heart disease and cancer. Berries, such as blueberries and strawberries, are well-known for their high antioxidant content.
2. Dietary Fiber: Essential for digestive health, fiber can help prevent constipation and promote regular bowel movements. It can also aid in controlling blood sugar levels and lowering cholesterol. Foods like oats, beans, and whole grains are excellent sources of fiber.
3. Omega-3 Fatty Acids: Found in foods like fatty fish and walnuts, omega-3s are known for their heart-protective properties. They can help reduce inflammation, reduce blood pressure, and improve overall heart health. Omega-3s are also beneficial for brain health, potentially lowering the risk of cognitive decline and dementia.
4. Vitamins and Minerals: Superfoods are often packed with essential vitamins and minerals. Leafy greens like spinach and kale provide vitamins A, C, and K, as well as calcium and iron, which are vital for bone health, immune function, and overall energy.

Adding Superfoods Into Your Diet. If you’re interested in incorporating superfoods into your daily meals, this can be both simple and enjoyable. Here are some tips to help you get started:

Start Your Day with Berries: Add a handful of blueberries or strawberries to your morning cereal or yogurt for flavor and an antioxidant boost.

Snack on Nuts: A small handful of almonds or walnuts makes a satisfying and nutritious snack, providing healthy fats and protein.

Choose Whole Grains: Opt for brown rice or quinoa to boost fiber intake and help support heart health.

Try Fatty Fish: Aim to include fatty fish, like salmon or sardines in your diet at least twice a week for a good dose of omega-3s.

Conclusion. While superfoods are not a cure-all, they can play a valuable role in a balanced diet. Focusing on nutrient-rich foods can help support overall health, prevent chronic diseases, and enhance quality of life. Remember, it’s important to combine superfoods with other healthy lifestyle choices, such as regular exercise and adequate hydration. Always consult with a healthcare provider or dietitian when making significant dietary changes to ensure they meet your individual health needs.

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A: Adaptogens and nootropics are both popular dietary supplements aimed at enhancing well-being, but they serve different purposes and functions.

Adaptogens are natural substances, often herbs or roots, that help the body resist stressors of all kinds—whether physical, chemical, or biological. They work by stabilizing physiological processes and promoting homeostasis, which can lead to increased energy, improved mood, and enhanced resilience to stress. Common adaptogens include ashwagandha, rhodiola, and ginseng. They are typically used to help the body adapt to stress and reduce fatigue.

Nootropics, on the other hand, are substances that specifically target brain function, aiming to improve cognitive abilities such as memory, creativity, focus, and executive functions. Nootropics can be natural or synthetic. Popular examples include caffeine, L-theanine, and racetams. While some nootropics have stimulating effects, others work by increasing blood flow to the brain or supporting the production of neurotransmitters.

The Bottom Line. Adaptogens focus on enhancing the body’s overall resilience to stress, while nootropics may boost cognitive performance and health. 

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1.Embrace a Mediterranean Diet. The Mediterranean diet, rich in fruits, vegetables, whole grains, olive oil, and lean proteins like fish, has been extensively studied for its health benefits, including its positive impact on brain health. A study published in the journal Neurology found that adherence to the Mediterranean diet is associated with a reduced risk of developing cognitive decline and Alzheimer’s disease. The diet’s high content of antioxidants, healthy fats, and anti-inflammatory compounds helps protect brain cells from damage.

Tip: Incorporate foods like leafy greens, tomatoes, nuts, seeds, and fatty fish such as salmon and sardines into your meals.

2.Include Omega-3 Fatty Acids. Omega-3 fatty acids, particularly EPA and DHA, are essential fats that play a critical role in brain function. They are key components of cell membranes in the brain and have anti-inflammatory effects. Research published in the American Journal of Clinical Nutrition indicates that omega-3 fatty acids can enhance memory and slow age-related cognitive decline.

Tip: Aim to consume fatty fish like salmon, mackerel, and sardines at least twice a week. If you’re not a fan of fish, consider omega-3 supplements derived from algae or fish oil.

3. Prioritize Antioxidant-Rich Foods. Oxidative stress is a major factor contributing to brain aging and cognitive decline. Antioxidants help combat oxidative stress by neutralizing free radicals. Foods rich in antioxidants, such as berries, dark chocolate, and nuts, can support brain health.

Tip: Enjoy a variety of berries like blueberries, strawberries, and blackberries, which are high in flavonoids—potent antioxidants linked to improved cognitive function.

4. Stay Hydrated. Dehydration can impair cognitive function, leading to difficulties in concentration, short-term memory, and alertness. The brain is highly sensitive to changes in hydration status, so maintaining adequate fluid intake is crucial for optimal brain performance.

Tip: Drink plenty of water throughout the day. Herbal teas and water-rich foods like cucumbers and watermelon can also contribute to your hydration needs.

5. Get Enough B Vitamins. B vitamins, including B₆, B₁₂, and folate, are essential for brain health. They are involved in the production of neurotransmitters and play a role in reducing homocysteine levels, an amino acid linked to cognitive decline and brain shrinkage. A study in the journal Proceedings of the National Academy of Sciences found that high doses of B vitamins can slow brain shrinkage in areas particularly affected in Alzheimer’s disease.

Tip: Incorporate foods like leafy greens, eggs, legumes, and fortified cereals to ensure adequate intake of B vitamins.

6. Incorporate Healthy Fats. Healthy fats, particularly unsaturated fats, are crucial for brain health. They help build cell membranes and support the overall structure of brain cells. Diets high in healthy fats, like those found in avocados, nuts, and olive oil, have been associated with improved brain function.

Tip: Use olive oil as your primary cooking oil and snack on nuts and seeds for a boost of healthy fats.

7. Limit Processed Foods and Sugars. Diets high in processed foods and sugars have been linked to impaired brain function and an increased risk of neurodegenerative diseases. These foods can lead to inflammation and insulin resistance, both of which negatively impact brain health.

Tip: Focus on whole, unprocessed foods, and minimize the intake of sugary snacks, beverages, and refined grains.

8. Embrace Intermittent Fasting. Intermittent fasting, which involves cycling between periods of eating and fasting, has shown promise in supporting brain health. Research published in the Journal of Neuroscience Research suggests that intermittent fasting can enhance brain function, promote neuroplasticity, and reduce the risk of neurodegenerative diseases.

Tip: Consider incorporating a daily fasting window, such as the 16/8 method, where you fast for 16 hours and eat during an 8-hour window.

9. Maintain a Balanced Diet. Ultimately, maintaining a balanced diet that includes a variety of nutrients is key to supporting brain health. While specific foods and nutrients play critical roles, a holistic approach ensures that your brain receives all the essential components it needs to function optimally.

Tip: Plan meals that incorporate a diverse range of foods, ensuring you get a balance of carbohydrates, proteins, and fats along with vitamins and minerals.

The Bottom Line. Eating to support brain health involves making conscious choices that prioritize nutrient-rich, whole foods. By incorporating these science-based tips into your daily diet, you can help protect your brain, enhance cognitive function, and potentially reduce the risk of neurodegenerative diseases. Remember, it’s not just about individual foods but the overall pattern of your eating habits that makes the most significant impact on brain health.

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According to the American Heart Association, women should have no more than six teaspoons of added sugar a day and men no more than nine teaspoons (which is equal to about 100 calories for women, or 150 calories for men). Many people are blowing past these numbers, and that is concerning. A 2023 review of 73 meta-analyses, published in The BMJ, found that a diet high in added sugar was linked to 45 poor health outcomes, including diabetes, cancer, gout, hypertension, cardiovascular disease, asthma, and depression. “In essence, added sugar contributes “empty energy” or calories without the benefits of key nutrients like fiber, protein, or vitamins,” says Debbie Petitpain, MBA, RDN, spokesperson for the Academy of Nutrition and Dietetics.

The good news is you can make a few simple changes to the way you eat to decrease (not eliminate!) your added sugar intake. Here’s how to cut back on the sweet stuff without feeling deprived.

Read the Fine Print. Now that the Nutrition Facts panel on packaged foods requires producers to list the grams of added sugar in their products, it is easier than ever to spot how much is being steathfully added to everything from granola to ketchup to jerky. Petitpain says this lets you compare the nutrition numbers on products so you can choose those with fewer grams of added sugar. Another good move is to look for labels such as “no added sugar” or “unsweetened” on items like almond milk and applesauce.

Natural Selection. To help quell a sweet tooth, try eating more foods that are naturally sweet. Sugars in vegetables, like beets or sweet potatoes, and fruit, such as apples don’t count as added sugars, and research is bereft of any data linking natural occurring sugars with health woes. “Naturally occurring sugars in vegetables, fruits, and dairy are part of a complex food matrix which alters how the body digests, breaks down, and uses these sugars, which changes the effects on the body,” notes Petitpain. “There also tends to be a lot less sugar, bite for bite, compared to foods with added sugars.” So buy plain versions of items like yogurt and oatmeal and sweeten them with naturally sweet foods such as berries.

Make the Cut. If you are keen on baking, keep in mind that many recipes including those for muffins and cakes call for more sugar than what is necessary. So, you can try reducing the amount of sweetener called for by about 25 percent. Petitpain suggests including sweet tasting items like mashed banana, dates, and applesauce in your baking in place of some of the added sugar.

Embrace Other Tastes. Sweet is one of the five main tastes, with others being salty, sour, bitter, and umami. To reboot your taste buds, gradually increase your intake of unsweetened sour (such as plain yogurt or tart cherries), bitter (like arugula and radicchio), and umami (such as parmesan and mushrooms) foods. As a payoff, you’ll net more nutrients.

Be Wary of Free. Be especially skeptical of products like peanut butter, frozen yogurt, and salad dressings advertised as “reduced-fat” or “fat-free,” “When fat is removed from a product, sugar is usually added as a replacement to improve mouthfeel and flavor” Petitpain says. A serving of fat-free, fruit-flavored yogurt typically has three times as much sugar as a serving of two percent plain yogurt.

Spice it Up. Research suggests amping up the flavor of your cuisine with spices may allow you to cut back on the amount of sugar added to foods while still preserving acceptable overall liking. So, go bigger on spices like cinnamon and nutmeg in items like baked goods, oatmeal, and hot chocolate.

Don’t Fall for Health Halos. Sugar now comes in many guises, some of which, such as honey and maple syrup, are marketed as being better-for-you “more natural” ways to get your sweet fix. But for the most part, they don’t live up to their hype. “While they may offer extremely minimal nutritional benefits over refined sugar, they should still be consumed in moderation,” says Petitpain. No matter how virtuous it might sound, “organic sugar” is still sugar.

Walk Away from Cravings. The next time you’re about to give into candy bar temptation, lace up your running shoes. Research shows the simple act of taking a 15-minute brisk walk is enough to tame cravings for sugary snack foods. “Exercise releases endorphins and can improve mood and reduce stress, which are common triggers for sugar cravings,” notes Petitpain.

Order Water. Soft drinks, even the smallest sized ones, sold at top-earning restaurant chains in the U.S., have greater amounts of added sugar than the suggested daily limit, according to a report from the Center for Science in the Public Interest. When dining out, look for unsweetened beverage options. Many chain restaurants now have added sugar numbers for their foods and drinks listed on their websites, making it easier to tailor your order so it’s less sweet.

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Grief can be like that. It also can manifest as deep sorrow, hostility, guilt, confusion, and fatigue. It’s a process that waxes and wanes and an experience that varies from person to person. There’s no absolute timeline or way to grieve, but most people start to return to a sense of normalcy in about six to 12 months.

Grief occurs not only when a loved one passes but also can happen with a terminal diagnosis, such as cancer or Alzheimer’s disease. Known as “anticipatory” grief, it affects both the diagnosed person and loved ones.

Grief’s Impact on Health

The grieving process can lead to everything from bodily pain and a weakened immune system to stomach upset and insomnia. According to George Slavich, PhD, director of the Laboratory for Stress Assessment and Research at the Semel Institute for Neuroscience and Human Behavior at UCLA, the root of these symptoms can be traced back to our evolutionary response to the loss of a social connection.

“As humans, we are strongly motivated to seek out social bonds that are warm, dependable, friendly and supportive,” says Slavich. “Losing someone close to us terminates that bond and the social and physical protection they provided, which historically could have put the body at an increased risk of physical danger.”

When you lose someone that you’ve been with for a long time, the body and brain go on high alert to protect you from potential dangers. Your immune system ramps up and sends immune cells throughout the body to deal with possible physical wounds that might occur. At the same time, however, your immune system lowers its antiviral defense system, making your body more vulnerable to viral infections. “If you’ve ever come down with a cold after a stressful time, you may have experienced this response,” says Slavich.

The grieving process can cause prolonged inflammation and lead to psychological and behavioral symptoms such as fatigue, loss of pleasure, and social withdrawal. If these symptoms persist beyond six months, it may indicate prolonged grief, which can have serious health implications.

Prolonged Grief

This type of grief is marked by persistent and pervasive feelings of longing, sadness, and preoccupation with the deceased. It can significantly interfere with a person’s daily functioning and quality of life. Common symptoms include an inability to accept the loss, numbness, bitterness, difficulty engaging in life, and a feeling that life is meaningless without the deceased.

Prolonged grief is associated with increased cancer risk, cardiovascular problems, and early mortality. It may lead to heart attacks, especially in people who already have a higher risk of heart disease.

Takotsubo cardiomyopathy, also known as broken heart syndrome or stress cardiomyopathy, can be triggered by intense grief. This condition temporarily weakens the heart’s left ventricle and can mimic a heart attack, even in those who do not have cardiovascular disease. It tends to affect postmenopausal women much more than men. Recovery from this transient condition can take days or weeks. However, this doesn’t mean the condition should be ignored or untreated, because there can be long-term consequences.

Anticipatory Grief

Anticipatory grief is the emotional response experienced when a loss is expected but has not yet occurred, such as with a terminal illness diagnosis. Key characteristics of anticipatory grief include feelings of sadness, anxiety, anger, and helplessness. It affects both the diagnosed and loved ones. For example, loved ones can become consumed with imagining life after the loss and worrying about how to cope. It may change how an individual interacts with the dying person, such as increased closeness or emotional distancing as a protective measure.

Stress and anxiety can lead to physical symptoms like fatigue, changes in appetite, and sleep disturbances. Feelings of relief or guilt also can be part of anticipatory grief, especially if the loved one has been suffering. Understanding and acknowledging anticipatory grief can help in the processing of emotions and better prepare for the eventual loss.

Patience, Acceptance, and Self-Care

It’s important to accept that it is normal to grieve and give yourself permission to experience the full range of emotions. Surrounding yourself with supportive friends and family with whom you can share your feelings can provide comfort and validation. Support groups, both in-person and online, can also offer a sense of community and understanding. Sometimes, the intensity of grief requires professional intervention. Therapists or counselors specializing in grief can provide strategies and support to navigate the emotional turmoil.

After losing a loved one, thoughts can constantly drift between the past and the future. Practicing mindfulness meditation is one way of becoming aware of your thoughts, grounding your awareness in the present, and reducing overall psychological stress.

Sleep may become challenging. It may be difficult to fall and stay asleep. And a sense of purposelessness can make it hard to get out of bed up in the morning. However, “sleep is one of the strongest drivers of immune activity,” Slavich says, and “having a standard sleep schedule is really important for properly regulating your immune system.”

Along with quality sleep, a healthy diet and regular exercise are recommended for self-care. Choose nutritious foods daily. Include lean proteins, fruits, vegetables, healthy oils and leafy greens. These choices help reduce inflammation. Likewise, moving your body regularly supports brain and immune health. Breaking a sweat helps decrease feelings of stress and anxiety. Exercise triggers the release of dopamine and serotonin; two brain neurotransmitters that play a pivotal role in maintaining positive mood. Exercise also slows the release of cortisol, the hormone that can wreak havoc when it flows unabated under chronic stress.

“Each of these strategies can help promote resilience following interpersonal loss,” Slavich says, “but the most important thing is to begin with the strategy that you know you’ll actually follow through with.” He also recommends telling your healthcare provider about your loss. This will enable your provider to take your personal situation into consideration and to understand how your grief may be involved in any symptoms you may be experiencing.

Coming up with the best strategy for dealing with grief needs to be a team effort between you and your healthcare provider, Slavich says, but “if they don’t know what’s going on in your life, they won’t be able to help.”

Creating a memorial or engaging in rituals to honor the person you’ve lost can help with healing and acceptance. This could be through a dedicated space in your home, a scrapbook, or participating in activities that the deceased loved. It helps keep their memory alive and allows you to celebrate their life.

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Similarly, the buildup of beta-amyloid plaques in the brain is associated with a greater risk of Alzheimer’s disease (AD). Beta­amyloid, often referred to simply as “amyloid,” is a type of protein that can form clumps or plaques in the brain, disrupting communication between brain cells (neurons) and triggering neuroinflammation—a condition that sets the stage for AD and other types of dementia.

But unlike cholesterol, which can often be controlled through lifestyle modifications and statin therapy, amyloid buildup is a more complicated and challenging health problem to manage. One reason is that an individual’s risk for amyloid accumulation can be greatly influenced by genes that predispose a person to abnormal amyloid buildup.

Though variants of many genes are associ­ated with amyloid buildup, the APOE4 gene is among the most significant and well-studied when it comes to AD risk. It’s associated with a higher density of amyloid plaques. Inheriting one copy of the APOE4 gene increases your AD risk threefold (compared with not having the gene), while inheriting two copies increases your AD risk by about 14­ fold, says Alzheimer’s researcher Rudolph Tanzi, PhD, director of the Genetics and Aging Research Unit at Massachusetts General Hospital (MGH) and co-director of the Henry and Allison McCance Center for Brain Health at MGH.

For those reasons, Dr. Tanzi sug­gests individuals with a known genetic risk should prioritize man­aging the AD risks that are within their control. That includes regular exercise, a plant-based diet, and mental stimulation. “If you have one or two copies of APOE4, incorpo­rating those steps in your life goes from a good idea to almost obliga­tory,” he says. He adds that just as it’s better to target cholesterol control earlier in your life rather than later, when arterial plaques have formed and put you at risk for heart disease, it’s worth giving amyloid buildup that same attention throughout your life.

Is Genetic Testing Right for You? A study published earlier this year in Nature Communications garnered a lot of media attention, as it reaf­firmed the risks associated with inheriting two copies of APOE4. It also prompted a lot of discussion about genetic testing.

Should you be tested for the APOE4 gene or any of the others associated with AD risk? This is the million-dollar question, and the right answer depends on the indi­vidual, and often that person’s family, too. You can find out, through testing, whether you’ve inherited one or two APOE4 genes or whether you’ve escaped that genetic misfortune. But if you get an answer you don’t want, what then?

“Do you really want to know?” Dr. Tanzi says. “And do you want your kids to live with that stress? It’s a pretty big decision.”  Often, people are advised to consider genetic test­ing if they have a family history of  early-onset AD, generally considered to be AD that takes hold before the age of 60. An individual who devel­ops early-onset AD may also want to be tested, even if there is no known family history of the disease.

Attacking Amyloid

As concerning as amyloid is, Dr. Tanzi notes that amyloid buildup does not guarantee that AD will follow. Research has shown that people can have a significant amount of amyloid in the brain, but have no AD symptoms.

One reason, Dr. Tanzi explains, is that there can be a lag of many years between the accumulation of amyloid in the brain and the development of neuroinflammation and subsequent AD. Other studies have shown that some people who preserve cognitive health despite the presence of amy­loid plaques have a unique protein makeup within their synapses (con­nections between neurons) that may offer some protection.

Rather than take a chance that you’ll be spared the potential compli­cations of amyloid plaques in the brain, you may want to follow some basic lifestyle behaviors that may help prevent amyloid buildup and reduce your risk for AD. Dr. Tanzi refers to these behaviors with the acronym SHIELD.

• Sleep: While you sleep, your brain can clear out some amyloid.

• Handle stress: “Stress causes cell death, which activates neuroin­flammation,” Dr. Tanzi says.

• Interact with others: Interacting with other people on a regular basis stimulates the brain to create new brain cells, a process called neurogenesis.

• Exercise: “Exercise induces neuro­genesis. Think of it as getting your reserves in place,” says Dr. Tanzi. He adds that exercise also triggers the muscles to produce a hormone called irisin, which in turn induces the release of an enzyme called neprilysin, which helps break down amyloid in the brain.

• Learn new things: Like socializ­ing, learning fosters the produc­tion of new neurons and strength­ens the synapses, Dr. Tanzi says.

• Diet: “If your microbiome is healthy in your gut, it will help reduce amyloid and reduce neu­roinflammation,” Dr. Tanzi explains.

Blood sample for ATN (Amyloid-Tau-Neurodegeneration) profile test, to diagnosis of Alzheimer’s disease. Alzheimer’s test.

Your microbiome is the collection of all bacteria, fungi, and other microorganisms and their genes living inside and outside of your body. Studies have demonstrated a strong connection between gut health and brain function. Dr. Tanzi’s research and that of others suggests that a plant-based diet may be opti­mal for a healthy gut microbiome and, by extension, better brain health.

Takeaway

As with so many diseases and medi­cal conditions, AD can develop through a combination of genetic, environmental, and lifestyle factors. While you can’t control the genes you inherit, you can pursue the life­style behaviors that appear to offer some protection.

And, of course, regular exercise, a balanced diet, mental stimulation, good sleep, and stress management won’t just help protect against dementia. Those traits make up the recipe for good overall health and well-being.

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